Can life ever be too sweet?

Sugar intake and Metabolic health - what does it mean and why do we care?

This is a bit of a long read, but worth every minute. Much of this information will be shared in more detail during my upcoming 21 Day Sugar Detox. After reading this I hope you’ll join me!!

Metabolic health describes how well our body produces and uses energy. Every one of the trillions of cells in our bodies is a small powerplant that converts fuel (usually glucose or fat) to energy the body can use (typically ATP). When our cells cannot run those processes efficiently, it can lead to any number of conditions.

In the brain, poor metabolic health can contribute to decreased mental acuity (brain fog), anxiety, or Alzheimer’s disease. In the blood vessels, it can contribute to microvascular disease (like erectile dysfunction and retinopathy, and kidney disease) and cardiovascular disease (like heart attacks and strokes). In the liver, non-alcoholic fatty liver disease. In many cells: cancer, which is linked to poor metabolic health. Metabolic dysfunction can lead to obesity by interfering with our body’s fat storage and burning capabilities.

But poor metabolic health doesn’t always manifest in overt cardiometabolic diseases. We can also feel it in pain points and symptoms of everyday life: fatigue, brain fog, depression, anxiety, lack of exercise endurance, infertility, balding, acne, chronic pain, increased appetite, hormonal imbalances, digestive problems etc.

One of the most direct measures we have for metabolic health is glucose, or blood sugar, since that constitutes much of the fuel for your cells, as well as insulin, the hormone that helps our cells take in glucose. Consistently high blood sugar and impaired insulin function (called insulin resistance) are behind most of the conditions that come with poor metabolic health, including, most directly, diabetes and prediabetes.

Type 2 diabetes is advanced insulin resistance, where the body has become so insulin resistant that blood sugar climbs dangerously high, damaging parts of the body from the eyes to the muscle tissue. So increases in diabetes and other metabolic-related chronic conditions mean that our metabolic health is getting worse. And we see a lot of increases.

10 Stats that Show Metabolic Health is Getting Worse:

1. 93% of North Americans are not metabolically healthy. Using data from the National Health and Nutrition Examination Survey (NHANES) covering 1999–2018, researchers found that only 1 in 14 North American adults showed optimal levels of all five metabolic risk factors: BMI, glucose, blood pressure, HDL, and triglycerides without medication. The same data showed only 37% of adults had fasting glucose under the typical threshold for prediabetes.
2. More than 10% of people in North America have diabetes, and 21% are undiagnosed. Worse, the incidence rate is rising globally, especially in kids under 19 and Type 2 makes up the vast majority of those cases.
3. More than a third of North American adults have prediabetes. Of those, more than 84 percent don’t know they have it. The likelihood of progression to Type 2 diabetes depending on the person and other factors, but could be as high as 64%. However, prediabetes alone increases the risk of stroke, heart disease and Alzheimer’s.
4. Insulin resistance affects more than 129 million North Americans. That is a huge number. This stat includes the 34.2 million people of all ages with diabetes and the 88 million who have prediabetes. It also includes another 7.3 million adults who meet laboratory criteria for diabetes but were unaware they had it. These numbers are staggering! With early insulin resistance, your cells no longer respond well to insulin, and the pancreas produces more. But insulin resistance can begin developing up to 13 years before elevated glucose levels appear on a test.
5. 73.6% of North Americans are overweight or obese. That is pretty much ¾ of us, a dreadful stat! Rates of obesity have tripled since the 1070’s. While up to 30% of obese patients are metabolically healthy, abdominal obesity is associated with metabolic syndrome. Globally the prevalence of adult obesity is 13%, whereas, in the US alone, it’s the highest at over 35%. Researchers are still studying the underlying mechanisms. But we know that obesity is linked to insulin resistance, likely by way of excess fat that inhibits proper signalling as well as fat tissue producing inflammatory responses.
6. ¼ of North Americans suffer from preventable non-alcoholic fatty liver disease (NAFLD). Globally, cases of NAFLD have more than doubled from 1990 to 2017. Countries with a surge in obesity and diabetes over the past three decades have also seen an increase in NAFLD. Metabolic disorders are risk factors for NAFLD, which, if left untreated, can progress to end-stage liver disease.
7. High blood sugar is linked to 8 of 10 leading causes of death (pre-COVID), including cardiovascular disease, stroke, cancer, Alzheimer’s disease, chronic respiratory disease, kidney disease; there are even correlations between metabolic dysfunction and suicide.
8. Individuals meeting at least 3 criteria for metabolic syndrome have 60% higher annual healthcare costs; diabetes alone contributes to over $327 billion in medical costs and lost productivity This is expected to exceed $600 billion by 2030.
9. COVID-19 became a top 3 leading cause of death in 2020 and 2021, and 40% of people who died from COVID had diabetes. Another study found that nondiabetic COVID-19 patients hospitalised with elevated blood sugar were 3x more likely to die than those with stable glucose levels. And a new study finds that having 3 or more symptoms of metabolic syndrome —obesity, pre-diabetes or diabetes, hypertension and high cholesterol—when hospitalized with COVID makes you 20% more likely to die in the hospital. Researchers say the dual pandemics of metabolic syndrome and COVID-19 are linked. COVID-19 may also exacerbate the ongoing metabolic crisis or increase Type 2 diabetes rates, due to a link between infection and high blood sugars.
10. It’s even worse for kids. This is a heart breaking stat - more than 20% of children aged 2-19 meet the criteria for obesity up from 6% in the early 1970s. The number of kids with severe obesity has grown from 1% to 6%.

What’s fueling this metabolic health crisis?

How have insulin resistance, prediabetes, and Type 2 diabetes become endemic? Our genetics have not changed in the last 100 years. However, our lifestyles have changed dramatically!

There are several contributing factors, but the inspiring (and frustrating) fact is that all of them are within our control.

• Chronic overnutrition (aka over-eating) broadly refers to the standard hypercaloric (and often, high-carbohydrate) diets many people now eat. Those can coexist with the double burden of malnutrition.In other words, someone can be obese or overweight but still not get proper nutrition. Overfed and undernourished.
• The macro- and micronutrient needs of the human body haven’t changed dramatically in the last several hundred years. Yet, we have an ever-increasing amount of food choices available to us, whether at a grocery store, a restaurant, or a drive-through. Our bodies haven’t adapted to cope with this level of incoming energy—especially from processed foods.
• We eat nearly 10x more sugar per day than we did 100 years ago. Sugar stimulates the pancreas to make insulin (the hormone that aids cells in glucose uptake). But cells can eventually become unresponsive to insulin. Insulin resistance is at the core of many chronic diseases.
• We are more sedentary than ever. Research shows that from 2001 to 2016, Americans increased their total sitting time. The COVID-19 pandemic, which has required widespread remote learning and working from home, exacerbated this trend of increased sitting and decreased physical activity, especially for children.
• We seem to get less sleep, which has consequences for our metabolic health. The prevalence of shorter sleep times, characterized by getting less than seven hours, increased from 2013 to 2017. Inadequate sleep is linked to obesity, Type 2 diabetes, heart disease, and even death.
• We’re increasingly exposed to environmental chemicals and pollution and metabolism-disrupting compounds. After years of somewhat declining levels of fine particulate pollution, we saw a worsening of America’s air quality which is associated with systemic inflammation that may result in metabolic syndrome or exacerbate existing dysfunction. And our exposure to bisphenol A (BPA), phthalates, perfluoroalkyl substances (PFAS), pesticides, antifouling agents, and more has consequences for metabolism.
• Ultra-processed foods make up 60% of the calories North Americans eat. 60%!!!! And a high consumption of ultra-processed foods increases one’s risk of becoming overweight or obese by up to 39% and developing metabolic syndrome by up to 79%.
• Levels of stress are increasing. Stress kicks off a hormonal cascade that promotes fat storage and impairs glucose control. Chronic psychological stress and higher levels of the stress hormone cortisol are linked to insulin resistance. Cortisol signals the liver to release stored glucose, but it also makes it harder for insulin to signal cells for glucose uptake, a vicious cycle.
• Late night eating can result in insulin resistance. Post-meal glucose levels and insulin are elevated at night when compared to meals consumed earlier in the day. And without physical activity before bed, the body takes longer to clear a glucose load. Snacking can lead to frequent blood sugar spikes.

What Can We Do About It?

Are you depressed yet?? Not to worry as I will be covering so many lifestyle, diet and supplements hacks in my 21 Day Sugar Detox program. By the end of the 3 weeks you will have learned how to eat a metabolically healthy diet, understand how certain dietary, lifestyle and supplements can help or hinder your progress.

We will cover what we can do individually and what we can do as a society to improve our overall health (for example, did you know that The seven major subsidized foods in American Agriculture are corn, soybeans, wheat, rice, sorghum, dairy, and livestock. A recent study published in JAMA Internal Medicine looked at National Health and Nutrition Examination Survey data from 2001 to 2006 of more than 10,000 adults. The study found that adults who ate higher food commodities had a higher probability of cardiometabolic risks.)

I hope you’ll join me!