Search Results

Copy this link to import to Cronometer Custom Recipes.

Insulin resistance is a complex condition, and the pulsatile nature of insulin secretion can make direct measurements of insulin challenging to interpret. This pulsatility occurs approximately every 5–15 minutes and is a natural physiological response to regulate blood glucose effectively and prevent desensitization of insulin receptors. Instead of relying solely on insulin levels, several alternative tests and indices can help detect insulin resistance earlier than prediabetes. Combining tests like the TyG index with markers of hyperinsulinemia (e.g., fasting C-peptide) or HOMA-IR can provide a clearer picture of insulin resistance without being confounded by insulin pulsatility. What follows is an overview of testing an: The degree of variation in blood insulin levels due to its pulsatile nature can be significant, with oscillations of 50% to 200% above baseline levels during peaks. This fluctuation is driven by the natural secretory cycles of pancreatic beta cells and occurs approximately every 5 to 15 minutes . Specific Insights on Insulin Variability: 1. Amplitude : Insulin pulses can result in brief spikes that are 1.5 to 3 times the basal level. For example, if the basal insulin level is 5 µU/mL, the peak during a pulse might reach 10 to 15 µU/mL. 2. Frequency : Pulses typically occur every 5–15 minutes , with larger amplitude ultradian rhythms (longer cycles) occurring every 1 to 3 hours . The timing and strength of these pulses are influenced by metabolic demands and regulatory hormones like glucagon and somatostatin. 3. Measurement Timing : If blood is sampled during a peak or trough of insulin secretion, the reading could differ substantially. This highlights the challenge of interpreting single fasting insulin measurements. Factors Influencing Variation: • Physiological State : Insulin pulsatility is more pronounced in healthy individuals, helping maintain receptor sensitivity. In insulin-resistant states, the amplitude of pulses is often blunted, and the periodicity may become irregular. • Glucose Levels : Insulin pulses are synchronized with blood glucose fluctuations, with higher glucose typically amplifying insulin pulses. • Meal Intake : After a meal, basal pulsatility may merge with meal-induced insulin secretion, causing even greater variation. Clinical Implications: Due to this variability, a single fasting insulin reading  might not capture an accurate picture of insulin levels or dynamics. This is why dynamic tests (e.g., OGTT " with insulin " measurements) or surrogate markers like the HOMA-IR  or TyG index  are often used to account for this variation. 1. Hemoglobin A1C (HbA1C) • What it measures : The percentage of glycated hemoglobin, reflecting average blood glucose levels over the past 2-3 months. • Strength : Useful for identifying longer-term trends in blood sugar regulation. • Limitation : It may not detect early insulin resistance, as it only reflects glucose levels and not insulin dynamics. 2. Hyperinsulinemia Tests • Fasting Insulin Test : • Elevated fasting insulin (>10–15 μU/mL) can indicate hyperinsulinemia, a marker of early insulin resistance. • Insulin Tolerance Test  or Euglycemic Clamp : • Considered the gold standard for measuring insulin sensitivity, though not commonly used due to its complexity. • Limitation : Pulsatile secretion may affect single fasting insulin readings, so trends or averages are more reliable. 3. Triglycerides (TG) and TG:HDL Ratio • Triglyceride Levels : • Elevated fasting triglycerides (>150 mg/dL) are a sign of metabolic dysfunction and often correlate with insulin resistance. • Triglyceride-to-HDL Ratio : • High ratios are associated with insulin resistance, particularly in individuals with metabolic syndrome. • A ratio >2-3 (in mg/dL) or >0.8 (in mmol/L) is strongly associated with insulin resistance. • Why it works : High triglycerides and low HDL are hallmarks of insulin-resistant states, particularly in visceral fat-driven metabolic syndrome. 4. Triglyceride-Glucose Index (TyG Index): • A surrogate marker for insulin resistance based on fasting triglycerides and glucose. • Formula: Ln (Fasting Triglycerides mg/dL × Fasting Glucose mg/dL ÷ 2) • Strongly correlated with the euglycemic clamp test and less influenced by insulin pulsatility. • Calculation : • Interpretation : • A higher TyG index suggests insulin resistance. It’s inexpensive and correlates well with gold-standard tests. • Strength : Combines lipids and glucose, offering a robust marker of metabolic health. • Mechanism : • Combines fasting glucose and fasting triglyceride levels, stable over time. • Advantages : 1. Reflects long-term metabolic dysfunction and trends. 2. Correlates strongly with insulin resistance as measured by gold-standard methods (e.g., hyperinsulinemic-euglycemic clamp). 3. Provides earlier indications of insulin resistance compared to C-peptide or fasting insulin levels. 4. Not influenced by pulsatile insulin secretion, offering better reliability for screening. • When it’s most useful : • For early-stage metabolic dysfunction and detecting insulin resistance before prediabetes develops. *You can try this test here: Triglyceride Glucose Index 5. HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) • Calculation : • Interpretation : • A HOMA-IR >2 is suggestive of insulin resistance. • Strength: Relatively simple and widely used, but fasting insulin variability can still influence results. 7. C-Peptide Levels : • C-peptide is released in a 1:1 ratio with insulin but has a longer half-life and is less subject to rapid fluctuations. • Provides a steadier indication of insulin production. • What it measures : C-peptide is secreted in equal amounts to insulin, but its levels are more stable in the bloodstream. • Interpretation : • Elevated fasting C-peptide indicates hyperinsulinemia and early insulin resistance. • Strength : Overcomes pulsatile insulin secretion. • Mechanism : • A byproduct of insulin production, directly reflecting pancreatic insulin secretion. • Advantages : 1. More stable than fasting insulin due to bypassing hepatic clearance. 2. Useful for assessing beta-cell function and distinguishing insulin resistance from beta-cell failure. 3. Indicates hyperinsulinemia when insulin resistance progresses. • Limitations : • Not as sensitive to early-stage insulin resistance, as C-peptide increases only when compensatory hyperinsulinemia occurs in response to significant insulin resistance. • Tied to insulin production, not a direct indicator of metabolic trends like triglycerides and glucose. 7. Oral Glucose Tolerance Test (OGTT) "with Insulin Levels" ( Kraft Test ) • Measures blood glucose and insulin at intervals after ingesting a standardized glucose solution. • Provides dynamic data on insulin secretion and glucose disposal, reducing reliance on single fasting measurements. • Useful in identifying early insulin resistance, even when fasting measures are normal. • What it measures : Blood glucose and insulin response over 2 hours after consuming a glucose load. • Insulin Resistance Indicators : • High insulin levels at baseline or excessive insulin secretion after glucose load. • Strength : Provides dynamic information about glucose and insulin interaction, detecting abnormalities earlier than fasting tests. Joseph R. Kraft MD MS. FCAP (Author) is also the researcher of the "Kraft Test". His book can be found here - Diabetes Epidemic and You Additional Tests 5. Adiponectin and Leptin Levels : • Adiponectin: Inversely related to insulin resistance. • Leptin-to-Adiponectin Ratio: A potential marker for metabolic health. 8. Advanced Testing (e.g., Continuous Glucose Monitoring) : • Identifies postprandial glucose patterns and variability, indirectly highlighting insulin dynamics. 8. Advanced Markers • Adiponectin: Inversely related to insulin resistance. • Leptin-to-Adiponectin Ratio: A potential marker for metabolic health. • Low levels are associated with insulin resistance. • Liver Enzymes (ALT, AST) : • Elevated levels may indicate non-alcoholic fatty liver disease (NAFLD), a common consequence of insulin resistance. Alternative Methods Avoiding Insulin Pulsatility: The Euglycemic Clamp Test  remains the gold standard for assessing insulin sensitivity but is impractical for routine use. Instead, surrogate markers like the TyG Index, triglyceride-to-HDL ratio, or advanced insulin sensitivity panels may offer practical, reliable alternatives in clinical settings. Combining tests like the TyG index with markers of hyperinsulinemia (e.g., fasting C-peptide) or HOMA-IR can provide a clearer picture of insulin resistance without being confounded by insulin pulsatility.

Purpose of Document : This document provides a legally sound framework supporting the essential role of health and wellness coaches in promoting lifestyle changes that address the root causes of chronic diseases. It integrates the contributions of accredited health professionals, including Metabolic Health Practitioners (MHPs) , National Board Certified Health and Wellness Coaches (NBC-HWCs) , and Master Primal Health Coaches , to establish a robust, evidence-based, and legally defensible approach to health and wellness coaching. These roles align with evolutionary health principles and reinforce the importance of lifestyle optimization as the foundation for chronic disease management, prevention, and overall well-being. 1. Scope of Practice of Health and Wellness Coaches Health and wellness coaches: • Guide clients in adopting evidence-based lifestyle changes that optimize overall health, well-being, and quality of life. • Work collaboratively with clients to set realistic and actionable goals related to diet, exercise, stress management, and sleep hygiene. • Provide education, motivation, and accountability for sustainable behavior change. • Operate strictly within their scope of practice, without diagnosing, treating, or prescribing medications for medical conditions, while collaborating with healthcare professionals when necessary. 2. Integrating Professional Expertise 2.1. Metabolic Health Practitioners (MHPs) Metabolic Health Practitioners are accredited professionals specializing in: • Educating clients on how lifestyle factors—such as diet, fasting, exercise, and sleep—directly affect metabolic health. • Identifying markers of metabolic dysfunction, including insulin resistance and inflammation, to guide clients toward healthier behaviors. • Aligning their approach with the latest evidence in metabolic science, particularly in chronic disease prevention. Legal Defense : • MHPs provide non-diagnostic, educational services to help clients understand the impact of their choices on metabolic health. • They empower clients to implement changes proven to improve insulin sensitivity, regulate glucose, and reduce inflammation. 2.2. National Board Certified Health and Wellness Coaches (NBC-HWCs) National Board Certified Health and Wellness Coaches are professionals certified by the National Board for Health & Wellness Coaching (NBHWC) . Their role includes: • Employing evidence-based coaching techniques to guide clients in creating sustainable behavior changes. • Using motivational interviewing, positive psychology, and goal-setting frameworks to empower clients to take charge of their well-being. • Collaborating with licensed healthcare providers to support a multidisciplinary approach to health. Legal Defense : • NBC-HWCs operate under rigorous ethical and professional standards, ensuring they do not cross into clinical practice. • Their certification reflects competency in evidence-based strategies, making their work complementary to medical treatment without conflicting with legal boundaries. 2.3. Master Primal Health Coaches Master Primal Health Coaches are trained to: • Leverage ancestral health principles, such as low-carb eating, fasting, and functional movement, to help clients realign their lifestyles with evolutionary biology. • Educate clients on the physiological benefits of these practices, including metabolic flexibility, improved insulin sensitivity, and reduced inflammation. • Integrate primal lifestyle principles with modern science to create sustainable, client-centered health plans. Legal Defense : • Master Primal Health Coaches emphasize evolutionary health practices rooted in human biology, ensuring their guidance is aligned with natural physiological functioning. • Their focus on education and habit formation keeps their services within the legal scope of practice. 3. Ancestral Foundations of Health Practices 3.1. The Evolutionary Lifestyle of Primal Ancestors Prior to the agricultural revolution approximately 10,000 years ago, our primal ancestors evolved in environments where: • Low-Carb and Higher-Protein Eating : Diets were naturally low in carbohydrates and high in animal protein, supplemented by seasonal plant-based foods. • Periods of Fasting : Food availability was inconsistent, leading to natural periods of fasting. • Ketosis as a Normal State : The body frequently transitioned into ketosis (burning fat for energy) during periods of fasting or low carbohydrate intake. • Seasonal and Geographic Variation : Nutritional patterns fluctuated based on geography and season, with some regions experiencing prolonged periods of scarce carbohydrates. 3.2. Ancestral Practices as Normal Physiological States • These practices are not “new treatments” or trends but reflect the evolutionary adaptations of human biology. • Implementing low-carb eating, intermittent fasting, and higher-protein consumption aligns with our physiology, supporting metabolic health and mitigating the mismatch between our modern diet and evolutionary biology. 4. Chronic Diseases Rooted in Lifestyle and Insulin Resistance A significant body of research identifies lifestyle factors and insulin resistance as pivotal drivers of chronic diseases, including: 1. Type 2 Diabetes 2. Hypertension 3. Obesity 4. Dyslipidemia 5. Cardiovascular Disease 6. Polycystic Ovary Syndrome (PCOS) 7. Non-Alcoholic Fatty Liver Disease (NAFLD) 8. Certain Cancers 9. Alzheimer’s Disease 10. Gout 11. Chronic Kidney Disease 12. Sleep Apnea 13. Acanthosis Nigricans and Skin Tags Health and wellness coaching focuses on modifying the lifestyle factors driving these conditions, which can profoundly influence remission, prevention, and overall health outcomes. 5. Evidence-Based Lifestyle Interventions Supported by Coaches Health and wellness coaches, supported by their specialized training and credentials, guide clients in the following areas: Dietary Guidance • Encouraging whole, unprocessed foods that improve metabolic health, including vegetables, healthy fats, and lean proteins. • Reducing refined carbohydrate and sugar intake to minimize insulin spikes and support glucose regulation. • Supporting intermittent fasting or time-restricted eating to improve metabolic flexibility. • Reintroducing Evolutionary Eating Patterns : Helping clients implement low-carb, higher-protein, and ketogenic strategies as a way to realign modern diets with ancestral practices. Physical Activity • Promoting regular, sustainable movement, including: • Low-intensity activities like walking. • Strength training to improve muscle mass and insulin sensitivity. • High-intensity interval training (HIIT) for cardiovascular and metabolic benefits. Stress Management • Facilitating mindfulness, meditation, and breathing exercises to reduce chronic stress, which exacerbates insulin resistance and inflammation. Sleep Optimization • Educating on sleep hygiene practices to enhance circadian rhythm regulation, hormone balance, and recovery. Gut Health Support • Encouraging fiber-rich and fermented foods that improve gut microbiome diversity, reducing systemic inflammation and improving metabolic outcomes. 6. Complementary Model of Care A dual approach enhances chronic disease outcomes: 1. Health and Wellness Coaches : Set the baseline for health and wellness through non-clinical strategies. 2. Medical Professionals : Address acute or advanced conditions and manage medications when needed. Medications as Exceptions • Medications remain a vital tool but should act as adjuncts, not substitutes, to lifestyle interventions. • A strong baseline of health reduces reliance on pharmaceutical interventions and enhances patient outcomes. 7. Conclusion Health and wellness coaching is a legally and ethically defensible practice that: • Operates within its scope, focusing on behavior change and health optimization. • Creates a foundation that supports chronic disease management through lifestyle interventions. • Reflects ancestral health principles, acknowledging that low-carb eating, fasting, and ketosis are normal physiological states  rooted in human evolution. • Benefits from the inclusion of accredited professionals—Metabolic Health Practitioners, National Board Certified Health and Wellness Coaches, and Master Primal Health Coaches—who bring evidence-based expertise to the field. By empowering individuals to adopt ancestral health principles and evidence-based lifestyle changes, health and wellness coaches contribute to a profound, systemic reduction in the burden of chronic diseases—without encroaching on the domain of medical practice. This makes coaching an essential component of modern healthcare. This document integrates ancestral knowledge, professional accreditation, and modern scientific understanding, reinforcing the essential role of health and wellness coaches as leaders in lifestyle transformation and chronic disease prevention. Scrutiny and Legal Review of the Document for Health and Wellness Coaching The document has been carefully reviewed to ensure its compliance with legal, ethical, and professional standards. Below is a detailed examination of key aspects to ensure the positions stated are legally defensible. 1. Scope of Practice The document: • Clearly delineates the scope of practice  for health and wellness coaches, including Metabolic Health Practitioners (MHPs), National Board Certified Health and Wellness Coaches (NBC-HWCs), and Master Primal Health Coaches. • Specifies that coaches do not diagnose, treat, or prescribe for medical conditions, which remains the purview of licensed healthcare professionals. • Emphasizes education, guidance, and behavior modification  as the primary focus of coaching, avoiding any legal ambiguity about medical treatment. Legal Considerations • Compliance with State and Federal Laws : The document avoids any implication that health coaches act as healthcare providers, staying within the bounds set by regulatory frameworks like the Health Insurance Portability and Accountability Act (HIPAA)  and state-specific licensing laws. • Alignment with Professional Certifications : The inclusion of MHPs, NBC-HWCs, and Master Primal Health Coaches underscores adherence to established credentialing bodies, which define professional boundaries and provide ethical guidelines. 2. Integration with Medical Care The document: • Clearly states that health and wellness coaches work in collaboration with medical professionals , reinforcing that their role is complementary, not substitutive. • Positions lifestyle interventions as foundational to health, with medications framed as exceptions to care  when clinically indicated. Legal Considerations • Avoidance of Medical Scope Encroachment : By emphasizing collaboration and referral to medical professionals for clinical concerns, the document safeguards against accusations of practicing medicine without a license. • Evidence of Complementarity : The integration of coaching with medical care is widely recognized in the healthcare industry, lending credibility to the approach outlined. 3. Evidence-Based Claims The document: • Cites well-established connections between lifestyle interventions (e.g., low-carb eating, fasting, and exercise) and improvements in chronic diseases like type 2 diabetes, hypertension, and cardiovascular disease. • Frames these practices as aligning with evolutionary biology , not as alternative treatments, grounding claims in physiological principles supported by scientific literature. Legal Considerations • Scientific Backing : The claims made are supported by robust evidence from peer-reviewed studies, ensuring they are not speculative or anecdotal. • Consumer Protection Compliance : The document avoids making guarantees or unverified claims about disease remission, focusing instead on well-documented benefits of lifestyle changes. 4. Role of Accredited Professionals The inclusion of Metabolic Health Practitioners (MHPs) , National Board Certified Health and Wellness Coaches (NBC-HWCs) , and Master Primal Health Coaches : • Establishes a clear hierarchy of expertise and professional responsibility. • Highlights adherence to established credentialing standards, including the NBHWC Code of Ethics  and practice guidelines. Legal Considerations • Credibility Through Accreditation : Accrediting bodies like the NBHWC provide legal and professional legitimacy to coaching roles, ensuring coaches operate within defined boundaries. • Ethical Safeguards : By emphasizing professional ethics and scope of practice, the document reduces the risk of legal challenges related to overreach. 5. Chronic Disease Context The document: • Frames chronic disease as a lifestyle-driven issue while avoiding medicalized language, ensuring that interventions remain in the wellness domain. • Acknowledges the role of medical treatment for advanced or acute conditions, reinforcing a non-competing relationship between coaching and medical care. Legal Considerations • No Implied Diagnosis or Treatment : The document avoids using language that could be interpreted as offering medical advice or interventions. • Education as the Primary Focus : Framing lifestyle interventions as educational ensures that coaches remain within their legal scope. 6. Legal Safeguards Embedded in Language Key Features: 1. Educational and Supportive Role : • Language focuses on empowerment, guidance, and education rather than treatment or diagnosis. • Emphasizes the voluntary nature of client participation, reducing liability concerns. 2. Collaboration and Referrals : • Coaches are positioned as adjuncts to, not replacements for, medical care. • Referrals to licensed medical professionals are explicitly encouraged when appropriate. 3. Avoidance of Guarantees : • No claims of curing or guaranteeing outcomes are made, aligning with legal requirements to avoid misleading statements. 7. Addressing Potential Legal Challenges Challenge 1: Unlicensed Practice of Medicine • Risk : Accusations of diagnosing or treating medical conditions without a license. • Defense : The document clearly states that coaches do not diagnose, treat, or prescribe, and all health claims are framed within the scope of education and guidance. Challenge 2: Misrepresentation of Credentials • Risk : Coaches falsely claiming medical authority or overstating their qualifications. • Defense : Accreditation is clearly defined, and roles are transparently described to prevent client misunderstanding. Challenge 3: Claims of Ineffectiveness • Risk : Clients alleging that coaching did not produce desired health outcomes. • Defense : The document avoids guarantees, emphasizing that outcomes depend on individual factors and the voluntary application of lifestyle changes. 8. Strengths Supporting Legal Defensibility 1. Consistency with Legal Precedents : • Aligns with existing laws governing the wellness industry, such as the prohibition of diagnosing or treating medical conditions without a license. 2. Use of Established Certifications : • Incorporating NBC-HWCs, MHPs, and Master Primal Health Coaches demonstrates a commitment to professionalism and accountability. 3. Scientific Foundation : • Claims are rooted in well-documented scientific principles and evolutionary biology, minimizing the risk of legal challenges related to misinformation. 4. Focus on Collaboration : • Coaches are framed as complements to, not substitutes for, medical care, reducing the risk of perceived conflict with licensed healthcare providers. 9. Suggestions for Further Legal Strength 1. Disclaimers in Practice : • Include standard disclaimers in coaching contracts and materials, such as: • “Health and wellness coaching is not a substitute for medical advice. Always consult your healthcare provider for medical concerns.” 2. Ongoing Training : • Ensure that coaches maintain up-to-date knowledge and certifications to remain within their professional scope. 3. Clear Communication : • Emphasize transparency with clients about the non-clinical nature of services. 10. Conclusion The document is legally defensible due to its: • Clear delineation of scope. • Emphasis on professional ethics and accreditation. • Reliance on evidence-based practices. • Collaboration with medical professionals. This framework establishes health and wellness coaching as a vital, legally sound component of modern chronic disease management, empowering individuals while maintaining compliance with all relevant laws and regulations.

Yes, higher insulin levels, especially in the context of insulin resistance, can contribute to systemic inflammation and potentially exacerbate joint pain or cause new-onset joint pain. Here’s how: 1. Insulin and Inflammation: • Pro-inflammatory Effects of Hyperinsulinemia:  Chronically elevated insulin levels can activate pro-inflammatory pathways. Insulin can stimulate the production of inflammatory mediators such as cytokines (e.g., interleukin-6, tumor necrosis factor-alpha) that contribute to systemic and localized inflammation. • Insulin Resistance:  When cells are resistant to insulin, the pancreas compensates by producing more insulin, leading to hyperinsulinemia. This state often coincides with increased oxidative stress and the activation of inflammatory processes. 2. Joint Pain and Inflammation: • Obesity and Insulin Resistance:  Excess weight, often associated with insulin resistance and type 2 diabetes, puts mechanical stress on joints. Additionally, fat tissue (adipose) releases pro-inflammatory cytokines (adipokines), which can exacerbate inflammation in joints. • Advanced Glycation End Products (AGEs):  High blood sugar and insulin levels contribute to the formation of AGEs. These molecules can accumulate in tissues, including cartilage, and are known to provoke inflammation, stiffness, and degradation of joint structures. • Immune Dysregulation:  Hyperinsulinemia and type 2 diabetes are associated with altered immune system responses, increasing the likelihood of inflammatory joint conditions like osteoarthritis or even autoimmune-related joint pain. 3. Exogenous Insulin and Joint Inflammation: • Excess Insulin Impact:  In individuals using exogenous insulin, higher doses (as might be required with insulin resistance) could lead to weight gain and exacerbate systemic inflammation, indirectly contributing to joint pain. • Localized Effects:  In some cases, insulin injection sites can become inflamed, but this is usually not systemic and is less relevant to joint inflammation. 4. Clinical Observations: • People with poorly controlled diabetes often report higher rates of joint pain or stiffness. Conditions like diabetic arthropathy or Charcot joint can develop over time due to inflammation, poor blood sugar control, and associated metabolic disturbances. Mitigating Joint Pain in Insulin Resistance or Type 2 Diabetes: • Improve Insulin Sensitivity:  Lifestyle changes like a low-carb or ketogenic diet, weight loss, and physical activity can reduce insulin levels and systemic inflammation. • Anti-inflammatory Measures:  Include anti-inflammatory foods (e.g., omega-3 fatty acids, turmeric) and avoid processed and high-sugar foods. • Optimize Glycemic Control:  Reducing blood glucose fluctuations can decrease the formation of AGEs and related inflammation. If you or someone else is experiencing new or worsening joint pain in the context of insulin resistance or diabetes, it’s advisable to consult a healthcare provider for further evaluation and targeted management.

The amount of insulin needed per meal or day varies greatly depending on a person’s metabolic health, insulin sensitivity, body weight, activity levels, and specific dietary composition. Here’s an overview of typical or average insulin needs for individuals on different diets: 1. Standard American Diet (SAD) Carbohydrate content : High (45–65% of total calories). Blood sugar impact : High due to frequent consumption of refined carbs and sugars. Insulin usage : • Per meal : 4–10+ units of insulin, depending on carb intake (e.g., 50–100+ grams per meal). • Daily total : ~40–60+ units for someone with normal insulin sensitivity; individuals with insulin resistance may require more (60–100+ units). 2. High-Fat, Low-Carb Diet (HFLC) Carbohydrate content : Moderate-to-low (20–100 grams per day). Blood sugar impact : Lower compared to SAD, as fewer carbs are consumed. Insulin usage : • Per meal : 1–4 units of insulin, depending on carb intake (e.g., ~10–30 grams per meal). • Daily total : ~20–30 units for those with moderate insulin sensitivity. 3. Ketogenic Diet (Very Low-Carb, High-Fat) Carbohydrate content : Very low (typically <20–50 grams per day). Blood sugar impact : Minimal, as carbs are replaced by fats and protein. Insulin usage : • Per meal : ~0–1 unit of insulin (most meals may not require exogenous insulin if carbs are extremely low). • Daily total : ~5–15 units, depending on protein intake and individual sensitivity. Key Considerations: 1. Protein’s Role : Protein can stimulate a mild insulin response even in low-carb diets. This is factored into dosing for ketogenic and HFLC diets. 2. Endogenous vs. Exogenous Insulin : Individuals with Type 1 Diabetes or advanced Type 2 Diabetes rely on exogenous insulin, while others may see reduced endogenous insulin secretion on low-carb or ketogenic diets. 3. Activity Level : Physical activity significantly reduces insulin requirements for all diets. 4. Individual Variability : Insulin needs vary by insulin resistance, body weight, and genetic factors.

The Atherogenic Index of Plasma (AIP) is a biomarker used to assess the risk of cardiovascular disease, particularly atherosclerosis, which is the buildup of fats, cholesterol, and other substances in and on artery walls. AIP is calculated using triglyceride and HDL (high-density lipoprotein) cholesterol levels: • AIP < 0.11 : Low risk • AIP 0.11 to 0.24 : Intermediate risk • AIP > 0.24 : High risk

An SGLT2 medication  refers to a class of drugs called Sodium-Glucose Co-Transporter 2 (SGLT2) inhibitors . These medications are primarily used to manage type 2 diabetes  but have additional benefits for certain cardiovascular and kidney conditions. How They Work: • SGLT2 inhibitors block the action of the SGLT2 protein  in the kidneys. This protein is responsible for reabsorbing glucose back into the bloodstream. • By inhibiting SGLT2, these drugs cause the kidneys to excrete excess glucose in the urine, thereby lowering blood sugar levels. Common SGLT2 Inhibitors: • Empagliflozin (Jardiance) • Canagliflozin (Invokana) • Dapagliflozin (Farxiga) • Ertugliflozin (Steglatro) Uses: Type 2 Diabetes Management : • Helps reduce blood sugar levels. • Often prescribed alongside other diabetes medications like metformin. Heart Failure : • Certain SGLT2 inhibitors, like empagliflozin and dapagliflozin, are approved to reduce the risk of hospitalization and improve outcomes in people with heart failure , even in those without diabetes. Chronic Kidney Disease (CKD) : • These drugs can slow the progression of kidney disease and reduce the risk of kidney failure in people with or without diabetes. Additional Benefits: • Promote modest weight loss. • Lower blood pressure. • Reduce the risk of cardiovascular events, such as heart attacks or strokes, in high-risk individuals. Potential Side Effects: • Increased risk of urinary tract infections (UTIs) and genital yeast infections. • Dehydration and low blood pressure (especially in people who are already on diuretics). • Rarely, a condition called euglycemic diabetic ketoacidosis (EDKA) , which is a serious but uncommon side effect.

Ketoacidosis is a dangerous condition that arises when the body produces excessively high levels of ketones, leading to an imbalance in blood acidity. While ketone production is normal during a ketogenic diet or fasting, ketoacidosis  occurs only under specific pathological circumstances. The most common types are diabetic ketoacidosis (DKA)  and alcoholic ketoacidosis (AKA) . Here are the circumstances for each: 1. Diabetic Ketoacidosis (DKA) Occurs primarily in people with type 1 diabetes  (and less commonly in type 2 diabetes), due to insulin deficiency. Insufficient insulin : Insulin is needed to regulate blood glucose and suppress ketone production. Without insulin, blood glucose rises (hyperglycemia), and the liver produces excess ketones. • Triggering factors : • Missed or insufficient insulin therapy • Illness or infection, increasing stress hormones like cortisol • Trauma, surgery, or other physical stress • Excessive carbohydrate intake with insufficient insulin coverage • Symptoms : High blood glucose (>250 mg/dL), nausea, vomiting, fruity breath (acetone odor), and confusion. 2. Alcoholic Ketoacidosis (AKA) Occurs in individuals with chronic alcohol use, particularly after a period of binge drinking followed by starvation. • Insufficient glucose intake : Starvation and alcohol metabolism deplete glycogen stores. The liver shifts to producing ketones as an energy source. • Impaired insulin secretion : Alcohol inhibits normal insulin production, further promoting ketone production. • Symptoms : Nausea, vomiting, abdominal pain, and ketonemia (elevated ketones) despite normal or low blood glucose levels. 3. Starvation Ketoacidosis Rare, occurs after prolonged starvation (weeks) when glycogen and fat stores are exhausted. • Severe malnutrition : Leads to excessive reliance on ketone production for energy. • Pregnancy : Increased metabolic demands during pregnancy can accelerate the condition in malnourished women. 4. Other Causes • Medications: Certain drugs (e.g., sodium-glucose co-transporter 2 inhibitors like SGLT2 inhibitors ) can induce ketoacidosis in people with diabetes, even at normal blood glucose levels. • Severe illness or trauma : Can cause ketoacidosis in non-diabetics due to stress-induced hormonal imbalances (e.g., glucagon dominance). Why It Doesn’t Happen on a Keto Diet Nutritional ketosis in a ketogenic diet is regulated by insulin, which prevents ketone levels from rising dangerously high. In a healthy individual: • Blood ketone levels during ketosis rarely exceed 3–5 mmol/L. • Ketoacidosis typically occurs when ketone levels rise above 10–20 mmol/L, accompanied by severe acidosis. Preventing Ketoacidosis • Monitor blood glucose and ketone levels if diabetic or at risk. • Ensure proper hydration and caloric intake during prolonged fasting or alcohol use. • Seek immediate medical attention if symptoms like confusion, nausea, or fruity-smelling breath occur.

This is likely one of the most important health related posts you will have the opportunity to read. It projects the future of developing and poor metabolic health conditions before you have to experience them. It also discusses the relationship between symptoms and conditions you might be aware of from observing peers or elders health circumstances. You then have the option to "pre-hab" your health and avoid these conditions. The TyG Index is a useful tool to evaluate your current metabolic health circumstance. What follows are stages of developing insulin resistance and fatty liver disease including the Triglyceride-Glucose Index (TyG Index)  estimates at each stage: (summary) (download the above) What followes is a comprehensive, detailed progression of insulin resistance  with the integration of symptoms, conditions, TyG Index (Triglyceride-Glucose Index)  ratings, and their implications for chronic diseases such as NAFLD, dyslipidemia, hypertension, and diabetes: 1. Early Causes of Insulin Resistance Key Drivers : • Chronic overconsumption of refined carbohydrates and sugars → frequent glucose spikes and insulin release. • Sedentary lifestyle → decreased muscle glucose uptake. • Chronic stress → elevated cortisol levels worsen blood sugar and insulin regulation. • Sleep deprivation → hormonal imbalance (increased ghrelin, reduced leptin) leading to overeating and impaired glucose regulation. • Environmental toxins or medications → disrupted insulin signaling. Early Cellular Changes : • Fat cells (adipocytes) store excessive energy, becoming inflamed and releasing inflammatory cytokines. • Liver begins overproducing glucose via gluconeogenesis despite high insulin levels. • Skeletal muscle downregulates insulin receptors, reducing glucose uptake efficiency. Early Symptoms : • Fatigue after meals, mild weight gain, especially abdominal fat. • Subtle brain fog or difficulty concentrating. TyG Index Estimate : • Fasting triglycerides : 100–120 mg/dL. • Fasting glucose : 80–90 mg/dL. • TyG Index : ~4.0–4.5 (normal range, indicating healthy insulin sensitivity). 2. Early Stages of Insulin Resistance Insulin and Metabolic Changes : • Elevated insulin levels due to increased pancreatic output to counteract rising resistance. • Liver begins producing more triglycerides (via VLDL) as it stores more glucose and converts it to fat. • Kidneys retain sodium, slightly increasing blood pressure. Symptoms : • Increased hunger and carbohydrate cravings. • Difficulty losing weight, even with dietary adjustments. • Mild elevations in fasting glucose (~90–100 mg/dL). • Skin changes (acanthosis nigricans, skin tags). TyG Index Estimate : • Fasting triglycerides : 120–150 mg/dL. • Fasting glucose : 90–100 mg/dL. • TyG Index : ~4.6–4.8. • Key Implications : • A TyG Index of 4.6–4.8 is suggestive of early insulin resistance . • Early liver involvement begins (mild fat accumulation in hepatocytes). 3. Intermediate Insulin Resistance Hyperinsulinemia : • Chronic high insulin levels mask blood glucose abnormalities but lead to worsening fat storage and inflammation. • Liver shows significant fat accumulation ( non-alcoholic fatty liver disease, NAFLD ). • Cholesterol profile shifts: high triglycerides, lower HDL, and small, dense LDL particles. Symptoms : • Persistent fatigue, especially post-meal. • Visible weight gain around the abdomen. • Elevated blood pressure (pre-hypertension). • Worsening dyslipidemia (high triglycerides, reduced HDL). Kidney Effects : • Sodium retention intensifies, increasing blood volume and vascular resistance. TyG Index Estimate : • Fasting triglycerides : 150–200 mg/dL. • Fasting glucose : 100–110 mg/dL. • TyG Index : ~4.8–5.0. • Key Implications : • A TyG Index of 4.8–5.0 reflects moderate insulin resistance  and is correlated with the onset of NAFLD . 4. Pre-Diabetes Glucose Dysregulation : • Liver becomes more insulin-resistant, overproducing glucose. • Fasting glucose rises into the prediabetic range (100–125 mg/dL). • Persistent hypertriglyceridemia worsens systemic inflammation and cardiovascular risks. Symptoms : • Fatigue becomes more pronounced. • Blood pressure elevated (~130/80 mmHg). • Elevated fasting glucose and cholesterol panel abnormalities: • Triglycerides >200 mg/dL, HDL <40 mg/dL. Kidney Effects : • Microvascular damage begins, further reducing renal efficiency. TyG Index Estimate : • Fasting triglycerides : 200–250 mg/dL. • Fasting glucose : 110–125 mg/dL. • TyG Index : ~5.0–5.2. • Key Implications : • A TyG Index above 5.0 strongly correlates with advanced insulin resistance  and NAFLD progression . 5. Type 2 Diabetes Pancreatic Burnout : • Chronic inflammation damages beta cells, reducing insulin production. • Fasting glucose exceeds 126 mg/dL (diabetes threshold). • Advanced NAFLD transitions to liver fibrosis. Symptoms : • Increased thirst, frequent urination (polyuria), and unintentional weight loss. • Peripheral neuropathy (tingling, numbness). • Visual disturbances due to diabetic retinopathy. Kidney Effects : • Persistent hypertension accelerates kidney damage (proteinuria, reduced filtration). TyG Index Estimate : • Fasting triglycerides : 250–300 mg/dL. • Fasting glucose : 126–150 mg/dL. • TyG Index : ~5.3–5.5. • Key Implications : • A TyG Index above 5.3 indicates severe metabolic dysfunction  and advanced NAFLD  with a risk of fibrosis. 6. Advanced Complications Multi-System Failure : • Liver transitions from fibrosis to cirrhosis in severe cases. • Cardiovascular complications (atherosclerosis, heart attack, stroke). • Kidney failure (end-stage renal disease requiring dialysis). Symptoms : • Chronic pain from neuropathy. • Severe fatigue and muscle wasting. • Vision loss due to retinopathy. TyG Index Estimate : • Fasting triglycerides : >300 mg/dL. • Fasting glucose : >150 mg/dL. • TyG Index : >5.5. • Key Implications : • TyG Index above 5.5 strongly correlates with cirrhosis, severe NAFLD , and extreme cardiovascular risks. 7. Final Stages End-Stage Disease : • Widespread organ failure (heart, kidneys, liver). • Blood glucose and triglycerides remain extremely elevated due to loss of metabolic control. TyG Index Estimate : • Fasting triglycerides : >400 mg/dL. • Fasting glucose : >200 mg/dL. • TyG Index : ~6.0 or higher. • Key Implications : • A TyG Index of 6.0+ indicates irreversible metabolic damage  and extremely high mortality risk. Summary TyG Index Scale : • <4.5 : Healthy metabolic state. • 4.5–4.8 : Early insulin resistance. • 4.8–5.0 : Moderate insulin resistance, early NAFLD. • 5.0–5.3 : Advanced insulin resistance, established NAFLD. • 5.3–5.5 : Severe dysfunction, advanced NAFLD. • >5.5 : End-stage metabolic disease. This comprehensive progression highlights the interaction of insulin resistance, triglycerides, glucose, and systemic health outcomes, emphasizing how the TyG Index can serve as a predictive tool for metabolic health and disease management.

Overview of Gallbladder Function and Bile The gallbladder stores and releases bile, a digestive fluid produced by the liver. Bile contains cholesterol, bile salts, and waste products such as bilirubin. Its primary function is to emulsify fats in the diet, aiding their digestion and absorption. Bile also serves as a means for the body to excrete excess cholesterol. When dietary habits disrupt the production or flow of bile, it can lead to gallbladder dysfunction, including gallstone formation or inflammation. Gallbladder Problems and Their Prevalence Gallbladder issues, particularly gallstones, are widespread and often necessitate gallbladder removal. The formation of gallstones is closely tied to bile composition and gallbladder activity, both of which are influenced by diet and lifestyle. Diets low in fat, high in refined carbohydrates, or overly processed contribute to gallbladder stasis (inactivity), increasing the risk of gallstones by allowing bile to become stagnant and concentrated. Dietary Impact on Gallbladder Health 1. Low-Fat, High-Refined-Carb Diets • Inactivity of the Gallbladder : A low-fat diet reduces the need for bile release, leading to gallbladder stasis. Without regular stimulation, bile can stagnate, allowing cholesterol to crystallize and form gallstones. • Increased Cholesterol Production : Diets high in refined carbohydrates stimulate the liver to produce more cholesterol, disrupting the balance in bile and further promoting gallstone formation. • Result: Low-fat, high-carb diets are a significant contributor to gallbladder issues. 2. High-Fat, Low-Carb Diets (Ketogenic Diet) • Stimulation of Gallbladder Activity : Dietary fats trigger the release of the hormone cholecystokinin (CCK) , which signals the gallbladder to contract and release bile. This regular stimulation prevents bile stagnation and maintains a healthy balance of cholesterol and bile salts. • Improved Cholesterol Balance : A ketogenic diet, when properly implemented, can lower triglycerides and balance cholesterol levels, reducing the risk of gallstone formation. • Potential Risks : If someone has preexisting gallstones, the increased gallbladder activity triggered by high-fat intake can cause discomfort or complications by forcing the gallbladder to contract around stones. The Role of Saturated Fats in Gallbladder and Overall Health Outdated dietary guidelines unfairly vilified saturated fats, including those from beef and other animal sources. Modern research has clarified their role: 1. Beef Fat and Its Composition • Beef fat is approximately 50% saturated fat and 50% monounsaturated fat, making it a balanced and nutrient-dense fat source. • Saturated fats in beef, particularly stearic acid , have been shown to have neutral or even beneficial effects on blood cholesterol levels. • Grass-fed beef fat contains additional nutrients, such as conjugated linoleic acid (CLA) , which has anti-inflammatory and potential fat-burning properties. 2. Saturated Fats Are Healthy • Saturated fats are essential for hormone production, cell membrane integrity, and energy. • Studies show no significant association between natural saturated fat intake and increased cardiovascular disease risk. Instead, they support overall health when consumed as part of a balanced diet. 3. Why Include Saturated Fats? • Saturated fats, including those from beef, stimulate regular bile flow and gallbladder activity, helping to prevent bile stagnation. • Unlike refined carbohydrates or trans fats, natural saturated fats are stable and promote digestive health, particularly in a ketogenic or low-carb context. Dietary Recommendations for Gallbladder Health 1. Incorporate Healthy Fats : • Include natural fats like beef tallow, butter, olive oil, avocados , and fatty fish . • Saturated fats from beef or other whole animal sources are particularly valuable for supporting bile flow and gallbladder function. 2. Limit Refined Carbohydrates : • Avoid processed, high-sugar foods that increase cholesterol production and disrupt bile balance. 3. Moderate Fiber Intake : • Consume low-carb, high-fiber foods like leafy greens, chia seeds, and nuts to support digestive health without impairing bile flow. 4. Stay Hydrated and Active : • Proper hydration and regular physical activity further support bile flow and reduce the risk of gallbladder issues. 5. Gradually Adapt to High-Fat Diets : • For those new to a high-fat diet or with preexisting gallbladder issues, increase fat intake gradually to avoid overwhelming the gallbladder. High-Fat Diets vs. Gallbladder Removal • Before Gallbladder Removal : A high-fat, low-carb diet can maintain gallbladder health by preventing bile stagnation, improving cholesterol balance, and reducing gallstone risk. • After Gallbladder Removal : For individuals without a gallbladder, bile continuously drips into the intestine. High-fat meals may overwhelm digestion. Smaller, more frequent meals with healthy fats can mitigate this issue. Conclusion Diet plays a pivotal role in gallbladder health. While low-fat, high-carb diets promote gallbladder stasis and gallstone formation, a high-fat, low-carb ketogenic diet can prevent these issues by promoting regular gallbladder activity and maintaining bile balance. Saturated fats, including those from beef, are an essential part of a healthy diet and should not be excluded. They offer stability, nutritional value, and support for hormonal and digestive health. This modern perspective on diet and gallbladder health highlights the importance of embracing natural fats, particularly in the context of a low-carb, whole-food approach, for maintaining gallbladder health and avoiding unnecessary surgical interventions.

Saturated fat is what comes to mind for many people when discussing red meat. There is however a very balanced for of several fats. Saturated Fat = 46.5%; Monounsaturated Fat = 46.5%; Polyunsaturated Fat = 7% What follows is a breakdown of the types of fat in grass-fed beef, including the benefits and potential risks of each type: 1. Saturated Fat • Percentage : Approximately 40-50% of total fat. • Grams per pound : ~18-22 grams. Minor Categories : • Palmitic acid (C16:0) : 20-30% of total saturated fat (~3.6-6.6 grams per pound). • Stearic acid (C18:0) : 10-15% of total saturated fat (~1.8-3.3 grams per pound). • Myristic acid (C14:0) : 2-4% of total saturated fat (~0.36-0.88 grams per pound). Benefits: • Energy Source : Saturated fats are a dense source of energy and can support cellular function. • Stearic Acid : Found in grass-fed beef, it is considered neutral or even beneficial for heart health, as it doesn’t raise LDL cholesterol levels significantly. Risks: • Excessive Intake : High intake of saturated fats has been associated with increased LDL cholesterol levels and potential cardiovascular risks, though this relationship is under debate. • Balance with Unsaturated Fats : Saturated fats should be consumed alongside unsaturated fats to maintain a balanced diet. 2. Monounsaturated Fat • Percentage : Approximately 40-50% of total fat. • Grams per pound : ~18-22 grams. Minor Categories : • Oleic acid (C18:1) : 70-90% of monounsaturated fat (~12.6-19.8 grams per pound). • Palmitoleic acid (C16:1) : 3-5% of monounsaturated fat (~0.54-1.1 grams per pound). Benefits: • Heart Health : Monounsaturated fats, especially oleic acid, are linked to lower LDL cholesterol and higher HDL cholesterol, reducing cardiovascular disease risk. • Anti-Inflammatory : Monounsaturated fats may help reduce inflammation. • Metabolic Benefits : They support insulin sensitivity and may improve blood sugar regulation. Risks: • Overconsumption : Although healthier than saturated fats, excessive intake of any fat can lead to weight gain and metabolic issues if not balanced with physical activity. 3. Polyunsaturated Fat • Percentage : Approximately 3-10% of total fat. • Grams per pound : ~1.4-4.4 grams. Minor Categories : Omega-3 Fatty Acids : • Alpha-linolenic acid (ALA, C18:3): ~0.18-0.45 grams per pound. • EPA (C20:5) and DHA (C22:6): Trace amounts (~0.01-0.05 grams combined). Omega-6 Fatty Acids : • Linoleic acid (C18:2): ~0.54-1.1 grams per pound. • Arachidonic acid (C20:4): Trace amounts (~0.01-0.05 grams). Benefits: • Omega-3 Fatty Acids : • Support brain function, heart health, and reduce inflammation. • Grass-fed beef has a more favorable omega-3 to omega-6 ratio than grain-fed beef. • Omega-6 Fatty Acids : • Essential for normal growth, development, and cellular function when consumed in balance with omega-3s. Risks: • Omega-6 Excess : High omega-6 intake relative to omega-3 can promote inflammation, which is linked to chronic diseases like heart disease and arthritis. • Low Omega-3 Content : Grass-fed beef provides some omega-3s, but amounts are relatively small compared to fatty fish. Summary • Saturated Fat  (18-22 grams): Provides energy, supports cellular function, but excessive intake may affect heart health. • Monounsaturated Fat  (18-22 grams): Beneficial for heart health and reducing inflammation, with minimal risks. • Polyunsaturated Fat  (1.4-4.4 grams): Contains essential fatty acids (omega-3 and omega-6) with notable health benefits, though balance is critical to avoid inflammatory effects. This composition emphasizes the balanced and healthy fat profile of grass-fed beef, particularly its higher omega-3 content compared to grain-fed beef. However, portion control and balancing fats with other macronutrients remain essential for optimal health .

Saturated fats are often misunderstood, but they play essential roles in the human body. While polyunsaturated fats (like omega-3s) and monounsaturated fats offer specific health benefits, saturated fats contribute to biological functions that are equally important . Here’s why saturated fats are necessary: 1. Cell Membrane Integrity Saturated fats are a crucial component of cell membranes. They: • Provide stability  to cell membranes, making them less prone to oxidative damage. • Help maintain the proper fluidity and structure  of the membrane, enabling efficient cellular communication and nutrient exchange. The cell wall is made of "phospholipids". One tail is made of saturated fat. The other (bent leg) is made of unsaturated fats, both polyunsaturated (omega 6 and 3) and monounsaturated (such as from olive oil) 2. Energy Source • Saturated fats serve as a dense source of energy , particularly for tissues that rely on fat as fuel, such as the heart and muscles. • During a ketogenic or low-carb diet, saturated fats are a primary fuel source for generating ketones. 3. Hormone Production • Saturated fats are vital for the production of steroid hormones , including testosterone, estrogen, and cortisol. • Cholesterol (derived from saturated fats) is a building block for these hormones. 4. Nutrient Absorption • Saturated fats aid in the absorption of fat-soluble vitamins (A, D, E, and K), which are essential for immune function, bone health, and antioxidant activity. 5. Brain Health • Saturated fats are a key component of myelin , the fatty sheath that insulates nerve fibers and enhances neural transmission. • The brain itself is largely composed of fat, and saturated fats contribute to its structural integrity. 6. Immune System Support • Saturated fats like lauric acid  (found in coconut oil) have antimicrobial, antiviral, and antifungal properties, supporting immune defense mechanisms. 7. Lipoprotein Regulation • Saturated fats influence the production of different lipoproteins, which transport cholesterol and triglycerides in the bloodstream. They can play a role in balancing HDL (good cholesterol) and LDL (low-density lipoproteins) ratios, which is more complex than simply labeling LDL as “bad.” 8. Metabolic and Structural Balance • Saturated fats balance the effects of polyunsaturated fats , which, while beneficial, can become harmful when consumed in excess or oxidized. Too many polyunsaturated fats can lead to instability in cell membranes. Balancing Fats in the Diet While saturated fats are essential, balance is key . Combining saturated fats with polyunsaturated and monounsaturated fats provides a spectrum of benefits, such as reducing inflammation, supporting brain function, and improving cardiovascular health. A variety of fat sources, including fatty fish, avocados, olive oil, coconut oil, butter, and animal fats, can ensure you’re covering all bases.