So metabolic dysregulation follows a fairly predictable sequence, right? First it's calorie excess, right? So it's in the Western diet, it's usually glucose, right? So you have too much glucose around. You could have too much saturated fat too, but too much glucose. And then too much glucose, you could catch that by doing a CGM, right? So that's one way you could do it, a continuous glucose monitor. You could then see if you have particularly glucose spikes to certain foods. And if your glucose is shooting up to 200 with certain meals, you know you're sensitive to that and maybe you should change how you're eating it. Try to eat it after having something fatty, maybe avoid it, right? So because we know this is part of a sequence that's going to lead to problems. And this goes back to the Whitehall 2 study, which, to give relevance here. So the Whitehall 2 study was on British civil servants. It was a prospective kind of longitudinal thing and they found that they followed all sorts of metrics. One of them was insulin. Fasting insulin was one thing that they followed. They followed other things as well. And they saw that if someone had high fasting insulin, they're more likely to get diabetes long term. So, and it was a long period of time. It was like a 10, 15 year time. They could detect this thing 15 years earlier, they could do something about it, right? But no one does because no one looks for fasting insulin. And the other thing that's very relevant here is there's another study, which was the NHANES study, okay? And that's another large database. It's more cross-sectionally looking at a point in time. And what they found was that less than a third of people that are lean are metabolically healthy. That's crazy. 12% of the whole population, less than a third of lean people are metabolically healthy based on their parameters. And the parameters looked at waist circumference and glucose and blood pressure and whatnot, right? So looking at metabolic signals. The word there is start looking and don't look with the traditional things, okay? We have to look at other things. Getting back to, you know, metabolic syndrome ideas. So first you could check for glucose. So glucose spikes, a CGM can do that. I wouldn't say wear it all the time. Get one for a month or two, learn what spikes your glucose, see if something spikes your glucose and adjust it. Next, you have fasting insulin, okay? So the next thing that happens is first in anybody, they have that insult of excess calories. The excess calories comes, that's what happens. Insulin's job is to take that sugar and push it into the cells because glucose is really bad for the body. We know this. If you look at end-stage diabetes where they can't control their glucose anymore, they go blind. You know, they have kidney failure. It's killing the vasculature. It's sticky. Glucose is sticky. It glycates things. It causes problems. So the insulin's got to get it out of the bloodstream. So next in the sequence of metabolic dysregulation is high insulin levels. Fasting insulin goes up. So you can get a fasting insulin level. That's the next thing you check, right? It's not a lot to ask for. It's an inexpensive test and you can see if you've evolved into that problem where now you have chronically high insulin levels. And part of that honestly is due to eating too frequently and could be eating, you know, certain things that are, you know, high fructose corn syrups or things that basically, you know, have a high glycemic index or load that's going to cause your sugar to spike. So, and the problem is if you're eating every few hours, insulin goes up and it spikes. It drives the glucose out of your blood, but then that insulin stays high, okay? It doesn't go right back down. It stays high for a few hours. So if you're eating every few hours, you always have this high insulin. That's going to lead to other problems. And the next thing that happens is ectopic fat, right? So your fat exists in different areas. You have subcutaneous fat. That's where it's supposed to be. That's your depot for energy and it's healthy there. It has different ways of growing. Then you have visceral fat which is really in your momentum. You know, it's in the abdomen and in your mesentery in the abdomen that's around the bowel. Okay, so that's kind of your visceral fat. Then you have your organ-associated fat. You have some fat around the heart. You have some fat around the kidneys, etc. It's kind of supposed to be there. They're all adipocytes. They're all fat cells. Their job is to store fat and release it, right? That's what they do. Then the last bucket is ectopic fat. And ectopic fat is where you have fat in cells that it's not their job to store fat, right? Like liver cells or muscle cells or pancreas cells. And that becomes a problem.
