We have an advancing epidemic -- or pandemic, really, if you compare the numbers -- that’s killing the entire world. And it presents itself in the form of insulin resistance, type 2 diabetes, metabolic syndrome, hyperinsulinemic-driven health issues.
We live in the age of metabolic disease; it’s the preeminent issue of our times. It’s surging as a consequence of the messages that our genes are getting from our environment: our diet, our lifestyle, our stress patterns.
What we’re observing is a transition from a view that a disease is caused by one, specific singular mechanism to this multipronged model, one where there are multiple different routes to get to the same disease that we call a diagnosis.
While so often the diagnosis is often the same (type 2 diabetes), the route by which a person got to that diagnosis may be very different from individual to individual.
The Metabolic Dysfunction Pathway
At the extreme, there are the clinical signs that occur with raging, unmanaged type 1 and type 2 diabetes: neuropathy, nephropathy, retinopathy, liver failure, or kidney failure. These types of very acute illness situations present in the most extreme edge of the type 1 diabetes or type 2 diabetes spectrum.
But these extreme situations aren’t predestined. Rather, they are part of a slow, festering progression of other dull, more moderate presentations of underlying health issues.
In the earlier stages, the signs and symptoms of the underlying issue are much more subtle; they’re not as poignant as a pathology. Instead, they present themselves through cognitive dysfunction, obesity, hypertension, chronic kidney-related dysfunctions, or a whole host of other, seemingly lesser manifestations. And often, they cluster together in their presentation.
Social Determinants and Lifestyle
It’s not easy just to pinpoint a specific sign or symptom when accounting for this wide spectrum of conditions that are under the umbrella of metabolic syndrome. As it pertains to prevalence, there is no doubt that this is a rising tide.
Yet, few in medicine or government have done anything to address the situation. In fact, in 2016 (prior to our current global pandemic), Luke Allen put it quite bluntly (and perfectly):
"The global boom in premature mortality and morbidity from noncommunicable diseases (NCDs) shares many similarities with pandemics of infectious diseases, yet public health professionals have resisted the adoption of this label. It is increasingly apparent that NCDs are actually communicable conditions, and although the vectors of disease are nontraditional, the pandemic label is apt."
We have reached those pandemic proportions with COVID-19, certainly. But we’ve also reached that other pandemic Allen recognizes: premature mortality by way of NCDs.
Not only has this taken the US by storm, but we’ve now exported it. Other countries around the world have also taken on the American lifestyle and, consequently, are seeing the same pandemic proportions of metabolic dysfunction and disease.
One of those countries is China. Twenty years ago, type 2 diabetes was almost unheard of in China. It was a condition that was only seen with great prevalence in the United States. Today, China is at the forefront -- China has the highest prevalence of type 2 diabetes of all countries in the world.
What changed in 20 years? The Western lifestyle arrived in China. En masse.
In comparison, a study in 2014 revealed the significant and overwhelming increase of both type 1 diabetes and type 2 diabetes from 2001-2009; similar staggering (and growing) statistics were found in a 2017 study. The takeaways?
Exponential increase of both type 1 and type 2 diabetes in adolescents. And that’s not even covering the same results found in the adult populations.
What’s perhaps even more interesting, though, is the sustained increase of the prevalence of type 1 diabetes. Type 1 diabetes is associated with autoimmune disease: the immune system kills the beta cells inside the pancreas out of a protective response to some sort of trigger.
If you're like me, you've been told since diagnosis that your type 1 diabetes was caused (more than likely, but never confirmed) by some sort of virus: that your body attacked itself, mistaking your beta cells for viral cells. But the how or why that happens was always a mystery.
If you look at these studies, it’s not that the genetic predisposition to type 1 diabetes is increase. It’s that whatever it is that initiates the autoimmune response to the pancreas is on the rise; some thing or things in our current environments are triggering this autoimmune attack response.
These diseases, conditions, disorders, and symptoms are all on the rise. And they are all tied to immunological disorders (the autoimmune family of disorders), akin to the idea of the body being allergic to itself.
So what’s causing the allergy?
We Must Cook Up a New Standard American Diet
Our bodies give way to these autoimmune responses when it feels like it’s under attack. What’s attacking it? Lifestyle factors. Most notably, dietary.
The food -- or lack thereof -- our general population is currently ingesting is killing us, little by little. Or (most recently) quite quickly, given the coronavirus pandemic.
Our abnormal immune function is directly related to metabolic syndrome, as well as chronic inflammation (which many say are cyclical). Our bodies feel attacked by the food we’re putting inside and, therefore, are reacting as they should: protecting itself against the outsider.
What’s happening, though, is that it’s not an actual outsider in the sense of a virus or infection, which is what our bodies are supposed to guard us against. Rather, our bodies are reacting to chronic metabolic dysfunction, often caused by insulin resistance. And we know, insulin resistance is, more often than not, caused by what we eat.
Insulin resistance doesn’t happen overnight. It’s a slow and steady build up that happens when we consume a constant and abundant amount of carbohydrates (the quickly-absorbed kind, like bread, pasta, cereal, oatmeal, rice, etc.) and sugar. Yes, even the “healthy” ones, like all-natural honey.
While there are certainly outliers, diet plays the biggest role in insulin resistance. And it makes perfect sense when we return to those studies listed above (the intense increase of metabolic syndrome issues in such a short amount of time). The Western diet has consumed virtually the entire world at this point, creating a global environment of cheap, overly processed, sugar-laden and nutrient-deficient food.
The way out of this pandemic -- the silent, metabolic one -- is possible. And urgent. To rid our world of metabolic disease and dysfunction, we must change our ways of eating. It’s the carbs (the refined grains, the sugar) that’s creating this mounting disaster of clustered metabolic dysfunction.
Meaning, we can fix it. Start by ditching the processed foods. Eat foods that don’t need an ingredient list because the food itself is the sole ingredient: a breast of chicken, asparagus, green beans, eggs.
Interestingly enough, as complex as the entire metabolic system is, the solution to metabolic syndrome can be quite simple. In the majority of cases, this pandemic can be reversed; it's up to us to make the necessary lifestyle changes to halt it in its tracks.