Metabolic health refers to how your body processes nutrients to produce energy and provide other body functions. By anlage, when we use this term in the context of health and medicine, it refers to how we process sugars and fats. I have already done an extensive article on how we handle cholesterol (fats), so this article will focus on the other important aspect of metabolic health, sugar and by extension, insulin.

What’s with the current obsession about blood sugar?

The total amount of sugar going around our bloodstream at any given point should be around one teaspoon’s worth. Deviate from this amount significantly, and damage starts to occur to the cells of our body.

Acutely having very high sugar levels can be fatal. However the effects of moderately elevated blood sugars, and recurrent large or prolonged spikes in blood sugar over many years leads to often irreversible damage to almost every organ in the body.

 In order to maintain this tight balance, one of the main controllers of blood sugar levels is insulin. Insulin is released from your pancreas in response to an increase in blood sugar levels outside the normal range.

In my article about the importance of muscle for metabolic health, I explained how the accumulation of fat within muscle makes it resistant to the effects of insulin. As a result, more and more insulin is needed to push blood sugar out of your bloodstream into your cells. This phenomenon occurs in lots of other tissues  too, importantly the liver.

The body however is smart and adaptable. Your pancreas, the body’s insulin factory, has enormous capacity to increase its output to keep the blood sugar levels normal. In fact, it is able to compensate for the insulin resistance for almost 10-15 years before eventually it can’t keep up and you get diabetes.

So your insulin is high – why should you care?

If sugar was the only problem to consider, it wouldn’t be so bad waiting for your blood sugars to become abnormal before intervening. Insulin itself however is a hormone with many other undesirable effects in the body when it is produced in excess.

It has been shown that insulin can directly contribute to the development of atherosclerosis (the clogging up of your arteries). This is one of the reasons why some diabetes treatments that increase your insulin levels (or using insulin itself) have not been shown to reduce the risk of heart attacks and strokes as much as you would expect for the amount they reduce blood sugar levels.

Insulin also promotes the storage of fat which directly contributes to weight gain and obesity. Fat deposition increases in all tissues capable of doing so, but perhaps most importantly the liver and muscle. Both of these are the initial sites of the insulin resistance that set off this whole cascade of events. Storing more and more fat, particularly visceral fat (around our internal organs) actually perpetuates the problem.

Non alcoholic fatty liver disease (NAFLD) is the leading cause of women (second most common of men) needing a liver transplant today (overtaking alcohol as the leading cause). This condition is directly linked to excess insulin.

High insulin levels are the primary driver of the development of polycystic ovarian syndrome (PCOS). PCOS troubles so many women and can affect their fertility and their quality of life significantly.

Gout, if you are not aware, is an extremely painful condition of the joints and is also linked to having high insulin levels.

The above are just a few examples of why we should not ignore high insulin levels. Standard practice however usually waits until someone is diabetic to get really serious about treating them with medications to control their blood sugar. By this point so much of the damage has been done already due to high insulin levels. It can be very difficult to reverse the process at this late point due to the chronic complications of insulin resistance, most importantly obesity.

Signs your insulin is a problem

Most people who have insulin resistance have no idea. Aside from the diagnosed conditions above, here are some symptoms and signs you may notice if you have developed insulin resistance:

Don’t wait for your diabetes check to flag up

Standard medical screening of your metabolic health in terms of glucose involves a blood test checking something called HbA1c (pronounced H-bee-A-1-C). This is a surrogate marker of your average blood glucose levels over the past 3 months.

By the time someone has an abnormal blood sugar (HbA1c), they potentially have had insulin resistance and high blood insulin levels for 10-15 years! I am sure you can imagine a 10-15 year delay in cancer diagnosis could be deadly. The complications of diabetes are often much worse than many cancers.

This is another important example of how standard medical practice is missing the boat when it comes to chronic disease prevention. In fact, even today in the NHS when someone has a blood test showing they are prediabetic (HbA1c between 42-47mmol/L), they are given brief generic advice (if any) about diet and lifestyle measures which may help. The gravity of the predicament their metabolic health is in by that point I think is not emphasised enough.

The Agami Approach to metabolic health

1. Prevent insulin resistance developing with emphasis on calorie balance and personalised macronutrient combinations
2. Screen early for high levels of insulin and calculate your degree of insulin resistance. NOT waiting for blood sugars to be abnormal
3. Reduce insulin levels and insulin resistance using personalised nutrition, exercise and lifestyle measures
4. Medications for diabetics to reduce their requirement or production of insulin and normalise blood sugar levels, with personalised monitoring

Contact us to find out how we can help optimise your metabolic health as part of your longevity strategy towards a fuller, longer, healthier life.