It may not get the headlines, but it has the potential to destroy our health care system in a few decades. What is this new epidemic? It is prediabetes.
What is prediabetes? It is the beginning of the disruption of your metabolism caused by rising insulin levels in the blood. A more general term that describes this condition is insulin resistance. So, what’s the big deal about insulin resistance? Here is a starter: It is the driving cause for virtually all chronic diseases associated with disruption of your metabolism. Here is a short list of those chronic diseases strongly related to insulin resistance:
- Obesity
- Type 2 diabetes
- Heart disease
- Liver disease
- Kidney disease
- Cancer
- Alzheimer’s
- Parkinson’s
- Depression
That’s a pretty big list. Since all of these diseases are strongly linked with increased insulin resistance, any increase in prediabetes is going to create havoc in the American health system. More ominously, prediabetes is rapidly growing in adolescents.
Here are some facts on the growing prevalence of insulin resistance. Between 2005 and 2016, the level of prediabetes in adolescents was 18 percent (1). The newest data from the Centers for Disease Control (CDC) indicates the level of prediabetes in adolescents has risen to 33 percent (2). That is nearly a doubling in eight years. And if all of those above chronic disease conditions are associated with increased insulin resistance, then the future health of America is very bleak.
How do you know if you have prediabetes? Your blood will tell you. If you have an HbA1c reading of greater than 5.7, then you have prediabetes. According to the CDC, 98 million Americans have prediabetes (3). This puts them at high risk of developing those chronic diseases discussed above.
However, the term “insulin resistance” has little to do with insulin, but has everything to do with the inhibition of the master regulator of metabolism, AMPK. This fact is critical, since AMPK is under profound dietary control (4, 5). This means your diet can either activate AMPK or inhibit it. For many Americans, their diets are inhibiting AMPK activity.
What insulin resistance describes is the inability of a cell to take up glucose from its exterior. One of the earliest terms to explain this phenomenon was glucose resistance (6). It is only when glucose enters the cell that it can be used as a source of energy to keep your metabolism running effectively. When you have insulin resistance, each of your 30 trillion cells in the body is running low on energy. This sets the stage for metabolic dysfunction.
You have two distinct metabolic pathways to bring external glucose into the cell. The hormone insulin mediates one pathway, and AMPK controls the other. When one pathway is activated, the other pathway is inhibited. The insulin pathway is only activated when you have spikes in blood glucose levels caused by eating a meal containing carbohydrates.
In response to the surge of carbohydrates entering the blood as glucose, insulin is released from the pancreas. As a result, insulin usually peaks in the blood within an hour after a meal and then decreases. However, you don’t eat constantly. That is why most of the time, the AMPK pathway handles the necessary glucose uptake to keep the cell going. However, if AMPK activity is inhibited, the cells’ metabolism is disrupted due to a lack of energy. If inhibition of AMPK activity is continued for a long enough period, you begin to see a lot of metabolic diseases develop, such as those listed above.
The fastest way to reduce insulin resistance is by following the Zone diet (7-10), as it is not a weight loss diet but an AMPK-activating diet. The Zone diet is patented to treat insulin resistance (11). Why is activating AMPK so important? It controls the expression of your genes that control metabolism (12).
Can the Zone diet work to reverse prediabetes? More importantly, can it possibly reverse type 2 diabetes? The answer to both questions appears to be yes. In placebo-controlled studies, where all food was supplied to the subjects and calorie restriction levels were identical in both groups, only those following the Zone diet achieved complete reversal of both conditions within six months (8–10).
The placebo groups in these studies were not as successful, even though they had the same degree of calorie restriction. Why? To activate AMPK, a relatively precise balance of protein to carbohydrate is required for success. Why is that important? It is because the protein-to-carbohydrate ratio controls the ability of AMPK to alter the expression of your genes. This is key since those on the Zone diet lost more excess body fat and gained lean body mass compared to those in the placebo groups, who had far less fat loss and significantly greater lean body mass loss in the studies. Their loss of body fat was only half that of the Zone diet group, and they lost lean body mass instead of gaining it as found in the Zone group.
When you add high-dose omega-3 fatty acids and polyphenols to the Zone diet, you get even better results as these nutrients decrease inflammation and oxidative stress. That is the foundation of Metabolic Engineering®, which is designed to maximally activate AMPK in every one of your 30 trillion cells (4).
So, going back to the headline of this blog on America’s silent epidemic, there appears to be a solution. It’s the Metabolic Engineering®. It’s a dietary program to reprogram your metabolism to operate at peak efficiency, which can be defined as the absence of insulin resistance. And if you eliminate insulin resistance, then you can expect that all of the chronic diseases associated with insulin resistance will also improve.
References
1. Andes LJ, Cheng YJ, Rolka DB, Gregg EW, Imperatore G. Prevalence of prediabetes among adolescents and young adults in the United States, 2005-2016. JAMA Pediatr. 2020; 174:e194498. doi: 10.1001/jamapediatrics.2019.4498.
2. Centers for Disease Control. Spotlight on Prediabetes. https://gis.cdc.gov/grasp/diabetes/diabetesatlas-spotlight.html#:~:text=Featured%20diabetes%20data%20insights%2C%20highlighting%20the%20latest,of%20the%20US%20adolescent%20population%2C%20had%20prediabetes. (2024)
3. Centers for Disease Control. Prediabetes. https://www.cdc.gov/diabetes/communication-resources/prediabetes-statistics.html#:~:text=About%2098%20million%20American%20adults,diagnosed%20as%20type%202%20diabetes (2024)
4. Sears B, Saha AK. Dietary control of inflammation and resolution. Front Nutr. 2021; 8:709435. doi: 10.3389/fnut.2021.709435.
5. Sears B, Perry M, Saha AK. Dietary technologies to optimize healing from injury-induced inflammation. Antiinflamm Antiallergy Agents Med Chem. 2021; 20:123-131. doi: 10.2174/1871523019666200512114210.
6. Del Prato S, Matsuda M, Simonson DC, Groop LC, Sheehan P, Leonetti F, Bonadonna RC, DeFronzo RA. Studies on the mass action effect of glucose in NIDDM and IDDM: Evidence for glucose resistance. Diabetologia. 1997; 40:687-697.
7. Johnston CS, Sears B, Perry M, Knurick JR. Use of novel high-protein functional food products as part of a calorie-restricted diet to reduce insulin resistance and increase lean body mass in adults: A randomized controlled trial. Nutrients. 2017; 9:1182. doi: 10.3390/nu9111182.
8. Stentz FB, Brewer A, Wan J, Garber C, Daniels B, Sands C, Kitabchi AE. Remission of prediabetes to normal glucose tolerance in obese adults with high protein versus high carbohydrate diet: randomized control trial. BMJ Open Diabetes Res Care. 2016; 4:e000258. doi: 10.1136/bmjdrc-2016-000258.
9. Stentz FB, Mikhael A, Kineish O, Christman J, Sands C. High protein diet leads to prediabetes remission and positive changes in incretins and cardiovascular risk factors. Nutr Metab Cardiovasc Dis. 2021; 31:1227-1237. doi: 10.1016/j.numecd.2020.11.027.
10. Stentz FB, Lawson D, Tucker S, Christman J, Sands C. Decreased cardiovascular risk factors and inflammation with remission of type 2 diabetes in adults with obesity using a high protein diet: Randomized control trial. Obes Pillars. 2022; 4:100047. doi: 10.1016/j.obpill.2022.100047..
11 . Sears, B. Method of and nutritional and pharmaceutical compositions for reduction of hyperinsulinemia. U.S. Patent No. 6,140,304 (2000).
12. Canto C, Auwerx J. AMP-activated protein kinase and its downstream transcriptional pathways. Cell Mol Life Sci. 2010; 67:3407-3423. doi: 10.1007/s00018-010-0454-z.
