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1. Chronic back pain, osteoarthritis, and tendon-related injuries
Chronic pain and acute injuries that were once regarded as an inevitable result of aging or overuse of the body are now understood as symptoms of poor metabolic health. Considering that only 12% of Americans are considered to be metabolically healthy (refer to last month’s issue for a refresher on metabolic health), it’s no wonder why so many people suffer from chronic back pain, joint pain, and old injuries that never seem to heal completely. High cholesterol in the body not only causes damage to arteries, but it can also accumulate in tendons (the tissue that attaches muscle to bone). This is one reason why people with high cholesterol are more likely to get injuries to the rotator cuff (the group of muscles and tendons that stabilize the shoulder joint) than people who do not have high cholesterol. Elevated levels of glucose in the blood even in people who don’t have diabetes or prediabetes causes damage to collagen in the body because excess glucose in the blood causes the production of advanced glycation end products (AGEs). AGEs tend to reduce the elasticity of collagen, making it more weak and brittle. This can manifest as joint stiffness and our next topic, accelerated skin aging and acne. 2. Accelerated Skin Aging and Acne You may have heard about advanced glycation end products (AGEs) being formed when certain foods are cooked at high temperatures. Grilled and smoked meats, roasts, cheese, toasted bread and pastries, and fried anything are the categories of food that tend to be the highest in AGEs. The acronym is appropriate because eating AGEs can age you from the inside out. In addition to exogenous AGEs found in the above mentioned categories of food, your body can produce its own AGEs when excess levels of glucose in the blood bond with proteins and fats in the bloodstream. Regardless of whether AGEs are obtained exogenously through your diet or are formed endogenously inside your body from excess glucose bound with fats and proteins, these AGEs can accumulate in the tissues of your body - including your skin. When excess sugars bond with collagen in the skin, this results in reduced skin elasticity, fine wrinkle formation, a dull appearance to the skin, delayed wound healing, and premature greying of hair. Elevated blood glucose can cause acne too, by ramping up levels of insulin and insulin-like growth factor (IGF-1). These hormones increase the production of androgens (“male hormones”) and stimulate oil production in hair follicles, among other things. 3. Mental Health Conditions Depression and anxiety are more common in people who have been diagnosed with prediabetes or type 2 diabetes than in the general population. But even in individuals who don’t have diabetes, wide fluctuations in blood glucose (characterized by high blood glucose after a meal, followed by a “crash” when glucose levels drop) can cause depressed mood, irritability, or anxiety. Chronically high blood glucose, as well as frequent episodes of hyperglycemia (such as after eating foods high in processed carbohydrates), can lead to various changes in the brain that may cause mood disorders. These brain changes include insulin resistance in the emotional regulation centers of the brain, impaired neurogenesis (the process in which new brain cells are produced), a “rewiring” of signaling pathways in the reward and learning centers of the brain, a decrease in serotonin in the brain, and an increase in the production of stress hormones. 4. Difficulty Losing Weight or Maintaining Weight Loss Anyone who has ever observed a lean person devour a colossal amount of food on a daily basis without ever gaining an ounce, while also observing an overweight person gain weight just by looking at a donut, knows that there’s something flawed about the “calories in, calories out” theory of weight loss. While calories are an important component of weight loss, individual hormonal response to food and metabolic health have a much greater influence on one’s ability to obtain and maintain a lean body composition. Eating less and exercising more does not produce lasting weight loss if you aren’t metabolically healthy. While many weight loss “experts” denied for years that eating late at night could cause weight gain, science now clearly shows that meal timing plays a critical role in whether that meal is used for energy or stored in your adipose tissue for a future famine that never comes. Eating when your muscle and liver cells are relatively insulin resistant rather than insulin sensitive not only causes higher levels of blood glucose after meals, but also causes your pancreas to pump out higher amounts of insulin. Chronically elevated levels of insulin promote fat storage. But that's not all. Insulin works antagonistically to melatonin, a hormone that increases at night to help you sleep. Rising melatonin levels at night suppress insulin, and rising insulin levels during the day suppress melatonin. When you eat at night, the subsequent rise in insulin suppresses melatonin during the hours in which your body needs it. Having suppressed levels of melatonin at night interferes with your ability to get a restful night of sleep, and that causes a decreased metabolic rate (AKA you burn fewer calories) and an increase in appetite-stimulating hormones. The Solution The conventional way of tackling these varied conditions is to look at the body as a collection of unrelated parts and try to fix each individual component, much like repairing an old car. Got a flat tire? Just patch it up. Car won’t start? You probably need a new battery. Following medical convention, someone experiencing chronic pain is sent to a neurologist or an orthopedic surgeon. Those experiencing skin problems may visit the dermatologist or cosmetologist. Mental health conditions are deemed the territory of psychiatrists, psychologists, and counselors. People struggling with obesity may see an endocrinologist, bariatrician, or even a mental health specialist. But if each one of these varied conditions is rooted in metabolic dysfunction, that too must be addressed in order to achieve lasting relief. Stay tuned for Part 2 (in next month’s issue), where we’ll dive deep into what you can do to heal your metabolism. Ready for a personalized approach to overcoming chronic ailments with nutrition and lifestyle modifications? Send an email to team@drjamiekoonce.com and let’s get you a plan to help you start feeling better!
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