and you’ll learn how later.
Look, I remember what it felt like when my doctor, complete with white lab coat, looked right at me and said in a matter-of-fact voice, “You are at a high risk for heart attack and stroke.” I recall the bewilderment and fear in my gut as I stared my own mortality in the face. That happened when I was still in my twenties, and thanks to the information in this book, it is not an issue for me anymore. But even when I was just a kid, I had symptoms of cardiovascular issues, specifically blood pressure instability, a condition normally reserved for much older people. When I stood up quickly, my blood pressure was too low to keep oxygen in my brain. This caused me to start seeing stars and feel extremely fatigued. As a youngster, I would lean my head forward after getting out of a car in order to avoid seeing stars. I was so used to this that I thought it was how everybody lived.
Now I know these were symptoms of postural orthostatic tachycardia syndrome, or POTS, which is often triggered by toxic mold exposure but can also happen with age. In either case, inflammation disrupts the line of communication between the nervous system and the endocrine (hormonal) system. The disruption of these signals leads to fatigue and blood pressure instability, and can lead to symptoms of attention deficit disorder (ADD)8 and Asperger’s syndrome,9 which I certainly exhibited as well.
This manifested in my not knowing the names of most of the kids in my class, even at the end of the school year. I had zero facial recognition and no understanding of basic social skills. My body was filtering out those signals to conserve energy because my biology was so trashed. Our bodies will always prioritize survival over socialization, and I didn’t have enough energy to go around.
It may be hard to comprehend how cognitive symptoms could be connected to vascular issues, but as you will learn in this book, everything in the body is connected. And that includes the diseases that age us and too often lead to premature death.
DIABETES
While the idea of inflammation “causing” heart disease remains controversial, we have definitive proof that type 2 diabetes is an inflammatory disease,10 and having diabetes dramatically increases your risk of cardiovascular issues. More than ten years ago, researchers discovered that when macrophages—immature white blood cells that play a key role in the immune response—find their way into otherwise healthy tissues, they release inflammatory substances called cytokines that cause nearby cells to become insulin resistant.11
In insulin resistance, the body has an impaired response to insulin, which is normally responsible for moving sugar out of the blood and into your cells. The result is that your blood sugar levels are not well regulated and become chronically high. Because chronic high blood sugar will eventually lead to diabetes—a disease in which the pancreas is unable to produce enough insulin to keep up with the body’s demands—a diagnosis of insulin resistance is most often accompanied by the label prediabetic. Prediabetes is so common now that it almost seems like no big deal. The CDC says that more than one out of every three Americans is prediabetic. But it is actually a huge deal because having diabetes dramatically increases your risk of developing the other killers.
Excess blood sugar causes damage to the entire vasculature, so if you have diabetes, you’re more likely to have heart disease or a stroke. High blood sugar also causes dangerous nerve damage by injuring the walls of the capillaries that bring blood and nutrients to your nerves. This is called peripheral artery disease, and it is especially common in the legs and feet, which is why you may have heard of people suffering from diabetes needing foot or leg amputations. When this happens in the eyes, it causes blindness. If that’s not bad enough, diabetes can damage your kidneys’ filtering system, resulting in kidney disease. And finally, the higher your blood sugar, the greater your risk for Alzheimer’s disease, to the point that some researchers call Alzheimer’s “type 3 diabetes.” So you’ve got to keep your blood sugar levels stable, no matter what.
You may think you’re off the hook if you are not overweight, but you can be thin and still be prediabetic (or even fully diabetic). Those problematic macrophages are most likely to trigger inflammation in adipose tissue, aka fat. So the more excess fat you’re carrying, the higher your chance of becoming insulin resistant and developing type 2 diabetes. But the same thing can happen if you are not overweight but have excess visceral fat, which is the type of fat that’s packed around your internal organs instead of underneath the skin. This “skinny fat” is even more dangerous than fat you can see.
There is new evidence that maintaining normal amounts of muscle strength as you age can help ward off this killer. In a study following five thousand people for over twenty-five years, participants were given regular strength tests. The risk of diabetes was slashed by 32 percent in those with even moderate muscle strength as opposed to those with low muscle strength.12 The reduced risk did not change if the participants were even stronger, so you don’t have to get ripped to live longer, but you should avoid carrying excess fat.
I had no idea as an obese teenager that inflammation was making it difficult for me to control my blood sugar. Instead, I bought into the myth that I just wasn’t trying hard enough to lose weight. I exercised a ton and constantly watched what I ate. For breakfast, I had Grape-Nuts, which were supposed to give me energy, and skim milk, which was meant to do my body good. But they did neither of those things. I distinctly remember one morning in ninth grade eating a bowl of Grape-Nuts with skim milk to prepare for a big soccer match. I was convinced this was a healthy breakfast, but I didn’t perform very well in the game. I thought to myself afterward, Well, that didn’t work the way it was supposed to.
This was the first time I questioned conventional wisdom about what was actually good for me. It would be many more years before I started to get real answers, but in my desperation I started experimenting with things that no teenager should need to explore. I was sick of feeling like an old man. So I started reading everything I could get my hands on that offered some advice for how to feel and perform better. While my peers were (I assume) out drinking and having fun, I was at home biohacking.
For my knee pain, I tried the glucosamine pills from the health food store, and they brought some serious relief. I didn’t know it then, but glucosamine inhibits glycolysis, your body’s breakdown of glucose (sugar). As a result, your body has to get energy from fat instead of sugar, which helps prevent insulin resistance. Recent research on mice has found that glucosamine promotes mitochondrial biogenesis (the birth of new mitochondria) and mimics the effects of calorie restriction.13 And there are plenty of studies to show that calorie restriction (a diet consisting of fewer than 1,200 calories a day) in conjunction with good nutrition extends life-span. In mice, calorie restriction can extend life-span by as much as 40 percent. Most researchers estimate that the impact on humans is more like 10 percent, which is still pretty amazing14—if you’re willing to be hungry, anyway.
If you’re like most people, you don’t enjoy feeling hungry, and you don’t want to restrict your calories to fewer than 1,200 a day. The good news is that researchers have been testing compounds that mimic the benefits of calorie restriction without the starvation. Glucosamine is one of those compounds. In one study, glucosamine extended the life-span of mice by 10 percent.15 And it most likely helped with my knee pain because of the way it impacted my body’s sugar metabolism.
Despite this small win, I was heavier than ever and fed up. In college I spent eighteen months working out six days a week for an hour and a half at a time while on a low-calorie, low-fat semi-vegetarian diet with lots of rice and beans and everything that was supposed to be good for me. I got really strong, but I was still covered in blubber, and later blood tests revealed that I was prediabetic thanks to all that fat and the inflammation it was fueling.
I knew something had to change, but I had no idea what that thing was. Then one day while I was at a coffee shop getting my daily fix, I spotted a weightlifting magazine on a rack. No one I knew in my small farming
