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       The HbA1c Blood Test

      In the HbA1c blood test, red blood cells are used because they can be extracted when we draw blood, and they have a life span of 90 to 120 days. Thus, the amount of sugar glazing or stickiness on them will depend on the blood sugar level for the last three months or so. Table 1.2 shows the correspondence between the HbA1c blood test and average blood glucose levels over the past ninety days.

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      We know from research that a 1 percent reduction in HbA1c corresponds to about a 20 percent reduction in the risk of heart attacks and strokes and close to a 40 percent reduction in the risk of kidney, nerve, and eye damage.5 Though most diabetes medications reduce HbA1c by about 1 percent, they do nothing for the underlying cause, so the disease progresses over time. When we start to understand the cause of diabetes, and act upon what we know, we not only stop the disease’s progression, we can reverse most of its harmful effects, improving the HbA1c blood test by a lot more than prescription drugs. Table 1.3 shows some HbA1c levels and corresponding glucose levels.

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      CASE STUDY: JOHN

      John, a sixty-six-year-old retired firefighter, was diagnosed as a type 2 diabetic with an HbA1c score of 9.5 percent. He was prescribed medications, but he avoided taking them. He had an aversion to testing procedures. Then, John joined the Turbo Metabolism program, and getting this information empowered him to take charge of his health. Now, John fully understands how his decisions directly affect his body, and he is much more mindful of what he eats. He also exercises regularly. His most recent HbA1c was 6.9 percent, and he feels much better. He recently returned from a hike to Machu Picchu in Peru, which is something he could not have imagined even a year before.

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      The Effects of Cortisol

      Another hormone critical in insulin resistance is cortisol. Cortisol is a “stress hormone” secreted by the adrenal glands in response to a perceived threat. An integral part of our fight-or-flight stress response, cortisol provides a necessary bump in available blood glucose so that we have the energy needed to react quickly in an emergency.

      Cortisol makes us hungrier, especially for calorie-dense, sugary, and fatty foods, and it increases insulin resistance, thereby increasing glucose levels in the bloodstream. It also contributes to belly fat. Cortisol is an example of a short-term survival mechanism kicking in to keep us alive in high-stress situations, but one that has harmful effects if it remains active — that is, if our cortisol levels remain elevated for a prolonged period of time in response to perceived stress.

      The combination of high levels of cortisol and high levels of insulin is ideal for creating midsection or belly fat. Chapter 7 discusses the effect of stress as a contributor to metabolic diseases in more detail.

      Inflammation

      Another important concept is inflammation, which may be defined as the process of increased blood flow to an injured body part to deliver healing nutrients and infection-fighting white blood cells. Inflammation is characterized by swelling, heat, redness, and pain, and it typically occurs when we twist an ankle or stub our toe.

      Many scientists and doctors accept chronic inflammation as the basis of most of our chronic disease and even of the aging process. The reality, however, is that short-term inflammation serves an important purpose in keeping us healthy. Have you ever bit your cheek eating dinner and woken up amazed the next morning because the cut has healed overnight? This is the miraculous, innate healing power of our bodies — our inflammatory response sends a SWAT team of infection-fighting white blood cells that secrete infection-fighting chemical signals to heal the wound.

      This healing process goes haywire when we bombard the body with unrecognizable substances in the form of a diet rich in processed foods, sugar, fat, salt, high-fructose corn syrup, and synthetic compounds. The body activates the inflammation response, essentially sensing a five-alarm fire, and it continues this every day, so the inflammation response goes on and on. In other words, the body sends a SWAT team on an endless mission, so that it never leaves!

      By the way, stress works the same way. An acute stressor followed by a short-term inflammation response is natural. But chronic, unmanaged stress leading to long-term inflammation can be harmful. For more on this, see chapter 7.

      Hormone Imbalances from Excess Belly Fat

      As I’ve said, insulin resistance, cortisol, inflammation, and belly fat are a direct result of our modern, unhealthy diet. In addition, lack of regular physical activity, chronic stress, and lack of sleep are also major contributors.

      Yet there is another serious issue with belly fat: It is an active hormone-signaling system that wreaks havoc on our appetite, our cravings, and even our endocrine system — the network of hormone signals that allows our body organs to act in harmony.

      In men, belly fat contains aromatase, an enzyme that converts testosterone to estrogen, which is bad news for men because men need testosterone for energy, vitality, maintaining healthy metabolism, erections, and libido.6

      In women, excess belly fat signals the ovaries to produce more testosterone, which contributes to acne, hair loss, cysts on the ovaries, and lack of ovulation (also known as polycystic ovary syndrome, to use fancy doctor words). This is an important factor behind infertility and menstrual irregularity in women. It is in fact very common for supposedly infertile women to be able to conceive after losing some of their excess weight.7

      Yet another problem with a diet loaded with processed foods full of carbohydrates and fats is that it triggers resistance to leptin, a satiety hormone. This resistance to leptin helps create the perception that we are starving, even as we are being overloaded with calorie-dense fake foods.

      The Difference between Real Hunger and Craving

      Your goal should be to maintain satiety or satisfaction, to start thinking about food as a source of energy and wisdom from nature. However, to understand satiety, you must first understand hunger. What does hunger mean to you? Craving sugar, chocolate, cheese, or meat is less likely real hunger and more likely an addiction reaction, arising from the effect of these substances on the reward center of the brain. The same sensations of craving — jitteriness, headaches, fatigue, irritability — are present in drug withdrawal. True hunger is a mouth or throat sensation similar to thirst. We often mistake thirst, boredom, nutritional deficiency, or a low blood sugar for hunger.

      Have you ever been truly hungry?

      A good gauge of whether a meal is truly nourishing is the degree to which it keeps you satiated. A meal that is biochemically suited to your needs should keep you satisfied for three to five hours.

      In the following chapters, we will come up with a “zero-belly strategy” to turbocharge your metabolism, by exploiting the healing power that each of us is blessed with the day we are born.

      Shedding ugly belly fat can be the key to reversing diabetes, improving heart health and memory, increasing energy and vitality, improving erectile dysfunction, preventing cancer, and getting rid of sleep apnea and fatty liver disease, in addition to injecting you with more energy and zest for life.

      When your body is given the right fuel, you gain energy and vitality, and there is no need for it to be hoarded as fat in places where it can cause harm.

      Every

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