Dear Reader,

Most people don't know this: you don't have to have excess body fat to be well on the road to serious bad health.

Most people think of health as "the absence of disease", meaning the doctor hasn't diagnosed you with anything yet.

But the chronic diseases that today plague modern societies take decades before a doctor notices them. And the progression of disease weaves a story while it's still under the radar.

That story can be revealed in just 19 questions.

That's why I created my Health Quiz - to spot the signs early, before you actually have a diagnostic-able disease.

Take this recent example:

A man scored 8pts out of 39 on my Health Quiz. That’s pretty good, but….also pretty worrying because the quiz revealed a not so good future.

This is what I wrote to him:

“My evaluation: Moving into the danger zone. I estimate it will take 6-12 months to turn things around.

The good news: you’ve identified the problems early.

From the symptoms your answers revealed, I’d recommend you get yourself thoroughly checked out for insulin resistance/pre-diabetes.

🗂️ Evidence based on your responses:

• The small, dark growths on your skin around your neckline or armpits (skin tags, acrochordons) are strongly linked to high levels of insulin caused by insulin resistance/pre-diabetes.
• Poor sleep is both a symptom of disrupted metabolism and accelerates it in a negative feedback loop.
• Insulin resistance also contributes to mood imbalances.

🔥 The risk:

Apart from the standard effects of Insulin Resistance and eventual full-blown Type 2 Diabetes (sepsis, lower body amputations, kidney failure, erectile dysfunction, fatty liver), it’s a leading cause of heart attack and stroke and linked to as many as 12 types of cancer.

​Alzheimer’s has also been coined Diabetes Type 3 for its link to insulin resistance.

👉 What next: If you decide to have your insulin resistance status checked, I’d recommend getting a HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) test or, even better, a Kraft OGTT (Kraft Oral Glucose Tolerance Test) from your doctor or a clinic.

However, most medical systems will only do a fasting glucose and HbA1C test which won’t give you the full picture. The standard HbA1C lab levels are, anyway, horribly augmented. Which is probably why over 250 million adults around the world don't know they have Type 2 Diabetes.

A standard lipid panel and liver enzyme test could also be done to confirm the likely pattern (raised liver enzymes, high triglycerides, low HDL).

Unfortunately, most doctors will only treat the various symptoms individually - not the root cause - or will wait until a diagnosis of full blown type 2 diabetes shows up.

To the medical system, this is a progressive, terminal disease, “managed” by pills and ultimately insulin injections/pumps. The standard of care treatment course only slows the progression.

Type 2 Diabetes (and its precursors pre-diabetes and insulin resistance) is, however, an inherently treatable disease through lifestyle (with or without some supplemental aids to make it easier) and can be put into remission when caught in time.

🎯 More good news: once you’ve sorted out the insulin resistance through lifestyle you will have already established a new lifestyle (systems) so you’ll never be at risk again.”

To hammer this home, this gentleman reported a waist-to-height ratio of less than 0.5, i.e. he didn't have an excessive tummy by his estimation.

So, as you can see, Thin on the Outside, Fat on the Inside (TOFI) can be a real thing.

Forward this link to anybody you know who's hesitating seeing a doctor about their health.

If you do have Insulin Resistance, Pre-diabetes or Type 2 Diabetes, but you're not yet ready to attend to the lifestyle root causes, then this document will do 2 things (click image for download):

1. It'll help you understand why you should do something about it
2. It provides you with a useful crutch to bridge the gap from what you're doing now to an eventual, new health-promoting lifestyle (no injections or pills required).

In other news, these studies/publications caught my eye:

​The myth of An Apple A Day: "Appealing the Conventional Wisdom That an Apple a Day Keeps the Doctor Away".

My comment: re-read my recent Diet Wars newsletter and you'll know that there's a time and a place for apples (or any fruit and vegetables in fact).

​Screening for Vitamin D - US Preventive Services Task Force Recommendation Statement: "The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for vitamin D deficiency in asymptomatic adults."

My comment: Get out in the sun (while UV is still around)!

If you want to get into the reeds, then watch this excellent video lecture with Professor Richard Weller on the "Health effects of sunlight, UV and blue light", or you can read Cameron Borg's thoughtful Substack post about how our skin is probably built to maximise UV absorption.

Hope this newsletter has been useful. Please let me know:

Take care,

Roderick

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​MidlifeMetabolicHealth.com​ ​Robot clicks here​

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