I really dislike when people start depending on all this nonsense to improve their health rather than what's tried and true.
What we know for sure is that losing body fat will improve insulin sensitively. There hasn't been a single human that has not improved insulin sensitivity and function with the loss of body fat, in the history of documented metabolic interventions to date. It has 100% success rate. Tried and true. Losing body fat simply means you have affected your blood glucose enough to normalize its regulation and break the starvation adaptation.
This is true whether the body fat was lost using caloric restriction, vegetarian diet, low carb diet, "keto" diet, Twinkie diet, rice diet, exercise or bariatric surgery.
The loss of body fat significantly improves insulin sensitivity because high body fat is a primary contributor to metabolic dysfunction and a sign that there is a disruption to proper blood glucose regulation. Its loss is a sign that these problems are improving. Now there are good ways of sustaining this body fat loss, in the long term, and bad ways. Hint: the Twinkie diet is a very bad way, regardless of your initial success.
Controlling body fat is a process that occurs over time so the treatment must be long term as body fat can only be lost through regaining proper blood glucose regulation, which normalizes insulin, which improves leptin sensitivity and leptin only responds to long term nutrient availability and energy flux (exercise). That's why caloric restriction, rice diets and bariatric surgery are not advised. Proper dietary, fasting and exercise protocols are.
So what does all of this mean? Drop the berberine and go drop some body fat. You did not develop metabolic syndrome from "berberine deficiency".
2. Dean Ornish's diet is recommended for the reversal of diabetes and heart disease but even when following it for months, it hasn't yet improved my weight or blood glucose.
I can tell you that there is a lot of junk food that can pass as "Ornish" but that's not the way he intended his diet to be followed. Drop the sweets and truly follow his diet. This diet has caloric recommendations. There is also no junk food allowed. Dean Ornish is pretty adamant about that. Look at him. He's basically a human skeleton.
What may be going on with you is that you simply cannot sustain this diet for a long period of time and it's completely understandable. For that reason, you should find a diet that you can sustain. Find a dietitian/nutritionist for better options and a more targeted approach to what's going on specifically with you.
3. I have an HbA1C of 9 but have had a blood glucose of 400+ mg/dL. My sister has an HbA1C of 14 but I have never seen her blood glucose at 400+ mg/dL.
HbA1C is a measure of your average blood glucose in a three month period. An average is determined by adding quantities together and dividing the total by the number of quantities. This puts the average at the center of the lowest and highest numbers possible. It provides only one snapshot into your overall metabolic health and so it must be combined with other tests in order to get a more complete and accurate picture.
Erratic fluctuations in blood glucose are present in people who have metabolic dysfunction. These large disparities between highs and lows are what deteriorate insulin function and ultimately causes you to lose blood glucose regulation. That's why I get a kick out of low carb advocates, when they say they lowered their HbA1C below the "diabetic range" while still having crazy blood glucose regulation issues like hyperglucagonemia and Dawn Phenomenon.
An HbA1C of 14 is approximately an average blood glucose of 355 mg/dL. An HbA1C of 9 is approximately an average blood glucose of 212 mg/dL. Your HbA1C may appear lower, even with high blood glucose, because your blood glucose does not stay at 400 mg/dL all the time. That would actually be better. It can be 60 mg/dL at times, then 200 mg/dL and it just so happened that you caught it at 400 mg/dL one time. This is very bad and you have to take control of it.
You should check your blood glucose first thing in the morning and then two hours after your largest meal, daily, for about two weeks in order to see these blood glucose fluctuations in real time and see what precipitates them so you can take back control.
4. My doctor said I will feel better with higher blood glucose. When my blood glucose drops into the low 100's mg/dL, I feel dizzy and sick.
The reason that doctors accept higher blood glucose numbers are because they are not attempting to put the condition into remission. Conventional medicine's goal is not to achieve remission of metabolic syndrome/diabetes. Their goal is to only treat its symptoms. This is why they focus on blood glucose by "how you feel". This makes sense as metabolic syndrome/diabetes are extremely complicated conditions which have no known cure and if symptoms aren't controlled, it can cause death. Of course, this doesn't mean that you can't do anything to improve your outcomes.
Metabolic syndrome/diabetes is an adaptation towards hyperglycemia. The worse your insulin function and the higher your resistance, the higher your blood glucose. The minute that blood glucose lowers from the "set point" your body wants it at, "pseudo" hypoglycemic symptoms occur, such as dizziness, exhaustion, sweating and headaches.
Not everyone experiences these symptoms. Some people have none. Others will have these symptoms early on in the syndrome's process, before it progresses into diabetes, but then not have them again once they become full diabetics. These differences are because metabolic syndrome/diabetes are exactly as the name suggests - syndromes, not true diseases.
In order to tackle the progression of metabolic syndrome/diabetes, you have to force the body to adapt to lower blood glucose levels. This means that you have to ignore these pseudo hypoglycemic symptoms as they are not indicative of true hypoglycemia. They are only trying to make you raise your blood glucose higher than it already is.
Always check your blood glucose, every time you feel symptoms, just to confirm that the symptoms are pseudo and not truly the result of clinical hypoglycemia. Clinical hypoglycemia begins at a blood glucose below 70 mg/dL. This is especially true for Type II diabetics on medications like injectable insulin.
5. Exercise cannot affect weight.
Exercise causes weight loss. There is no doubt about that. Consistently, across the board, exercise has been associated with lower weight and weight management. This means that exercise causes weight loss and the prevention of further weight gain. For people who have no understanding of obesity, and that is the bulk of who runs the diet and health industry, this weight loss is attributed to "calories out". This is incorrect. Instead, exercise helps normalize blood glucose regulation through non insulin mediated glucose uptake and the improvement of leptin/adiponectin ratios.
There is no amount of exercise, short of swimming the English Channel, that can cause calories out to be less than calories in. This is because the body is extremely efficient at burning the least amount of calories while storing the most amount of calories. This is the way it prevents starvation. Couple that with the dysfunctional calories out mechanism, true of the obese, and you can see how exercise would be futile when linearly associated with calories.
The association with weight loss seen in exercise is not in direct line between calories in/calories out but between better blood glucose regulation. Exercise causes two things:
- Burning of blood glucose already in the blood stream which lowers it and doing so without the need for insulin.
- Release of blood glucose already in the tissues causing a rise which prevents abnormal lowering.
Why does this lowering and rising of blood glucose mean better blood glucose regulation? Because they counteract each other. The lowering and rising of blood glucose through exercise does not allow too low lows or too high highs. Exercise is the modulator. Better blood glucose control equates to lower weight.
Another way exercise causes weight loss is through leptin function. Exercise improves leptin function. Period. Without leptin there is no fat loss. Leptin is what signals to the brain to burn stored fat. People who exercise have better leptin to adiponectin ratios. This allows for the burning of body fat, even when the person is done exercising and is at rest, since fat is the main energy that the body uses for everything.
This is why exercise is vital for long term weight management. You have to exercise until you are tired. Strolling around is not enough. High intensity interval training is not necessary. You just need sufficient long duration exercise of moderate intensity with few sedentary periods.
6. Even with a proper diet and doing everything right, you will still gain body fat.
Unfortunately, lifestyles that deviate from our original hunter/gatherer state increases body fat through a disruption in proper blood glucose regulation.
Of course diet plays into this, but even when diet is perfect, body fat is still ubiquitous and increases over time. Why? This has been studied ad nauseum and many things have been blamed for it but if we look at the problem through the lens of metabolic function, we can pinpoint exactly what it is - blood glucose dysregulation. A lot of people focus on their diet but forget the other thing that is needed for proper blood glucose control - physical activity.
Hunter/gatherers have very little time to be idle. They also rarely do strenuous activity. They are mostly in an in-between state of constant low to moderate intensity physical activity, such as walking throughout most of the day. We were designed to be in movement constantly but that's not the way we live in modernity. We will exercise for a few hours a day, several times a week, and spend the rest of the time siting down in front of a computer, in the car, in the living room, in the office, in the school, etc. In other words, the daily 12 hours of mostly movement we used to do has now become 2 hours. This is detrimental to metabolic function in the long term. This is mostly the result of the disruption of blood glucose regulation and leptin expression, explained in the reply above.
You can bypass this through caloric deficits but those cannot be sustained for long as we weren't designed to be under chronic starvation. We were designed to be under chronic movement. Chronic movement is impossible in the modern world because we have machines that do most of the work for us and we have to work for others in jobs where we are mostly still, either standing or sitting.
Hunter/gatherers average 16K steps a day and this is mainly achieved by hiking, for the hunting and gathering of food, and finding of new shelter. We just don't have that type of time in our day to do this consistently. You might be able to pull that off once a week but not daily. Little by little blood glucose control begins to deteriorate and body fat starts to accumulate as leptin expression degrades over time.
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