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Here’s the kicker. Being thin is not a safeguard against metabolic disease or early death. Up to 40 percent of normal-weight individuals harbor insulin resistance—a sign of chronic metabolic disease—which will likely shorten their life expectancy. Of those, 20 percent demonstrate liver fat on an MRI of the abdomen (see chapter 8).7 Liver fat, irrespective of body fat, has been shown to be a major risk factor in the development of diabetes.
It’s not the obesity. The obesity is not the cause of chronic metabolic disease. It’s a marker of chronic metabolic disease, otherwise known as metabolic
syndrome. And it’s metabolic syndrome that will kill you. Understanding this distinction is crucial to improving your health, no matter your size. Obesity and metabolic syndrome overlap, but they are different. Obesity doesn’t kill. Metabolic syndrome kills. Although they travel together, one doesn’t cause the other.
as good as you think. If you’re going to use exercise as your protection against chronic disease, you’ll have to be consistent about it.
of weight, consistent exercise (even just fifteen minutes a day) is the single best way for people to improve their health. That’s 273 hours paid in for 3 years of life gained, or a 64,000 percent return on investment. The best deal in all of medicine.
and they tend to multiply. There is one simple, cheap, and effective way to reduce your cortisol: exercise.
Although exercise raises your cortisol while you’re doing it (to mobilize glucose and free fatty acids for energy), it reduces your cortisol levels for the rest of the day. It burns off fat in your muscles to improve muscle insulin sensitivity, and in your liver to improve hepatic insulin sensitivity. In our clinic, the rule is to buy your screen time with activity. Every hour of TV or computer games means an hour of playing sports.
