Obesity, Insulin, and Inflammation (Part 1)

Children playing at Greenwich Park

The National Diabetes Month continues, and citizen scientist Dave Asprey reports back from the far fringes of diabetes research, tying that subject up with his belief that, in the human body, as much as one-third of what appears to be fat could be swelling caused by inflammation. His theories about maladaptive metabolic responses rest on the work of such researchers as D. Giugliano. A. Ceriello, and K. Esposito, of the University of Naples, who wrote “The effects of diet on inflammation: emphasis on the metabolic syndrome.”

From this and many other respected academic sources, Asprey concludes:

High insulin levels in the body are at the center of many diseases. Together, cardiovascular disease, cancer, and diabetes account for almost 70% of all deaths in the United States — inflammation is a common link between these diseases… Your diet modulates key pathways to inflammation through sympathetic activity, oxidative stress, and proinflammatory cytokine production. Stress and depression are also correlated to higher insulin levels. Stress influences your food choices, and increases insulin resistance.

Asprey cites another recent study, from Ohio State University, showing that “insulin is a key pathway leading to stress and negative influences in the body.” A specialty called psychoneuroimmunology (PNI) says that many common foods cause low-level, but cumulatively damaging, system-wide inflammation.

Asprey says:

Diets that promote inflammation are high in refined starches, sugar, and trans-fats. Refined starches and sugars can alter blood glucose and insulin levels, and postprandial hyperglycemia can increase production of free radicals as well as proinflammatory cytokines… In order to avoid inflammation, and therefore many diseases, eating a diet with high ratios of omega-3 to omega 6 fatty acids and natural antioxidants is important. Omega-3 fatty acids […] curb the production of AA-derived eicosanoids, which spike insulin.

Fat doesn’t make us fat, by the way. Our bodies need saturated fat. For this reason, Asprey does not recommend a strict vegan diet, although he admits that some people do thrive as vegans and, on the whole, that’s better than incorporating industrial meat. (He can also explain in great detail why grass-fed meat is better than no meat.)

More importantly, he starts from the premise that people are different, each with hundreds of individual factors acting on them, so it’s difficult to find answers where “one size fits all.” He says:

… [W]e’re not robots. We’re not like a car that you put gas in and get so many miles so long as the wind resistance is the same.

That’s right, calories don’t make you fat, either. Asprey believes that “calories in — calories out” is only a very rough sketch of the reality, because many other things determine how the calories are processed and used in the body. It may be an unorthodox belief, but he came by it honestly, from experimenting on himself.

At the age of 23, he was physically enormous, and was affected by some form of autism, too. He was taking in only 1,800 calories a day, and working out six days a week for an hour and a half each time, and weighed just a smidgen under 300 pounds.

In a recent interview,  Asprey told Joe Rogan what happened next:

So, I thought I’d eat 4000 calories a day, I’d sleep 5 hours a night or less, and I’d stop exercising. I went for two years… I weighed 210 at then end of it, and was actually more muscular than I was before… I can eat pretty much as much as I can stand, and I won’t gain any weight.

If fat doesn’t make you fat and calories don’t make you fat, what does? Asprey ascribes obesity (link is PDF) to three main causes: leptin resistance, inflammation in the gut, and insulin. One of the interesting studies, he points out, found that when people live through a famine, their grandchildren are two to three times as likely to develop diabetes. This is a multi-generational problem with no quick fix, apparently.

His advice is, don’t go on some punitive diet that gives your body the impression that it is living in a time of famine, because your descendants may pay the price. But also, don’t feed it constantly. When it receives a snack to digest every couple of hours throughout the day, the body gets all out of practice and forgets how to use stored energy.

Your responses and feedback are welcome!

Source: “Psychoneuroimmunology (PNI) shows what to do about inflammation that harms your performance,” The Bulletproof Executive, 10/24/12
Source: “Joe Rogan Experience Transcript” (PDF), The Bulletproof Executive, 10/15/12
Image by Visit Greenwich.

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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