Hello Healthy

The book based on the video series “12 Weeks to Wellness & Optimal Health” is now here.

Hello Healthy

As I work with clients in my office, by phone, or by Skype, and as I speak at health seminars or medical conferences, people often ask, “Of all the health strategies we’ve been discussing and learning about—which is the most important?”

Hello Healthy is a book about helping you get the synergy effect by applying all the strategies necessary to reach your full health and wellness potential. The twelve chapters of this book are a series of twelve sessions in a practical program that you can follow as you go about your daily routine. These are twelve major strategies that I specifically address with each patient, regardless of their health concerns or wellness goals. They provide the foundation that each of us can use to master our genetic risk by actually turning off disease- causing genes and turning on the genes that promote health.

As you come to better understand the principles we’ll be discussing—and incorporate them as part of your new lifestyle—you’ll be able to enjoy a higher level of health and wellness than you’ve ever thought possible.
Hello Healthy is how friends and family may soon be addressing you!

Wes Youngberg, DrPH, MPH, CNS, FACLM
Lifestyle Medicine Specialist & Clinical Nutritionist

There is no better description of this book than what others have said about “Hello Healthy”

“What you hold in your hand is nothing short of a health education masterpiece. In it Wes Youngberg weaves a tapestry of anecdotes that provide a powerful and compelling case for health-behavior change and adoption of a healthy lifestyle.  Wes provides a detailed rationale and very practical cutting-edge health advice that, if followed, will produce in the reader a reasonable approach to life transformation.  His easy going writing style is “smooth” yet so filled with up-to-date health counsel that it cannot be classified as casual reading.  Anyone can make improvements following his modern rendition of age-old principles that we use in our own Lifestyle Medicine practice at Wildwood.  This is must reading for the sick and required reading for the well!”

Zeno L. Charles-Marcel, MD
Vice President for Medical Affairs.
Wildwood Lifestyle Center and Hospital

“Once again, Wes Youngberg shares health strategies that transcend the usual medical dialogue. By giving each of us information that we can use personally, he has empowered health behaviors that can impact our enjoyment of life, our productivity, and our longevity. With a practitioner’s understanding of the difficulty of change, Wes gently encourages each of us to seek the best for ourselves.”

Richard Hart, MD, DrPH
President, Loma Linda University Health

“With U.S. healthcare spending having just crossed the $3 trillion dollar line, Dr. Wes Youngberg’s book couldn’t have come at a more crucial time. The topics covered in his book are the ones patients have been asking me for the past two decades when I worked at a medical group. Now that I’m back in an academic center, these are the very topics we are researching and teaching our public health graduate students, because these are the challenges they’ll face when they get out into the real wold. If you don’t have time for grad school, but care about your health and lifestyle medicine, this book will save you a lot of time, money, and improve the health and quality of life for you and your family.”

Ernie Medina, Jr., DrPH, CHFS
Assistant Professor-Preventative Care; Executive Director
Center for Nutrition, Healthy Lifestyle & Disease Prevention
Loma Linda University School of Public Health

“Dr. Youngberg does it again! He uses the latest research and real patient stories to teach us how we as individuals and as a society can transform our health. He shows that those with disease can still achieve optimal wellness. Following his plan form the beginning could help save our troubled Healthcare system by preventing disease from even starting. This book is for anyone wanting to live a long, prosperous healthy life.”

Eric Madrid, MD, ABIHM
Rancho Family Medical Group, Temecula California
Author of “Vitamin D Prescription,
The Healing Power of the Sun and
how it can save your life

“Heart disease has been the leading killer of Americans for the past 100 years and despite advances in medical therapy it shows no sign of relenting. It is clear that Americans are bringing this on themselves by the lifestyle choices they make. As a Cardiologist I see the effects of smoking and poor diet and sedentary lifestyle affecting younger and younger patients. It doesn’t have to be this way. Nearly 90% of Heart disease and other lifestyle diseases could be prevented by the principles articulated so well in Dr. Youngberg’s book. The principles of a healthy lifestyle are laid out in an easy to understand approach, along with compelling stories of real people who have made changes in their lifestyle and benefited from a more abundant life as a result. I highly recommend this book to anyone who desires to live a healthier and fulfilling life, free of lifestyle diseases.”

Brian Schwartz, MD
Director, Interventional Cardiology Fellowship Program
Kettering Medical Center, Dayton, Ohio.

“Poor health is the modern world’s ‘plague,’ literally destroying mankind’s potential to live a productive, satisfying life. This book explains in simple, practical terms how to reverse that plague and achieve optimal health. Read it. Live it. Share it. It just might be the best thing you’ll ever do.”

John Kelly, MD, MPH, Founding President American College of Lifestyle Medicine.

Goodbye Diabetes

Over 40% of everyone, 20 years or older, and 72% of us over 65 years old, already have prediabetes or diabetes! Most are completely unaware of this problem or its implication to their risk of heart attacks, strokes, cancer and many other diseases. But even more of us have underlying metabolic imbalance that represents our biggest health threat. This book is for anyone trying to improve their health or prevent future disease. Diabetes and PreDiabetes just represent the tip of the ice berg! We all have health risk. Each of its 23 chapters and 332 pages are written in a way that clearly help us understand and functionally address these risk factors. “Goodbye Diabetes” fully explains the lab tests, now available, that are predictive, preventive, and practical. Most importantly, this book shares the key strategies that place us on the path of health and healing.

Buy a Signed Copy of “Goodbye Diabetes”

Goodbye Diabetes Presentation

“A comprehensive, credible and remarkably empowering book. I highly recommend it!”
David Katz, MD, MPH, FACPM, FACP
Director, Yale University Prevention Research Center

“Love, love, love this book! It’s a great resource for diabetics or prediabetics, those at risk, family members and friends, and health professionals. Goodbye Diabetes is entertaining, educational, and life-changing. I read it in two sittings.”
Evelyn Kissinger, MS, RD
Director, Lifestyle Matters at Work, Lansing, Michigan​

“Goodbye Diabetes should be required reading for all physicians, dietitians, and others caring for people with both types of diabetes.”
John McDougall, MD
Internist & Author, Founder, McDougall Program

“If you are at risk for, or already have diabetes or prediabetes, Goodbye Diabetes could be the most important book you ever read.”
Brenda Davis, RD
Author, Defeating Diabetes, British Columbia, Canada

“Wes Youngberg presents a simple yet profound prevention and treatment option for the diabetes epidemic.”
Richard Hart, MD, DrPH
President, Loma Linda University

“Over the years, I have looked for a book that is comprehensive and scientific, but also readable. It has finally arrived! ”
Eric Ngo, MD, MPH
Founder, Preventive Medicine, Kaiser Permanente Southern California

“I devoured his diabetes book. Then read again for understanding. Then again for enjoyment. Extremely informative. Extremely empowering. Extremely readable.” Carl Grey

Many Diseases Linked to High Insulin – The Longer Story

Insulin Testing and Dietary Supplements to Help You Reduce Insulin, Lose Weight & Feel Better

The article below by Suzy Cohen shows why testing your insulin, both fasting and 2 hours into a Glucose Tolerance Test, is one of the most powerful ways to evaluate your risk for developing many health problems. As her title suggests, many diseases can be triggered and greatly promoted by excessive production of insulin by the pancreas. My new book, Goodbye Diabetes – preventing and reversing diabetes the natural way, released February 1, 2013 can be ordered by calling our office.  Goodbye Diabetes outlines multiple effective strategies on how to naturally bring unhealthy insulin levels back into optimal ranges. – Wes Youngberg

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Dear Pharmacist,

I really need your help because I am now up to 14 medications for the following problems:  High cholesterol, heart disease, pre-diabetes, cataracts, arrhythmias, allergies, memory problems and enlarged prostate (BPH).  The medications make me sick and sleepy.  The reason I am writing to you is because you always have a fresh perspective.  Can you help me get off these medications?

– C.P.  Kansas City, Kansas

Answer:  Fresh perspective is my middle name.  I would never tell you to stop taking your medications, but your doctor might in the coming months, as you get well. How to get you well is my major concern but since I’m not a doctor, I will just give you advice to take back and discuss.  Currently you take a lot of medicine for many conditions, which makes me wonder why they call it the “golden” years. Regardless, I’ve got big news about something you’ve probably never heard of before.

In the email you sent me, something stood out.  No one has measured your serum insulin! You should ask your doctor to measure this for you. Based on my studies, I suspect that high insulin is one common denominator for many, if not all, of your medical concerns. There are numerous studies available on pubmed and printed in respected journals that show an association to high insulin and the very disorders that you have.

For those who don’t realize, insulin is a pancreatic hormone that reduces blood sugar which rises in response to eating. Many physicians routinely measure your blood glucose, but not your insulin.  The ratio of glucose to insulin is more valuable than the level of either one alone.  That’s a very important statement and it often comes as a surprise to folks who are used to having their blood glucose measured (FBS) but not their insulin.  Just because your blood glucose is normal (and you are sent home with the good news that you do NOT have diabetes) does not mean that everything is hunky dory.

The following information is hard to find, and I’m happy to share it with you.  A person’s insulin  levels may be SKY HIGH because the pancreas could be working on overdrive to push the blood sugar into the cell.  Remember, insulin puts sugar into the cell, so if you have a lot of sugar on board (from eating the typical American diet or lots of carbs) then your insulin can be very high  for many years while your blood sugar is normal.  This is a dangerous place to be, and many doctors never think to measure a person’s insulin.   The insulin can be high because the pancreas is pumping it out all day long to push the sugar into the cell.   Good time to tell you that insulin makes a person fat.  The more insulin, the more weight gain.  So as a side note, if you are dealing with stubborn weight that refuses to come off, you may have high insulin.

So you see now, why it’s the ratio of glucose to insulin that is so important.  High insulin gives you a higher risk for many diseases.

Serum insulin levels should be measured by the blood.  If it’s high, we need to talk.  Chronically elevated insulin causes a cascade of inflammatory chemicals and high cortisol which lead to major diseases some of which you already have. If I was a physician, I would have my patients take this blood test as part of their annual physical, or at the onset of any major disease.  This is very important, I think taking the test twice in one day might be useful to certain patients.

That probably sounds odd, allow me to explain. The first test would be taken on an empty stomach (fasting) and then you would eat a meal (or drink a sugary sweet drink offered by the lab facility, which tastes fairly nasty to be honest) and then you would take your second test 2 hours after that. What I’ve described is called a “post-prandial” test.    So to summarize, some people can just do one test which evaluates two parameters (fasting serum insulin AND fasting blood glucose) while other people may need to be evaluated more fully and take two tests.  In this case, they would do the fasting tests and also a  “2 hour post-prandial test” which evaluates two parameters (serum insulin and blood glucose).  Why?  Because some people are perfect when a fasting test is performed, but when they eat, their body goes haywire with the insulin and glucose.  You wouldn’t see this on a fasting test.

I realize this is somewhat complicated but I’m here to help you, and if I don’t share these intricate details, you might fall through the cracks. I care to much to let that happen.  So if this was hard to understand, re-read it, or print it for your doctor to see if you need to be tested in this way.  These are blood tests (not saliva or stool).

Here are the ranges to help you/your doctor and please note that this is just a guideline, it’s not the be-all, end-all… there are many tests that your physician will suggest to help you get better.  Here’s one of them.

Fasting Serum Insulin: Serum insulin levels should be 5 – 10 microunits/ml.  Optimally speaking, they should be less than 5.   As a general rule, if your levels are higher than 10, your risk for developing diabetes increases. Above 25, and I think it’s a slam dunk for diabetes and other major disabilities.

2 hour post-prandial serum insulin should be less than 25.

Fasting glucose: Optimal 70 – 100 mg/dl

2 hour post-prandial blood glucose: 70 – 145 mg/dl

Here’s the big deal:  The ratio of glucose to insulin should be less than 10:1.

For example, if your blood sugar is 170 and your insulin is 8, then your ratio is 21  (NOT GOOD).  You want the ratio to be less than 10:1.     Here’s another example,  your blood glucose is 85 and your insulin is 6 then your ratio is 14.   It’s BETTER than 21, but more work needs to occur.

Chronically elevated insulin hormone has also been associated with Parkinson’s disease, nerve pain, and autoimmune diseases like lupus and cancer.  Yes, cancer!  Breast cancer and pancreatic cancer are connected to high insulin.  And according to an August 2009 study published in The Journal of The National Cancer Institute – elevated insulin increases the risk for prostate cancer too.  Here’s their conclusion:

Elevated fasting levels of serum insulin (but not glucose) … appear to be associated with a higher risk of prostate cancer.

That’s straight out of the National Cancer Institute’s own journal.  By now you may be wondering, how does one reduce insulin?  The simplest way is free and totally up to you.  Lose weight!  Exercising helps you to reduce blood glucose levels.  Even better, exercising makes your cells happy to see insulin, which improves insulin sensitivity.

Now, I’m going to say the unthinkable to many of you reading this.  Eat a vegan diet, including more raw foods for just 30 days and see what glorious things take place.  Caloric restriction and the consumption of nourishing foods (rather than soda, fast food and candy bars) can reduce insulin and pain-causing chemicals. It’s really not as hard as it sounds, and maybe a healthy diet is the solution for you, considering the current path you’re facing. With dietary compliance, your doctor may be able to discontinue some of your medications.

Certain supplements drive biochemical pathways in the body which tell your cells to burn fat and sugar, and that reduces insulin levels.  These supplements include vitamin D, resveratrol, quercetin, lipoic acid, curcumin and L-arginine.  Let’s take a look at each supplement so that you can decide (with your physician) which of these are right for you:

[In addition to lifestyle interventions, like meal balancing and exercise, I usually recommend my three top nutraceutical strategies for optimizing insulin levels. These include:

Glycemic Foundation 1+ scoops with smoothie for breakfast and lunch: including 1tbsp of extra virgin coconut oil. For improved blood sugar control. Lowers insulin levels and supports stable blood sugars in those prone to hypoglycemia (low blood sugars) and adrenal fatigue. 

Young Life Complete: Take 2 capsules three times daily with meals as a multiple designed for immune, cardiovascular, and metobolic health. This combines the benefit of a high potency multiple vitamin/mineral nutritional and B-Complex supplement, 1,000mcg of B12 Methyl Cobalamine, 1,000mcg of whole food methyl folate (Quatrefolic), as well as comprehensive nutrient support for the process of detoxification (therapeutic doses of N-Acetyl Cystine, Acetyl L-Carnitine, and Alpha Lipoic Acid). 

Cardio Meta Young: Merges optimal doses of Berberine, Biotin, and Chromium in a 2 capsule dose.  This formula is for metabolic syndrome, blood sugar control, and improved metabolism. The  Youngberg Clinic recommends this nutritional support for individuals with diabetes, prediabetes, elevated insulin, chronic low grade infections, inflammatory conditions and anyone at risk of cardiovascular/heart disease. – DrY]

Vitamin D: This is affectionately dubbed the “sunshine” vitamin because sunlight sparks a reaction in the skin to begin the formation of active vitamin D.  It is your liver and kidneys which fully activate the D to a hormone which has far-reaching effects in the body.  One of these effects is that D can improve insulin sensitivity.   The effect is fairly dramatic.  There are many studies, one appeared in “Diabetic Medicine” in January 2009 (References below).   If your doctor approves, buy an over-the-counter version because it is more natural to the body (compared to prescribed sources) and look for “Vitamin D3” or “Cholecalciferol.”   A suggested dose would be about 5,000 IU per day in the morning (with food/snack). [In my opinion it is best to use an emulsified form of Vitamin D. My professional choice is Bio D Mulsion Forte from Biotics. Each drop has 2,000iu of D3. – DrY]

Resveratrol: This is best known as the heart-healthy antioxidant from red wine.  You can buy pure supplements of resveratrol and that is my recommendation.  It is thought to work by awakening a longevity gene.  Yes, it appears that we are not ruled by our genes!  The gene is in charge of burning fat so in this case, resveratrol appears to help a person burn fat by triggering a lazy gene (called PGC1-alpha).  Don’t worry about the technicalities, okay, the point is that this antioxidant has important effects like doing good housekeeping on your cells, and waking up your lazy sluggish genes which then start to holler, “Burn the fat!  I said get the fat and sugar out of this cell right now!”

When buying resveratrol supplements, be choosy.  The better form of resveratrol is the “trans” resveratrol, and dosages vary widely.  I’d suggest about 100 – 500 mg daily, in the morning (on an empty stomach meaning no food, but fine with other supplements that you take).   Resveratrol is often combined with another grape-derived extract called quercetin or grape seed extract, those types of combos are fine with me. [I recommend ResveraMax Young containing 400mg of 99% standardized Resveratrol making it the highest nutraceutical grade stimulation of the human longevity gene. – DrY]

Quercetin: A citrus “bioflavonoid” this is a potent antioxidant that comes from citrus plants as well as the skin of grapes and apples.  It is best known as nature’s antihistamine, and it helps prevent easy bruising by protecting capillaries.  Quercetin makes vitamin C work better and it also happens to upregulate your genes and get some fat-burning action to occur. It’s all subtle, these supplements are not magic bullets. Some naturopaths suggested quercetin to help reduce LDL cholesterol.   In this case, you can take it as part of a resveratrol formula (see above) or you can take it by itself.  Dosages are typically 500 mg and you take it once or twice daily (with food/snack).

Lipoic Acid: I could write a book on this one!   It’s a powerful antioxidant that penetrates both the fat-loving (lipophilic) and the water-loving (hydrophilic) cells of your body.  This means it gets into your kidneys, liver, pancreas, heart, brain, lungs, everywhere!   No organ can hide from lipoic acid.  It sweeps away free radicals.  I’ve included the nutrient in my list to lower insulin because it has a rarely known talent.  Lipoic acid happens to prod some transcription factors in your body, which in turn awaken a gene called PGC1-alpha.  When you wake up this gene, your cells are awakened and the little fat-burning organelles inside your cells (called “mitochondria”) start the party. [My choice for activating  mitochondrial metabolism and the fat burning genes is YoungMax Lipoic. One capsule twice daily gives 600mg of Alpha Lipoic Acid and 300mg of Acetyl L-Carnitine. This also provides special protection for the liver and nerves – DrY]

The party consists of burning up a lot of fat and sugar that is making you unhealthy.   So lipoic acid basically gets these mitochondria working harder and that helps you lose weight.   Now be sensible, you’ll have to sweat a little too, lipoic acid is not a magic bullet, it’s just a helping hand. I like the R-lipoic acid version (over the “alpha” version) and the dose is approximately 200 mg two to four times daily.  Another interesting physician-exclusive formula is called “ALAMax CR” and this is available from doctors or online sellers of Xymogen products.  It is a 300mg dose, so it is taken once or twice daily.   Be warned, lipoic acid makes your urine smell like cooked asparagus

L-arginine: It’s almost the same type of “party” as described above for lipoic acid.  L-arginine is an amino acid which works to awaken the same longevity gene I discussed above.  This begins a cascade of signaling which could help you lose weight.  L-arginine is found in many sex formulas too, because it widens blood vessels and sends blood flowing down South.  In addition to helping one with pre-diabetes, high blood pressure and angina, it may very well be the best bedroom secret known to men.  Dosages vary tremendously:  1,000 – 3,000 (or much more if your doctor suggests) taken one to four times daily.  There isn’t a lot of counterfeiting/contamination with arginine (as compared to other dietary supplements) so just use your best judgement in picking a  formula.  One that I am sure of is high-quality is sold at CVS, by “Life Fitness” makers and it’s called “Arginine TR” but there are many others, sold at health food stores. Please ask your doctor if arginine is right for you because it can lower blood pressure, and there are some studies that suggest it is not right for people who have already had a heart attack. Be warned, taking too much may increase your risk for an outbreak of shingles or fever blisters or any type of herpes-driven infection. [The most effective L-Arginine formula for improving circulation in those with diabetes, PAD peripheral artery disease, cardiovascular disease, erectile dysfunction, depression caused by poor cerebral blood flow, and any form of poor circulation is Cardio Flow Argi produced by a brilliant pharmacist in Las Vegas – DrY]

Curcumin: Found in the spice turmeric and curry, this is a powerful herb and it is pretty well known in the scientific community to improve insulin sensitivity (by increasing adiponectin levels which is a good thing).  The big, huge deal with curcumin is that there are well-designed trials and positive emerging studies that suggest curcumin plays a role in preventing and possibly treating various cancers.  It has an effect of lowering inflammatory chemicals which cause swelling, pain and inflammation all over the body.  Curcumin has many other effects too, such as lowering levels of tumor necrosis factor (TNF alpha) which in some cases causes damage to your heart and pancreas.  There are several high-quality versions of this herb sold nationwide but unfortunately, with curcumin, there is a lot of garbage out there. This frustrates me because some people buy this supplement to prevent/treat serious cancers so I wish there was better regulation.  Regardless, it’s impossible to list all the good brands out there, but I don’t mind telling you the formulas that I have taken myself and trust for my family. [My favorite anti-inflammatory formula is one scoop of InflammaCore twice daily in a smoothie or mixed in as shaker cup with crushed ice. This is important because high insulin promotes inflammation and this turns on the genes related to diabetes, heart disease, certain cancers, and autoimmune disease – DrY]

Just a few references, more can be obtained from pubmed and peer-reviewed journals:

http://jnci.oxfordjournals.org/cgi/content/abstract/djp260

http://www.ncbi.nlm.nih.gov/pubmed/19125756?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/12800453?ordinalpos=9&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultR

What is Pre-diabetes, and How does it Affect my Health?

Bill was a fit man for his age and appearing to be in good health. He said, “I am just retiring, so I want to make sure I am properly evaluating my health.” He came to see me to get blood-based laboratory testing. As I evaluated his medical records, I noticed a couple of times when his fasting blood sugars had been running a little high. They were not in the pre-diabetic range but were above the optimal range of 70–85; they were running just above 90.

“I think one of the best tests you could do is a two-hour glucose tolerance test,” I suggested. The test came back a few days later, showing a two-hour blood sugar well above 140, indicating advanced pre-diabetes. Bill wasn’t overweight and had been exercising three to four times a week, so these results caused him to reevaluate his health.

“Clearly,” he said, “what I have been doing is not enough to overcome the natural genetic tendency I have toward pre-diabetes or diabetes.” So at the next appointment, he came in with his list of many questions and said, “OK, what do I need to do that will be enough to reverse this pre-diabetes?” So he went through our twelve-week program designed to optimize blood sugars and correct the underlying causes of his health risk.

Through that process, he learned simple strategies that, when brought together, helped him totally reverse his pre-diabetes. One of the things Bill learned in the program was that the timing of exercise is really important. Remember, Bill was lean and fit—he already exercised more than most men. His blood sugars, before meals, were essentially fine—but not his blood sugars after meals. So he learned two primary strategies: to note what kinds of meals caused the biggest spike in his blood sugars—and also to note the time of his exercise that had the greatest impact on lowering his blood sugar spike after meals.

What he learned was that exercising immediately after a meal had the potential to lower his blood sugars anywhere from one to three points for every minute he exercised. So for instance, if someone’s blood sugar is typically ninety points higher than it should be one or two hours after a meal, but now they go out right after eating and exercise moderately to briskly for thirty minutes, there is a good chance they could lower their blood sugar (at three points for every minute of exercise) by up to ninety points, bringing their high blood sugar down to a much healthier level.

The second thing Bill recognized is that he needed to learn how to balance his meals. He needed to know how to use whole plant-based foods that incorporated nuts and seeds in moderate amounts, with their healthy fats and proteins. This would slow down the absorption of sugar from his meal, so his sugar would not spike nearly as much. He also needed to learn how to choose healthy starches. Not all starchy complex carbohydrates are healthy starches—these need to be unprocessed, high in fiber and full of nutrients before they help control blood sugar levels and ultimately, the health of our heart and blood vessels.

Bills story is one of many examples showing the importance of proper testing and how it guides us in making simple changes that can transform our health and greatly lower our risk for future disease. That is why I believe one of the best health assessment tests available today is the two-hour oral Glucose Tolerance Test (GTT for short). Typically, only the fasting and two-hour glucose levels are now tested in the GTT. But the most likely time to see an elevated blood sugar (glucose) is at the one-hour point after drinking 75 grams of Glucola (a standard carbonated glucose drink used to see how high blood sugar goes). So I always add the one-hour glucose test to the GTT. In addition, I always add the fasting and two-hour insulin test. Even in patients who have completely optimal blood sugar responses to the GTT, the insulin levels are among the first risk factors to indicate a risk to health.

While testing insulin levels is not currently part of standard recommendations, I learned the value of testing insulin several decades ago by paying attention to the advice of Dr. Nancy Bohannon, a preventive endocrinologist, director of the Cardiovascular Risk Reduction Program at St. Luke’s Hospital in San Francisco, and professor at UCSF. In 1991 Dr. Bohannan—who sub-specializes in diabetes prevention and management—gave a lecture sent out to family practice physicians in “Family Practice Audio Digest.” As part of the talk, she explained how the fasting insulin should always be less than 10 microIU/mL. Because of my willingness to listen to one of the world’s leading experts and not simply wait the average of twenty-five to thirty years it usually takes for good evidence to be fully accepted by the average clinician, I was able to effectively counsel thousands of patients as to their future health risk and how to transform that risk through comprehensive lifestyle medicine.

Why is this important? Because having a high insulin level predicts a three-fold increase in risk toward developing heart disease. In addition, elevated blood insulin is a major contributor to the development of high blood pressure and is closely associated with increased prostate, breast, and colon cancer risk.

Now, back to Bill’s story. Once we learned that Bill had advanced pre-diabetes, I discussed the relationship between blood sugars, insulin, and blood pressure with him. For many years he had struggled with hypertension, even while on medications for his blood pressure.