Health & Fitness

Vitamin C, also known as ascorbic acid (AA), is not synthesized by humans.¹ It has many proven benefits from boosting the immune system, lessening cognitive decline, improving cardiovascular function and reducing oxidative stress to mineralizing bones, reducing the incidence of cataracts and acting as a pro-oxidant that may be toxic to cancer cells, according to research published in 2010.²

Yet, identifying the optimal dosage of vitamin C to achieve its many benefits has been a slow process. It has been hampered by lack of valid data, faulty methodologies that yielded incorrect conclusions and even infighting and politics.

Recently, in the video above, James DiNicolantonio, a cardiovascular research scientist and doctor of pharmacy, clarified the ways in which the optimal dosage of vitamin C can be ascertained and revealed how original calculations have resulted in lower and inadequate doses.³

A Second Look at Original Vitamin C Research

Most people know that vitamin C was originally identified as a cure for scurvy, a disease characterized by bruising and bleeding that killed more sailors in the 16th, 17th and18th centuries than all other causes, such as battles, storms and other illnesses, put together.⁴ Vitamin C is so linked to its first dramatic benefit that its name "a-scorbic acid," means "anti-scorbutic," scorbutic referring to scurvy.⁵

Linus Pauling, an American chemist, biochemist and chemical engineer who was awarded the Nobel Prize in Chemistry in 1954, was an early proponent of the value of vitamin C to treat many illnesses, including cardiovascular disease, cancer, influenza, infections and age-related degeneration.⁶

Pauling also contended that environmental stresses and other factors such as molecular disease and biochemical individuality could increase a person's need for vitamin C and other nutrients significantly above the recommended daily allowance (RDA).⁷ Sadly, Pauling's research and findings were largely ignored, disputed and even mocked by mainstream medicine for many years.⁸

For example, in a 1976 study conducted by Pauling and Dr. Ewan Cameron, a Scottish surgeon, of 100 patients with terminal cancer, those treated with vitamin C had an improved quality of life and a fourfold increase in their mean survival time.⁹

Subsequent double-blind randomized clinical trials conducted at Mayo Clinic and published in two papers in The New England Journal of Medicine showed no positive effects, discrediting Pauling and Cameron's trials, which had not been as well designed. According to the National Cancer Institute:¹⁰

"So why did the Pauling and Mayo Clinic trials have different results? There are at least two crucial differences. First, the Mayo Clinic trials abruptly stopped the ascorbate administration, switching to traditional chemotherapy, when the patient developed signs of tumor progression.

Thus, the overall median time of vitamin C treatment under the Mayo Clinic trials was only 2.5 months, while the Pauling and Cameron trials treated patients for the duration of the entire study period or as long as 12 years.

Secondly, the Mayo Clinic trials administered 10 g of daily ascorbate to patients only orally, while the Cameron and Pauling trials administered their vitamin C both orally and intravenously. This difference in the two dosage routes proved highly consequential."

Oral and Intravenous Vitamin C Treatment Differs

Research conducted by Dr. Mark Levine and colleagues and cited in DiNicolantonio's video established a clear difference in saturation levels between orally administered and intravenous administered of vitamin C, which likely explains the different trial results. According to the National Cancer Institute:¹¹

"[T]he oral vitamin C doses used in the Mayo Clinic studies would have produced peak plasma concentration of less than 200 μM [micromolars]. In contrast, the same dose given intravenously, as used in the Pauling studies, would produce peak plasma concentrations of nearly 6 mM, more than 25 times higher.

When given orally, vitamin C concentration in human plasma is tightly controlled by multiple mechanisms acting together: intestinal absorption, tissue accumulation, renal reabsorption and excretion, and potentially even the rate of utilization."

Administering vitamin C intravenously bypasses these tight controls and significantly higher vitamin C plasma concentrations can be achieved, says the Institute:¹²

"Given the fact that cancer patients were only treated with vitamin C orally in the Mayo Clinic studies, the studies do not disprove high dose vitamin C's efficacy as a cancer treatment."

Virtually all high-dose vitamin C treatments, whether used as monotherapy or in combination with cancer drugs, show improved quality of life, minimized pain and protection of normal tissues, says the Institute.¹³

Vitamin C Saturation Has Been Misunderstood

According to DiNicolantonio, optimal vitamin C levels have long been misunderstood. If a dose of vitamin C did not greatly increase blood levels, researchers have claimed that saturation had been produced and higher doses were redundant.¹⁴

The problem was, the video notes, researchers did not realize the apparent "redundancy" stemmed from the fact that some of the vitamin C had been excreted just as salt and water are excreted.¹⁵ It did not mean more vitamin C was not being absorbed.

Moreover, some researchers have used white blood cells to ascertain how much vitamin C has been absorbed, even though white blood cells can register high levels of the nutrient when supplies elsewhere in the body are low, according to Medical News Today.¹⁶

Because of the faulty doses rendered by misread saturation levels, DiNicolantonio agrees with Levine and colleagues that the recommended dose of daily vitamin C should be much higher than has been established. The adult RDA for adults is currently 90 milligrams (mg) a day for men and 75 mg for nonlactating women.¹⁷

Writing in the Proceedings of the National Academy of Sciences USA, Levine and his group comment on results from a vitamin C trial:¹⁸

"The steep portion of the curve occurred between the 30- and 100-mg daily dose, the current RDA of 60 mg daily [when the paper was written] was on the lower third of the curve, the first dose beyond the sigmoid portion of the curve was 200 mg daily, and complete plasma saturation occurred at 1000 mg daily …

Bioavailability was complete for 200 mg of vitamin C as a single dose. No vitamin C was excreted in urine of six of seven volunteers until the 100-mg dose. At single doses of 500 mg and higher, bioavailability declined and the absorbed amount was excreted … Based on these data … the current RDA of 60 mg daily should be increased to 200 mg daily."

Vitamin C Requirements Could Be as High as 2.5 Grams a Day

Referring to other vitamin C research in his video, DiNicolantonio says he believes the optimal dose may well be much higher than 200 mg daily. Research shows there is a huge gap between the amount of vitamin C ingested and the blood levels that are achieved, and that divided doses are also crucial in achieving optimal levels.¹⁹

For example, to achieve 80 μM of vitamin C you need to take 1,250 mg twice a day, says DiNicolantonio, and to achieve 250 μM of vitamin C, you need to take 5 grams a day. Even 2.5 grams of vitamin C per day does not produce fully saturated vitamin C blood levels, he notes.²⁰

Research that DiNicolantonio cites in the video verifies his stance that vitamin C RDAs need to be increased to achieve more of its benefits. A paper published in The Journal of Alternative and Complementary Medicine stated:²¹

"Numerous studies have demonstrated that vitamin C consumption higher than the RDA enhances the immune system and decreases the risk of DNA damage. Vitamin C greater than 400 mg/day can improve protection against oxidative stress, certain cancers, and degenerative and chronic diseases."

In one study of high-dose vitamin C supplementation cited in the paper, improvements in male fertility were seen:²²

"A recent study has shown that vitamin C supplementation (1000 mg twice daily, for a maximum of 2 months) in infertile men might improve sperm count, sperm motility, and sperm morphology and might have a place as an additional supplement to improve the semen quality leading to conception."

There is another reason for vitamin C supplementation, wrote the researchers. Contemporary farming practices, which are so reliant on GMOs, pesticides, herbicides and heavy processing of the food, all deplete nutrients and add to the increased need many have for vitamin C. According to the article:²³

"… modern farming leads to a lowering in food quality, inducing a considerable loss of micronutrients, and not allowing a sufficient intake of vitamin C simply through food consumption."

Vitamin C Offers Many Benefits

Vitamin C offers many impressive benefits for your immune system and other important systems in your body. That's why it is so important to achieve the correct dose; suboptimal levels of vitamin C will probably not produce the many available benefits.

According to The Journal of Alternative and Complementary Medicine, vitamin C enhances the immune system by stimulating leukocyte function, antimicrobicidal and natural killer cell activities and lymphocyte proliferation.²⁴ High levels of vitamin C, according to the journal, also protects:²⁵

"… against damage to blood vessels and very significantly reduce mortality rates in the elderly. Indeed, Fletcher et al. have measured that men (mean age 80 years) with 100 mg daily vitamin C intake presented a mortality risk nearly half that compared to peer men with a consumption of 50 mg/day.

Moreover, men with low serum ascorbate concentrations may have an increased risk of mortality. A large body of evidence demonstrates that high dietary vitamin C supplementation (between 1 and 10 g/day or more …) can enhance resistance to and improve recovery from infectious, degenerative diseases, and certain types of cancer …

Large doses of ascorbate have been found to reduce cardiovascular disease risk, lengthen the lifespan of patients with cancer, and … lengthen lifespan in general. Moreover, daily supplementation with 1000 mg of ascorbic acid results in a significant decrease of blood-lead levels associated with the general population."

Oxidative stress that is associated with so many diseases may increase your need for vitamin C, the research also stated.²⁶ Special populations may also require higher doses. According to the journal Health:²⁷

"The safety and benefit of vitamin C supplements is of critical importance, especially for those in war zones at risk for brain trauma or of advancing years at risk for chronic disease and stroke."

Vitamin C May Help Fight Cancers

There is strong scientific evidence that high doses of vitamin C are a tool against some cancers. According to DiNicolantonio's video, liposomal vitamin C can produce blood levels that have a 50% kill rate against lymphoma cells in vitro — a dramatic finding.²⁸

Vitamin C has shown effectiveness against prostate, pancreatic, hepatocellular, colon, mesothelioma and neuroblastoma cell lines.²⁹ According to the Stephenson Cancer Center:³⁰

"The potential mechanisms through which treatment with high-dose ascorbic acid may exert its effects on cancer cells have been extensively investigated. Several studies have demonstrated that the in vitro direct cytotoxic effect of ascorbic acid on various types of cancer cells is mediated through a chemical reaction that generates hydrogen peroxide.

Treating colon cancer cells with 2 mM to 3 mM of ascorbic acid resulted in downregulation of specificity protein (Sp) transcription factors, iron metabolism disruption, and Sp-regulated genes involved in cancer progression.

One study suggested that ascorbate-mediated prostate cancer cell death may occur through activation of an autophagy pathway … Another in vitro study found that ascorbic acid killed colorectal cancer cells with KRAS or BRAF mutations by inhibiting the enzyme glyceraldehyde 3-phosphate dehydrogenase."

Vitamin C Benefits May Be Downplayed

With benefits from immune enhancement and fighting cancers to improving cardiovascular function, reducing oxidative stress, mineralizing bones and lessening cognitive decline,³¹ why is vitamin C not a staple of mainstream medicine?

The answer is that since vitamin C is not "patentable," drug makers see no profit in pursuing its therapeutics or performing clinical trials. That means doctors and practitioners are told about high-priced and likely less effective treatments more frequently than they are told about lower-priced and accessible vitamin C.

Just as the public often doesn't know about vitamin C benefits, the optimal doses of vitamin C are also often hidden, as DiNicolantonio points out in his excellent video. Clearly, the RDAs for vitamin C need to be much higher.

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Optimizing your vitamin D level is ideally done through sensible sun exposure. However, many simply are unable to obtain sufficient levels from the sun alone and need supplemental vitamin D. In this case, nutritional synergies become an important factor.

According to research by GrassrootsHealth,¹ “combined intake of both supplemental magnesium and vitamin K2 has a greater effect on vitamin D levels than either individually,” and “those taking both supplemental magnesium and vitamin K2 have a higher vitamin D level for any given vitamin D intake amount than those taking either supplemental magnesium or vitamin K2 or neither.”

You Need 2.5 Times More D if Not Taking Magnesium and K2

GrassrootsHealth is a nonprofit, independent public health research institute that has been conducting large-scale population-based nutrient research since 2007.² While a significant focus is on vitamin D, the organization has also branched into other nutrients.

Its D*action project includes a global cohort of over 10,000 self-subscribed individuals who, anonymously, provide information about their supplement use and overall health status.

GrassrootsHealth research shows blood levels in the range of 40 nanograms per milliliter to 60 ng/ml (100 nanomoles per liter to 150 nmol/L) are safe, effective and will lower overall disease incidence and health care costs.³

That said, other nutrients have been shown to work synergistically with vitamin D, and being deficient in them can significantly influence your vitamin D status as well. Importantly, data from nearly 3,000 individuals reveal you need 244% more oral vitamin D if you’re not also taking magnesium and vitamin K2. As reported by GrassrootsHealth:⁴

“… 244% more supplemental vitamin D was needed for 50% of the population to achieve 40 ng/ml (100 nmol/L) for those not taking supplemental magnesium or vitamin K2 compared to those who usually took both supplemental magnesium and vitamin K2.”

What this means in practical terms is that if you take all three supplements in combination, you need far less oral vitamin D in order to achieve a healthy vitamin D level.

How Magnesium Affects Vitamin D

I’ve previously written about the importance of taking vitamin K2 when you’re taking high-dose supplemental vitamin D to avoid complications associated with excessive calcification in your arteries. In fact, relative vitamin K2 deficiency is typically what produces symptoms of “vitamin D toxicity.”

That said, magnesium is also a crucial part of the equation, as it is a component necessary for the activation of vitamin D. Without sufficient amounts of it, your body cannot properly utilize the vitamin D you’re taking.^5,6,7,8

This actually helps explain why many need rather high doses of vitamin D to optimize their levels — it could be that they simply have insufficient amounts of magnesium in their system to activate the vitamin D. As noted by Mohammed Razzaque, professor of pathology at Lake Erie College of Osteopathic Medicine in Pennsylvania:⁹

"People are taking vitamin D supplements but don't realize how it gets metabolized. Without magnesium, vitamin D is not really useful. By consuming an optimal amount of magnesium, one may be able to lower the risks of vitamin D deficiency, and reduce the dependency on vitamin D supplements.”

According to a scientific review^10,11 published in 2018, as many as 50% of Americans taking vitamin D supplements may not get significant benefit as the vitamin D simply gets stored in its inactive form, and the reason for this is because they have insufficient magnesium levels.

Research published in 2013 also highlighted this issue, concluding that higher magnesium intake helps reduce your risk of vitamin D deficiency by activating more of it. As noted by the authors:¹²

“High intake of total, dietary or supplemental magnesium was independently associated with significantly reduced risks of vitamin D deficiency and insufficiency respectively.

Intake of magnesium significantly interacted with intake of vitamin D in relation to risk of both vitamin D deficiency and insufficiency … Our preliminary findings indicate it is possible that magnesium intake alone or its interaction with vitamin D intake may contribute to vitamin D status.” 

Similarly, GrassrootsHealth has found¹³ you need 146% more vitamin D to achieve a blood level of 40 ng/ml (100 nmol/L) if you do not take supplemental magnesium, compared to taking your vitamin D with at least 400 mg of magnesium per day.

The interplay between magnesium and vitamin D isn’t a one-way street, though. It goes both ways. Interestingly, while vitamin D improves magnesium absorption,¹⁴ taking large doses of vitamin D can also deplete magnesium.¹⁵ Again, the reason for that is because magnesium is required in the conversion of vitamin D into its active form.

Vitamins D, B12 and Magnesium May Affect COVID-19 Outcomes

While vitamin D and magnesium are important for overall health year-round, they may be of particular importance right now, as we’re still dealing with the COVID-19 pandemic in many areas of the world, and a second wave is expected in the fall.

According to preliminary research,^16,17 that is still undergoing peer review, older COVID-19 patients given a combination of vitamin D, magnesium and vitamin B12 fared significantly better than those who did not receive the supplements:

“Between 15 January and 15 April 2020, 43 consecutive COVID-19 patients aged ≥50 were identified. 17 patients received DMB [vitamin D, magnesium and B12] and 26 patients did not. Baseline demographic characteristics between the two groups were similar.

Significantly fewer DMB patients than controls required initiation of oxygen therapy subsequently throughout their hospitalization (17.6% vs 61.5%). DMB exposure was associated with odds ratios of 0.13 … and 0.15 … for oxygen therapy need and/or intensive care support on univariate and multivariate analyses respectively.

Conclusions: DMB combination in older COVID-19 patients was associated with a significant reduction in proportion of patients with clinical deterioration requiring oxygen support and/or intensive care support. This study supports further larger randomized control trials to ascertain the full benefit of DMB in ameliorating COVID-19 severity.”

Signs of Vitamin D Deficiency

The idea that vitamin D might play a role in COVID-19 severity makes sense considering its importance in infections, including viral infections, in general. Vitamin D helps regulate your immune function, and deficiency is associated with more frequent infections and inflammation-related illnesses of all types. Other common signs and symptoms of vitamin D deficiency include:¹⁸

• Muscle weakness and fatigue
• Bone and joint pain, as well as fractures
• Depression
• Impaired cognition and headaches
• Slow wound healing

Long-term deficiency can also contribute to more chronic health problems, including rickets, cardiovascular disease and autoimmune disease.¹⁹ Risk factors for vitamin D deficiency include:

• Rarely spending time outdoors and/or always wearing sunscreen
• Having darker skin
• Being over the age of 50
• Obesity
• Having gastrointestinal problems

Optimize Your Vitamin D Before Fall

Aside from age and comorbidities such as diabetes, obesity and heart disease, vitamin D deficiency has also been identified as an underlying factor that significantly impacts COVID-19 severity and mortality. I discuss this in “Vitamin D Is Directly Correlated to COVID-19 Outcome.”

The following graph is from a May 18, 2020, letter²⁰ to the Federal Chancellor of Germany, Angela Merkel, from retired biochemist Bernd Glauner and Lorenz Borsche, in which they highlight studies²¹ showing a clear correlation between COVID-19 mortality and vitamin D levels.

It’s important to note that experts are already warning SARS-CoV-2 may reemerge in the fall when temperatures and humidity levels drop, thereby increasing the virus’ transmissibility.

To improve your immune function and lower your risk of viral infections, you’ll want to raise your vitamin D to a level between 60 ng/mL and 80 ng/mL by fall. In Europe, the measurements you’re looking for are 150 nmol/L and 200 nmol/L. Optimizing your vitamin D is particularly important if you are older or have darker skin.

One of the easiest and most cost-effective ways of measuring your vitamin D level is to participate in the GrassrootsHealth’s personalized nutrition project, which includes a vitamin D testing kit, either alone or in combination with the omega-3 test. This is done in the convenience of your home.

To make sure your vitamin D level and immune system function are optimized, follow these three steps:

Not only will optimizing your vitamin D be an important strategy for you and your family, but it would be really helpful to start thinking about your community as well.

If you can, speak to pastors in churches with large congregations of people of color and help them start a program getting their congregation on vitamin D, and if you have a family member or know anyone who is in an assisted living facility, meet with the director of the program and encourage them to get everyone tested or at least start them on vitamin D.

I am currently in the process of writing a comprehensive resource book to help you in this effort. We really need an army of people to make a difference and build up the immune resiliency of the population before the next wave hits in the fall. This will work FAR better than any unsafe and untested vaccine that will most likely never be ready by the fall anyway.

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In the past, I've written extensively about the differences between dairy from cows raised in concentrated animal feeding operations (CAFOs) and those that are grass fed and raised in a more natural manner. Many of the health and environmental benefits associated with raising and consuming grass fed milk and dairy products originate in the cows’ diets.

Grasses are a cow's natural food, while corn and other grains that are routinely fed to CAFO livestock, are not. When cows eat grains, it alters the composition of their meat and milk.¹ This results in an inferior nutritional profile, which dairy pasteurization continues to reduce.²

In addition to these problems with CAFOs, the use of genetically engineered feed increases the challenges. While the cows would continue to suffer health problems from being fed grain, it would eliminate the high number of toxic herbicides that contaminate the environment and end up in the milk supply.

Cows that are allowed to graze and live outdoors produce high-quality raw milk with many health benefits, including a healthy number of bacteria for your gastrointestinal tract, conjugated linoleic acid and beneficial raw fats, amino acids and proteins in a highly bioavailable form.³

Children who are allowed to drink raw milk have been shown to have a 30% lower risk of respiratory infections and fever,⁴ and may benefit from “a protective effect for the development of childhood allergic diseases.”⁵

Full-Fat Dairy Improves Health Parameters

In a recent study published in BMJ Open Diabetes Research and Care,⁶ researchers noted that participants who ate at least two servings of dairy products each day had a lower risk of high blood pressure and Type 2 diabetes. In addition, they were at lower risk for metabolic syndrome.⁷

The researchers used information from the Prospective Urban Rural Epidemiology (PURE) study that included 35- to 70-year-old people from 21 countries across five continents. Some of the countries included Argentina, Bangladesh, Canada, India, Pakistan and the United Arab Emirates.⁸

By taking data from a broad range of countries, they hoped to determine whether their findings could be generalized, as they were investigating whether there is an association between dairy intake and the prevalence of metabolic syndrome.

The researchers used questionnaires to determine a person's usual intake of full- and low-fat milk, yogurt and cheese from the past 12 months using milk. Within the study group, the researchers found 112,922 who presented with components of metabolic syndrome.⁹

People who said they ate at least two servings a day had a 24% reduced risk of the condition. Over nine years of follow-up, 57,547 participants were tracked for high blood pressure and 131,481 for diabetes. During that time, 13,640 went on to be diagnosed with high blood pressure and 5,351 with diabetes.

Individuals who ate two servings of dairy per day had an 11% to 12% lower risk of developing the combination of high blood pressure and diabetes. Those who said they ate three servings per day had a risk reduction of nearly 14%.¹⁰

The results of this study¹¹ supported those of another published in 2017,¹² in which researchers found that those who ate and drank the most dairy had a lower body mass index and lower blood pressure.

Scientists from the University of Dublin engaged 1,500 adults to use a food diary to record what they ate over the course of four days. The study team collected blood samples from 897 participants and tested their fasting blood sugar. Emma Feeney, the lead researcher, commented:¹³

“What we saw was that in the high consumers [of cheese] they had a significantly higher intake of saturated fat than the non-consumers and the low consumers and yet there was no difference in their LDL Cholesterol levels.”

Dangerous Duo: High Blood Pressure and Diabetes

High blood pressure and diabetes have similar risk factors. In fact, having high blood pressure puts you at risk for diabetes¹⁴ and having diabetes increases your risk for high blood pressure.¹⁵ High blood pressure can also put you at risk for heart disease and stroke, which are two of the leading causes of death in the U.S.

The American Heart Association¹⁶ estimates that almost half of all U.S. adults have high blood pressure. From 2005 to 2015, the number of deaths caused by this condition rose nearly 38%. When the guidelines changed in 2017, they estimated that the number increased to nearly 46%.

High blood pressure is a quiet disease that can damage your body before you even know you have it.¹⁷ It can affect your arterial system, heart, brain, kidneys, eyes and sexual function. Most of these systems are also adversely affected by high blood sugar and diabetes.

The American Diabetes Association (ADA)¹⁸ estimates that 10.5% of the U.S. population had diabetes in 2018. Of those who did, an estimated 7.3 million went undiagnosed. In 2017, diabetes ranked as the seventh-leading cause of death. This was based on death certificates in which diabetes was either the cause of death or mentioned as an underlying cause.

Once the average medical costs were adjusted for age and sex differences, the ADA found that those who had diabetes spent 2.3 times more on health care than those who didn’t. The price tag came to $237 billion for direct medical costs and $90 billion for reduced productivity.

These numbers may seem overwhelming until you consider that many who have diabetes also have high blood pressure. According to the American Heart Association,¹⁹ 68% of adults over the age of 65 who also have diabetes die from a form of heart disease.

Even when an individual’s glucose level is under good control, they experience an increased risk because the common combination of high blood pressure and diabetes increases the risk for heart disease.

Metabolic Syndrome Sets the Stage for Chronic Disease

Metabolic syndrome is a term that describes a cluster of risk factors. Your risk for heart disease, stroke and diabetes will increase as the number of risk factors you have increases. The rise in obesity rates is linked to an increasing number of people diagnosed with metabolic syndrome.

The National Heart, Lung, and Blood Institute predicts that this condition may, in the future, “overtake smoking as the leading risk factor for heart disease.”²⁰ These factors include:

• Abdominal obesity, or excess fat deposits in the stomach area
• High triglyceride levels
• Low high-density lipoprotein (HDL) cholesterol
• High blood pressure
• High fasting blood sugar

These conditions can set the stage for developing chronic disease, including Type 2 diabetes, heart disease, stroke, Alzheimer's and nonalcoholic fatty liver disease (NAFLD). At the heart of each of these is insulin resistance.

Measuring your insulin level gives you significant information about your potential for other metabolic syndrome parameters. As I've written in the past, insulin resistance leads to symptoms of Type 2 diabetes, high blood pressure, inflammation and dyslipidemia. Insulin resistance is the result of eating a diet high in sugar.

In a paper published in JAMA Internal Medicine,²¹ researchers studied a group of people over two decades. They looked at their sugar intake and compared that to the percentage of total calories participants ate. They found that the higher the percentage of sugar, the greater the risk of cardiovascular death. Participants whose diet consisted of 25% sugar had a 2.75-times higher risk of dying from heart disease.

Metabolic Flexibility Key to Reducing Your Risk

When you have metabolic flexibility, your body can respond to changes in metabolic demand.²² You can then burn fat for fuel more quickly and easily. As I recently wrote in “The Real Pandemic Is Insulin Resistance,” one significant risk factor for a serious COVID-19 infection is metabolic inflexibility.

In a 2019 study,²³ data from the National Health and Nutrition Examination Survey showed that a startling 87.8% of U.S. adults may be metabolically inflexible. The researchers concluded that the prevalence of metabolic health was “alarmingly low, even in normal weight individuals.”²⁴

Another repercussion of metabolic inflexibility is the inhibition of autophagy. This is a necessary process to maintain optimal health and longevity. When your body cannot properly get rid of damaged cells and their components, it leads to increased damage and a decline in functionality.

One of the most effective ways to regain metabolic flexibility and your insulin sensitivity is through time-restricted eating, also known as intermittent fasting. Your body's ability to burn fat and ketones is how metabolic flexibility is measured. There are several ways to simply integrate it into your daily routine.

The method you choose can vary on the number of days, the number of hours and the number of calories. You’ll find more information on how to start in my previous article, “Intermittent Fasting May Prevent Diabetes.”

Some find it hard to get started. However, strategies that help include remaining hydrated, choosing not to obsess over food and finding time to engage in relaxing activities. You'll experience the best results when you find what fits with your lifestyle and your preferences. This improves your body's ability to respond to changes in metabolic demand.

As you try intermittent fasting or cyclical fasting, it's important to remember that the foods you choose should be well-balanced, high in healthy fats and low in carbohydrate choices. In my best-selling book Fat for Fuel, I strongly recommend implementing strategies to help improve your metabolic flexibility; these include intermittent fasting and cyclical nutritional ketosis.

The next step is the program I discuss in KetoFast, which is a term I coined to describe a protocol that combines the three key strategies: a cyclical ketogenic diet, intermittent fasting and cyclical partial fasting.

More Steps You Can Take to Reduce Metabolic Syndrome

Common food and lifestyle choices in the western world increase the risk of metabolic inflexibility, insulin resistance and metabolic syndrome. These predispose you to Type 2 diabetes, cardiovascular disease, cancer and Alzheimer's disease. The good news is that insulin resistance is simple to address, fully preventable and reversible.

In addition to using intermittent fasting and nutritional ketosis, there are other steps you can take that lower your risk of diabetes and chronic illnesses. Here's a quick summary of some of the more important guidelines I recommend.

Limit added sugars to a maximum of 25 grams per day. If you're insulin-resistant or diabetic, reduce your total sugar intake to 15 grams per day until your insulin/leptin resistance has resolved.

Limit net carbs (total carbohydrates minus fiber) and protein and replace them with higher amounts of high-quality healthy fats such as seeds, nuts, raw grass fed butter, olives, avocado, coconut oil, organic pastured eggs and animal fats, including animal-based omega-3s.

Get regular exercise each week and increase physical movement throughout waking hours, with the goal of sitting down less than three hours a day.

Get quality sleep. Most people need right around eight hours per night. This will help normalize your hormonal system.

Optimize your vitamin D level, ideally through sensible sun exposure. If using oral vitamin D3 supplementation, be sure to increase your intake of magnesium and vitamin K2 as well, as these nutrients work in tandem. It’s important to test your vitamin D level to see if you need supplementation.

Optimize your gut health by regularly eating fermented foods and/or taking a high-quality probiotic supplement.

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