I weighed 11 pounds, 9 ounces when I was born.
My mom’s doctors treated this as an amusing outlier statistic.
While many parents brag about having large babies, my high birth weight meant that my mom had a baby with fetal macrosomia, a condition where babies are born above the “healthy” weight of 8 pounds, 13 ounces. Fetal macrosomia (literally meaning “big body”) can lead to increased risk of many complications for the baby, including childhood obesity and metabolic syndrome. Studies show that having babies who far exceed the criteria for large birthweight is a clear sign of insulin resistance (i.e., poor glucose management). While she wasn’t diagnosed at the time, I suspect she may have had gestational diabetes, where higher than normal blood sugar and insulin levels during pregnancy often results in babies gaining excess weight in utero.
It is perplexing to me why my mom’s physicians didn’t explain to her that fetal macrosomia is related to impaired glucose management for the mother, particularly since she went on to die prematurely from a disease directly linked to blood sugar dysregulation that was preventable with early intervention. When glucose (sugar) enters in the blood, insulin is released to let the sugar into cells where they are powered for energy. High-sugar diets overwhelm the body with glucose, leading cells to become insulin resistant and causing excess glucose to build up in the bloodstream.
My extreme birthweight could have been one of the first signs in her life that she needed to control her insulin, but nobody told her. As cells become resistant to insulin, they do not behave properly. This metabolic dysfunction is what causes disease.
My mother’s metabolic dysfunction showed up in my excess birthweight, her difficulty losing weight after her pregnancy, her rising weight throughout her 40s, and blood sugar problems and prediabetes that started in her 50s.
Her metabolic dysfunction was also a link to the pancreatic cancer that ended her life – more than 80% of people who contract pancreatic cancer have some degree of insulin insensitivity. This could have been prevented if my high birthweight was seen as a warning sign instead of an amusing, isolated health situation.
Canary in the Coal Mine
My mom’s experience is just the tip of the iceberg in the relationship between fertility and larger root causes of our health issues. Is there anything more evolutionarily vital than our reproductive organs? How could skyrocketing fertility issues, for both men and women, not be related to wider health problems?
Polycystic ovary syndrome (PCOS), which is interconnected to gestational diabetes, is the most common form of female infertility. Friends I have spoken to who have struggled with PCOS have also said the condition is treated as an isolated incident, with them leaving the OBGYN with a pile of prescriptions but little understanding of the underlying causes. A woman diagnosed with PCOS today will most likely be prescribed an assortment of pills to artificially induce egg production, lower cholesterol, and/or regulate insulin levels. If fertility issues persist, procedures like IVF are often recommended.
But insulin resistance is a causal link to PCOS: excess insulin stimulates the ovaries to produce “masculine” hormones, including testosterone – causing fertility issues. And insulin resistance is preventable and reversible.
Ignoring the root causes isn’t working. Today, up to 26% of women have PCOS and gestational diabetes rates have doubled between 2006 and 2016. This is directly tied to our diet, which has seen a 150x increase in sugar intake in the past 100 years. Often, these fertility issues are the first visible signs of metabolic dysfunction that will severely limit the quality and duration of life.
Between 1973 and 2011, male sperm count has reduced more than 50%. In the past 10 years, the case of miscarriages has gone up 10%.
What about erectile dysfunction? We all know about Viagra. There is certainly a place for it. But have you ever heard a medical professional ask why an exponentially growing number of penises aren’t working? Could this possibly be related to wider health issues?
The penis is not a siloed part of the body. Viagra might reduce inflammation in the arteries leading the penis, but shouldn’t we be asking why those blood vessels are inflamed in the first place?
It turns out erectile dysfunction is one of the best indicators we have of metabolic dysfunction. In fact, 79% of men with ED are overweight, up to 75% of men with diabetes will experience ED, and there is almost no relation between the aging process and ED – it is all about lifestyle and diet factors.
Most importantly, ED is one of the strongest warning signs of larger health issues. In fact, ED is highly correlated with diseases such as diabetes, heart disease, and hypertension. This shouldn’t be a surprise – ED is constrained blood flow between capillaries which is the same thing as hypertension. Having ED also increases the risk of depression by 192%.
ED should be a big flashing warning light that you have other health problems. But you will rarely hear this.
It is hard to turn on the television without seeing advertisements for online services like Hims or Ro that offer Viagra mailed to you in a few clicks. My venture capitalist friends tell me these companies are “innovative,” but I increasingly see them as part of a dysfunctional system that generates recurring revenue by selling pills and procedures that ameliorate symptoms of disease – while ignoring the root causes of why we are sick.
I think patients want to know why they are infertile, why their penises are not working, why they are unable to lose weight when they are desperately trying, why 25% of adult women are on an antidepressant, why 30% of adults over 40 are on a statin, and why 12% of adults in the United States need to carry an insulin pen.
What we are currently doing isn’t working.
For the first time in American history, life expectancy is in consistent decline. We are experiencing record rates of diabetes, obesity, heart disease, chronic liver disease, stroke, and Alzheimer’s. These preventable chronic diseases kill 70 percent of Americans and make up 80% of healthcare costs.
Millions of lives are being shortened by not seeing early signs of metabolic dysfunction for the warning signs they are.
We need to start demanding explanations for the root causes of diseases.
I’m publishing ideas on healthcare to hopefully spark ideas among friends, stress-test my thinking, and engage with other people who are passionate about these issues. You can contact me via Email, Instagram, or Twitter.
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