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The Hierarchy of Influence

September 30, 2017
Mary Kay

Lately, I’ve been talking to adults facing some kind of major health crisis...Crohns, MS, arthritis, liver disease, early onset Parkinson’s, etc.  And all these people are very active and eat clean, balanced diets.  They’re also diligent Wellness detectives who get regular check-ups and watch their labs.  The most common thing I hear from them is, “How did this happen?”  Interestingly, in a recent seminar my teacher commented that we live in a very different era…that it’s not a matter of if you’ll get sick, it’s just a question of when.  He also said there’s a growing number of doctors who are changing their assessment protocols.  Instead of asking if a person is at risk for disease, they automatically assume they are.  Hence, they look at genetic propensities and watch for inflammation markers.  And when a person gets sick, instead of asking what’s causing this, they ask 1) what triggered it and 2) what are all the contributing factors?  Then, they take a multi-pronged approach to resolving it.  Well, besides the basic eat well, exercise and minimize toxins recommendations we’ve all heard, I wondered, what else can fitness-minded adults do now to minimize the intensity of a future health crisis?

Mitochondrial Damage … The Trigger for Most Diseases

One of the most interesting discoveries of the last 90 years is the notion that the majority of diseases are at their core a metabolic issue.  Interest first grew in 1924 after German scientist Otto Warburg observed that cancer cells had a perverted method of generating energy.  That is, rather than using oxygen to produce energy, he found they relied on a different pathway (devoid of oxygen) known as fermentation.  (Note:  cells feed on sugar and/or starch to create energy.)  He also believed when the cell’s ability to generate energy through the oxidative pathway is damaged, the cell automatically reverts to it’s back-up generator… or switches to fermentation.

Since then other researchers have expanded upon Warburg’s hypothesis noting that, across the board, many serious issues have another condition present…namely insulin resistance.  Dr. Robert Lustig, Professor of Pediatric Endocrinology at the University of California, San Francisco (USCF), says insulin resistance happens at a tissue or organ level.  That is, whatever organ becomes insulin resistant ends up manifesting its own chronic metabolic disease.  If you develop insulin resistance of the liver, you end up with type 2 diabetes.  When you have insulin resistance of the brain, you end up with Alzheimer’s disease.  Insulin resistance of the kidney leads to chronic renal disease or adrenal issues, and so forth.  All of these diseases at the start are insulin resistant states. The question is what triggers the insulin resistance in the first place?  According to him, the primary cause is damaged mitochondria. 

You might recall when mitochondria become overloaded or damaged, they cannot generate energy for cellular survival.  That’s when they send out emergency signals to the nucleus, pleading for it to switch on its emergency generators.  But here’s the thing.  This call is not a switch that toggles from one process to the other as a continuous energy system.  Once this call is made and DNA responds, the entire complexion of the cell changes so that it can support a new cellular level of energy metabolism and activity.  (This is why people who are insulin resistant have a difficult time changing their metabolism.  It’s because the DNA are following a new set of energy-producing instructions.)

Insulin Resistance Can Be Localized...Within Cells

Because insulin resistance starts in the local tissues, it isn’t always strong enough to register on blood tests.  This is important because insulin and blood glucose levels change over the course of a day, and many people experience “false negatives” on their tests…meaning total levels are not significant enough to yield a positive result.   But the body leaves clues.  Many experts now believe the following symptoms may be early warning signs that the body is experiencing localized insulin resistance:

  • Feeling sluggish (physically and mentally)
  • Inability to focus or feeling fuzzy-minded
  • Gaining weight (especially around waist) and having difficulty losing it
  • Having blood pressure creep up year after year and finding that blood cholesterol, triglycerides, and blood sugar levels are doing the same
  • Increased # of colds or flu each year
  • Progressive muscle atrophy and/or loss of work capacity year over year
  • Aging faster than your peers

The Hierarchy of Influence

Low carbohydrate and/or ketogenic diets as well as intermittent fasting are very popular these days.  They teach people how to limit the amount of carbohydrates and sugar they consume while helping the body use fat for energy…all good techniques for reducing weight, increasing mitochondrial function and improving insulin/blood sugar levels.  But the latest research coming out of the AIDS, cancer, Alzheimer’s and auto-immune disease fields is showing us that the body is a much more complicated biological organism. That regardless of the trigger for disease, there are actually a host of contributing factors.  Yes, weak or damaged mitochondria is important, but add to that...a person's genetic propensities, too many chemicals (which damage the intestinal lining and kill off beneficial bacteria), too many omega-6 fatty acids (which are pro-inflammatory), too many branched-chain amino acids (which can overload the liver and cause chronic metabolic disease), too little fiber, too few micro-nutrients, and too little omega-3 fatty acids (which are anti-inflammatory), and you've created a biological eco-system for damaged cells to multiply and thrive. 

Hence, many Wellness front-runners are now advocating a set of new rules to help adults pro-actively navigate their body’s health and Wellness journey. They call it the hierarchy of influence…a set of “interconnected levers” that together shift the body into a state of wellness or illness.  Now, while some fields have as many 35 levers, I find that’s too many for most adults to keep track of.  So, I’ve distilled into the "Big 5" with a specified order.  For example, it does no good to jump to hormonal deficiencies if your diet is bad, you don’t exercise, etc.  They are:  

#1 Diet – This is the MOST influential thing you can do.  You have to have your house in order, starting with the food and liquids you consume.  Many people like Paleo, Ketogenic and vegetarian diets.  Regardless of your food structure, make sure you:

  • Eat the amount of organic, macronutrients that align to your  activities
  • Aim for 7-10 cups of raw leafy greens and colored vegetables a day
  • Aim for ≤25 grams of sugar a day (or 60 grams of carbohydrates and 15 grams or less of sugar if you are insulin resistant)
  • Aim for 40-50% of your calories to come from healthy fats (e.g., avocados, raw nuts, coconut and extra virgin olive oil, etc.).  The less fat you consume the less ability for the body to replenish hormones.
  • Drink lots of filtered water (aka not stored in plastic bottles)

Also, if you find meal planning particularly stressful, consider trying out local services that deliver fresh, organic paleo or ketogenic meals to your door.  It saves a ton of planning and shopping time and the cost for the service is a “wash” with groceries/going out to eat.

#2 Exercise –The research is clear, if you’re going to keep muscle mass and be able to work at 80% of your work capacity as you age, you need to exercise.  For adults, this means weight lifting at least 3-4x a week and some form of cardio (aka HIIT or low intensity cardio) 2x a week.

#3 Supplements – Lots of money is wasted here.  Seriously, it’s more common for adults to have drawers or traveling duffle bags full of supplements and protein bars versus having a refrigerator stocked with live food.  Having said that, most adults are deficient in several key micro-nutrients.  If you can afford it, consider getting a full nutritional work-up, such as Genova’s NutraEval panel.  These panels go way beyond checking cholesterol levels and dig into oxidative stress levels, fatty acid ratios, antioxidant and amino acid production, digestive support and much more.  Common deficiencies to look out for include:

  • Vitamin D (builds healthy bones and a strong immune system)
  • Vitamin K2 (when taken with vitamin D, shuttles calcium into the bones while simultaneously removing it from the arteries and brain)
  • Magnesium (support the body’s many chemical processes)
  • Alpha Lipoic Acid (helps prevent cell damage and enhances the body’s ability to use insulin)
  • N-Acetylcysteine (NAC) (supports liver detoxification and increase glutathione production)
  • Nicotinamide riboside (NR) (precursor to NAD which is used in the production of ATP for energy and in mitochondria biogenesis
  • Digestive Enzymes
  • Amino Acids (Note:  Many adults are deficient in the amino acid Tryptophan which is necessary for the biosynthesis of proteins…especially in the replication of the intestinal lining.)

#4 Hormones – This makes a HUGE difference if you’ve already done 1-3 as all hormones decline with age.  Replacing them makes you feel like you’re 30 again.  A good naturopath or anti-aging doctor can be of great service, but there’s a lot you can do yourself through bloodwork or saliva tests.  Most health plans only cover testing of thyroid and insulin levels.  You should also look at cortisol (too much shuts off body’s protein synthesis and fat burning processes), pregnenolone (master hormone that converts to other hormones that the body needs), DHEA (helps boost testosterone levels), testosterone, estrogen, progesterone (ideally want a 2:1 ratio with estrogen to prevent estrogen dominance and susceptibility for cancer) and growth hormone (via IGF-1).  

#5 Chemicals – Beyond eating organic and using chemical free toiletries and make-up, the next largest offender is pollutants.  If you’re frequently traveling on planes, working in closed up office spaces or gyms, chances are you’re inhaling high levels of BPA, flame retardants and pthlates…even molds which are not easily cleared by the body.   In fact, research is showing us that chemicals (even air-bound ones) change the behavior of our environment sampling cells (part of the immune system) in 3 distinct ways:

  • By killing beneficial microbes in the body, soil and air
  • By depleting vitamin D in the body – a nutrient that calms immune activity
  • By changing how the immune system develops and reacts

The net of all that is chemical exposure increases the development of all sorts of food sensitivities and digestion disorders.  So, besides eating and using the cleanest food and products, make sure your liver is functioning well, eat plenty of fiber and consider investing in an air purifier that removes volatile organic compounds for your home and office.

Finally, if you’re a strength seeker, consider starting or joining a “Biochemical Club.”  These health clubs on steroids are comprised of savvy men and women who keep up on the latest research and then use their professional network and/or highly analytical minds to develop personal biochemical recipes for just about everything strength and wellness-focused that you may need.  Need a good cellular hydration recipe… a food that triggers protein synthesis when you’re eating only greens…or an amino acid drink that helps curb hunger on “toggle” days (aka focus on losing body fat vs. gaining muscle), these folks have done their research, understand human biochemistry and how that interacts with food and plants and like to share that knowledge to support the aging body.

Bottom line, while we all go through illness bouts, your fate is NOT sealed. Learn how your unique biochemistry works and then master the body’s hierarchy of influence.  All it takes is a few simple changes and a few weeks to see improvements in energy, health and strength.


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