Weaker Grips

Thursday, June 23rd, 2016

Researchers from the Winston-Salem State University in North Carolina found that men and women under 30 have weaker grip strength than they did back in 1985:

The researchers asked almost 240 men and women under 30 — most 20 to 24 years old — to exert as much force as they could on a hand dynamometer, which measures grip force in pounds. On average, men’s hand strength decreased by 20 pounds, and women’s hand strength decreased by 10 pounds.

The culprit? Probably a combination of increased technology use at home and at work, and less manual labor. “As a society, we’re no longer agricultural or manufacturing,” Elizabeth Fain, an occupational therapist and lead author of the study, told NPR.

Ten to Twelve Percent Slower

Thursday, June 2nd, 2016

Transgender athlete Joanna Harper explains what happened after her transition:

In 2005, nine months after starting HRT, I was running 12% slower than I had run with male T levels; women run 10-12% slower than men over a wide range of distances. In 2006 I met another trans woman runner and the she had the same experience. I later discovered that, if aging is factored in, this 10-12% loss of speed is standard among trans women endurance athletes. The realization that one can take a male distance runner, make that runner hormonally female, and wind up with a female distance runner of the same relative capability was life changing for me.

Dorian Yates’ First Cycle

Friday, May 20th, 2016

I stumbled across an interview with Dorian Yates — it takes some odd turns, by the way — where he briefly mentions how he started using “gear” right before his first competition — where he blew everyone away:

It was 1985. I was 23 years old and had decided to enter my first competition after a year and a half of training, in which I had made excellent progress. I knew the others who would be competing would be using gear, and I wanted to even the playing field. It was a very deliberate decision that I didn’t take lightly, and I did as much reading as I could first. At 23, I feel I was old enough. At that age, you are fully matured physically, you’ve reached your full adult height, and so on. Even though I hadn’t been training terribly long, I had already managed to develop my physique to a decent level.

Looking back, I may have been able to win that contest without using anything. I did one six-week “building” cycle of 20 milligrams of Dianabol a day, which took me from 215 at 5’11” to 235. Those were the most dramatic results I ever saw from steroids. I took six weeks off the gear, then at eight weeks out from my contest I began using 15 milligrams of Anavar per day, as well as one shot of Primobolan a week, which was 200 milligrams.

I competed at around 210-215 and won that contest. EFBB [Britain’s equivalent of the NPC] officials were there and convinced me to represent the United Kingdom the following weekend as our heavyweight at the IFBB World Games. I placed seventh, and competed with men like Berry de Mey and Matt Mendenhall, both of whom were the top amateur heavyweights in their respective nations at that time.

I suppose Dorian was a natural, even if he wasn’t natural.

One Minute All Out

Wednesday, May 11th, 2016

It still surprises people that one minute of all-out exercise may have all the benefits of 45 minutes of moderate exertion:

[The scientists at McMaster University in Hamilton, Ontario] began by recruiting 25 out-of-shape young men and measuring their current aerobic fitness and, as a marker of general health, their body’s ability to use insulin properly to regulate blood sugar levels. The scientists also biopsied the men’s muscles to examine how well their muscles functioned at a cellular level.

Then the researchers randomly divided the men into three groups. (The scientists plan to study women in subsequent experiments.) One group was asked to change nothing about their current, virtually nonexistent exercise routines; they would be the controls.

A second group began a typical endurance-workout routine, consisting of riding at a moderate pace on a stationary bicycle at the lab for 45 minutes, with a two-minute warm-up and three-minute cool down.

The final group was assigned to interval training, using the most abbreviated workout yet to have shown benefits. Specifically, the volunteers warmed up for two minutes on stationary bicycles, then pedaled as hard as possible for 20 seconds; rode at a very slow pace for two minutes, sprinted all-out again for 20 seconds; recovered with slow riding for another two minutes; pedaled all-out for a final 20 seconds; then cooled down for three minutes. The entire workout lasted 10 minutes, with only one minute of that time being strenuous.

Both groups of exercising volunteers completed three sessions each week for 12 weeks, a period of time that is about twice as long as in most past studies of interval training.

By the end of the study, published in PLOS One, the endurance group had ridden for 27 hours, while the interval group had ridden for six hours, with only 36 minutes of that time being strenuous.

But when the scientists retested the men’s aerobic fitness, muscles and blood-sugar control now, they found that the exercisers showed virtually identical gains, whether they had completed the long endurance workouts or the short, grueling intervals. In both groups, endurance had increased by nearly 20 percent, insulin resistance likewise had improved significantly, and there were significant increases in the number and function of certain microscopic structures in the men’s muscles that are related to energy production and oxygen consumption.

The Sweet Spot for Intermittent Fasting

Wednesday, May 4th, 2016

Mangan shares some research that suggests that the sweet spot for intermittent fasting occurs between 18 and 24 hours:

Fasting Sweet Spot

Understanding and Training the Female Shooter

Monday, May 2nd, 2016

Greg Ellifritz shares some things he learned from Lou Ann Hamblin’s Understanding and Training the Female Shooter class:

When measured on a dynamometer, most men have similar grip strength between their dominant and non-dominant hands (as tested in class, my hands differed by only 2 lbs. of force between right and left). Most women have a HUGE disparity…differences of up to 40% are common. Would that knowledge affect how you teach off-handed shooting for a female student? It should.

Female vision is different than male vision. Women have less depth perception, but better peripheral vision than men. It affects how women see the sights on their guns and how far they have to move their head to do an after-action scan.

Shorter-waisted women have difficulty drawing from many traditional holsters. Their body styles change which gear works best for them.

Women are known to be better multi-taskers than men. This can be problematic in firearms training as some women will try to do too much, taking your suggestions very literally. If you give most women a list of 10 things they are doing “wrong”, they will try to work on them all simultaneously and won’t make as much improvement as if you gave them just one or two things to improve at a time.

Because of differing motivational strategies, competition in training will often yield different results between men and women. Most men really enjoy competition and find it valuable. Because most women are motivated more by social connection than by ego gratification, competition may not give the same benefits. Lou Ann suggested using team competitions (where students are partnered up to achieve a goal) when training women. She believes that women will be better motivated to perform if they are trying to help their partner than if they were trying to win some type of individual award.

“Women need details…but only when they are ready for them. Don’t over-explain things in the beginning, but be ready to explain things in much more detail that you ever imagined necessary when she asks for it. But, she won’t ask for the details if she thinks you are a dick.”

The Sugar Conspiracy

Thursday, April 21st, 2016

The sugar conspiracy seems so brazen in retrospect:

Robert Lustig is a paediatric endocrinologist at the University of California who specialises in the treatment of childhood obesity. A 90-minute talk he gave in 2009, titled Sugar: The Bitter Truth, has now been viewed more than six million times on YouTube. In it, Lustig argues forcefully that fructose, a form of sugar ubiquitous in modern diets, is a “poison” culpable for America’s obesity epidemic.

A year or so before the video was posted, Lustig gave a similar talk to a conference of biochemists in Adelaide, Australia. Afterwards, a scientist in the audience approached him. Surely, the man said, you’ve read Yudkin. Lustig shook his head. John Yudkin, said the scientist, was a British professor of nutrition who had sounded the alarm on sugar back in 1972, in a book called Pure, White, and Deadly.

“If only a small fraction of what we know about the effects of sugar were to be revealed in relation to any other material used as a food additive,” wrote Yudkin, “that material would promptly be banned.” The book did well, but Yudkin paid a high price for it. Prominent nutritionists combined with the food industry to destroy his reputation, and his career never recovered. He died, in 1995, a disappointed, largely forgotten man.

[...]

When Yudkin was conducting his research into the effects of sugar, in the 1960s, a new nutritional orthodoxy was in the process of asserting itself. Its central tenet was that a healthy diet is a low-fat diet. Yudkin led a diminishing band of dissenters who believed that sugar, not fat, was the more likely cause of maladies such as obesity, heart disease and diabetes. But by the time he wrote his book, the commanding heights of the field had been seized by proponents of the fat hypothesis. Yudkin found himself fighting a rearguard action, and he was defeated.

Not just defeated, in fact, but buried. When Lustig returned to California, he searched for Pure, White and Deadly in bookstores and online, to no avail. Eventually, he tracked down a copy after submitting a request to his university library. On reading Yudkin’s introduction, he felt a shock of recognition.

“Holy crap,” Lustig thought. “This guy got there 35 years before me.”

[...]

Look at a graph of postwar obesity rates and it becomes clear that something changed after 1980. In the US, the line rises very gradually until, in the early 1980s, it takes off like an aeroplane. Just 12% of Americans were obese in 1950, 15% in 1980, 35% by 2000. In the UK, the line is flat for decades until the mid-1980s, at which point it also turns towards the sky. Only 6% of Britons were obese in 1980. In the next 20 years that figure more than trebled. Today, two thirds of Britons are either obese or overweight, making this the fattest country in the EU. Type 2 diabetes, closely related to obesity, has risen in tandem in both countries.

At best, we can conclude that the official guidelines did not achieve their objective; at worst, they led to a decades-long health catastrophe.

[...]

We tend to think of heretics as contrarians, individuals with a compulsion to flout conventional wisdom. But sometimes a heretic is simply a mainstream thinker who stays facing the same way while everyone around him turns 180 degrees. When, in 1957, John Yudkin first floated his hypothesis that sugar was a hazard to public health, it was taken seriously, as was its proponent. By the time Yudkin retired, 14 years later, both theory and author had been marginalised and derided. Only now is Yudkin’s work being returned, posthumously, to the scientific mainstream.

Read the whole thing.

Metformin is for fat, sick people

Saturday, January 2nd, 2016

Metformin is for fat, sick people, Mangan concludes:

As is the case with normal lab reference ranges, metformin may help people who are fat and sick, which is almost everyone these days. Two thirds of the people in the U.S. are overweight or obese, most don’t exercise, and they eat processed junk out of boxes and bags. They take lots of prescription drugs.

These people aren’t capable of fighting aging and disease except with a pill.

If you exercise vigorously and regularly (especially strength training), incorporate an intermittent fasting regimen into your health practices, drink coffee, tea, and red wine, take supplements like aspirin and curcumin, and eat a relatively low-carbohydrate diet, is metformin going to increase your lifespan? That seems very doubtful.

If you’re fat, diabetic, and sedentary, and totally unwilling to make any changes in your lifestyle, will metformin help? Probably yes.

The 20 Principles of Rogue Health

Friday, January 1st, 2016

Mangan lists his 20 principles of Rogue Health:

  1. Maintenance of a lean body mass with a relatively low level of body fat is important both for health and for slowing aging.
  2. While having too much fat is bad, having too little muscle may be worse.
  3. We all lose muscle as we age, and most people do nothing about it.
  4. Insulin sensitivity is important for health and aging.
  5. Weightlifting, also known as strength training and resistance training, is the best form of exercise for staying lean, maintaining and growing muscle, combating the frailty of aging, and maintaining good insulin sensitivity.
  6. High intensity training (HIT), is a very effective form of exercise and can be used as an adjunct or, for some, a replacement to weightlifting.
  7. Aerobic exercise, that is exercises such as running, walking, or the use of cardio machines in the gym, have health benefits, but as such they come in a distant second to weightlifting and HIT.
  8. You can’t outrun a bad diet.
  9. If hunger always wins, then to lose fat one must choose a way of eating that dampens hunger.
  10. The cholesterol hypothesis of heart disease is nonsense.
  11. Paleo is a healthy way to eat.
  12. Aging is a multifactorial process, but much of it seems due to a growth-longevity trade-off.
  13. Calorie restriction (CR) robustly extends lifespan in lab animals, but intermittent fasting gives most or all of the benefits of CR without any of its nasty side effects,
  14. Quit eating all the time.
  15. Aging is characterized by a decline in the process of autophagy, the physiological process used by cells to rid themselves of cellular junk and to recycle it.
  16. Hormesis is the process in which a low dose of a toxic compound or stressor elicits a beneficial response from the body, and it is critical to health and anti-aging.
  17. Aging is controlled in part by AMPK, which is a cellular nutrient/energy sensor.
  18. Testosterone is important for men.
  19. Iron can reasonably be suspected as being a primary cause of aging, as well as the cause of the lower life expectancy and higher heart disease and cancer rates versus women.
  20. Stay active.

Ground Combat Element Integrated Task Force

Monday, September 14th, 2015

Some 400 Marines, including about 100 women, signed up to be test subjects in the Marine Corps’ Ground Combat Element Integrated Task Force experiment:

Cpl. Janee’ Sheffield knew she was done when she kept rolling the same ankle on daily hikes, leaving her in constant pain. She dropped on request from the provisional rifle platoon — made up of Marines who had not attended ITB — six days before the unit completed its round of assessments at Twentynine Palms and traveled to nearby Bridgeport for mountain warfare exercises.

Like the other rifle platoons, the provisional platoon was on a repetitive cycle that alternated between two assessment days: a movement-to-contact exercise in which Marines would charge 1,000 yards up a hill with weapons and 30-pound packs, scramble over an 8-foot shipping container and maneuver together toward simulated enemy fire while shooting at pop-up targets; and a hike day involving a roughly 4.5-mile march followed by two arduous hours digging fighting holes.

Before opting out of the task force, Sheffield, 23, had decided the infantry wasn’t for her.

“It sucked; it really sucked,” she said. “I wouldn’t do this experiment again.”

[...]

While videos and photographs released by the Marine Corps show women excelling at combat tasks, Bradshaw said they omitted the moments of failure. He watched a four-woman team struggling for more than seven minutes to move a 200-pound dummy, without success, he said. Another time, he said, female Marines failed to clamber over the top of the shipping container during movement-to-contact assessments.

One lance corporal who entered the experiment “believing that women should get a shot at service in the infantry as long as they could meet existing standards” changed his mind after he saw what happened in the light armored vehicle platoon — where the physical demands weren’t extreme:

Over time, he said, discipline broke down because some noncommissioned officers were hesitant to hurt the feelings of more junior female Marines with orders or correction. Romantic relationships and friendships between male and female unit members also became a distraction, he said.

“The female variable in this social experiment has wrought a fundamental change in the way male NCOs think, act and lead,” Augello wrote in the 13-page paper he presented to Marine leaders, which he shared with Marine Corps Times. “A change that is sadly for the worse, not the better.”

Physically, both the men and women in Augello’s platoon fared well. No one was dropped due to injury over the course of the experiment, unit members said. But the lance corporal said he became frustrated during group assessments, such as an exercise in which platoon members had to work together to haul a dummy weighing nearly 200 pounds out of the vehicle turret and to a designated recovery spot dozens of yards away. When partnered with the platoon’s female Marines, he said he frequently had to compensate for their smaller frames and lack of upper body strength by hauling more of the load.

“I told myself, ‘I don’t know how much longer my back will have after doing this,’” he recalled.

During one assessment, Augello said he found himself paired with the smallest male Marine in the platoon — one who was physically shorter and slighter than a number of the unit’s female Marines. But the Marine’s build and musculature made a significant difference, he said.

“I didn’t feel a lot of stress on my back because he was able to actually help me,” he said. “His upper body strength made the difference at the end of the day.”

The Marine Corps’ data findings included the following:

  • All-male squads and teams outperformed those that included women on 69 percent of the 134 ground combat tasks evaluated.
  • All-male teams were outperformed by mixed-gender teams on two tasks: accuracy in firing the 50-caliber machine gun in traditional rifleman units and the same skill in provisional units. Researchers did not know why gender-mixed teams did better on these skills, but said the advantage did not persist when the teams continued on to movement-under-load exercises.
  • All-male squads in every infantry job were faster than mixed-gender squads in each tactical movement evaluated. The differences between the teams were most pronounced in crew-served weapons teams. Those teams had to carry weapons and ammunition in addition to their individual combat loads.
  • Male-only rifleman squads were more accurate than gender-integrated counterparts on each individual weapons system, including the M4 carbine, the M27 infantry automatic rifle and the M203 grenade launcher.
  • Male Marines with no formal infantry training outperformed infantry-trained women on each weapons system, at levels ranging from 11 to 16 percentage points.

Female Marines often struggled with routine tasks:

In scaling an 8-foot wall obstacle, researchers wrote, male Marines would throw their packs to the top of the wall, while female Marines “required regular assistance” to do the same. During simulated casualty evacuations involving a 200-pound dummy, mixed-gender groups were notably slower at the task, except in cases when a single Marine would move the dummy using a fireman’s carry. And in those cases, “it was most often a male Marine who ‘evacuated’ the casualty,” according to the findings analysis.

Some of the biological data surprised me:

  • The average male Marine volunteer was 178 pounds with 20 percent body fat; the average female volunteer weighed 142 pounds with 24 percent body fat.
  • In anaerobic power and capacity, female Marines averaged 15 percent lower levels than their male counterparts. In anaerobic power performance, the top 25 percent of female performers and the bottom 25 percent of male performers overlapped.
  • In aerobic capacity, female Marines demonstrated levels 10 percent lower on average than male Marines.
  • Over the course of the assessment, musculoskeletal injury rates totaled 40.5 percent for women, more than double the 18.8 percent rate for men.
  • In all, female Marines sustained 21 “time-loss” injuries which took them away from task force duties for a day or more. Nineteen of the women’s injuries were lower extremity injuries and 16 percent took place during a task that required movement while carrying a load. Officials said they could not immediately provide the comparable injury rates for men but said lower extremity injuries were the most common among male Marines as well.

I wouldn’t expect young male Marines to carry 20 percent body-fat.

The real problem is injury rates:

High injury rates among women were also a problem at the Infantry Training Battalion, the Marines’ basic infantry training school for enlisted troops that temporarily opened to women between 2013 and 2015. Researchers found that female ITB participants were injured at more than six times the rate of male participants, and nearly one-third of their injuries occurred during movement-under-load tasks, while just 13 percent of male injuries did.

Overall, women graduated ITB with a 36 percent success rate during the evaluation period. Male Marines had a 99 percent graduation rate during that same window.

Dear Fat People

Monday, September 7th, 2015

I had never heard of comedienne Nicole Arbour before, but it caught my attention when YouTube shut down her page because her “Dear Fat People” rant offended the Powers That Be.

Not terribly clever — but it doesn’t have to be.

How Serena Williams Produced Her Second Act

Tuesday, September 1st, 2015

There’s no better word to sum up Serena Williams in 2015, Tom Perrotta suggests than — wait for it — wisdom:

At age 33, Williams has improbably peaked when injuries and indifference usually spell the end for a tennis champion. She remains an otherworldly athlete, blessed with speed, flexibility and strength that equals or surpasses her competitors. It’s not a trivial advantage.

But Williams’s speed and power have long obscured other, quieter attributes. She is a tennis player’s tennis player, and these days she relies more than ever on her mind, her determination, her tactics, her anticipation and a serve that is a study in perfect mechanics.

“I’m a really amazing thinker on the court,” Williams said.

To illustrate her wisdom, the Wall Street Journal chose this image:

Serena Williams Serving at 124 MPH

10-20-30 Training

Sunday, August 16th, 2015

Interval training has its strengths and weaknesses:

Many studies have shown that even a few minutes of these intervals can substantially improve health and cardiovascular fitness.

But high-intensity interval workouts have a drawback that is seldom acknowledged. Many people don’t like them and soon abandon the program.

Jens Bangsbo, a professor of physiology at the University of Copenhagen in Denmark, and his team came up with a candidate routine and named it 10-20-30 training:

Run, ride or perhaps row on a rowing machine gently for 30 seconds, accelerate to a moderate pace for 20 seconds, then sprint as hard as you can for 10 seconds. (It should be called 30-20-10 training, obviously, but that is not as catchy.)

It worked:

After eight weeks, almost all of the runners in the 10-20-30 group were still following the program. And when they repeated their 5K runs, they had shaved an average of 38 seconds from their times. Most also had lower blood pressure and other markers of improved health.

There were no changes among the runners in the control group.

(Hat tip to Mangan.)

Don’t be a victim of muscle loss

Sunday, August 2nd, 2015

The average muscle loss in men between the ages of 50 and 70 is 30 percent, Mangan notes, and from ages 70 to 80, another 20 to 30% of muscle is lost:

Add those figures and you’ve got the basis for the fact that most 80-year-old men will have lost 50% of their muscle mass.

It doesn’t have to be that way, if you keep active:

Muscle-Loss Cross-Sections

Blowing up a Balloon

Saturday, August 1st, 2015

Nutrition gets little attention or respect in medicine, but Dr. Malcolm Kendrick became side tracked by the very powerful and consistent association between heart disease and diabetes:

In short, if you added together what was clear about diabetes and insulin resistance, you got a model of type II diabetes which looked pretty much like this:

  • You eat too much food.
  • You put on weight.
  • As you put on weight you become more and more insulin resistant.
  • At first you will develop insulin resistance syndrome.
  • If you keep putting on weight you will become so insulin resistant that you will develop frank type II diabetes.

I call this the ‘blowing up a balloon’ theory of diabetes. As a balloon expands you have to blow harder and harder to overcome the resistance. As you get fatter and fatter you need more and more insulin to force fats into fat cells. As with many things in medicine this is a nice simple story. It is also very easy to understand, and it is tantalisingly close to being correct.

[...]

Beginning with the most obese group people on the planet earth, namely Sumo wrestlers. I wanted to know how many of them have diabetes, and it did not take long to discover that, whilst in training, none of them have diabetes.

I then searched for the opposite end of the spectrum. Were there people with no adipose tissue, and how many of them had diabetes? Surprisingly, there is one such group, the least obese people on earth. They are those with Beradinelli-Siep lipodystrophy. This is a genetic abnormality which means that these poor unfortunates have almost no fat cells. How many of them have type II diabetes? Well, all of them actually.

I then looked for the population with the highest rate of diabetes in the world. This happens to be the Pima Indians of North Mexico/Southern US. I have seen figures reporting that over 80% of adult males Pima Indians have type II diabetes. It may even be more. And yes, they are very obese.

However, there are two other very interesting facts about the Pima Indians. First, they have a very low rate of heart disease. Or they did last time I looked. Perhaps most importantly, in their youth, when they are not obese, they produce far more insulin in response to food than ‘normal’ populations. Or, to put this another way, they are hyper-insulinaemic before they are obese, and long before they become diabetic. So their excess insulin production is not a result of becoming fatter. The causal chain is the other way around.

I have found that if you speak to most doctors about these facts, a look of complete incomprehension passes over their faces. ‘That cannot be right.’ Of course if you believe in the ‘blowing up a balloon’ model of diabetes, then the Pima Indians, Sumo Wrestlers and those with Beradinalli-Siep lipodystrophy do not make any sense. However, in science, when observations do not fit your hypothesis, it is the hypothesis that needs to change, not the facts.

Just to summarize these ‘paradoxical’ facts:

  • You do not need any fat cells to develop diabetes/if you have no fat cells there is a 100% probability that you will be diabetic.
  • You can be very , very, obese and not have diabetes.
  • You can have increased insulin production long before you become obese (and/or insulin resistant). You become obese later.

[...]

However, luckily, there is another model that fits all the facts. One that I prepared earlier:

  • You produce too much insulin.
  • This forces your body to store fat.
  • You become obese.
  • At a certain point insulin resistance develops to block further weight gain.
  • This resistance becomes more and more severe until…
  • You become diabetic.

This model explains the Pima Indians. Can Sumo wrestlers be fitted into this model? Yes, with a couple of addendums. Sumo Wrestlers eat to become fat, because added mass provides a competitive advantage if you are trying to shove someone else out of a small ring, before they do it to you.

To achieve super-obesity, they wake up, train for two hours, then eat as much as they can of a high carbohydrate, low fat, broth. They then lie about for a few hours allowing the high insulin levels created by the high carbohydrate diet to convert excess sugars to fat, storing this in adipose tissue. Later on they train very hard again, then eat, then sleep. Rpt.

The reason why they do not become diabetic is on this regime is simply because they exercise very, very, hard. They burn up all the sugar/glycogen stores in the liver and muscle whilst exercising, which means that when they eat, the sugar(s) can – at least at first – be easily stored in muscle and liver (so there is no insulin resistance to overcome). However, once these guys stop training, things do not look so good. Diabetes lurks..

Those with Beradinelli-Siep lipodystrophy have the reverse problem to Sumo Wrestlers. Because they have no fat cells there is nowhere to store excess energy to go. If they eat carbohydrate/sugar, the first 1,500 calories can be stored as glycogen – after that there is nowhere left. If the liver converts sugar to fat, there is nowhere for that to go either. So, you get ‘back-pressure’ through the system. It doesn’t matter how high the insulin level gets, if you have nowhere to store energy you have nowhere to store energy. End of.

Whilst those with lipodystrophy cannot tell us much about diabetes and obesity in ‘normal’ people. This condition does make it very clear that diabetes – insulin resistance, high insulin and high sugar levels – is primarily an issue with energy storage and how the body goes about this storage, and the role that insulin plays. If there is somewhere for excess energy to go easily, insulin levels will not go up, and nor will blood sugar levels.

But what of ‘normal’ people. Can normal people be fitted into the updated model of type II diabetes? Well, of course, they can. But you need another step in the new model, the first step. Which means we have a new causal chain, and it looks something like this ‘You eat too much carbohydrate.’ Adding in this step gives us the new model:

  • You eat too much carbohydrate/sugar.
  • You produce too much insulin.
  • This forces your body to store fat.
  • You become obese.
  • At a certain point insulin resistance develops to block further weight gain.
  • This resistance becomes more and more severe until…
  • You become diabetic.

(Hat tip to Mangan.)