Not a journal articleCDC, National Diabetes Statistics Report (prediabetes: ~96 million U.S. adults in the 2019 estimate; more than 8 in 10 do not know they have it).
Against the Current
Each entry shows the sentence from the book, the study behind it, and what that study actually found. Read them side by side and check the book against its own evidence.
A printed citation is frozen. This page is not. When a paper is retracted or a number is corrected, it changes here first.
Education only. Nothing here is medical advice.
114 sources across 23 chapters. The tag on each source is its address: source 15-4 is at /books#15-4, the same tag printed in the book.
Not a journal articleCDC, National Diabetes Statistics Report (prediabetes: ~96 million U.S. adults in the 2019 estimate; more than 8 in 10 do not know they have it).
Athinarayanan SJ, Adams RN, Hallberg SJ, et al. "Long-Term Effects of a Novel Continuous Remote Care Intervention Including Nutritional Ketosis for the Management of Type 2 Diabetes: A 2-Year Non-randomized Clinical Trial." Front Endocrinol (Lausanne). 2019;10:348.
In the bookmore than half her patients did it, and it stuck at two years.
Hallberg SJ, McKenzie AL, Williams PT, et al. "Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year." Diabetes Ther. 2018;9(2):583-612.
Kearns CE, Schmidt LA, Glantz SA. "Sugar Industry and Coronary Heart Disease Research: A Historical Analysis of Internal Industry Documents." JAMA Intern Med. 2016;176(11):1680-1685.
Ioannidis JPA. "Why Most Published Research Findings Are False." PLoS Med. 2005;2(8):e124.
Not a journal articleYerushalmy J, Hilleboe HE. "Fat in the diet and mortality from heart disease: a methodologic note." N Y State J Med. 1957;57(14):2343-2354.
In the bookHe had data on 22, and kept the 6 that fit his theory.
Not a journal articleAmerican Diabetes Association conflicts of interest (Ch2). Sources: Reuters and Fox News (Nov 2023) on former ADA nutrition director Elizabeth Hanna, "pay to play" lawsuit; ADA 2022 Annual Report (Splenda listed among "elite" supporters giving more than $1 million); PR Newswire (Nov 2025), "Idaho Potatoes and the American Diabetes Association Team Up to Bust Common Nutrition Myths" (the "Mashing the Myth" campaign).
Levine H, Jorgensen N, Martino-Andrade A, et al. "Temporal trends in sperm count: a systematic review and meta-regression analysis." Hum Reprod Update. 2017;23(6):646-659.
Not a journal articleCDC/NCHS, "Prevalence of Overweight, Obesity, and Severe Obesity Among Adults" (Health E-Stat).
In the bookone in eight adults were obese. Now almost 75% of American adults are overweight or obese.
Not a journal articleUSDA Economic Research Service, Sugar and Sweeteners Yearbook Tables (per-capita caloric-sweetener availability, loss-adjusted).
In the bookBy 1999 we hit 158 pounds per person. We're still over 120 pounds today.
Lustig RH. "Fructose: metabolic, hedonic, and societal parallels with ethanol." J Am Diet Assoc. 2010;110(9):1307-1321.
In the bookSugar is alcohol without the buzz. Same liver, same damage.
Not a journal articleMelkonian EA, Asuka E, Schury MP. "Physiology, Gluconeogenesis." StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; last updated 13 November 2023.
In the bookgluconeogenesis
Tondt J, Yancy WS, Westman EC. Application of nutrient essentiality criteria to dietary carbohydrates. Nutr Res Rev. 2020;33(2):260-270. PMID 32102704.
Stewart WK, Fleming LW. Features of a successful therapeutic fast of 382 days' duration. Postgrad Med J. 1973;49(569):203-209. PMID 4803438. PMC2495396.
Kraemer WJ, Ratamess NA. Hormonal responses and adaptations to resistance exercise and training. Sports Med. 2005;35(4):339-361. PMID 15831061.
Catalano PM, Tyzbir ED, Roman NM, Amini SB, Sims EA. Longitudinal changes in insulin release and insulin resistance in nonobese pregnant women. Am J Obstet Gynecol. 1991;165(6 Pt 1):1667-1672. PMID 1750458.
Apter D, Sipila I. Development of children and adolescents: physiological, pathophysiological, and therapeutic aspects. Curr Opin Obstet Gynecol. 1993;5(6):764-773. PMID 8286688.
Louis M, Punjabi NM. "Effects of acute intermittent hypoxia on glucose metabolism in awake healthy volunteers." J Appl Physiol (1985). 2009;106(5):1538-1544.
Ken-Dror G, Fry CH, Murray P, Fluck D, Han TS. "Changes in cortisol levels by continuous positive airway pressure in patients with obstructive sleep apnoea: Meta-analysis of 637 individuals." Clin Endocrinol (Oxf). 2021;95(6):909-917.
Alomri RM, Kennedy GA, Wali SO, Alhejaili F, Robinson SR. "Association between nocturnal activity of the sympathetic nervous system and cognitive dysfunction in obstructive sleep apnoea." Sci Rep. 2021;11(1):11990.
van Raalte DH, Ouwens DM, Diamant M. Novel insights into glucocorticoid-mediated diabetogenic effects: towards expansion of therapeutic options? Eur J Clin Invest. 2009;39(2):81-93. PMID 19200161.
Boivin DB, Boudreau P, Kosmadopoulos A. "Disturbance of the Circadian System in Shift Work and Its Health Impact." J Biol Rhythms. 2022;37(1):3-28. DOI: 10.1177/07487304211064218
In the bookWork the night shift and your body clock does not follow you.
Chen IY, Jarrin DC, Ivers H, Morin CM. "Investigating psychological and physiological responses to the Trier Social Stress Test in young adults with insomnia." Sleep Med. 2018;40:11-22. DOI: 10.1016/j.sleep.2017.09.011
In the bookCortisol can do that.
Battelino T, Danne T, Bergenstal RM, et al. "Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range." Diabetes Care. 2019;42(8):1593-1603.
Shah VN, DuBose SN, Li Z, et al. "Continuous Glucose Monitoring Profiles in Healthy Nondiabetic Participants: A Multicenter Prospective Study." J Clin Endocrinol Metab. 2019;104(10):4356-4364.
In the bookHealthy people without diabetes live between 70 and 140, about 96 percent of the day.
Mo Y, Wang C, Lu J, et al. "Impact of short-term glycemic variability on risk of all-cause mortality in type 2 diabetes patients with well-controlled glucose profile by continuous glucose monitoring: A prospective cohort study." Diabetes Res Clin Pract. 2022;189:109940.
In the bookThose swings have a name: glucose variability.
Mo Y, Lu J, Zhou J. "Glycemic variability: Measurement, target, impact on complications of diabetes and does it really matter?" J Diabetes Investig. 2024;15(1):5-14.
Yajnik CS. "Early life origins of insulin resistance and type 2 diabetes in India and other Asian countries." J Nutr. 2004;134(1):205-210.
In the bookSouth Asians become insulin resistant at a BMI (body mass index) of 23.
Romeo S, Kozlitina J, Xing C, et al. "Genetic variation in PNPLA3 confers susceptibility to nonalcoholic fatty liver disease." Nat Genet. 2008;40(12):1461-1465.
Ostbye T, Welby TJ, Prior IA, Salmond CE, Stokes YM. "Type 2 (non-insulin-dependent) diabetes mellitus, migration and westernisation: the Tokelau Island Migrant Study." Diabetologia. 1989;32(8):585-590.
Svetkey LP, McKeown SP, Wilson AF. "Heritability of salt sensitivity in black Americans." Hypertension. 1996;28(5):854-858.
Schmidlin O, Forman A, Leone A, Sebastian A, Morris RC. "Salt sensitivity in blacks." Hypertension. 2011;58(3):380-385.
Warburg O. "On the origin of cancer cells." Science. 1956;123(3191):309-314.
Lauby-Secretan B, Scoccianti C, Loomis D, et al. "Body Fatness and Cancer — Viewpoint of the IARC Working Group." N Engl J Med. 2016;375(8):794-798.
In the bookObesity and type 2 diabetes sit on the accepted list of cancer risk factors.
Giovannucci E, Harlan DM, Archer MC, et al. "Diabetes and Cancer: A Consensus Report." Diabetes Care. 2010;33(7):1674-1685 (also CA Cancer J Clin. 2010;60(4):207-221).
In the bookObesity and type 2 diabetes sit on the accepted list of cancer risk factors.
WHO Expert Consultation. "Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies." Lancet. 2004;363(9403):157-163. DOI: 10.1016/S0140-6736(03)15268-3
In the bookSouth Asians become insulin resistant at a lower BMI
Taylor R. "Type 2 diabetes and remission: practical management guided by pathophysiology." J Intern Med. 2020;289(6):754-770. PMID 33289165. PMC8247294.
Reaven GM. "Banting lecture 1988. Role of insulin resistance in human disease." Diabetes. 1988;37(12):1595-1607. PMID 3056758.
Hieronimus B, Ensenauer R. "Influence of maternal and paternal pre-conception overweight/obesity on offspring outcomes and strategies for prevention." Eur J Clin Nutr. 2021;75(12):1735-1744. PMID 34131301. PMC8636250.
Shukla AP, Iliescu RG, Thomas CE, Aronne LJ. "Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels." Diabetes Care. 2015;38(7):e98-e99.
Shukla AP, Dickison M, Coughlin N, et al. "The impact of food order on postprandial glycaemic excursions in prediabetes." Diabetes Obes Metab. 2019;21(2):377-381.
In the bookLead with carbs and the spike drowns the fullness signal... Save them for last and fullness gets there first
Anderwald C, Brabant G, Bernroider E, Horn R, Brehm A, Waldhäusl W, Roden M. "Insulin-dependent modulation of plasma ghrelin and leptin concentrations is less pronounced in type 2 diabetic patients." Diabetes. 2003;52(7):1792-1798. PMID 12829648.
Damjanovic SS, Lalic NM, Pesko PM, et al. "Acute effects of ghrelin on insulin secretion and glucose disposal rate in gastrectomized patients." J Clin Endocrinol Metab. 2006;91(7):2574-2581. PMID 16621911.
Polito R, Messina G, Valenzano A, et al. "The Role of Very Low Calorie Ketogenic Diet in Sympathetic Activation..." Int J Environ Res Public Health. 2022;19(4):2253.
Dulloo AG, Jacquet J. "Adaptive reduction in basal metabolic rate in response to food deprivation in humans: a role for feedback signals from fat stores." Am J Clin Nutr. 1998;68(3):599-606. PMID 9734736.
In the bookthe men's resting burn had fallen further than their lost tissue could explain
Yoneshiro T, Aita S, Matsushita M, et al. "Recruited brown adipose tissue as an antiobesity agent in humans." J Clin Invest. 2013;123(8):3404-3408. PMID 23867622. PMC3726164.
In the bookSix weeks of daily cold raised both brown fat activity and the energy people burned in the cold
Schwarz JM, Noworolski SM, Erkin-Cakmak A, et al. "Effects of Dietary Fructose Restriction on Liver Fat, De Novo Lipogenesis, and Insulin Kinetics in Children With Obesity." Gastroenterology. 2017;153(3):743-752.
In the bookin nine days, the fat in their livers dropped by almost half.
Eke PI, Dye BA, Wei L, Thornton-Evans GO, Genco RJ. "Prevalence of periodontitis in adults in the United States: 2009 and 2010." J Dent Res. 2012;91(10):914-920.
In the bookmore than 40 percent of adults over 30.
Bard RL, Rubenfire M, Eagle K, Clarke NS, Brook RD. "Utility of C-reactive protein measurement in risk stratification during primary cardiovascular disease prevention." Am J Cardiol. 2005;95(11):1378-1379.
In the bookUnder 1.0 mg/L is ideal. Over 1.0 should trigger an investigation.
Guyenet SJ, Carlson SE. "Increase in adipose tissue linoleic acid of US adults in the last half century." Adv Nutr. 2015;6(6):660-664.
In the bookIn 1959, linoleic acid was about 9 percent of the fat stored in an American body. By 2008 it was over 21 percent.
Wheless JW. "History of the ketogenic diet." Epilepsia. 2008;49 Suppl 8:3-5.
Ramsden CE, Zamora D, Majchrzak-Hong S, et al. "Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73)." BMJ. 2016;353:i1246.
In the bookThe corn oil group had nearly twice the rate of heart attack scarring in the heart muscle. Forty-one percent against twenty-two.
Raichle ME, Gusnard DA. "Appraising the brain's energy budget." Proc Natl Acad Sci U S A. 2002;99(16):10237-10239.
In the bookIt uses roughly 20% of your total energy despite being about 2% of your body weight.
Yu Y, Chen KC, Chen J. "Exclusive enteral nutrition versus corticosteroids for treatment of pediatric Crohn's disease: a meta-analysis." World J Pediatr. 2019;15(1):26-36.
In the bookabout as well as steroids
Levine A, Wine E, Assa A, et al. "Crohn's Disease Exclusion Diet Plus Partial Enteral Nutrition Induces Sustained Remission in a Randomized Controlled Trial." Gastroenterology. 2019;157(2):440-450.
Yanai H, Levine A, Hirsch A, et al. "The Crohn's disease exclusion diet for induction and maintenance of remission in adults with mild-to-moderate Crohn's disease (CDED-AD): an open-label, pilot, randomised trial." Lancet Gastroenterol Hepatol. 2022;7(1):49-59.
Lewis JD, Sandler RS, Brotherton C, et al. "A Randomized Trial Comparing the Specific Carbohydrate Diet to a Mediterranean Diet in Adults With Crohn's Disease." Gastroenterology. 2021;161(3):837-852.
Norwitz NG, Soto-Mota A. "Case report: Carnivore-ketogenic diet for the treatment of inflammatory bowel disease: a case series of 10 patients." Front Nutr. 2024;11:1467475.
Peppard PE, Young T, Barnet JH, et al. "Increased prevalence of sleep-disordered breathing in adults." Am J Epidemiol. 2013;177(9):1006-1014.
In the booktens of millions.
Young T, Evans L, Finn L, Palta M. "Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women." Sleep. 1997;20(9):705-706.
In the bookThe majority have never been diagnosed.
Benjafield AV, Ayas NT, Eastwood PR, et al. "Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis." Lancet Respir Med. 2019;7(8):687-698. DOI: 10.1016/S2213-2600(19)30198-5
In the booktens of millions of Americans have sleep apnea
UK Prospective Diabetes Study (UKPDS) Group. "U.K. prospective diabetes study 16. Overview of 6 years therapy of type II diabetes: a progressive disease." Diabetes. 1995;44(11):1249-1258.
In the bookyou have often already lost more than half of your beta cell function
DeFronzo RA. "Banting Lecture. From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus." Diabetes. 2009;58(4):773-795.
In the bookIn 2008, a physician named Ralph DeFronzo stood up at the American Diabetes Association's most prestigious annual lecture.
Graham DJ, Campen D, Hui R, et al. "Risk of acute myocardial infarction and sudden cardiac death in patients treated with COX-2 selective and non-selective NSAIDs: nested case-control study." Lancet. 2005;365(9458):475-481.
Rizza RA, Mandarino LJ, Genest J, Baker BA, Gerich JE. "Production of insulin resistance by hyperinsulinaemia in man." Diabetologia. 1985;28(2):70-75.
Del Prato S, Leonetti F, Simonson DC, Sheehan P, Matsuda M, DeFronzo RA. "Effect of sustained physiologic hyperinsulinaemia and hyperglycaemia on insulin secretion and insulin sensitivity in man." Diabetologia. 1994;37(10):1025-1035.
In the bookfour days
Currie CJ, Poole CD, Evans M, Peters JR, Morgan CL. "Mortality and other important diabetes-related outcomes with insulin vs other antihyperglycemic therapies in type 2 diabetes." J Clin Endocrinol Metab. 2013;98(2):668-677.
Currie CJ, Peters JR, Tynan A, et al. "Survival as a function of HbA1c in people with type 2 diabetes: a retrospective cohort study." Lancet. 2010;375(9713):481-489.
Holden SE, Jenkins-Jones S, Currie CJ. "Association between Insulin Monotherapy versus Insulin plus Metformin and the Risk of All-Cause Mortality and Other Serious Outcomes." PLoS One. 2016;11(5):e0153594.
ORIGIN Trial Investigators; Gerstein HC, Bosch J, Dagenais GR, et al. "Basal insulin and cardiovascular and other outcomes in dysglycemia." N Engl J Med. 2012;367(4):319-328.
Not a journal articleAmerican College of Cardiology, ORIGIN trial summary (Outcome Reduction With Initial Glargine Intervention).
In the bookthe cardiologists who reviewed it.
Dubin RL, Heymsfield SB, Ravussin E, Greenway FL. "Glucagon-like peptide-1 receptor agonist-based agents and weight loss composition: Filling the gaps." Diabetes Obes Metab. 2024;26(12):5503-5518.
In the booka real share of the weight lost can be lean mass.
Hirst JA, Farmer AJ, Ali R, Roberts NW, Stevens RJ. "Quantifying the effect of metformin treatment and dose on glycemic control." Diabetes Care. 2012;35(2):446-454.
In the bookThe effect is modest, a little more than one A1C point.
Not a journal articleHimsworth HP. "Diabetes mellitus: its differentiation into insulin-sensitive and insulin-insensitive types." Lancet. 1936;227(5864):127-130.
Yalow RS, Berson SA. "Immunoassay of endogenous plasma insulin in man." J Clin Invest. 1960;39(7):1157-1175.
Reaven GM. "Banting lecture 1988. Role of insulin resistance in human disease." Diabetes. 1988;37(12):1595-1607.
Ramsden CE, Zamora D, Majchrzak-Hong S, et al. "Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73)." BMJ. 2016;353:i1246.
In the bookForty-one percent of the corn oil group had the scar of a heart attack in the heart muscle. Twenty-two percent of the controls did.
Not a journal articleKeys A, Aravanis C, Blackburn HW, et al. "Epidemiological studies related to coronary heart disease: characteristics of men aged 40-59 in seven countries." Acta Med Scand Suppl. 1966;460:1-392.
Not a journal articleTaubes G. Good Calories, Bad Calories. New York: Alfred A. Knopf; 2007.
In the bookBefore the heart attack it was 165 mg/dL. On his last day in office it was 259.
Cholesterol Treatment Trialists (CTT) Collaboration; Baigent C, Blackwell L, Emberson J, et al. "Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials." Lancet. 2010;376(9753):1670-1681.
Not a journal articleCDC/NCHS, "Prescription Cholesterol-lowering Medication Use in Adults Aged 40 and Over" (NCHS Data Brief No. 177, 2014) and later NHANES analyses.
In the bookover 40 million Americans take a statin.
Norwitz NG, Cromwell WC. "Oreo Cookie Treatment Lowers LDL Cholesterol More Than High-Intensity Statin therapy in a Lean Mass Hyper-Responder on a Ketogenic Diet: A Curious Crossover Experiment." Metabolites. 2024;14(1):73.
Soto-Mota A, Flores-Jurado Y, Norwitz NG, et al. "Increased low-density lipoprotein cholesterol on a low-carbohydrate diet in adults with normal but not high body weight: A meta-analysis." Am J Clin Nutr. 2024;119(3):740-747.
In the bookforty-one controlled trials
Norwitz NG, Feldman D, Soto-Mota A, Kalayjian T, Ludwig DS. "Elevated LDL Cholesterol with a Carbohydrate-Restricted Diet: Evidence for a 'Lean Mass Hyper-Responder' Phenotype." Curr Dev Nutr. 2022;6(1):nzab144.
Padala KP, Padala PR, McNeilly DP, Geske JA, Sullivan DH, Potter JF. "The effect of HMG-CoA reductase inhibitors on cognition in patients with Alzheimer's dementia: a prospective withdrawal and rechallenge pilot study." Am J Geriatr Pharmacother. 2012;10(5):296-302.
In the bookeighteen Alzheimer's patients.
Adhikari A, Tripathy S, Chuzi S, Peterson J, Stone NJ. "Association between statin use and cognitive function: A systematic review of randomized clinical trials and observational studies." J Clin Lipidol. 2021;15(1):22-32.
In the bookthe large reviews, covering more than a million, find no cognitive harm at all.
Norwitz NG, Loh V. "A Standard Lipid Panel Is Insufficient for the Care of a Patient on a High-Fat, Low-Carbohydrate Ketogenic Diet." Front Med (Lausanne). 2020;7:97.
Ramsden CE, Zamora D, Leelarthaepin B, et al. "Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis." BMJ. 2013;346:e8707.
In the bookWhen it came out, 16 percent of the safflower oil group had died of heart disease. Ten percent of the controls had.
Not a journal articleLasby CG. Eisenhower's Heart Attack: How Ike Beat Heart Disease and Held On to the Presidency. Lawrence: University Press of Kansas; 1997.
Howard JP, Wood FA, Finegold JA, et al. Side Effect Patterns in a Crossover Trial of Statin, Placebo, and No Treatment (SAMSON). J Am Coll Cardiol. 2021;78(12):1210-1222. PMID 34531021.
Herrett E, Williamson E, Brack K, et al. Statin treatment and muscle symptoms: series of randomised, placebo controlled n-of-1 trials (StatinWISE). BMJ. 2021;372:n135. PMID 33627334.
Kristiansen O, Vethe NT, Peersen K, et al. Effect of atorvastatin on muscle symptoms in coronary heart disease patients with self-perceived statin muscle side effects. Eur Heart J Cardiovasc Pharmacother. 2021;7(6):507-516. PMID 32609361.
U.S. Food and Drug Administration, Drug Safety Communication: "Important safety label changes to cholesterol-lowering statin drugs" (28 February 2012). [regulatory, non-journal]
In the bookIn 2012 the FDA added a memory-and-confusion note to every statin label.
Hazell L, Shakir SAW. “Under-reporting of adverse drug reactions: a systematic review.” Drug Saf. 2006;29(5):385-396.
In the bookReviews of that system put the median at fewer than one in ten ever reported.
Mach F, Ray KK, Wiklund O, et al., European Atherosclerosis Society Consensus Panel. “Adverse effects of statin therapy: perception vs. the evidence.” Eur Heart J. 2018;39(27):2526-2539.
In the bookIn the trials that mattered, cognition was asked about, not tested.
Brooks GA, Mercier J. "Balance of carbohydrate and lipid utilization during exercise: the 'crossover' concept." J Appl Physiol (1985). 1994;76(6):2253-2261.
Volek JS, Freidenreich DJ, Saenz C, et al. "Metabolic characteristics of keto-adapted ultra-endurance runners" (FASTER study). Metabolism. 2016;65(3):100-110.
Noakes TD. "What Is the Evidence That Dietary Macronutrient Composition Influences Exercise Performance? A Narrative Review." Nutrients. 2022;14(4):862. DOI: 10.3390/nu14040862
In the bookliver glycogen depletion drives fatigue.
O'Hearn M, Lauren BN, Wong JB, Kim DD, Mozaffarian D. "Trends and Disparities in Cardiometabolic Health Among U.S. Adults, 1999-2018." J Am Coll Cardiol. 2022;80(2):138-151.
In the bookFewer than one in ten American adults is in optimal metabolic health. Nine out of ten are not.
Papachristoforou E, Lambadiari V, Maratou E, Makrilakis K. "Association of Glycemic Indices (Hyperglycemia, Glucose Variability, and Hypoglycemia) with Oxidative Stress and Diabetic Complications." J Diabetes Res. 2020;2020:7489795.
In the bookEvery spike also leaves glucose stuck to protein. That is glycation.
Mishra T, Wang M, Metwally AA, et al. "Pre-symptomatic detection of COVID-19 from smartwatch data." Nat Biomed Eng. 2020;4(12):1208-1220.
In the bookSometimes your data knows you're sick before you do.
Yalow RS, Berson SA. "Immunoassay of endogenous plasma insulin in man." J Clin Invest. 1960;39(7):1157-1175.
In the bookInsulin has been measurable in human blood since 1960, and the first thing it was used for was telling early diabetics from non-diabetics.
Grundy SM, Cleeman JI, Daniels SR, et al. "Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement." Circulation. 2005;112(17):2735-2752.
In the bookThe threshold is 35 inches for women and 40 inches for men.
Staten MA, Stern MP, Miller WG, Steffes MW, Campbell SE. "Insulin assay standardization: leading to measures of insulin sensitivity and secretion for practical clinical care." Diabetes Care. 2010;33(1):205-206.
In the bookIn 2010 they published two pages in their own journal, and they asked for it to be fixed.
Marcovina S, Bowsher RR, Miller WG, Staten M, Myers G, Caudill SP, Campbell SE, Steffes MW. “Standardization of insulin immunoassays: report of the American Diabetes Association Workgroup.” Clin Chem. 2007;53(4):711-716.
In the bookSend the same blood anywhere and the number comes back the same. Your A1C works that way. Your insulin does not.
Isokuortti E, Zhou Y, Peltonen M, et al. “Use of HOMA-IR to diagnose non-alcoholic fatty liver disease: a population-based and inter-laboratory study.” Diabetologia. 2017;60(10):1873-1882.
In the bookThe published cutoffs move with the population and the lab that ran the test.
Rohlfing C, Petroski G, Hatten-Beck M, Hanson S, Hoofnagle AN, Little RR, Kabytaev K. “The current status of serum insulin measurements and the need for standardization.” Clin Chem Lab Med. 2025;63(12):2442-2446.
In the bookThey do not standardize insulin.
O'Donnell M, Mente A, Rangarajan S, et al. "Urinary sodium and potassium excretion, mortality, and cardiovascular events." N Engl J Med. 2014;371(7):612-623.
Mente A, O'Donnell M, Rangarajan S, et al. "Urinary sodium excretion, blood pressure, cardiovascular disease, and mortality: a community-level prospective epidemiological cohort study" (PURE). Lancet. 2018;392(10146):496-506.
Not a journal articleAmerican Heart Association, sodium recommendation (ideal limit 1,500 mg/day).
Lustig RH. "Fructose: metabolic, hedonic, and societal parallels with ethanol." J Am Diet Assoc. 2010;110(9):1307-1321.
In the bookRobert Lustig changed how I see food addiction. Food scientists engineer products to hit reward circuits.
Norwitz NG, Sethi S, Palmer CM. "Ketogenic diet as a metabolic treatment for mental illness." Curr Opin Endocrinol Diabetes Obes. 2020;27(5):269-274.
Norwitz NG, Mota AS, Norwitz SG, Clarke K. "Multi-Loop Model of Alzheimer Disease: An Integrated Perspective on the Wnt/GSK3B, alpha-Synuclein, and Type 3 Diabetes Hypotheses." Front Aging Neurosci. 2019;11:184.
In the bookIt's what some researchers call Alzheimer's
American Diabetes Association, "About Us", diabetes.org/about-us: mission "to prevent and cure diabetes and to improve the lives of all people affected by diabetes." [organizational, non-journal]
In the bookTheir mission says prevent. It has said prevent since 1988.
Results may vary. Educational only. Not a diagnosis. Not medical advice. Discuss your numbers with your healthcare provider. >