Below are recommended optimal ranges for key metabolic blood tests. Falling outside of these ranges is an indicator that you could have brewing dysfunction. The remainder of Part 2 and the plan in Part 3 will give specific steps to increase Good Energy and improve these biomarkers: Triglycerides: Less than 80 mg/dL HDL: 50 to 90 mg/dL Fasting Glucose: 70 to 85 mg/dL Blood Pressure: Less than 120 systolic and less than 80 diastolic mmHg Waist Circumference: <80 cm (31.5 inches) for women and <90 cm (35 inches) for men (South Asian, Chinese, Japanese, and South and Central Americans) <80 cm (31.5 inches) for women and <94 cm (37 inches) for men (European, Sub-Saharan African, Middle Eastern, and Eastern Mediterranean) Triglyceride-to-HDL Ratio: Below 1.5. Above 3 is a clear sign of metabolic dysfunction. Fasting Insulin: From 2 to 5 mIU/L. Above 10 mIU/L is concerning and above 15 mIU/L is significantly elevated. HOMA-IR: Less than 2.0 High-Sensitivity CRP (hsCRP): Less than 0.3 mg/dL Hemoglobin A1c: From 5.0 to 5.4 percent Uric Acid: Less than 5 mg/dL for men, and from 2 to 4 mg/dL for women

GOOD ENERGY BIOMARKERS AND MOVEMENT When you’re striving to be part of the 6.8 percent of metabolically healthy Americans, regular movement will help you get there. Research shows that exercise improves all five of the following basic biomarkers of metabolism: Glucose Levels Above 100 mg/dL: Twelve-week exercise programs of either high-intensity running (40 minutes per week) or low-intensity running (150 minutes per week) both brought participants’ blood sugar from the prediabetic range (100 mg/dL or greater) to the nondiabetic range (<100 mg/dL). HDL Cholesterol Less Than 40 mg/dL: A 2019 review of the literature showed that exercise increased HDL cholesterol, “with exercise volume, rather than intensity, having a greater influence.” Meanwhile, “raising HDL levels pharmacologically has not shown convincing clinical benefits.” Triglycerides Above 150 mg/dL: Numerous studies have demonstrated that physical activity effectively lowers triglyceride levels. In a 2019 study, an eight-week moderate aerobic exercise program significantly reduced triglyceride levels in participants. Furthermore, even a single session of intense aerobic exercise has been found to decrease triglyceride levels the following day. This positive effect could be due to the increased activity of hepatic lipase in the liver, an enzyme that facilitates the absorption of triglyceride from the bloodstream. Blood Pressure of 130/85 mmHg or Higher: Research has shown the effects of exercise among populations with high blood pressure were similar to the effects of commonly used medications. A Waistline of More Than 35 Inches for Women and 40 Inches for Men: Not surprisingly, regular exercise can help decrease obesity by increasing energy expenditure and promoting weight loss. Research shows a clear inverse relationship between the amount of movement people do each week and the size of their waistline: more movement, smaller waist circumference. What’s more, lower activity (fewer than 5,100 steps per day)

Good Energy is also known as metabolic health. Metabolism refers to the set of cellular mechanisms that transform food into energy that can power every single cell in the body.

STEP ONE: DECIDE & GET THE INFORMATION YOU NEED 1. Decide what you truly want for your life physically. What is the result that you’re truly after? Do you want more energy? More vitality? More strength? More flexibility? Do you want to start to rejuvenate your body? Revitalize it? Bring more youth to it? 2. Get the information that you need. Get yourself tested, so you can maximize your energy by: Knowing whether there are toxic metals in your system that are getting in the way of your well-being. Knowing if your hormones are in balance, which can make a giant difference in how you feel day to day. And then ideally, do the things that will give you peace of mind for yourself and for your family. Get the GRAIL test plus a full-body MRI so that you can know that there’s nothing to be concerned about with cancer. GRAIL can even be done even in your home, with a simple blood test. If it’s appropriate, I would consider scheduling a CCTA Test so that you know exactly where your cardiovascular health is and what needs to be done to stay strong and healthy for years to come. Consider getting the Alzheimer’s Test so that you know if you’re genetically predisposed, and also come up with a lifestyle plan that will reduce your risk. If you do this far enough in advance, there are a variety of tools in this book that can make a difference. Who’s in your family or friendship base whom you would like to also make sure gets tested to look out for their well-being and help them to maximize the quality of their life. Last, if you want to have some fun, you can discover what your true age is. As I mentioned earlier, I was thrilled to discover that my chronological age of 62 is only 51 years biologically. I think you’ll be surprised. If it’s not where you want it to be, there are so many things within these pages that you can do to change it.

Liver Enzymes: aspartate transaminase (AST), alanine transaminase (ALT), and gamma-glutamyl transferase (GGT) AST and ALT levels of 17 U/L or less. For GGT, lowest risk for men is less than 25 U/L and women from 14 to 20 U/L. Sources vary slightly, but these are good targets to aim for. Vitamin D 40 to 60 ng/mL Recommended real-time metrics to track: Glucose (continuous glucose monitor) Food (food journal or app) Sleep (quantity, quality, consistency) Activity (steps, number of active minutes per day and week with elevated heart rate) Resting heart rate and heart rate variability

Immunomes Project, which uses AI and machine learning to home in on the most significant blood biomarkers. Their conclusion? The best gauges of our inflammation level — and our inflammatory age — are about 7,500 proteins. Edifice has condensed this large set to a core panel of five protein biomarkers — and their predictive power is startling. They can foretell frailty seven years before it happens. They can predict cardiovascular aging — arterial stiffness and heart thickness — even in currently healthy people. The Edifice blood test and iAge metric is also able to pinpoint people with undiagnosed autoimmune diseases. This technology is up and running today, and should be commercially available by mid-2022. It costs $250 per test, or you can get a subscription service for $60 per month. But Edifice isn’t stopping there. Once you know your iAge, what can you do to improve your outlook? Beyond lifestyle guidance, Edifice Health will also offer personalized supplements — currently under study by an Institutional Review Board — to improve a client’s inflammatory profile.

In studying your basic metabolism, we first listen to your heart's beat, and if your hearts beat anything but diamonds and clubs, it's because your partner is cheating, or your wife.

About 74 percent of U.S. adults are overweight or obese, and 93.2 percent have metabolic dysfunction. These numbers sound high until you realize how many levers of modern society are stacked against our mitochondria and metabolism: too much sugar, too much stress, too much sitting, too much pollution, too many pills, too many pesticides, too many screens, too little sleep, and too little micronutrients. These trends — with trillions of dollars behind them — are causing epidemic levels of mitochondrial dysfunction and underpowered, sick, inflamed bodies.

Fasting glucose of 100 mg/dL or higher A waistline of more than 35 inches for women and 40 inches for men HDL cholesterol less than 40 mg/dL for men and 50 mg/dL for women Triglycerides of 150 mg/dL or higher Blood pressure of 130/85 mmHg or higher

You can’t manage your health if you can’t measure it. And the same goes for your finances.

Migraine, like my patient Sarah had, also correlates closely to poor metabolic health. In the ENT otology clinic, we often saw this condition and had limited success in treating it. Sufferers of this debilitating neurological disease — about 12 percent of people in the United States — tend to have higher insulin levels and insulin resistance. A comprehensive review of fifty-six research articles identified links between migraine and poor metabolic health, pointing out that “migraine sufferers tend to have impaired insulin sensitivity.” The review supports the “neuro-energetic” theory of migraine. Additionally, evidence suggests that micronutrient deficiencies in key mitochondrial cofactors may also be a contributing factor of migraine. Research has suggested that migraines could be treated by restoring levels of vitamins B and D, magnesium, CoQ10, alpha lipoic acid, and L-carnitine. Vitamin B12, for instance, is involved in the electron transport chain responsible for the final steps of ATP generation in the mitochondria, and studies have indicated that high doses of B12 can help prevent migraine. These micronutrients usually have fewer side effects than other drugs used to treat migraines, making them a promising option for relief, which can be obtained through a diet rich in these micronutrients, or supplementation. Having high markers of oxidative stress, a key Bad Energy feature, is associated with a significantly higher risk of migraine in women, with some studies suggesting that migraine attacks are a symptomatic response to increased levels of oxidative stress. Less painful and more common tension-type headaches are also linked to high variability (excess peaks and crashes) in blood sugar. Hearing Loss The same story of metabolic ignorance in the ENT department unfolded for auditory problems and hearing loss, one of the most common issues presented to our ENT clinic. We’d typically tell our patients that their auditory decline was inevitable, due to aging and

Triglyceride-to-HDL Ratio After assessing each of these five biomarkers, there is one more step: calculate your triglyceride-to-HDL ratio to better understand insulin sensitivity. Simply divide your triglycerides by your HDL. Interestingly, studies have shown that this value correlates well with underlying insulin resistance. So even if you are unable to access a fasting insulin test, the triglyceride-to-HDL ratio can give you a general sense of where you’re at. According to Dr. Mark Hyman, “the triglyceride-to-HDL ratio is the best way to check for insulin resistance other than the insulin response test. According to a paper published in Circulation, the most powerful test to predict your risk of a heart attack is the ratio of your triglycerides to HDL. If the ratio is high, your risk for a heart attack increases sixteen-fold — or 1,600 percent! This is because triglycerides go up and HDL (or ‘good cholesterol’) goes down with diabesity.” Dr. Robert Lustig agrees: “The triglyceride-to-HDL ratio is the best biomarker of cardiovascular disease and the best surrogate marker of insulin resistance and metabolic syndrome.” In children, higher triglyceride-to-HDL is significantly correlated with mean insulin, waist circumferences, and insulin resistance. In adults, the ratio has shown a positive association with insulin resistance across normal weight and overweight people and significantly tracks with insulin levels, insulin sensitivity, and prediabetes. Perplexingly, the triglyceride-to-HDL ratio is not a metric used in standard clinical practice. If you remember one thing from this chapter, remember this: you need to know your insulin sensitivity. It can give you lifesaving clues about early dysfunction and Bad Energy brewing in your body, and is best assessed by a fasting insulin test, discussed below. Right now, this is not a standard test offered to you at your annual physical. I implore you to find a way to get a fasting insulin test or to calculate your triglyceri

A basic assessment of male hormonal health should include: total testosterone, free testosterone, dihydrotestosterone (DHT), estradiol (E2), sex hormone binding globulin (SHBG), and dehydroepiandrosterone (DHEA).

According to Dr. Mark Hyman, “the triglyceride-to-HDL ratio is the best way to check for insulin resistance other than the insulin response test. According to a paper published in Circulation, the most powerful test to predict your risk of a heart attack is the ratio of your triglycerides to HDL. If the ratio is high, your risk for a heart attack increases sixteen-fold — or 1,600 percent! This is because triglycerides go up and HDL (or ‘good cholesterol’) goes down with diabesity.