In episode 135 of his video series, Dr. Larson discusses:

We should all know our risk factors for diseases, especially the most common chronic illnesses like heart attack, cardiovascular disease, and even Alzheimer’s Disease, which appears to be on the increase. Metabolic syndrome (MetS) is a major risk factor for most chronic illnesses and diseases. So, it stands to reason that you should know what your risk factor of developing MetS is to try to mitigate the adverse effects that having it has on your overall health and wellbeing.

As I treat more people with it, and I dive into the medical literature, what I am finding is that there are stages of MetS. Your risk factors for chronic disease is relative to what stage you are in. Stage A is where you don’t have any of the criteria of metabolic syndrome, but you have some other criteria that might put you at risk for developing it down the line.

In Stage A, you don’t have any of the five criteria, which are high blood pressure, high blood sugar, high triglycerides, low HDL, or a waist circumference above 40 for men, and above 35 for women. But, for example, as a man, you have a waist circumference that is 38. How far along the path do we have to say you are before we take steps to reduce your risk? Maybe you are overweight, or maybe your parents had it; these are all things that would land you in Stage A, where you might want to make some therapeutic considerations.

Stage B is marked by not having three out of the five things that define MetS, but it means that you have two out of the five. Therefore, you might not have developed it yet, but you have an increased risk of doing so in the future. We don’t want to just ignore it and tell you to come back when you have full-blown metabolic syndrome. That is not creative healthcare; it makes more sense to work preemptively and preventatively. When you understand that changing the lifestyle that you choose can alter your longevity and quality of life, taking steps to go down a healthier path seems well worth it.

In medicine, we think the more advanced a health condition is, the more intense we need to address it. Stage A would involve a lighter treatment, where Stage C, where you have three out of five, would warrant us taking more drastic and immediate treatment steps to reverse it. Sometimes it just takes a few changes to alter your path, and other times it might take a bit more effort and transformation. But the key is to make incremental alterations that are attainable to change course.

Stage D is when you have some end-organ failure. In Stage D, you have the full-blown disease and three out of the five risk factors for metabolic disease. A person in Stage D has a condition that comes with a diagnosis and there is actual damage that is done like heart disease or diabetes. But even after reaching that point, there is still time to put it in reverse by making better lifestyle choices.


It is easier to focus on treating Stages A, B, and C to reduce your risks for both metabolic syndrome and long-term health conditions. If you are in Stage A, then we might have to suggest some dietary changes like eliminating sugar, sweets, and refined grains. And also, fasting for a minimum of 12-12 ratio where you fast for 12 hours and have a 12-hour eating window. In Stage A, that might be enough to address the issue and you might be good going forward.

-Dr Chad Larson


If you are in Stage B, you think of all the things that you need to do in Stage A to change your habits, and then you might have to tighten them up like watching total carbohydrate values and squeezing the time window to 13 or 14 hours of overnight fasting.

And in Stage C, treatment has to be more aggressive. We work against metabolic disease by trying to push down the carbs (particularly processed carbs) more and decrease the eating window. When you decrease the eating window, you can drive insulin down. And when you drive insulin down, you start to burn fat for fuel. That way, you can work on the three out of five, or more, categories that you might fit into. Each individual might have to vary what they do according to what their condition is and what markers for metabolic syndrome they have. The goal is to try to avoid Stage D, which has damage that is much harder to reverse.

So it is important to know not only your risk factors for chronic illness, but also to know your risk of metabolic syndrome. Since it is a major risk factor for developing disease, knowing where you stand is important. Be contentious of what your lifestyle is now, and the foods you eat, because your current habits will predict what happens in the future. The more you take care of yourself now, the more health you will enjoy in the future. Just a few small changes are often enough to derail a train that is heading down the wrong track. And those small alterations are surely insignificant enough for the reward that they provide in the long run.

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