Why are Americans sicker than ever before?

Added: 2026-05-11

[00:00:00]The United States is one of the wealthiest countries on the planet. We have the most advanced medical technology in the world. We spend more money on health care per person than any other nation. We have access to more food, more information, and more resources than any generation in human history. So, why are Americans aging faster, getting sicker earlier, and dying younger than almost every other developed country? Researchers at the University of Southern California reported that the United States has experienced the earliest and greatest slowdown in life expectancy improvements of any comparable country. Also, Americans aren't just dying sooner, we're spending a longer portion of our lives sick, dealing with diabetes, hypertension, heart disease, cognitive decline. So, what's actually going on?

[00:00:47]Well, today I want to walk you through exactly what's happening, why it's happening, and what we can realistically do about it starting right now. Let's start by talking about the food. Let me give you a number that I want you to sit with for a moment. 57% and that's the percentage of daily calories the average American adult gets from ultra-processed food. In fact, according to CDC data, more than half of everything Americans eat every single day falls into the category of industrially manufactured food products.

[00:01:19]And among teenagers, that number climbs to nearly 67%. Now, I want to be very clear about what ultra-processed food actually is because this goes way beyond fast food. We're talking about snacks, the flavored drinks, the frozen meals, the condiments, the granola bars marketed as healthy. These are not food in the biological sense of the word.

[00:01:40]They're industrial formulations engineered from refined or ultra-processed ingredients, additives, preservatives, artificial flavors, and oh yeah, seed oils. But, here's what the research shows. A large-scale study found that for every 10% increase in ultra-processed food consumption, biological age increased by nearly 2 and 1/2 months. But it gets more interesting than that because when we zoom in on the category of ultra-processed foods, there's a lot of noise around seed oils and the health risk that can be incurred. But the fact of the matter is this, there is one single substrate within the entire ultra-processed food category that is most consistently linked to >> [music] >> morbidity or illness and death. What's that? It's added sugar. When we compare sources of whole food sugar to ultra-processed forms of sugar, and specifically in the form of added sugar to beverages, what we call sugar-sweetened beverages, the risk of diabetes alone goes up by 20 plus percent per 12 oz can of Coke or whatever your favorite drink is. That is absolutely insane when you think about it. And by the way, fruit juices aren't exempt. In fact, they're number two in that risk stratification category. The risk for every increase in consumption, 12 oz increase in consumption, is 5% per drink >> [music] >> per day. If that isn't shocking, I don't know what is. But before we get any deeper into the weeds in terms of what all this actually means, what the implications and what maybe the solution might be, I want to acknowledge something because I know what some of you are thinking. You know this food is not great for you, and you're not eating it because you don't know any better.

[00:03:20]You're eating it because you're exhausted, you're busy, [music] you have kids to feed, you have 45 minutes between work and the next obligation, and there's a drive-thru on every corner, and nothing really else within reach, at least in terms of quality whole food. And I also want to acknowledge something. I live in the exact same world. I run two very busy clinical practices, surgery and longevity. I have two young kids. They play sports, they go to dance. It's extremely difficult to sit and plan a meal, find whole food, and prep it myself. That's just reality. The food environment that we're living in in Americans, it wasn't designed with our health in mind. In fact, it some would argue it was designed to corrupt our health as a means to profit. What we do know is ultra-processed food, it was designed for convenience, for shelf life, and for repeat purchasing. These products are specifically engineered to override your body's natural satiety or the feeling of fullness, those signals that the brain produces. The combination of refined sugars, industrial fats, and [music] added flavorings, it hits your brain's reward system in a way that whole food simply could never achieve.

[00:04:28]So, the goal is to help you understand what's actually happening here so that you can actually start making choices that work with your biology instead of against it. And that starts with better understanding the real engine underneath all of this. I've said it before, I'll say it again. Insulin resistance is indeed the core issue. The data that we have connecting type 2 diabetes, which is nothing more than end-stage insulin resistance, is so compelling when it comes to your health. The risk of dying from anything, what we call all-cause mortality in the setting of type 2 diabetes, is increased 300 to 400%.

[00:05:03]That's exponential. But, let's talk about the relationship then between insulin resistance and ultra-processed foods. See, when you eat ultra-processed food, particularly anything high in refined sugar, and we'll include simple carbohydrates with that, glucose floods your bloodstream rapidly. Your pancreas responds by releasing insulin to clear that glucose out. Your cells open up, glucose moves in, the system works. But, here's what gets overlooked, and this is one of my biggest pet peeves from the nutritional experts out there that reference data from clinical trials. Repeated sugar excursions and something called glycemic variability, which we've talked about previously, is a principal driver over time in the development and progression of insulin resistance. But, some social media influencers want to get into the weeds of good carbs, bad carbs. And honestly, it's silly. It detracts from the crux of the issue. But what you'll see they do is they refer to clinical trials, nutritional research. Here's the fundamental issue with that. Every single nutritional study done in humans is short-term. Some as few as two to eight days of a given intervention. The reality is the human lifespan is a little longer than eight days. So what we see in these very small, short-term trials is not reflective of the compounding impact of glucose excursions and glycemic variability, which ultimately drives insulin resistance to type 2 diabetes. So again, let's revisit what happens when that cycle of consuming simple sugars, spiking glucose followed by an insulin dump repeats itself over and over and over again.

[00:06:34]Multiple, multiple times a day, every single day for years, for decades, your cells start to stop listening to the insulin. The insulin receptors themselves become dysfunctional. And ultimately, the insulin receptors are down-regulated, decreased in overall number. They've been bombarded with so much insulin signaling that they ultimately become unresponsive.

[00:06:55]Essentially, think of it as the receptors becoming desensitized, and your body then has to respond with more and more insulin to get the same effect it used to at much smaller doses. In the meantime, glucose starts building up in the bloodstream because insulin is not functioning, it's not doing its job effectively, which is in part driving glucose into muscle cells and liver cells. With glucose circulating in your bloodstream, going into many different cell types that don't require insulin for access, inflammation begins to rise.

[00:07:26][music] Fat begins to accumulate. In fact, the liver is ultimately stimulated by insulin to turn glucose, excess glucose, into free fatty acids. Now, that fat that's accumulating begins to densely stick or adhere to the internal organs.

[00:07:42]This is what we call visceral adipose tissue. Please understand this. Visceral adipose tissue is an endocrine organ.

[00:07:48]That is, it sends signals to the body and guess what it does? It worsens insulin resistance. It literally is like a parasitic organism. It wants to grow at all costs. So, by worsening insulin resistance, increasing steady state insulin levels in effect is driving more fat production and more fat storage to itself. Now, what do you feel? Well, energy is erratic, brain fog sets in, and your body shifts from a state of repair and maintenance into a state of chronic metabolic stress. This [music] is insulin resistance. And as insulin resistance relates to the development of diabetes, it is in fact a central or root cause of increased death from anything, all cause mortality. We live on a spectrum from insulin sensitivity all the way to type 2 diabetes. And when we compare insulin sensitive individuals to those with type 2 diabetes, we see an exponential increase in risk of cardiovascular death, stroke, dementia, even cancer. Quite truthfully, of the top five leading causes of non-traumatic death in the United States today, type 2 diabetes reflects a minimum level of 2.8 to 3x higher risk than the general population. Why? It's driving chronic inflammation that damages tissues, actually interferes with healthy DNA.

[00:09:02]Researchers in longevity medicine now consider insulin sensitivity as the most important marker of how well and how long you live. In the modern American lifestyle, the ultra processed diet, sedentary lifestyles, chronic stress, disrupted [music] sleep, every single one of these factors drives insulin resistance deeper. It's been said very well by a Dr. Gabrielle Lyon, someone I admire and respect greatly. We live in a society that is over fueled or over fat and severely under muscled. But that key principle there is the impact that muscle health has on metabolic performance. And ultimately, in that condition, we are more sedentary as a society than ever [music] before. Think about it. Kids are playing video games, parents are watching Netflix, no one's moving. And these processes, they really begin to compound. Whole body inflammation, DNA repair, all of this is failing simultaneously as a direct result of a failed metabolic system. And the reality is, most people have no idea it's happening because it really at first, even for decades, it really may not manifest in any significant way at all. But, it is quietly changing the trajectory of your health year after year. So, what's my solution? Like I said, we're overfed or overfueled and undermuscled. So, the principal resource that we have, that we can entertain to live a longer, healthier life, is muscle. It's that simple. People want to make these elaborate claims, and especially in the longevity space, people are taking supplements, doing this and that, but let me tell you, if it doesn't somehow directly connect back to muscle and mitochondrial health, energy for muscle, it really doesn't move the needle. Skeletal muscle is the largest glucose management system in the human body. Now, why do I call it a management system? Because I used to call it a storage system, and we'll call it a metabolic regulator, right? It can store glucose in the form of glycogen, and it can consume glucose for fuel.

[00:10:55]But, it's actually way more advanced than that. Think of muscle as a glucose management system, fundamentally.

[00:11:00]Because, while we used to think of muscle as only being sensitive to glucose uptake in the presence of insulin, we now have a much deeper understanding of how muscle manages blood glucose. And in fact, every single muscle contraction brings GLUT4 channels, opening the door for glucose out of the bloodstream to the surface of the cell. And what we call that is insulin-independent glucose uptake. It's a powerful tool, and it's why a muscle and movement are medicine. Because, more muscle regulates glucose almost equally effectively as insulin does. And let's face it, if insulin resistance is on board, insulin is not doing the job it was set out to do. But, more muscle mass adds more opportunity to metabolize or use glucose as a fuel. But, even more importantly, active movement, something as simple as a 10-minute walk or 20 air squats after dinner, activates a secondary system, a God-given system, to actually take up glucose in the absence of insulin. So, we can actually reduce our insulin demand simply by moving. Because, what's the key driver driver of insulin? It's glucose. If that glucose is being taken out of the bloodstream before it ever has a chance to trigger an insulin response, imagine [music] how effective that strategy is in managing glucose and insulin altogether. Now, this is not about aesthetics. This is truly about metabolic rescue. Most people think building muscle requires hours in the gym, years of experience, and a strict diet that you hate. But, that belief is exactly what's keeping you from starting. You need to know this, that just 30 minutes of properly structured resistance training produces the same strength and muscle gains as sessions lasting 90 minutes or more. Now, of course, it depends on where you are at your own personal fitness journey. If you are a novice or a beginner, typically resistance training has a much more accelerated effect [music] in immediate change. If you're more seasoned and experienced, more resistance, progressive overload, really more work in the gym is required to grow muscle. But, at the end of the day, we have to understand that all the drugs, all the peptides, all the external resources that we want to tap into for longevity, really fail at the fundamental level if they're not driving muscle health and muscle performance.

[00:13:08]So, here's what you need to focus on >> [music] >> in the gym. Compound movements, that's squats, deadlifts, rows, presses. Pair push with pull, upper with lower. Train close to failure. We'll come back to that concept in another post. But, understand that the intensity of your training and the proximity to failure, regardless of volume, regardless of the number of repetitions, is the principal driver of muscle growth. And please, [music] track everything. There are so many apps, so many tools, so many resources.

[00:13:37]ChatGPT will give you a resistance training regimen. Progressive overload is the mechanism behind all muscle growth. 30 minutes, if done right at the optimal intensity, is probably at least a good starting point, if not enough for some people, especially beginners. Now, let's begin to the role of food and the infamous diet. [music] Because when I hear diet, and I think most humans hear diet, they hear restrict, restrict, restrict. And the brain says, "Ah, that doesn't sound so enticing." But I want you to take a pause here, relax, because you don't need to eat perfectly. [music] That's not the end game. The macros, the high-resolution calorie counters, those efforts, yes, [music] they can drive success, but they may also drive what we know to be true, which is disordered eating. They may impact over time in a phenomenon called metabolic adaptation.

[00:14:30]See, when we limit our calorie consumption, the body actually adapts.

[00:14:34]That's the difference, and that's why the whole calories in, calories out, energy balance mindset does not actually work in the human body. That's called the first law of thermodynamics. Energy can neither be produced or destroyed.

[00:14:45]But the first law of thermodynamics applies to a laboratory, a controlled setting, not a human organism, where there's interaction between cells and signals like hormones and peptides. All that's happening as the body adapts to its environment. So, what's really important here? Small, consistent shifts that compound over time. I know it's cheesy, but the 1% every day rule applies. You don't need to make radical change. And when you're seeking radical change, it is most effectively achieved by small, incremental movement with time. First, start adding whole foods wherever possible. Maybe add eggs instead of a colored cereal, real fruit instead of a flavored snack. I literally have a bag of almonds in my car and bags and bags of almonds in my home. I don't ever go anywhere without a quality whole food snack to tide me over. Then let's cut out the things that are doing the most damage and point-blank the solution is simple. Get rid of added sugars. Now, the microwave meals, I don't think those things are helping anybody. We've covered some of the issues with toxic endocrine disrupting chemical exposures, microplastics, the role of microwave meals and how that impacts our hormonal balance. If you can get rid of microwaving food, at least in the plastic packaging, that's a good start.

[00:15:58]Bear in mind, what we're trying to do is move the needle, not radically transform. I get it. We're busy. We're stressed. Access to food is very much a convenience-related issue. And if it's done appropriately, and you just sneak a look at that label, getting rid of added sugars moves the needle more than any single one maneuver you could possibly come up with. The human body is incredible. It's its own detox agency.

[00:16:20]It's its own metabolic workhorse. It's its own ultra highly regulated health and performance system. The problem is the world we live in, the lifestyles we pursue are rendering our bodies highly ineffective at just doing their job. Get back to the basics. 1% incremental change per day and target the things that have the most broad-reaching implications in your long-term health and well-being, and you'll come out on top.