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Wellness Writer

The Canary in the Coal Mine; Our Fine Feathered Friend

Updated: Apr 9

For a second time, I am reading Dr. Peter Attia’s latest book, Outlive, a powerful manifesto compiling the latest science on health and longevity. Dr. Attia is a renowned physician specializing in the applied science of longevity. He is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their vitality and healthspan.


Dr. Attia received his medical degree from Stanford University School of Medicine and trained for five years at the Johns Hopkins Hospital in general surgery. He is also the host

of The Drive, a popular podcast covering topics related to health and medicine.

In Outlive, Dr. Attia combines the latest research on preventive medicine with practical advice anyone can use to live better today and increase their odds of beating the four types of chronic disease that plague our population; cardiovascular disease, cancer, metabolic disorders, and neurodegenerative disorders. The book emphasizes the importance and the power of relatively simple, inexpensive interventions that we can all utilize to achieve a longer and healthier life; exercise, nutrition, sleep, and emotional health.

The phrase "canary in the coal mine" originated from the practice of using canaries as early indicators of potential hazards in coal mines. Canaries were used because they are highly sensitive to airborne poisons, such as carbon monoxide, due to their anatomy that allows them to respirate super efficiently, getting a dose of oxygen when they inhale and another when they exhale. The practice of using canaries in mines began in the last decades of the 19th century and was not discontinued until 1986, when it was replaced by modern carbon dioxide detectors. The canary cage used by the miners contained an oxygen canister, with which to rescue the miner’s fainted feathered friend. Who says engineers are cold and uncompassionate?!!

In Outlive, Dr. Attia uses the phrase "canary in the coal mine" in relation to his views on hyperinsulinemia, the critical early sign of a threatening metabolic disorder. Elevated insulin levels, the creation and release of more and more insulin, is the body’s first response to the early stage of insulin resistance. Insulin resistance occurs when cells in the muscles, liver, and fat no longer respond well to insulin, the hormone produced by the pancreas that helps glucose enter cells to be used for energy. As a result of insulin resistance, the pancreas produces more insulin to compensate, leading to high levels of insulin in the blood. The telltale imbalances can be detected by blood tests measuring glucose and insulin levels. No canaries will be put at risk in these laboratory procedures.


Here are some of the causes of insulin resistance:

  • Excess body fat, especially around the belly, is one of the main factors that contribute to insulin resistance.

  • Lack of physical activity is another factor that can lead to insulin resistance.

  • A diet of highly processed, high-carbohydrate foods and saturated fats has been linked to insulin resistance. This is because highly processed, high-carbohydrate foods cause blood sugar to spike, which puts extra stress on the pancreas to produce a lot of insulin, leading to insulin resistance over time.

  • Certain medications, such as glucocorticoids, some antipsychotics, and some medicines for HIV, can contribute to insulin resistance.

  • Hormonal disorders, such as Cushing’s syndrome and acromegaly, can cause insulin resistance.

  • Sleep problems, especially sleep apnea, can also contribute to insulin resistance.

  • Genetics can play a role in insulin resistance, and a family history of type 2 diabetes can increase the risk of developing insulin resistance.

However, the most common cause by far of insulin resistance, is excess body fat, especially around the belly, and a lack of physical activity. Some people with insulin resistance may not have any obvious symptoms for a while, but some emerging signs include a waistline over 40 inches in men and 35 inches in women, skin tags or patches of dark velvety skin called acanthosis nigricans, high blood pressure, and as emphasized, high levels of insulin as detected by lab tests.


Insulin resistance can lead to several immediate damaging effects on the body. These include weight gain, higher triglyceride levels, hardening of the arteries, and high blood pressure. It can also result in metabolic consequences such as hyperglycemia, high levels of damaging uric acid, elevated inflammatory markers, and damage to the functioning of the inner lining of blood vessels, leading to increased risk of strokes and heart attacks from excess blood clotting.


Insulin resistance also has significant effects on brain function. The brain, which was once considered an insulin-independent organ, has been found to be significantly affected by insulin resistance. Insulin plays a crucial role in the brain, controlling food intake and regulating cognitive functions, particularly memory. Insulin resistance in the brain can lead to damage in the cognitive system and potentially lead to dementia states. It can also cause alterations in mitochondrial function (energy production as well as many other key functions) and dopamine turnover, leading to erratic mood shifts, anxiety, and depressive symptoms.


Dr. Attia pays close attention to blood glucose levels by using continuous glucose monitors to track glucose levels accurately, when he is looking for hyperinsulinemia in his patients. By making an early assessment of hyperinsulinemia, Dr. Attia aims to prevent the immediate damaging effects and later occurrence of chronic health conditions that prematurely take the lives of so many Americans, all of which have been linked to insulin resistance; metabolic disorders, cardiovascular disease, cancer, and neurodegenerative disorders.

Dr. Peter Attia's book Outlive is a comprehensive guide to living a longer, healthier, and more fulfilling life. It empowers readers to optimize their exercise, nutrition, sleep, and emotional health for maximum longevity. Outlive is a fact-filled, clear-eyed, accessible handbook for longevity that helps people understand the why, not just the what. It is a book that's worth reading and re-reading, as it is filled with instructive, life-saving information. OK now! Inquiring canaries want to know; how are Your insulin and glucose levels?!

At Fasting and Thriving Retreats we strive to bring you relevant information regarding a holistic approach to healthy living. A Fasting Lifestyle will help jump start your journey into health.

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