Chap­ter 6 of The Cri­sis of Abun­dance explores the widen­ing gap between human evo­lu­tion and mod­ern dietary habits, focus­ing on the rapid rise of non­al­co­holic fat­ty liv­er dis­ease (NAFLD) and its more severe form, non­al­co­holic steato­hep­ati­tis (NASH). These con­di­tions have increased along­side obe­si­ty and meta­bol­ic dis­or­ders, often pro­gress­ing unno­ticed due to their sub­tle or nonex­is­tent ear­ly symp­toms. Orig­i­nal­ly iden­ti­fied in indi­vid­u­als with exces­sive fruc­tose intake rather than alco­hol con­sump­tion, the preva­lence of NAFLD and NASH high­lights a deep­er issue—our genet­ic incli­na­tion to store fat, which was once essen­tial for sur­vival but has become harm­ful in today’s calo­rie-dense food envi­ron­ment.

The chap­ter broad­ens the dis­cus­sion to the grow­ing epi­dem­ic of meta­bol­ic dys­func­tion, empha­siz­ing insulin resis­tance as a major under­ly­ing fac­tor. While obe­si­ty is often linked to meta­bol­ic dis­ease, the author chal­lenges this over­sim­pli­fi­ca­tion, point­ing out that many indi­vid­u­als with nor­mal body weight also suf­fer from insulin resis­tance and relat­ed con­di­tions. This dis­tinc­tion under­scores that meta­bol­ic health is not sole­ly deter­mined by body size but by how well the body process­es nutri­ents in a world dom­i­nat­ed by processed foods and high sug­ar con­sump­tion.

From an evo­lu­tion­ary per­spec­tive, fat stor­age was once a crit­i­cal advan­tage for human sur­vival dur­ing times of famine. How­ev­er, in the mod­ern era, where high-fruc­tose foods and refined car­bo­hy­drates are con­sumed reg­u­lar­ly, this adap­ta­tion has led to wide­spread meta­bol­ic dis­or­ders. Unlike glu­cose, which can be imme­di­ate­ly used for ener­gy, fruc­tose under­goes a dif­fer­ent meta­bol­ic process that encour­ages fat accu­mu­la­tion in the liv­er and impairs insulin func­tion. Over time, this con­tributes to a cycle of increased fat stor­age, insulin resis­tance, and inflam­ma­tion, all of which ele­vate the risk of chron­ic dis­ease.

A key aspect of this chap­ter is how fruc­tose metab­o­lism unique­ly con­tributes to meta­bol­ic dys­func­tion. Unlike oth­er ani­mals, humans lack uri­c­ase, an enzyme that helps break down uric acid, a byprod­uct of fruc­tose metab­o­lism. Ele­vat­ed uric acid lev­els con­tribute to fat buildup in the liv­er, chron­ic inflam­ma­tion, and a high­er like­li­hood of devel­op­ing con­di­tions such as high blood pres­sure and insulin resis­tance. The author argues that while dietary fat has long been blamed for meta­bol­ic dis­eases, exces­sive sug­ar intake—especially fructose—is often the real dri­ver behind meta­bol­ic dys­func­tion.

The chap­ter cri­tiques con­ven­tion­al med­ical approach­es, which tend to address meta­bol­ic dis­eases only after they have reached an advanced stage. Many tra­di­tion­al screen­ing meth­ods, such as fast­ing glu­cose tests, fail to detect ear­ly insulin resis­tance, allow­ing meta­bol­ic dys­func­tion to progress unno­ticed. The author advo­cates for a shift toward ear­li­er detec­tion and inter­ven­tion, rec­om­mend­ing the use of more effec­tive mark­ers such as fast­ing insulin, triglyc­eride-to-HDL ratios, and liv­er enzyme tests to assess meta­bol­ic health before seri­ous com­pli­ca­tions arise.

Pre­ven­ta­tive strate­gies play a major role in this chap­ter, empha­siz­ing the pow­er of lifestyle changes in revers­ing meta­bol­ic dys­func­tion. The author encour­ages adopt­ing a diet cen­tered around whole, nutri­ent-rich foods while reduc­ing processed car­bo­hy­drates and added sug­ars. By pri­or­i­tiz­ing pro­tein, healthy fats, and fiber-dense veg­eta­bles, indi­vid­u­als can improve insulin sen­si­tiv­i­ty, low­er inflam­ma­tion, and enhance over­all meta­bol­ic func­tion. Exer­cise is also high­light­ed as a crit­i­cal fac­tor, not just for weight man­age­ment but for increas­ing mito­chon­dr­i­al effi­cien­cy, improv­ing glu­cose metab­o­lism, and pre­vent­ing fat buildup in the liv­er.

Beyond diet and exer­cise, the chap­ter high­lights the impact of sleep on meta­bol­ic health, an often-over­looked com­po­nent of dis­ease pre­ven­tion. Poor sleep dis­rupts hor­mon­al bal­ance, lead­ing to increased crav­ings for sug­ary foods, reduced insulin sen­si­tiv­i­ty, and height­ened cor­ti­sol lev­els, all of which con­tribute to insulin resis­tance. The author stress­es the impor­tance of main­tain­ing con­sis­tent sleep pat­terns and opti­miz­ing sleep envi­ron­ments to sup­port meta­bol­ic func­tion. Addi­tion­al­ly, stress man­age­ment is pre­sent­ed as a cru­cial aspect of main­tain­ing meta­bol­ic health, as chron­ic stress leads to pro­longed cor­ti­sol ele­va­tion, pro­mot­ing fat stor­age and wors­en­ing insulin resis­tance.

The chap­ter con­cludes with a for­ward-look­ing per­spec­tive, rein­forc­ing the idea that meta­bol­ic dis­or­ders are not an inevitable part of aging but rather a con­se­quence of envi­ron­men­tal and lifestyle fac­tors that can be mod­i­fied. By mak­ing informed choic­es in diet, exer­cise, sleep, and stress man­age­ment, indi­vid­u­als can sig­nif­i­cant­ly low­er their risk of devel­op­ing chron­ic meta­bol­ic con­di­tions. The core mes­sage is that by under­stand­ing the dis­con­nect between human biol­o­gy and mod­ern dietary habits, indi­vid­u­als can make smarter, evi­dence-based deci­sions that improve both lifes­pan and healthspan. With ear­ly inter­ven­tion and proac­tive mea­sures, peo­ple can regain con­trol over their meta­bol­ic health and reduce the bur­den of dis­eases linked to mod­ern liv­ing.