Hormonal
Chronic ingestion of a western diet (high glucose and free fatty acids) causes endothelial stress and platelet hyperactivity, which precedes and drives systemic metabolic inflammation and insulin resistance.
Focus on the quality and combination of your meals rather than just calorie counting or sugar avoidance. High-fat and high-carb meals can both trigger acute blood vessel stress. Prioritize whole foods that minimize rapid spikes in blood glucose and free fatty acids to protect your endothelial health and prevent the inflammation that leads to insulin resistance.
We propose that since endothelial stress and increases in platelet activity precede inflammation and overt symptoms of the MS, they are likely the first hit. This suggests that endothelial activation and insulin resistance are probably causative in the observed chronic low-level metabolic inflammation, and thus both metabolic and cardiovascular complications linked to consumption of a western diet.
Why this rating
The paper is a comprehensive review citing numerous human and animal studies, establishing strong consensus on the temporal sequence.
Source
Hemostasis, endothelial stress, inflammation, and the metabolic syndrome
Gerald Grandl et al. · Seminars in Immunopathology · 2017
DOI 10.1007/s00281-017-0666-5
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