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Core protocols in PDF

Three evidence-based guides — sleep, glucose, vagus nerve. Authored by Dr Sergey Saadi, designed for print. Enter your email and we'll send the PDF right away.

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Lead magnet · Self-assessment

Insulin resistance self-assessment checklist

A 5-minute screen + lab formulas (TG/HDL, HOMA-IR).

Free PDF

Introduction

Insulin resistance (IR) is a state in which the body's cells stop responding effectively to insulin, leading to chronically elevated blood sugar and inflammation. IR is the central mechanism of type 2 diabetes, the metabolic syndrome, PCOS and cardiovascular disease — but it is fully reversible through lifestyle change.

Clinical signs and self-analysis

Persistent tiredness, especially 30–60 minutes after a carb-heavy meal.
Irresistible cravings for sweets and a need to snack between meals.
Fat accumulation around the waist (visceral obesity). Safe waist limits: women < 80 cm, men < 94 cm.
Acanthosis nigricans — darkening and thickening of the skin in neck folds, armpits or over the joints.
Frequent hunger and difficulty concentrating (brain fog).

How to estimate risk from lab tests

If you have a recent blood panel, calculate the ratio of triglycerides to HDL cholesterol. A TG / HDL ratio above 1.3 (women) or 1.5 (men) strongly suggests insulin resistance and the metabolic syndrome.

HOMA-IR = (fasting glucose mmol/L × fasting insulin mU/L) / 22.5

Optimal is below 1.0; a value above 1.9 indicates emerging resistance.

Additional markers worth requesting: fasting insulin (optimally < 6 mU/L), HbA1c (< 5.4%) and ApoB (the actual count of atherogenic particles). A classic lipid panel often misses these.

The first 7 days — what to change right away

Cut all sugary drinks (including juice and "healthy" smoothies) — the single biggest insulin trigger.
Eat protein and fibre first, carbs last. Reduces the post-meal glucose peak by up to 30%.
Walk for 10–15 minutes within 20 minutes of your main meal — muscles take up glucose independently of insulin (GLUT4 translocation).
Be in bed by 23:00 — one bad night drops insulin sensitivity by about 25%.
Strength training 2× a week — muscle mass is the body's largest glucose reservoir.

References: Reaven G., Diabetes 1988 (insulin resistance syndrome); Shukla et al., BMJ Open Diabetes Res Care 2017 (food order); Buffey et al., Sports Medicine 2022 (walking after meals).

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Lead magnet · Protocol

3-day express protocol to lower chronic inflammation

Step-by-step instructions — nervous system, glycaemia, circadian rhythm.

Interactive

Chronic low-grade inflammation (measured with hs-CRP) is the root cause of most lifestyle diseases and metabolic disorders. You can move it with lifestyle in just 72 hours.

Start the day with a 5-minute cyclic sigh (two quick inhales through the nose, one long slow exhale through the mouth) — in a Stanford study (Balban et al., 2023) this lowered cortisol and raised heart rate variability (HRV) faster than meditation.

Cut coffee after 14:00 — caffeine's half-life is 5–7 hours and it stays in the system well into the evening.

In the evening, a 10-minute vagus nerve activation: splash the face with cold water (30 °C → 10 °C, 30 seconds) or hum at a low pitch to engage the parasympathetic nervous system.

Remove all refined sugar, white flour and processed seed oils (sunflower, rapeseed, soy) — their omega-6 / omega-3 ratio exceeds 15:1 and drives IL-6 and TNF-α cytokine production.

For cellular support use high-quality olive oil (polyphenols > 250 mg/kg), wild fish (EPA + DHA), avocado and green vegetables with fibre.

Food order: protein and fibre first, carbohydrates last — reduces blood glucose peaks by 30–40% with no other changes.

Add 1 tbsp of apple cider vinegar (diluted in water) to each meal — lowers post-meal glucose by ~20% on average.

In the first 30 minutes after waking, get 10 minutes of direct daylight in your eyes (no sunglasses; through a window doesn't count) — it syncs the suprachiasmatic nucleus and builds a healthy morning cortisol peak.

In the evening wear orange glasses or block blue light 2 hours before bed. Bedroom temperature 17–19 °C.

Finish your last meal at least 3 hours before bed — late eating raises night-time insulin and disrupts melatonin synthesis.

Deep sleep activates the glymphatic system, which clears the brain of metabolic waste (including beta-amyloid deposits).

References: Harvard Medical School Inflammation Guide; Stanford Neurosciences Institute / Cell Reports Medicine, 2023.

Lead magnet · Nutrition

Low-carb eating — a beginner's science guide

How low-carb, ketogenic and moderate carb restriction differ — and when each one fits.

Evidence-based

Why cutting carbs works

Carbohydrates are the only macronutrient the body doesn't need for survival: protein and fat can't be replaced, carbs can. Every gram of carbs raises blood glucose and releases insulin — the main fat-storage hormone. When insulin is chronically high, fat cells don't release their stores and appetite goes up.

A low-carb diet lowers average insulin, improves insulin sensitivity, lowers triglycerides and often ApoB — all the key markers of insulin resistance, type 2 diabetes and the metabolic syndrome.

Three levels — choose by goal

Moderate (100–150 g/day)
For a healthy person seeking long-term balance and athletic performance. Suits most people.
Low-carb (50–100 g/day)
For insulin resistance, moderate overweight, PCOS and type 2 pre-diabetes. Glycaemic peaks flatten within a week.
Ketogenic (< 30 g/day)
Therapeutic level — epilepsy, resistant type 2 diabetes, some neurodegenerative conditions, fast weight loss. Requires electrolyte monitoring (Na, K, Mg).

What to eat — and avoid

Freely

• Eggs, fish, meat (grass-fed if possible)
• Avocado, olives, olive oil
• Nuts and seeds (in moderation)
• Leafy greens, broccoli, cauliflower, cabbage
• Cheese, butter, cream (if you tolerate dairy)
• Berries in small amounts

Avoid

• Sugar, honey, syrups, juice
• Bread, pasta, rice, potatoes (at the start)
• Refined seed oils (sunflower, rapeseed, soy)
• Processed snacks, biscuits, cereals
• "Diet" low-fat products (often compensated with sugar)

Preventing the "keto flu"

During the first 3–7 days you may feel tired, get headaches or cramps — this isn't real flu but an electrolyte shift as the body sheds water and sodium. Solution: 3–5 g extra sodium per day, 300 mg magnesium before bed, and 1000 mg potassium from greens and avocado.

References: Westman et al., Nutrition & Metabolism 2008 (low-carb and diabetes); Hallberg et al., Diabetes Therapy 2018 (Virta Health, 2-year study — 60% diabetes remission); Volek & Phinney,The Art and Science of Low Carbohydrate Living.

Lead magnet · Cardiovascular risk analysis

Cholesterol and its fractions — small dense LDL vs large buoyant LDL

What a standard lipid panel doesn't show — and why ApoB is a better predictor than LDL-C.

Advanced

Why "cholesterol" isn't one thing

The standard lipid panel shows four numbers: total cholesterol, LDL-C, HDL-C and triglycerides. The problem is that LDL-C only measures the mass of cholesterol inside particles — not their count and not their size. Two people with the same LDL-C of 3.5 mmol/L can carry very different risk: one has few large "fluffy" particles (low risk), the other many small dense ones (high risk).

Two-pattern model — A vs B

Pattern A — large buoyant LDL

Large "fluffy" particles (> 25.5 nm). Penetrate the artery wall poorly, cleared faster by the liver. Linked to low cardiovascular risk, even with a numerically high LDL-C.

Typical in healthy people eating enough saturated fat and few refined carbs.

Pattern B — small dense LDL

Small dense particles (< 25.5 nm). Easily slip under the endothelium, oxidise and drive atherosclerosis. 3× higher heart-attack risk at the same LDL-C.

Typical in insulin resistance, high triglycerides and low HDL — the "lipid triangle" of the metabolic syndrome.

Why these usually aren't measured in Estonia

LDL-C and total cholesterol are cheap and fast; fraction analysis (NMR LipoProfile, ApoB, Lp(a)) is more expensive and not part of the routine panel.
Clinical guidelines still rely on LDL-C thresholds, although several modern cardiology societies (including ESC 2019) recommend ApoB as the better predictor.
Patients often have to ask themselves: ApoB, Lp(a), fasting insulin, hsCRP, lipoprotein fractions.

What to ask your doctor — a mini-panel for sharper risk assessment

ApoB — the direct count of all atherogenic particles. Optimal < 0.8 g/L (low risk), > 1.0 g/L deserves attention.
Lp(a) — genetically determined, measured once in a lifetime. > 50 mg/dL is an independent risk factor.
TG / HDL — an indirect marker of particle size. < 1.5 indicates Pattern A, > 3.0 indicates Pattern B.
hsCRP — an inflammation marker that, combined with lipids, materially improves risk assessment.

References: Sniderman et al., JAMA Cardiology 2019 (ApoB vs LDL-C); Lamarche et al., Circulation 1997 (small dense LDL and CHD risk); ESC/EAS Guidelines on Dyslipidaemias 2019.

Interim summary

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