Thursday, June 25, 2020

Retrospective #495: “A Very Low Insulin Diet”

I’ll bet you’ve never heard of this diet! Am I right? Well, if you haven’t, it’s because there isn’t a diet as such. It’s an outcome actually, of eating a certain way that achieves a low blood insulin level.  And that is a very good outcome, as I’ll explain. It’s also the natural outcome, as I will show, of eating the way our ancestor ate. The problem is there’s no way yet of knowing, objectively, from a simple (inexpensive) blood test, that you’ve achieved that desired outcome.
As a consequence, once you have achieved this outcome – until a cheap blood test is available – you will have to rely on a surrogate marker to know if, how and when you have achieved your goal: a low blood insulin level.
To understand “how,” we’ll need to delve into a little basic human physiology. Insulin is a hormone that has multiple roles in metabolism and fat partitioning. It is secreted by the pancreas, a small gland near the stomach, in response to eating carbohydrates. And as carbs are digested into glucose, insulin accompanies them into the bloodstream and acts to “open the door” of the cells where the glucose is taken up for energy.
So, when you eat carbs, your blood insulin level naturally rises. And the glucose from the carbs you ate are in excess of your energy needs, they are stored or, when storage is full, by a process called de novo lipogenesis, the liver converts them to fat and stores them in your fat cells. Then, as the circulating glucose is absorbed and burned or stored or converted to fat, your blood insulin level drops. And that is what a normally functioning glucose metabolism does.
Then, in that normally functioning glucose metabolism, when you blood insulin level goes low between meals, when you body calls for energy for whatever purpose (basal metabolic or activity), your low blood insulin level signals the liver to take energy from those recently refilled or other fat cells. Your fat cells cycle the triglycerides back into your blood stream (broken down as free fatty acids), and you get all the energy you need from your stored fat. Again, that is what a normally functioning glucose metabolism does. A low blood insulin level allows your body to continuously access stored body fat to maintain energy balance, including any level of energy required by your activities.
But what happens if for years and years, to avoid “saturated fat and cholesterol,” you have eaten – as you’ve been told – a diet very high in carbohydrates? And what happens if that diet, for your “convenience,” is mostly processed carbs from prepared foods or products sold in boxes and bags? And what if, to make the food more “palatable,” sugar (a simple, easily digestible carb) is added to virtually all processed foods, e.g., store-bought bread or peanut butter?
What happens is that for many people the body resists the unnaturally high level of glucose in the bloodstream. The transport hormone – the insulin accompanying glucose in your blood, it unable to open the cell that needs the energy. Those cells have developed Insulin Resistance. Well, the glucose and the insulin, continue to circulate, the cells don’t get the glucose energy they need, and because your blood insulin level is still high, your liver can’t access your stored body fat for the needed energy. So, your metabolism slows, and you feel tired… and sluggish…and hungry.
If you are one of those who has developed…over many years…a degree of Insulin Resistance, your doctor has no direct measurement to find out. He doesn’t have an affordable or insurance reimbursable test that he can use to measure your blood insulin level. But she, and you, have a few good surrogates: 1) you body fat level. The cause of obesity, or “overweight,” is not sloth or lack of activity. It is Insulin Resistance. If you have a “touch” of Insulin Resistance, your elevated blood insulin is being transported back to your liver where it converts it to fat, and your elevated blood insulin is blocking body fat from being used for energy when your body needs it, so you’re hungry and you eat for energy.
Another surrogate is an elevated blood glucose level. Your doctor can easily test for this, either with a hemoglobin A1c test which measure the glucose on your red blood cells over 3 months. This is a good surrogate because, as we say, if you have an elevated blood glucose, it is because you have an elevated blood insulin because of Insulin Resistance.
If you have Insulin Resistance, the precursor condition for Type 2 Diabetes, you can treat it yourself by not eating the foods that make your body produce and transport insulin to help your body take up glucose: CARBOHYDRATES.

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