Why is Blood Sugar Sometimes Higher Than Expected on Keto?

We have a numbers problem in the keto community. 

We place too much stock in numbers without a good understanding of what they mean. 

We measure the level of every little molecule without an appreciation for the myriad feedback mechanisms and overlapping biochemical pathways that govern the systemic regulation that determines those levels. We assign way too much meaning to single measurements taken at single points in time rather than looking at longer term trends and patterns. It’s like seeing one frame of a movie—one isolated, frozen frame—and making wild guesses as to what the movie is about. It’s ridiculous. 

Allow me to tell you a story. Sometime in the early 1980s, when I was a little girl, my family took a trip to Disney World in Florida one winter. We lived in New York, so Florida was a way for me and my sister to see Disney World and for us to spend a few days away from the freezing cold and bask in the warmth of the Sunshine State. Well, a freak cold front happened while we were there. Yes, a freak, unexpected cold snap in Florida. Sea World was closed because some of the water was frozen. We had to buy winter coats down there, because who packs winter coats to go on vacation in Florida? 

Imagine if we knew nothing about Florida and based our assessment of Florida’s climate on the short-term weather of those few days. We would have assumed Florida was a bitterly cold place, rather than the hot, steamy swamp it usually is. The lesson here is, don’t mistake an acute occurrence for a general pattern, trend, or tendency. 

What does this have to do with blood glucose? 

(If you’re pressed for time and you want an abbreviated version of my take on this topic, watch this video. If you have a minute or two to read, the first part of this post will give you a brief synopsis of the most salient points. But if you have some extra time to spare and you want the juicy details, cozy up, settle in, and happy reading.) 

14 Ways to Tell if Keto Is Working for You Besides Weight Loss

 

Based on keto transformation pics on social media, it would be easy to think this very low-carb way of eating is used for just one thing: weight loss. And no doubt, the before and after pictures of people who’ve lost substantial amounts of weight are amazing. But low-carb and ketogenic diets are good for so many other things besides changing the size of your body. Some of these—like lower blood sugar, lower triglycerides, and lower blood pressure—can be shared via pictures of glucometers, home blood pressure cuffs, or printouts of your latest bloodwork. But what about the things we can’t see? What about all the great stuff keto does that you can’t capture in a picture? A picture speaks a thousand words, but what about the great things keto does that you can’t take a picture of? 

People use keto for fat loss, but what if you: 

A) Don’t want or need to lose weight, but you’re dealing with a laundry list of troubling health issues? 

B) Do want to lose body fat but you’re stuck in a stall and the scale hasn’t moved in a while? 

Well, if B is your issue, check out this article I wrote on how to stay motivated during a fat loss stall, and then grab a copy of my book, The Stall Slayer, to help break that stall. (I also encourage you to just stay off the scale altogether for a while.) 

 

Either way, here are 14 ways to know that keto’s working for you that have nothing to do with weight.

Get Early Access to Blog Posts

Hi all!

Just a quick note to let you know there’s a way to get early access to blog posts from now on. I’m on Patreon, and I’ve added a benefit to patrons who support me at the $5/month level. For the price of two or so cups of coffee, you can read new blog posts a few days before the rest of the world. If you have the means and want to check this out, see here for details.

In case you’re wondering what topics I'll be writing about next, right now I’m working on a post about the effects of chronically high insulin on the skin, and one on why people need to stop freaking out about slightly high blood sugar at random points in time. (See here for a preview of the one on insulin & skin. It’s a post I wrote on this topic for Designs for Health, but they don’t give me a byline. Trust me, it was me.)

The $10/month level gets you access to my monthly research review, wherein I discuss scientific papers I’ve read over the preceding few weeks. The papers cover a range of topics – whatever strikes my fancy that particular month, or whatever things I happen to be reading and learning more about. Sometimes it’s low carb and ketogenic diets, sometimes it’s diabetes, sometimes Alzheimer’s, sometimes cholesterol and statins…whatever papers catch my eye and that I think I’ll learn something valuable from.

You can also support me for as little as $2 or $3/month, but there are no special perks for that…unless you count my deep gratitude and appreciation for your generosity!  

As always, however, my blog itself is free and always will be. So if funds are tight and $5/month is beyond reach, no worries whatsoever. All posts will still be right here too. Patrons simply get to read them a few days in advance of the general public. And if you want to experience more of my approach to “Keto Without the Crazy,”™ remember my videos are all free as well, as is my Twitter account.

Here’s the link again to my Patreon page.

Thanks, everyone. I’m glad you’re here. In this age of quick sound bites and instant gratification, I’m thankful anyone out there still likes (prefers, even!) reading long, in-depth blog posts. I do love writing them, even if I don’t do it as often as I’d like to.

Disclaimer: Amy Berger, MS, CNS, NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

A New Look at Insulin, Glucagon & the Pancreas (a.k.a. ITIS part 9)

“Contrary to popular belief, insulin is not needed for glucose uptake and utilization in man.” (Source)

What? Insulin is not needed for glucose uptake? Did I just blow your mind a little?  If so, hang on to your hat. Lots more of that to come.

As I mentioned in my previous post on the personal fat threshold concept, what I enjoy most about writing my blog is that I get to share with you the fascinating and surprising things I learn. And one thing I can say with certainty is, the more I learn, the less I know. It seems like I barely hit publish on a new blog post before coming across a bunch of papers that teach me even more about the subject in question, or make me rethink what I wrote about it in the past.

One subject I’ve learned more about since I last wrote about it is insulin. If you’re new here, I recommend digging into my 8-part series on insulin. If I do say so myself, it’s some of the most important and educational stuff I’ve written.  But you don’t need to have read that to understand today’s post.

If you’re accustomed to thinking about insulin as a “blood sugar hormone,” you’re about to have your world turned upside down.  What I’ve learned about insulin over the past couple of years makes me think that lowering blood glucose might be one of the least important and impressive things it does.

Another very long post coming your way here, so grab a coffee or some pork rinds, and happy reading!

Before you dive in, though, I recommend scrolling way down to the bottom of this post where it says “End.” You might want to spend a while reading the whole thing, or you might not…that will help you decide. 

I Started a YouTube Channel!

I started a YouTube channel!

Yes, dear readers, if you enjoy my writing, you can now go a step further and see and hear me. You can get “the real thing,” instead of trying to picture my voice or demeanor in your head. Some of you will be happy about this development; others might be thinking, “Why would I ever watch videos of her?” If you prefer reading blog posts, stay here on the blog. If you like videos too, please subscribe to the channel and keep reading the blog. Definitely don’t abandon the blog! (More on this later.)

Why did I start a channel?

People are hungry for a voice of reason, sanity, and simplicity.

I see people making keto so complicated. I see people convincing folks who are new to this that they need powdered MCT oil for their coffee, or that they have to use exogenous ketones to transition to keto. I see people pricking their fingers and peeing on test strips without the slightest clue of how to interpret what they see. (Okay, I don’t actually witness people peeing on strips, like, in person, but you know what I mean.) I see people plugging in their anthropometric data and getting “macros” spit out to them by calculators that have no idea how much body fat they carry (as opposed to total weight), or whether they have a thyroid problem. I see people following arbitrary macro percentages and loading up their food with extra butter and oil because some app told them to, not because they’re hungry for more fat.  

I see people who are confused and overwhelmed, and they’re not getting the results they want. They’re either so confused that they never even start a low carb way of eating, or they do what they think is the kind of low carb or keto diet they need, but they’ve been given so much inaccurate and potentially harmful information that whatever they were looking to accomplish, they’re actually going backward.

I see people misguidedly emphasizing “keto” instead of low carb. I see people bashing the Atkins diet, as if that isn’t a perfectly effective option for most of us. (And as if “keto” isn’t really just the 46-year-old Atkins induction phase wrapped up in a shiny new bow.)

For a long time, I’ve been trying to figure out who I am in the low carb scene. What do I have to contribute? Do I offer anything unique? Anything valuable? Am I saying anything a zillion other people aren’t already saying, and saying it better than I am?

Well, I think I’ve finally found my niche. After having been at this for a few years now (I published my first blog post way back in 2012), it’s happened organically – my “voice” has emerged over time, as the writing has grown. I want to help people see how simple this is—when we let it be. I’m the one who says, no, you don’t have to eat exclusively grassfed meats and organic vegetables. No, you probably don’t need to measure your ketones (but some people do benefit from it). No, you’re not going to die immediately if you use regular store-bought salad dressing, made with soybean oil. And no, you don’t have to have a PhD in calculus to figure out what and how much to eat.

In a world—including the keto community—that is increasingly polarized with warring factions shouting at each other from their entrenched camps, I’m okay with NOT being a zealot. I understand that there’s more than one way to get healthy, more than one way to lose weight, more than one way to lower blood sugar, and more than one way to be a decent human being who enjoys his or her food. I think I’ve gotten a reputation for being low-carb and keto-oriented, but also open minded and accepting of other ways of doing things that work for people. Maybe it’s only my perception, but I think I’m getting this reputation, and I like it. I think it’s needed. I look forward to new people finding me and my message of sanity and simplicity. I sincerely hope it helps them navigate low carb/keto as calmly and effortlessly as it should be navigated.

Now, about the videos:

As you know quite well if you’ve been around the blog awhile, brevity is not my strong suit. My posts tend to be really long. I plan to keep the videos short: aiming for about 10 minutes, give or take a few minutes. Some might be a little shorter; others will likely be longer (the first two already are, but they are intros to me and the channel, and are not typical of what I plan to be talking about in future videos), but I plan to make them all short enough that anyone who clicks on the links won’t be put off by the length.

I have friends and colleagues who have their own channels and put out lots of video content regarding LCHF/keto. And while I respect them and agree with most of what they say, I’ve found myself taking issue with a few things here and there. And I realized that if I’m not satisfied with how other people are explaining keto, then I need to get in the driver’s seat and do it myself.

So I have.

Please join me and subscribe to the channel, if you are so inclined.

As I’ll explain in my second video (in which I share my own history and how I got into low carb and eventually transitioned to being a nutrition professional), I am nearly helpless with technology. I’m an embarrassment to my alma mater, Carnegie Mellon University. It’s one of the top computer engineering schools in the world, but I’m lucky if I can even figure out how to plug in my laptop. It’s a bit of a miracle that I have a blog, a Twitter account, and now, a YouTube channel. See, I majored in creative writing, not computer engineering, or anything else having to do with 1s and 0s. So that’s why the writing here is kinda-sorta okay, but the site itself is a disaster. (Working on getting help with this soon! Planning a major overhaul of the site over the next several months. Yay!)

So bear with me as I learn how to improve the quality of my videos. I’d like to learn how to embed links and add images and text to the background. I know there are programs and apps that make it easy to do this. On the other hand, I’ve gotten feedback from people that simple is best. No need for anything fancy & flashy. If I’m saying something valuable, something people need to hear, then that’s enough. (Still, when I refer to blog posts I’ve written or to relevant scientific papers, I’d like for people to be able to click right on the link. That seems like the least I can do.)

And in case you’re wondering, yes, yes, YES, I will most definitely still be writing blog posts. Writing is, always has been, and likely always will be my first love. I’m adding YouTube to the mix only because it seems like you kind of “have to” be there to make a dent in things these days. Many people who are put off by the length of my posts would be happy to watch a 15-minute video (never mind that it would take them less than that to read even some of my longest posts). And some old-school folks (like me!) prefer reading and would sooner read a long post than watch a short video. So now I can reach more people, both the readers and the viewers, and everyone’s going to get pretty much the same message: keto doesn’t have to be complicated, confusing, or expensive. You can enjoy absolutely delicious food while improving your health and/or losing weight, and your way of eating doesn’t have to become an adventure in theoretical physics. You don’t need an advanced degree to lose weight, lower your blood sugar, get rid of your acid reflux, improve your PCOS, and say goodbye to joint pain, migraines, and gout. You just need to ditch the carbs.

See you on the screen!

P.S. Do you have any preference as to the frequency of new videos? I’m thinking twice a week, maybe every 4 days or so. I haven’t dived into YouTube analytics yet to see if there’s a “best” day to post, when more people are likely to watch. I’ll probably do what I do on the blog, which is follow my heart: write what I want to write, in the way I want to write it, and post it when I want to post it. It’s worked so far. I’m happy with the loyal readership I have here, and I’ve built it honestly and genuinely: no gimmicks, no false promises, no emphasis on whatever’s trendy just for more likes & shares. I plan to do the same with YT. Here’s hoping the people who need it find it.

P.P.S. Sorry for the decrease in blog posting frequency over the past several months. I have 2 or 3 long posts in the works, all in various stages of completion. I’ve had a bunch of speaking engagements the past few months and have 3 more coming up before the end of November. Once those are done, I’ll be able to focus on finishing these posts and hopefully resume putting out sarcastic and snarky educational content here. (And I'll publish shorter posts before then if I can.)

Disclaimer: Amy Berger, MS, CNS, NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

Dietary Recommendations for Alzheimer's -- NPR Gets it ... Almost

“There’s a growing body of evidence linking elevated blood sugar to memory problems.”

Mainstream media is catching on, folks. The quote above, taken from this story from NPR over three years ago, is reflective of the growing awareness among the medical community and laypeople alike that there might actually be something to the wild and crazy notion of Alzheimer’s disease and cognitive impairment as “type 3 diabetes” or “diabetes of the brain.” I have written about this over and over again and need not rehash the details here. (If you want to know the full story, consider purchasing my book, The Alzheimer’s Antidote.)  Even The New York Times published a piece just the other day profiling a famous chef who is using a low-carb, high-fat diet to fight dementia. (Shout out to liberal use of butter abd MCT oil in her morning coffee!)

The NPR article is pretty good. It gets the point across while being very succinct – a feat I have proven I am totally incapable of. What I like best about it is that it references this paper, the key finding of which is that elevated blood glucose may be a risk for dementia even at levels lower than the diabetic range. This is not news to me, and probably not to you, but it’s nice to see this getting out to the general public, among whom it probably is news. (Or should have been a few years ago when this came out.) It’s not news to us because you and I already know that hyperinsulinemia alone—not high glucose, but high insulin—is an independent risk factor for developing Alzheimer’s disease. In fact, compared to people with “normal” insulin levels, those who are not diabetic but are hyperinsulinemic have double the risk of developing AD.

My Top 10 Favorite Posts

I missed my four year blogversary!

My blog has existed since August 2012. I would have celebrated sooner, but August 2016 blew right past me. (Probably because I was mired in a deep and longstanding depression, which I thought I was starting to come out of, but which is actually back in full force and only lifted temporarily.)  As of this writing, there are 242 posts. I don’t think I hit my stride until sometime mid-2013, but there are a couple of gems going back as far as September 2012.

For those of you who found me a few years into my blathering blogging, and since new people stumble upon my blog every week, I thought it would be nice to start the new year by sharing a selection of my personal favorite posts for those of you who have only recently tuned in, as well as for any of you who are wondering what the “must read” posts are. (In my opinion, anyway.) I tried to purge all my low carb and keto-related anger in a few posts prior to the close of 2016 so that I could start 2017 on a more positive note. I can’t promise I won’t post any more rants in the future (I think we can all agree I’m not physically capable of holding it in), but I am going to try to stick to things that are a little more scientific, as well as posting tips and insights that are helpful for following these types of diets in the real world.

With no further ado, here are my top ten favorites, in no particular order, except that the first one is probably nearest and dearest to my heart and resonates with me, personally, the most deeply:

Metabolic Theory of Cancer: Speculation on the Causes of Cancer -- and How to Mitigate Them (Pt.5A)

Graphic adapted from Seyfried et al., 2015

OH. EM. GEE!!!!!

It’s baaa-aaaaack!

Today is June 1, 2016. Looking back through the blog archives, I saw that the previous post in this series on the metabolic theory of cancer was published on June 1, 2015. Yes, kids, it’s been a year. A full year! An entire year to the day. If you have been waiting and waiting (and waiting!) for me to get back to this and address some key concepts we haven’t gotten to yet, believe me, nobody wanted me to get back to this more than I did. I absolutely did not plan on it taking a year. But alas. Hopefully, in that time, you’ve learned a thing or two about insulin, stubborn fat loss, and the use of ketogenic diets for Alzheimer’s disease and other neurological conditions. In fact, I am in the process of adding a new installment to the “ITIS/It’s the Insulin, Stupid” series, but when I saw that I was coming up on the one-year anniversary of neglecting the cancer series, I knew I had to get my rear in gear and just DO IT. I really wanted to do the insulin post first, but considering the date, I thought it would be apropos for me to do this one instead.

Also, just to let you know, since the writing of that last post, I have had the honor of meeting Drs. Seyfried, D’Agostino, and Poff in person. {Squee!!}  I also got to meet Dr. Cunnane, Dr. Newport, Dr. Rho, and Dr. Maffetone. Holy moly…it was a nonstop conference of metabolism rock stars.

I am most definitely going to get to the mamma-jamma, granddaddy of all topics we’ve been waiting for in this cancer series—the ketogenic diet—but please be patient. I’ve very recently had more work stuff come up (in a good way), and I am feeling a bit overwhelmed. I will write about ketosis. I can’t promise when, exactly, that will happen, but I promise it won’t take a year. (Maybe just a couple weeks, considering I’m already working on it.)  ;-)

If you’re new to my blog and have no idea what’s going on right now, the series I’ve written on the metabolic theory of cancer is a “fan favorite” – at least, among the people who like to geek out on the science with me. The cancer series is representative of when my blog becomes a free course in (very basic) biochemistry and physiology, and is peppered with links and quotes from the scientific literature. If you prefer my rants, shakedowns of food labels, and other casual-type posts, no prob! Whatever floats your boat. But for those of you who need to kill lots of time at your desk job, or who perhaps need help falling asleep, you might want to start way back at the beginning and work your way toward today’s post. (Actually, that’s sarcasm. The truth is, I think this stuff is fascinating, and perhaps some of my best work. I swear, that hexokinase 2 stuff STILL blows my mind.)

Since it has been a year (!!) since the last installment, I’ll make it easy for you and list all the posts in order, from first to most recent: 

1. Introduction
2. Cells Behaving Badly
3. Cellular Energy Generation 1 - Glycolysis
4. Cellular Energy Generation 2 - Mighty Mitochondria (Krebs Cycle, Electron Transport Chain)
5. Mitochondrial Dysfunction 1
6. Mitochondrial Dysfunction 2 - They ARE Broken
7. Glycolysis Run Amok & Mutant Hexokinase
8. Aerobic Fermentation (a.k.a. "The Warburg Effect")
9. Cancer Cells are Sugar Junkies
10. Mutations vs. Mitochondria
11. Cancer as a Protective Mechanism
12. Speculation on the Causes of Cancer (Pt.1)
13. Video Lesson! (Thomas Seyfried, PhD)
14. Speculation on the Causes of Cancer -- and How to Mitigate Risk (Pt.2)
15. Speculation on the Causes of Cancer -- and How to Mitigate Them (Pt.3 - Viruses)
16. Speculation on the Causes of Cancer -- and How to Mitigate Them (Pt.4 - Carcinogens)

Buckle up and hang on tight, everyone. HERE WE GO!

Podcast Interview: Lyme Ninja Radio

In case anyone out there isn’t completely sick yet of hearing me talk about the etiology of Alzheimer’s disease and the potential therapeutic role of very low-carb diets, I wanted to let you know about my latest podcast interview.

Hop on over to Lyme Ninja Radio, where I had a great conversation with the head ninja himself, Mackay Rippey. You can also find it on iTunes, but I’m not sure if this episode has been posted there yet. (I’m on episode 70.)

Some of it will be old news if you’ve listened to my previous podcast interviews on this subject, but Mackay was super fun to talk to, and we get into a couple of other low-carb and “real food” issues beyond Alzheimer’s. We recorded this one by phone, so there’s no static like when I was on Robb Wolf’s show, but I do kind of sound like I’m talking from inside a tin can. Not really sure why that happened, but you should be able to understand me just fine. (Except that I talk way too fast, just like my mother used to tell me, hehheh.)

And for those of you who are particularly interested in the notion of Alzheimer’s as “type 3 diabetes,” or “diabetes of the brain,” I’ve compiled links to my blog posts, journal articles, and podcast interviews, plus some of my favorite scientific papers, in a new tab on my website.

Enjoy!

Remember: Amy Berger, M.S., NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

ITIS -- It's the Insulin, Stupid (pt 8/8)

Well, here we are, folks! The 8^th and final installment of the crazy journey that began way back when we looked at Dr. Joseph Kraft’s 5-hour glucose tolerance tests with insulin assay. You remember those, right? The ones that suggested far more people are in the early stages of diabetes and insulin resistance than anyone ever would have guessed, based on their “normal” fasting glucose and hemoglobin A1c results.

In case anyone’s stumbling upon this series for the first time, here are links to the seven posts that preceded this one:

• Part 1: Introduction to insulin resistance and the work of Dr. Kraft: What is diabetes in-situ?
• Part 2: Health consequences of hyperinsulinemia & hyperglycemia unrelated to body weight.
• Part 3: Deep-dive into the pancreas and the balancing act between insulin and GLUCAGON.
• Part 4: The role of insulin in the gain & loss of body fat.
• Part 5: More on insulin & the regulation of body fat—how do different eating patterns (such as intermittent fasting and carbohydrate reduction) affect insulin, and what does that mean for body fat and energy levels?
• Part 6: The concept of “normal weight obesity” or TOFI—thin outside, fat inside, and what this means for overall health. (Summary: “thin” doesn’t automatically mean healthy.) Also: how come some people don’t become overweight when they’re insulin resistant?
• Part 7: “Calories in, calories out” and “eat less, move more.” Are these sound bytes the least bit helpful? In a word, no. If you have even the smallest appreciation for the complexity of the biochemical regulation of human metabolism, in general, and body fat, in particular, then you will agree that these phrases are laughably simplistic and one step shy of being completely meaningless.

Okay! Let’s get down to business.

Having covered some of the gnarly health conditions and debilitating downstream effects of insulin resistance (IR), hyperinsulinemia, and hyperglycemia—which can affect your eyes, your ears, your brain, your kidneys, your heart & blood vessels, your nerves, and your man parts or lady bits, not to mention make you the three Fs: fat, fatigued, and foggy-headed—it’s time to address perhaps the most important questions of all...

ITIS -- It's the Insulin, Stupid (pt 6/8)

LOOKS CAN BE DECEIVING!

We’re in the home stretch with all this insulin stuff, folks, I promise. Just two more posts after this, and we’ll be done. (I also promise to get back to the cancer series soon. I know I’ve got some readers who’ve been waiting a long time for that to be resurrected.)

Okay, I left off last time asking why chronically elevated insulin causes some people to gain body fat, but not others. I also hinted that the accumulation of adipose tissue might actually be a protective mechanism. We’ll start with the first issue, since it’s quicker to address. I also want to start with it because it is probably the zillion-dollar question in all of human metabolism in our current dietary  & cultural zeitgeist. Upon consuming the same diet—the same number of calories, possibly the same macronutrient ratios—and maybe even having the same degree of hyperinsulinemia/insulin resistance, why do only some people get fat?

And here, my friends, is my zillion-dollar answer:

I don’t know.

I don’t know if anyone knows. Most likely, there are genetic factors involved. After all, some people are tall; some are short. Some have blue eyes; some have brown eyes. In the face of chronically elevated insulin, some of us accumulate lots of adipose tissue, some don’t. (Lucky bastards…) How come some people’s bodies are so good at not accumulating excess adipose? Put more bluntly—and in terms most of us have probably said to ourselves a hundred times about friends and relatives who have never had weight problems—despite eating junk and being sedentary—Dammit, why don’t they ever get fat?!

ITIS -- It's the Insulin, Stupid (pt 5/8)

In part 3 of this series, we covered the role of insulin as a counter-regulatory force that keeps catabolic glucagon in check. (Reminder: in the absence of insulin, glucagon run amok will cause the body to waste away by catabolizing its own muscle and fat tissue for fuel). And in part 4, I mentioned that lowering blood glucose (BG) is probably not insulin’s primary function, but rather, one of the ways by which insulin helps keep BG in check gives us a clue as to one of its more important functions: it is anti-catabolic. While several other hormones break tissue down in order to provide glucose and fatty acids to fuel the body, insulin builds tissue up.

That’s right. Insulin is an anabolic hormone. It stimulates tissue growth, be it of muscle or adipose. (If the phrase “stimulates tissue growth” reminds you of cancer, hang onto that thought. I’ll be addressing insulin eventually in the cancer series.) If a lack or insufficiency of insulin causes type 1 diabetics to waste away due to catabolizing muscle and fat, then that tells us that insulin helps build up muscle and fat. (Or, at the very least, insulin hinders its breakdown.) Veteran bodybuilders can tell you that insulin spikes (properly timed) can help build muscle mass, and veteran low-carbers can tell you that insulin spikes can help build fat mass. Remember: insulin isn’t “toxic.” It’s all about context. Since we’re focusing on obesity here, we’ll leave muscle out of the discussion and focus on fat.

ITIS -- It's the Insulin, Stupid (pt 4/8)

“Insulin is vital for lipogenesis. Its role as a lipogenic hormone is underplayed, but we know that without insulin, you can’t get fat.”
                                        --Dr. Roger Unger

Having raved about Dr. Unger’s lecture in the previous insulin post, obviously, I think he’s pretty brilliant. That being said, chronically elevated insulin isn’t the only mechanism by which people accumulate excess adipose tissue. (For the newbies out there, “accumulating excess adipose tissue” is the fancy way to say “get fat.”) I prefer to use the word adipose instead of fat, because I am trying to make a distinction between dietary fat that we consume in food, and the body fat that we all love to hate so much on our bellies, hips, thighs, and elsewhere. Even if they both occur in the form of triglycerides, I still want to keep them separate, since eating dietary fat does not automatically result in said fat depositing itself on our rear ends or forming second and third chins.

Apart from insulin, there are several other things that contribute to the regulation of body weight, and, perhaps more important, the composition of that weight. And I’m not ignoring those. Sometime in the next few weeks, I’ll be writing a post about the myriad other reasons someone might not be losing weight on a low-carb diet (unrelated to this insulin series). For our purposes right now, though, we’ll stick with insulin. Because even if there are other factors playing a role in excess adiposity, when we look at changes that have occurred to the food supply and the general dietary guidelines from various government and professional medical/health organizations during the last several decades, systemic hyperinsulinemia is probably one of the largest influences, if not the single largest.

In tackling the role of insulin on the accumulation of adipose tissue, first we need to explore just a few more things about insulin’s biochemical & physiological roles. After that, we’ll see how it all plays out in the real world—that is, in the body.

ITIS -- It's the Insulin, Stupid (Pt 3/8)

If you made it through the encyclopedic posts that were part 1 and part 2 of this series on insulin, and you’ve come back for more, thank you! It is one of my biggest flaws as a writer: brevity is not my strong suit. (But at least I admit I have a problem. That’s the first step, right?) This post is no exception. In fact, it's probably longer than the first 2. So go grab a cuppa joe, or tea, or whatever you like, and hunker down for a nice, long read.

Okay. So I left off last time pointing out that, in covering the effects of elevated insulin and glucose on the cardiovascular system, reproductive function, the brain, kidneys, eyes, and inner ear & balance mechanisms, I had not said one word about obesity. I hope we’re all on the same page and can agree that insulin resistance is not something limited to people who are carrying around a few—or a couple hundred—extra pounds. Obviously, there are millions of non-overweight people who are infertile, have heart disease, kidney disease, vision problems, dementia, and more. (I have written about this before. One of my personal favorite posts on this entire blog is the one where I explained that obesity is simply one more effect of metabolic derangement, rather than its cause. I also wrote about this topic for Designs for Health.)

Nevertheless, we’d be missing a substantial piece of the insulin puzzle if we didn’t talk about the role of insulin in regulating body weight. Before we get to that, however, we first need to look at the actual functions of insulin, as well as the pancreas. It is an unfortunate byproduct of our epidemic of “diabesity” that we automatically think of blood glucose when we hear the word insulin. And there’s no doubt insulin does have an important role in regulating—or, more specifically, lowering—blood glucose (BG). But that’s not insulin’s only function. In fact, I would argue it’s not even the primary function. We will get to weight, I promise. But just like we did in the cancer series, we’ve got to trudge through a lot of biochemical weeds before we get to the good stuff. So here goes.

Time for a brief extremely verbose endocrinology lesson.

Food for Thought Friday: Yes, You *Are* Hungry

One of the frequently repeated claims about low carb and ketogenic diets goes something like, “I don’t get hungry anymore.” Many people find that being in ketosis suppresses the appetite. In some cases, the higher the ketones and/or the free fatty acids, the less desire there is to eat. But is this really true? If you follow a low carb diet, will your appetite go away completely? Will you never be hungry? I find this hard to believe, so let’s dissect this claim, shall we?

If you’ve been reading my blog for a while (and if so, I thank you!), then you know I’ve reserved these Food for Thought Friday posts as my place to do a little ranting, albeit in a humorous way. I hope I’m not becoming too negative, though. It’s just that I get pretty hung up on language, and I don't like us playing fast and loose with how we say things. It’s probably the writer in me. So I got a little annoyed the other day when I was catching up on Robb Wolf’s podcast, and I heard Perfect Health Diet author Paul Jaminet say something about this phenomenon of magically disappearing hunger.

ITIS -- It's the Insulin, Stupid (pt 2/8)

Warning: This is a ridiculously long post. I was going to break it up into two, but I figured, what’s the difference between one really long post, and two semi-long ones? You can always read a couple paragraphs and then come back later if you don’t have time to read it all at once.

Also: My blog has a very eclectic audience. I have physicians, PhDs, and others well-educated in biochem and A&P reading this, but I think the bulk of my readers are interested laypeople. I try to tailor my posts to the laypeople, keeping in mind that they are of above-average intelligence, and certainly above-average knowledge about all this low-carb, high-fat, Paleo, and ancestral health "stuff." Just wanted to remind everyone of the diverse audience here, because this post, in particular, contains simplified explanations of complex processes, and I apologize if any of the pros find themselves bored. :-/ 

OKAY! Now we come to the next part of why all of this insulin stuff is so important. (Missed the first part? Click here. And you’ll notice I’ve changed the title of this post to say it’s part 2 of I-don’t-know-how-many. In starting to write part 3, I realized this is going to be more like 5 or 6. I am learning new things about this every day that I feel are important enough to write about, and the number of posts it will take to include them keeps rising.) 

Here we go...

ITIS -- It's the Insulin, Stupid (pt 1 of 8)

As you can imagine, I spend a lot of time educating myself about health, nutrition, and food. Whether I’m reading papers in the scientific and medical literature, keeping up with posts by intelligent bloggers, or learning more about human anatomy and physiology, a good portion of my week is devoted to ensuring that, as a nutritionist and blogger, I know what I’m talking about, and I provide my clients and readers with reliable information. There’s so much hashing and rehashing of old news in this field, and you can’t walk five feet without bumping into a dead horse that’s been beaten over and over—and over—again. So it isn’t often that something comes along that really blows my mind. (Like this. I am still fascinated by this.) Once in a while, something that’s actually very simple, and which should be totally obvious, blows my mind, if only because it makes me think about things in ways I’d never considered before.

With the help of some very cool people in the low-carb, high-fat (LCHF) world, I have been introduced to a new concept—well, new to me, but certainly not “new” at all—and I’d like to share it with you. There’s a lot to talk about, but the overall theme boils down to this: by focusing almost exclusively on blood glucose, the medical and nutrition professions have been missing the boat on a much larger, much more insidious problem: insulin.

As you know, blood glucose and insulin are intimately related. It’s hard to discuss one without the other. But when was the last time your basic bloodwork panel included a measurement of your insulin levels? Have you ever had a doctor look at anything but your fasting glucose and maybe your A1c if (s)he was concerned about your blood sugar management? (Never mind that the A1c isn’t even included in a typical blood panel. You often have to specifically request it.) If you’ve ever been the victim of experienced an oral glucose tolerance test (OGTT), did your doctor measure your insulin levels, or only your blood glucose?

With a single-minded focus on glucose, glucose, glucose, we have distracted ourselves from what is really driving the ship in type 2 diabetes (T2D), metabolic syndrome, Alzheimer’s disease, and many more conditions that we’ll explore in detail in part 2 of this series. Hence, the title of this post.

Stop Saying "Ketogenic" When You Mean Low Carb

I’ve received a spate of inquiries from prospective clients recently that start off something like this:

“Hi, Amy, I’m interested in starting a ketogenic diet. Please let me know when we can set up an appointment.”

My initial response to these inquiries is:

“Hi ______,

Thanks for getting in touch. Do you mind if I ask why you’re interested in a ketogenic diet? Do you have a specific medical condition you’re looking to improve? Or if this is for weight loss, what is your current weight, and how much are you looking to lose?”

Once in a while, it’s someone with an autoimmune condition, and I’ve had a couple of inquiries about cancer, but the majority of people I hear from do not require a ketogenic diet. That is, not a classical ketogenic diet.

Alzheimer’s, Ketones, and Kidding Ourselves (Pt.2/3)

I ended the previous post by introducing the idea of using exogenous ketones for improving the signs and symptoms of Alzheimer’s, while not requiring the afflicted individual to make any dietary changes. (Recall that, according to researchers, a very low carb diet is “inconvenient” to prepare and consume.) Is there a place for exogenous ketones in AD therapy? Yes. I believe there is. It depends on the person’s age and severity of illness, but I absolutely acknowledge that exogenous ketones can improve quality of life. BUT: with the exception of some very specific cases, which I’ll mention in a bit, I cannot support them being used as the sole intervention. It’s as bad as telling a type-2 diabetic to use insulin and do nothing else to influence the way their body handles glucose, or, really, insulin, itself.  

Please tell me someone out there is on the same page as me here.

“Alzheimer's disease patients frequently undergo changes in food preference toward sweet, carbohydrate-rich foods, which would make compliance to a ketogenic diet difficult.” (Henderson et al., 2009)

Really? Do they undergo changes in food preference toward sweet, carbohydrate-rich foods after they develop Alzheimer’s disease, or are sugar addicts more likely to develop AD? Which is the chicken, and which is the Cadbury Crème Egg?

Now, here’s where things get deep.

Label Madness Monday: Et tu, BBQ? (Or: How to Eat at a BBQ Joint Without Wrecking Yourself)

I love me some good BBQ!

Set before me some nice sliced brisket or a pile of pulled pork and I’m in hog heaven. (Pun intended.) However, depending on what you order, barbecue joints can be a low-carb/Paleo paradise, or they can be a total blood sugar nightmare.

If you’re watching your carbohydrate intake, you already know to steer clear of the cornbread, baked beans, mac & cheese, and the cheap-o bread they usually stick under whatever meat you order in order to sop up the juices. (Confession: Sometimes I eat this bread, ‘cuz, really, what a waste of yummy meat drippings! I also eat the cornbread sometimes, ‘cuz…well, it’s a bit of a weakness.)

That’s the obvious stuff, though. What about things that are harder to avoid at a BBQ place, like the delicious sauces they use to marinate, baste, and slather your food with before serving it to you? BBQ sauce is a sneaky source of large amounts of sugar. (And by “sugar,” I mean cane sugar, molasses, honey, corn syrup, corn starch, and more.) Let’s take a look at a couple of examples from a popular restaurant chain, Famous Dave’s®. (I am a big fan of this place, and am absolutely not writing this to bash it. I only want to point out the ingredients in the sauces and help us make informed choices, wherever we eat.)