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.

Is Insulin Messing with Your Skin?

Question: Is there anything in the body insulin doesn’t affect?

Answer: From what I’ve seen, no.

If you’re new to my blog or are a newcomer to the science of the clinically therapeutic effects of dietary carbohydrate restriction, you might think of insulin mostly as a blood sugar hormone. People with diabetes have blood sugar that’s too high, so they take insulin to bring it down. Simple, right? Not quite.

I’ve written in past posts that reading and learning I’ve done over the past few years has led to me to the perspective that lowering blood sugar is among insulin’s least important effects. (In fact, insulin isn’t even required to lower blood sugar at all. Your body can do that just fine without insulin…even in someone with type 1 diabetes. Type 1 diabetics do need insulin, just not solely for the purpose of lowering blood sugar. Details on all this here.)

I’ve written articles about insulin as a major factor in the development of gout, migraines, Alzheimer’s disease, PCOS, erectile dysfunction, benign prostatic hyperplasia (BPH, a.k.a. enlarged prostate), Parkinson’s disease, and more. The short list of things we know for certain are damaged by chronically elevated insulin and/or blood glucose (BG) includes the liver, kidneys, eyes, cardiovascular system (heart muscle and blood vessels), ovaries, the brain and nervous system. At this point, knowing what I now know about insulin, I don’t need someone to explain to me why insulin would affect any particular organ, gland, or tissue system; I need them to explain why it wouldn’t.

With this in mind, is it possible insulin is affecting your skin? You can’t see a fatty liver, polycystic ovaries or an enlarged prostate gland from the outside; you need special tests to determine for sure whether you have those. But what about acne, skin tags, psoriasis, and other things we can see just by looking at someone? Could insulin be playing a role here, too?

Tl;dr: If you want a brief summary of this article, read this. And if you have a few extra minutes and want to read one paper that will give you an enormous amount of insight into this topic, read this one. But if you come to my blog because you enjoy digging into the meaty details, stay here and keep reading. 

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. 

Presentation on Insulin -- Much More Than a Blood Sugar Hormone

Hey all!

Busy, busy, busy for the next few weeks. I’m speaking at Low Carb Houston this weekend, at the Wise Traditions conference (from the Weston A. Price Foundation) in mid-November, and at the keto event in Ontario on December 1. Yowza!

So it might be a few weeks before I can write more blog posts of substance, but I’ll try to pop in and at least post something before I get back to (what I hope are) more meaningful and educational posts.

In the meantime, I want to share a link to a presentation I gave on insulin and chronic hyperinsulinemia. If you enjoyed my 8-part series on insulin a while back (two more parts coming, by the way!), then I think you’ll like this video. The primary message is that insulin is much more than merely a “blood sugar hormone.” Insulin has effects far and wide throughout the whole body. There’s almost no organ, gland, or tissue system that insulin doesn’t affect in some way, including the brain. (Hence the book I wrote on Alzheimer’s disease, and the talks I give on “brain insulin resistance.”)

In this presentation, I talk about chronically high insulin as a driver of several conditions/disorders not typically thought of as metabolic in origin. Aside from type 2 diabetes and obesity (which are so intertwined in some cases that they’ve coined the phrase “diabesity”), there’s gout, hypertension, PCOS, erectile dysfunction, cardiovascular disease, skin tags, migraines, and more. (Possibly even Parkinson’s disease!)

I go into detail on hypertension and gout as two examples of conditions where the underlying cause (high insulin) is ignored in favor of things that often have little to nothing to do with how the disease actually develops (sodium in the case of hypertension, and red meat in the case of gout). But my favorite part is when I talk about insulin’s role in directly inhibiting lipolysis—the breakdown of fat. It explains so elegantly why so many of us had such a very hard time losing body fat when we were eating all the whole grains we were advised to consume, along with our skim milk, fat-free yogurt, and other low- and no-fat carbohydrates, and why things became much easier when we ate in such a way as to keep our insulin levels low for most of the day.

Please forgive the poor sound quality in the video. This was recorded at an event that was organized by one person, and it was her very first time organizing something like this. We’re lucky someone did us the favor of recording it at all! It’s a little bit hard to hear at first, but it gets somewhat better as the video goes on. Please don’t let that stop you from watching. I think it’s educational and might give you some new knowledge about the role of insulin not just in body weight, but in overall health and wellness.

Here’s the link: Insulin Resistance Presentation, Perth, Ontario (10/16/2018)

   

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.

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.

Eating Keto on the Go

Hey Everyone,

As you know—or, as I hope is pretty obvious—something I try to use my blog for is helping people see how simple low carb and ketogenic diets can be. When we stick with basic principles and get out of our own way, these ways of eating are very straightforward and uncomplicated. There’s not a whole lot of weighing, measuring, tracking, and rules involved. Yes, you can fall down all those rabbit holes and make yourself as fully neurotic as your heart desires, but for those of us who have bigger concerns in our lives than how many grams of omega-6 fat a chicken leg contains, the beauty of low carb and keto is their simplicity.

Awhile back, I offered some suggestions for dining out while adhering to a reduced carb way of eating. Today, let’s take that a step further and talk about how to stay keto while you’re on the road or on the go. What if you’re in the car for a few hours, or maybe even just a short trip, and the hunger monster attacks?

One approach is to think of it as an opportunity to skip a meal or two. I don’t consider skipping meals to be “fasting,” but if thinking of it as intermittent fasting makes you feel like you have special superpowers, then go right ahead. Going longer between meals is a nice way to keep insulin low and “eat” your own stored body fat more than you might if you immediately chowed down on something as soon as a few mild hunger pangs hit.

However, if you’re having a “hangry” moment—and let’s face it, folks, sometimes these still happen even when you’re a “fat burning beast” and are fat- or keto-adapted—then maybe you’re better off pulling into the nearest gas station or convenience store and foraging for some low-carb provisions. (What, you don’t feel hangry on keto? Like, ever? Okay, maybe it’s just me.) 

Here are my suggestions for low carb and keto-friendly foods you can grab in a hurry from gas stations and convenience stores. (We’ll get to supermarkets in a bit, since there are more choices there.) These apply to North America…I’m not sure if convenience stores like this exist on other continents, but I’m guessing you have something similar in other parts of the world. I’ll also tack on suggestions for things to keep in your desk or cubicle if you have an office job and have a place nearby to stash non-perishables.

Food purists, avert your eyes. If you can’t imagine letting anything past your lips that isn’t grass-fed, organic, pastured, small-batch, or biodynamic, this post isn’t for you. (In fact, my entire blog probably isn’t for you, but you’re welcome to stick around anyway.) We’re talking about foods to grab in a pinch, when the highest quality and ethically unassailable stuff might not be available. I’m totally okay with that. If you’re not, that’s fine; I still like ya!

Gas Stations or Convenience Stores

• Pork rinds (plain might be best, but if you’re not a purist, hot & spicy or salt & vinegar flavors are fine; they typically contain little to no sugar but might be seasoned with MSG, yeast extract, maltodextrin, etc. Even so, the carb count is usually 0g per serving.)
• Beef jerky or meat sticks (stick to original or peppered flavors; teriyaki and BBQ are typically higher in sugar)
• String cheese; cheese sticks
• Salami or pepperoni slices or sticks
• Hard boiled eggs
• Nuts (avoid honey-roasted and nut mixes that include dried fruit)
• Dark chocolate (the higher the cocoa percentage, the lower the sugar content, usually)

Beverages: water, diet sodas, hot or iced tea (unsweetened or diet with artificial sweetener), coffee (hot or iced, unsweetened or diet with artificial sweetener—be careful with pre-made iced coffee; it’s usually sweetened with sugar). Pretty much anything that’s sugar-free. This isn’t rocket science, people! 

Supermarket

If you have time to go up an aisle or two in a supermarket, you’ll have a wider selection to choose from. Here are some great go-tos from a supermarket run on the road:

• Pork rinds (with or without sour cream dip or guacamole)
• Beef jerky
• Sliced pepperoni, salami, or dry sausage sticks
• Nuts or nut butter
• Pre-cooked bacon (yes, this is a thing!)
• Deli meats and/or cheese: roast beef, corned beef, and pastrami are probably the lowest in sugar, but baked or roasted turkey is fine; avoid or go easy on “honey baked” or “brown sugar” ham or turkey. Salami, prosciutto, mortadella, and other cured meats are great.
• Pre-made egg salad or tuna salad from the deli (ask about ingredients and sugar content)
• Rotisserie chicken
• Canned tuna, salmon, sardines, or mackerel – be sure to buy ones with a pop-top unless you have a can opener handy
• Hard boiled eggs
• Bagged salad greens
• Raspberries or strawberries (and maybe a small container of sour cream or plain yogurt for dipping)
• Salad bar, olive or antipasto bar – many supermarkets now have salad or antipasto bars stocked with fabulous low-carb fare: olives, cheese, artichoke hearts, bell peppers, marinated mushrooms, sliced or chopped hard boiled egg, turkey, grilled chicken, sunflower seeds, sliced almonds, lettuce, spinach, cucumbers, radishes, etc.  

If you like to live on the edge and are not afraid of eating unwashed produce, you can hit up the produce section and get low-carb vegetables like a cucumber, green bell pepper, radishes, button mushrooms, celery, etc., and just eat them raw. There is zero wrong with this!

Desk Drawer or Cubicle

Lots of flexibility here! You can practically have a supermarket of nonperishables at your fingertips if you have room to store a few things. Keep in mind, however, that if you’re prone to snacking when food is in your immediate vicinity even if you’re not hungry, you might be better off not keeping a keto stash handy. Do what’s right for you.

For those of you who want to have a keto cache at your disposal during the workday, consider the following:

• Pork rinds
• Beef jerky
• Pepperoni or any other cured meats that don’t require refrigeration until opened
• Nuts and/or nut butters (careful here if these are trigger foods for you)
• Jar of coconut, olive, or avocado oil
• Canned tuna, salmon, sardines, mackerel
• Dessicated/dried coconut flakes or chips (unsweetened)
• Your favorite vinegars (can be combined with the oils to make a vinaigrette for a lunch salad)
• Hot sauce (doesn’t need to be refrigerated, since it’s vinegar-based)
• Dark chocolate

Depending on your level of “keto purity,” consider keeping Quest bars, Adapt bars, or other low and low-ish carb products on hand.

Pro Tips

If you’re a salesperson, company rep, parent, or someone else who spends a lot of time in the car, consider keeping a supply of the following essentials in your trunk. (Also good to keep at the office.) It does no good to buy some of the foods above to eat on the go if you have no way of eating them without making a mess. Tuck a small box in the trunk and stock it with:

• Can opener
• Plastic or metal utensils
• Napkins or paper towels
• Paper plates or bowls (or use plastic containers, wash them at home or in your hotel room, and reuse)

Did I miss anything you consider a staple for when you’re on the go? (Besides, of course, a container of homemade food or leftovers! To be honest, this is really the best way to go if you're a cook. Always make enough to have some left over to spare for another meal or snack. [Tips on that here.])

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.

Does Protein Harm the Kidneys?

Hey kids! My previous blog post laid waste to the myth that a high protein intake is harmful for bone health. This time, it’s my great pleasure to decimate another “high protein is bad for you” thing. Today, it’s kidney function. Many of you have been eagerly awaiting this post. Here’s hoping I don’t disappoint.

Even if you’ve accepted that everything we thought we knew about saturated fat and cholesterol in our diets was almost completely wrong, and you’ve been following a low-carb or ketogenic diet confidently for fat loss, migraines, GERD/acid reflux,  reversing type 2 diabetes, reducing insulin needs and evening out blood sugar for type 1 diabetes, or for some other health issue, maybe there’s still some lingering fear in the back of your mind that the protein you’re eating—especially animal protein—is bad for your kidneys.

We’ve heard this over and over from just about everyone with an agenda to discredit the efficacy of low carb diets. Now, mind you, low carb diets are not, by definition, high in protein, but in walking away from sugars, grains, beans, and starchy vegetables, many of us find that, compared to our former high-carb life, our protein consumption does increase, whether in absolute grams, as a percentage of total calories, or both. Not to mention the growing carnivore movement, where people are eating only animal foods. For these folks, protein consumption almost certainly increases compared to a standard Western diet, and likely even compared to if/when they were following a ketogenic diet.

So with all this in mind, it’s important that we set the record straight about the influence of dietary protein on kidney function.

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:

Food for Thought Friday: Modern Medicine Rant

Pop Quiz:

The failure of institutions such as the American Diabetes Association, American Heart Association, and American Medical Association not just to acknowledge the undeniable efficacy of carbohydrate restriction for myriad chronic health complications, but also their failure to do what they should be doing—which is shouting it from the rooftops louder than any ol’ no-name blogger, and actively encouraging people to give it a try—is the result of which of the following:

A)  Stupidity

B)  Willful Ignorance

C)  Conspiracy

D)  Narcissism

E)  Malpractice 

F)  All of the above

Yeah. You can see where today’s rant is headed.

Food for Thought Friday: Pay the Farmer Now, or Pay the Doctor ... When, Exactly?

When well-meaning acquaintances mock us for spending more money than they do for food, those of us who take pride in buying, cooking, and eating whole, unprocessed, real foods are fond of saying, “Pay the farmer now, or pay the doctor later.” Meaning, if people don’t pony up a little extra cash for better quality food now, they’ll end up paying even more in the future, in the form of medical bills. But is this actually true? If people spend decades putting garbage down their pieholes and end up with some of the “diseases of civilization,” do they really end up all that much worse off, financially?

For the sake of keeping this post to a somewhat reasonable length, let’s stick solely to the financial burden of diet- and lifestyle-induced illness, and we’ll table the “cost” of missed work time, fatigue, illness, chronic pain, and overall reduced quality of life for another time. (But let’s go ahead and acknowledge that these other issues are arguably more important than one’s bank account balance.)

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.

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.

Statins: Sugar-Coating the Truth

A priest, a rabbi, and a cardiologist walk into a bar.

No, that’s not it…

Why did the cholesterol cross the road?

Nope, that’s not it either…

Did you hear the one about statins and increased risk for type 2 diabetes?

YES! That’s the one I meant. Only, this isn’t a joke.

Statin drug use is now associated with an increased risk for developing type 2 diabetes. Is this just fearmongering headlines, or is there really something to it?