Dear Mark: Does Eating A Low Carb Diet Cause Insulin Resistance?
157 Comments Despite all the success you might have had with the Primal way of life, doubts can still nag at you. Maybe it’s something you read, or something someone said to you, or a disapproving glance or offhand comment from a person you otherwise respect, but it’s pretty common when you’re doing something, like giving up grains, avoiding processed food, or eating animal fat, that challenges deeply-and-widely held beliefs about health and wellness. It doesn’t really even matter that you’re losing weight or seem to be thriving; you may still have questions. That’s healthy and smart, and it’s totally natural. A question I’ve been getting of late is the effect of reducing carb intake on insulin sensitivity. It’s often bandied about that going low carb is good for folks with insulin resistance, but it’s also said that low carb can worsen insulin resistance. Are both true and, if so, how do they all jibe together? That’s what the reader was wondering with this week’s question: Hi Mark, I’ve been Primal for a few months now and love it. Lowering my carbs and upping my animal fat helped me lose weight and gain tons of energy (not too shabby for a middle-aged guy!). However, I’m a little worried. I’ve heard that low carb diets can increase insulin resistance. Even though I’ve done well and feel great, should I be worried about insulin resistance? Do I need to increase my carb intake? I always thought low carb Primal was supposed to improve insulin function. Vince Going Primal usually does improve insulin sensitivity, both directly and in a roundabout way. It improves directly because you lose weight, you reduce your intake of inflammatory foods, you lower systemic inflammation (by getting some sun, smart exercise, omega-3s, and reducing or dea Continue reading >>
Ketogenic Diet
Tweet Ketogenic diets are very effective at achieving two common aims of diabetes control, lowering blood glucose levels and reducing weight What is the ketogenic diet? A ketogenic diet is a very low-carb diet, considered to be when you eat a level of carbohydrate of around 30g of carbohydrates per day or below. This encourages the body to get its energy from burning body fat which produces an energy source known as ketones. The diet helps to lower the body's demand for insulin which has benefits for people with type 1 and type 2 diabetes. Note that it is important that you speak to your doctor if you are considering following the diet as precautions may need to be taken before starting. How a ketogenic diet works On a ketogenic diet, blood glucose levels are kept at a low but healthy level which encourages the body to break down fat into a fuel source known as ketones. The process of breaking down or ‘burning’ body fat is known as ketosis. People on insulin will typically require smaller doses of insulin which leads to less risk of large dosing errors. The diet helps burn body fat and therefore has particular advantages for those looking to lose weight, including people with prediabetes or those otherwise at risk of type 2 diabetes. How to follow a ketogenic diet Based on the understanding that carbohydrate is the macronutrient that raises blood glucose the most, the primary goal of a ketogenic diet is to keep consumption lower than that of a traditional low carbohydrate diet with moderate protein and a very high fat content. This will determine the nutrient density of the ketogenic diet as well as how to follow it, as different foods will have different effects on insulin and blood sugar levels. Which foods to eat on a ketogenic diet There are a number of differen Continue reading >>
The Ketogenic Diet And Insulin Resistance
We recently touched on how you can use the ketogenic diet to control symptoms of diabetes such as elevated glucose and triglycerides. In this article, we examine research showing the impact that the ketogenic diet has on levels of the hormone insulin, a key regulator of blood sugar in the body. What is Insulin’s Role in the Body? Before we look at the research, we need to know our main players. Insulin is a protein-based hormone produced by beta-cells located in the pancreas. The pancreas, which is located under the stomach, also produces enzymes that aid with digestion. Insulin’s primary purpose is to regulate the metabolism of fats and carbohydrates. The digestive system breaks down carbohydrates, such as sugars and starches, into a molecule called glucose. This compound can be used by cells to produce energy through a process called cellular respiration. Insulin allows cells in the body absorb glucose, ultimately lowering levels of glucose in the blood stream. After a meal is consumed, blood glucose levels increase and the pancreas responds by releasing insulin into the blood. Insulin assists fat, liver, and muscle cells absorb glucose from the blood, resulting in lower levels of blood glucose. Insulin stimulates liver and muscle tissues to store excess glucose as a molecule called glycogen and also reduces glucose production by the liver. When blood sugar is low, the hormone glucagon (produced by alpha-cells in the pancreas) stimulate cells to break down glycogen into glucose that is subsequently released into the blood stream. In healthy people who do not have type II diabetes, these functions allow levels of blood glucose and insulin to stay in a normal range. What Is Insulin Resistance and Why Is It a Problem? Unfortunately, for many Americans and other peopl Continue reading >>
Ketosis
Tweet Ketosis is a state the body may find itself in either as a result of raised blood glucose levels or as a part of low carb dieting. Low levels of ketosis is perfectly normal. However, high levels of ketosis in the short term can be serious and the long term effects of regular moderate ketosis are only partially known at the moment. What is ketosis? Ketosis is a state the body goes into if it needs to break down body fat for energy. The state is marked by raised levels of ketones in the blood which can be used by the body as fuel. Ketones which are not used for fuel are excreted out of the body via the kidneys and the urine. Is ketosis the same as ketoacidosis? There is often confusion as to the difference between ketosis and ketoacidosis. Ketosis is the state whereby the body is producing ketones. In ketosis, the level of ketones in the blood can be anything between normal to very high. Diabetic ketoacidosis, also known as DKA, only describes the state in which the level of ketones is either high or very high. In ketoacidosis, the amount of ketones in the blood is sufficient to turn the blood acidic, which is a dangerous medical state. When does ketosis occur? Ketosis will take place when the body needs energy and there is not sufficient glucose available for the body. This can typically happen when the body is lacking insulin and blood glucose levels become high. Other causes can be the result of being on a low carb diet. A low level of carbohydrate will lead to low levels of insulin, and therefore the body will produce ketones which do not rely on insulin to get into and fuel the body’s cells. A further cause of ketosis, less relevant to people with diabetes, is a result of excessive alcohol consumption. Is ketosis dangerous? The NHS describes ketosis as a pote Continue reading >>
Why I Chose A Ketogenic Diet For Diabetes Management
Often people use the term “diet” to mean something that is temporary for a specific purpose, usually weight loss. For me, it is a permanent way of eating now. I am a retired physician living with Type 1 diabetes since 1998. I started to exercise regularly in 2007 to help ward off complications, particularly cardiovascular disease. I was unaware at the time that aerobic exercise alone would have little impact on the development of cardiovascular disease. It wasn’t until 2011 when I contemplated doing an ironman distance triathlon, that I discovered diet is the most important determinate in the development of most chronic diseases, including cardiovascular disease. My research led me to begin a very low carbohydrate, ketogenic diet in February 2012. Why I Chose a Low Carb Ketogenic Diet for Diabetes Management Carbohydrate is the macronutrient that raises blood glucose the most, so keeping consumption low is my primary goal. Of next importance is using whole foods that naturally have the necessary micronutrients and enough complete proteins to support my exercise. I had to add fat to my meals to replace calories from the omitted carbohydrates. My protein intake did not change after starting a ketogenic low carb high fat diet. This way of eating has resulted in a significant improvement in my blood glucose control and a 1.2% reduction in HbA1c. Most importantly, the diet supplies my body with the energy, substrates, and nutrients to enable daily resistance and aerobic/endurance exercise, with minimal need for sports nutrition (sugar), or development of hypoglycemia. I completed The Great Floridian Triathlon in October 2012 without any sugar, food, or hypoglycemia thanks to my low carbohydrate ketogenic lifestyle. Nutritional Ketosis My diet keeps me in a state of nut Continue reading >>
Does The Ketogenic Diet Work For Type 2 Diabetes?
You’ve probably seen dozens of headlines about the ketogenic diet by now, which has made its way into popular culture largely by celebrities and supermodels giving the long-standing fad diet a repeated stamp of approval. Is this the diet to follow if you have diabetes? Studies suggest the answer isn’t so simple. Some science shows its meal plan may be helpful, while other research, like one study published in September 2016 in Nutrients, highlights the importance of whole grains in the diets of people with diabetes — a restricted food category in the ketogenic diet. While the keto diet can offer many potential benefits for diabetes management, following it requires pretty serious commitment. So take a beat before you take the plunge — and consider these questions that can help you and your medical team determine if it’s right for you: How Does the Ketogenic Diet Work Exactly? There’s a good reason the ketogenic diet is also referred to as a low-carb, high-fat diet. Indeed, following the ketogenic diet means reducing carbohydrate intake to typically less than 50 grams (g) of carbohydrates per day, while increasing fat and protein intake, according to a review published in August 2013 in the European Journal of Clinical Nutrition. To put that into perspective, an individual on an average, non-restricted diet can easily eat more carbohydrates than that in one typical meal — for instance, a turkey, cheese, and veggie sandwich on whole-grain bread with a small, 1 ounce (oz) bag of classic potato chips would come in at around 51 g of carbs. These dietary changes drive down insulin levels, eventually leading your body into a state of ketosis, during which it is burning fat rather than carbohydrates. What Are Some of the Potential Benefits of a Ketogenic Diet for Continue reading >>
Study Shows Ketogenic Diet May Reverse Type 2 Diabetes
If you’ve ever read about health on the internet, you’ve probably seen stories and ads claiming to reverse diabetes. Maybe you saw the article about juicing bitter gourds, or the one that suggests boiling cinnamon powder in water. And isn’t there one out there that suggests rubbing your pancreas with aloe vera twice a day? Maybe you’ve tried one of the above, but hopefully every time you’ve seen the words reverse diabetes, you quickly closed your browser’s tab. However, while there is definitely no way to reverse type 1 diabetes yet, a new study suggests type 2 diabetes really can be reversed (but not by pancreatic massage). Recently, a trial conducted by Stephen Phinney and Jeff Volek, of The Art and Science of Low Carb, showed the positive effects of a low-carbohydrate diet. Phinney and Volek have been low-carb advocates for some time, and you can see their other research here. This particular trial provides evidence that a low-carb diet can improve blood sugar levels and facilitate weight loss in adults with type 2 diabetes. In almost 60% of participants, medication was decreased or stopped altogether. The study, conducted in Indiana in partnership with Indiana University Health, and published in the Journal of Medical Internet Research publications, looked at 262 people with type 2 diabetes who were also overweight. Each participant restricted their carbohydrate intake to 30 grams or less per day, and they increased fat and protein intake. This practice induces what is known as “nutritional ketosis” and is considered a ketogenic diet, forcing the body to burn fat for energy rather than carbohydrates. According to Diabetes.co.uk, “Previous studies have shown that such ketogenic diets can improve insulin sensitivity and bring many other benefits. How Continue reading >>
How The Ketogenic Diet Works For Type 2 Diabetes
Special diets for type 2 diabetes often focus on weight loss, so it might seem crazy that a high-fat diet is an option. But the ketogenic (keto) diet, high in fat and low in carbs, can potentially change the way your body stores and uses energy, easing diabetes symptoms. With the keto diet, your body converts fat, instead of sugar, into energy. The diet was created in 1924 as a treatment for epilepsy, but the effects of this eating pattern are also being studied for type 2 diabetes. The ketogenic diet may improve blood glucose (sugar) levels while also reducing the need for insulin. However, the diet does come with risks, so make sure to discuss it with your doctor before making drastic dietary changes. Many people with type 2 diabetes are overweight, so a high-fat diet can seem unhelpful. The goal of the ketogenic diet is to have the body use fat for energy instead of carbohydrates or glucose. A person on the keto diet gets most of their energy from fat, with very little of the diet coming from carbohydrates. The ketogenic diet doesn’t mean you should load up on saturated fats, though. Heart-healthy fats are the key to sustaining overall health. Some healthy foods that are commonly eaten in the ketogenic diet include: eggs fish such as salmon cottage cheese avocado olives and olive oil nuts and nut butters seeds The ketogenic diet has the potential to decrease blood glucose levels. Managing carbohydrate intake is often recommended for people with type 2 diabetes because carbohydrates turn to sugar and, in large quantities, can cause blood sugar spikes. If you already have high blood glucose, then eating too many carbs can be dangerous. By switching the focus to fat, some people experience reduced blood sugar. The Atkins diet is one of the most famous low-carb, high-p Continue reading >>
Should Keto Be Used To Manage Type 2 Diabetes? One Womans Story | Everyday Health
Although the keto diet isn't recommended for people with diabetes, Stephanie Lofton says that for her, the eating approach has helped jump-start a path to a healthier future. Nothing seemed to work for Stephanie Lofton when she began to try to lose weight and manage her blood sugar after being diagnosed with type 2 diabetes in 2015. She tried the South Beach Diet , calorie counting , eating low-fat at one point, she even considered bariatric surgery to lose weight and control type 2 diabetes . Thats when she came across the ketogenic diet, a popular high-fat, low-carb eating plan sometimes referred to as the keto diet. Lofton, 40, says that while she hasnt lost much weight, her blood sugar is in the mid-100s milligrams per deciliter (mg/dL) the healthiest level shes reached in years. She had previously recorded her highest blood sugar levels between 600 and 800 after being rushed to the emergency room in 2016. This looks like something that for me is sustainable, says Lofton, a medical biller who weighs 300 pounds. I haven't lost much weight, but for me my biggest priority has been to get my sugar numbers down. She says shes proud that her A1C the two- to three-month average of blood sugar levels is 8.7, down from 10.4 about a year ago. Although the improved level still signals diabetes (anything above 6.5 is defined as diabetes), Lofton is hopeful that the keto diet can continue to help her improve her health. RELATED: How to Stabilize Your Blood Sugar The Pros and Cons of the Keto Diet for People With Diabetes The basis of the keto diet is achieving ketosis , a natural state in which the body turns to burning fat instead of carbs (or sugar) for energy. During ketosis, ketones, or fat metabolites, are released in the blood. People on the keto diet are tasked with gett Continue reading >>
What’s The Difference Between Ketosis And Diabetic Ketoacidosis?
Ketosis and ketoacidosis sound similar and are sometimes confused, but don’t mistake these conditions for one another. These involve two different sets of circumstances with considerably different outlooks. Both are triggered by an increase of ketones in the body, which are acids released into the bloodstream when the body burns fat for energy instead of carbohydrates. But it’s how the body responds to this increase that sets ketosis and ketoacidosis apart from each other. RELATED: How to Tell the Difference Between Good and Bad Carbs What Is Ketosis and How Does the Process Work? “Ketosis is a natural state that occurs when you start to metabolize fat instead of sugar,” says Michael Greenfield, MD, endocrinologist and chief medical officer at El Camino Hospital in Palo Alto, California. “It occurs often when people fast and use up the stores of sugar in their body." To understand ketosis, it helps to understand how the body burns energy. Carbohydrates and fat are both energy sources, and the body typically burns carbs (sugar or glucose) first, and then fat. If there aren’t enough carbohydrates in your system, it begins to break down fat for energy, which puts your body into a state of ketosis. While in this state, the body becomes a fat-burning machine. For this reason, ketosis is the goal of many diets, particularly those that restrict carbohydrate intake and rely on fat for energy, such as the ketogenic diet. Understanding the Relationship Between the Ketogenic Diet and Ketosis “The ketogenic diet is a high-fat (60 to 80 percent of your total daily calories), moderate-protein (10 to 15 percent of your total daily calories), and low-carbohydrate diet (less than 10 percent of your total daily calories) that forces your body into ketosis, where it burns fa Continue reading >>
Fat Is The Cause Of Type 2 Diabetes
ron: I’m glad you asked this question, because it gets at a common issue that many people share. Due to science education in schools and the way media reports on scientific news, the general public is under the impression that each new study sort of wipes out any study that came before. Say that yesterday there was a study or article in favor of say butter, then you would see those headlines and think that the latest and greatest WORD from science is that butter is healthy. And then tomorrow, when another study comes out showing that butter is indeed unhealthy, there is another headline and people think that the latest “word” is that butter is now unhealthy. Another problem is that because people think the latest study is the latest word and since studies are not all going to agree, people think that the science keeps flip flopping and get frustrated with that. The media makes this worse by only reporting studies that they can make appear to be a “flip flop” as the media makes money off of eye catching headlines. . But that’s not how science actually works. When done in good faith, science is about hitting a subject from a whole bunch of different angles and attempting to replicate results multiple times. Understanding that life is messy and it’s extremely difficult (impossible?) to create perfect studies for subjects as complex as nutrition on long term health, we *expect* that not all the studies will agree with each other. However, over time, if we do our job, we can also expect that the *body of scientific evidence* will paint a fairly clear picture. I say all the time, “It’s not about any one study. It’s about the body of evidence.” . Did you know that there are over 100 studies showing that smoking is either neutral or health-promoting? But t Continue reading >>
A High-fat, Ketogenic Diet Causes Hepatic Insulin Resistance In Mice, Despite Increasing Energy Expenditure And Preventing Weight Gain
Go to: Low-carbohydrate, high-fat ketogenic diets (KD) have been suggested to be more effective in promoting weight loss than conventional caloric restriction, whereas their effect on hepatic glucose and lipid metabolism and the mechanisms by which they may promote weight loss remain controversial. The aim of this study was to explore the role of KD on liver and muscle insulin sensitivity, hepatic lipid metabolism, energy expenditure, and food intake. Using hyperinsulinemic-euglycemic clamps, we studied insulin action in mice fed a KD or regular chow (RC). Body composition was assessed by 1H magnetic resonance spectroscopy. Despite being 15% lighter (P < 0.001) than RC-fed mice because of a 17% increase in energy expenditure (P < 0.001), KD-fed mice manifested severe hepatic insulin resistance, as reflected by decreased suppression (0% vs. 100% in RC-fed mice, P < 0.01) of endogenous glucose production during the clamp. Hepatic insulin resistance could be attributed to a 350% increase in hepatic diacylglycerol content (P < 0.001), resulting in increased activation of PKCε (P < 0.05) and decreased insulin receptor substrate-2 tyrosine phosphorylation (P < 0.01). Food intake was 56% (P < 0.001) lower in KD-fed mice, despite similar caloric intake, and could partly be attributed to a more than threefold increase (P < 0.05) in plasma N-acylphosphatidylethanolamine concentrations. In conclusion, despite preventing weight gain in mice, KD induces hepatic insulin resistance secondary to increased hepatic diacylglycerol content. Given the key role of nonalcoholic fatty liver disease in the development of type 2 diabetes and the widespread use of KD for the treatment of obesity, these results may have potentially important clinical implications. Keywords: nonalcoholic fatty liv Continue reading >>
The Keto Diet Is Gaining Popularity, But Is It Safe?
A new twist on extreme weight loss is catching on in some parts of the United States. It’s called the "keto diet." People promoting the diet say it uses the body’s own fat burning system to help people lose significant weight in as little as 10 days. It has also been known to help moderate the symptoms of children with epilepsy, although experts are not quite sure why it works. Proponents say the diet can produce quick weight loss and provide a person with more energy. However, critics say the diet is an unhealthy way to lose weight and in some instances it can be downright dangerous. Read More: What is the “Caveman Diet?” » What Is Ketosis? The “keto” diet is any extremely low- or no-carbohydrate diet that forces the body into a state of ketosis. Ketosis occurs when people eat a low- or no-carb diet and molecules called ketones build up in their bloodstream. Low carbohydrate levels cause blood sugar levels to drop and the body begins breaking down fat to use as energy. Ketosis is actually a mild form of ketoacidosis. Ketoacidosis mostly affects people with type 1 diabetes. In fact, it is the leading cause of death of people with diabetes who are under 24 years of age. However, many experts say ketosis itself is not necessarily harmful. Some studies, in fact, suggest that a ketogenic diet is safe for significantly overweight or obese people. However, other clinical reviews point out that patients on low-carbohydrate diets regain some of their lost weight within a year. Where It’s Helpful The keto diet was created by Dr. Gianfranco Cappello, an associate professor of surgery at the Sapienza University in Rome, Italy. He claims great success among thousands of users. In his study, more than 19,000 dieters experienced significant, rapid weight loss, few side Continue reading >>
Diabetes & Ketogenic Diet: Can You Manage Your Diabetes On A Ketogenic Diet?
In this article we will cover what a Ketogenic diet is and if you can manage your diabetes while on this diet. Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject. As a CDE, I have been taught to follow the American Diabetes Association Dietary Guidelines for Americans which is low in carbohydrates, high in fiber, with fresh vegetables, fruits and whole grains. The Ketogenic Diet this article will be discussing is much lower in carbohydrates, in order to promote the state of nutritional ketosis, or the fat burning state for weight loss. What is a Ketogenic Diet? The Ketogenic Diet is a low carbohydrate diet, consisting initially of less than 20 carbohydrates per day. Not per meal, yes, you heard me correctly, per day. It is not for the faint of heart and yes I am writing from experience. Of course I have tried it! Hasn’t everybody in America at some point who has wanted to lose weight? Does it work you ask? Of course it does! The problem is how long can you keep it up? Your body uses the carbohydrates you eat for energy, so if we restrict how many carbohydrates we eat, the body has to get its fuel source from fat. A byproduct of this fat burning state are ketones which are produced; this is called nutritional ketosis. You can determine if you are in this fat burning state by purchasing urine ketone testing strips from your local pharmacy. The Ketogenic Diet with Diabetes Some precautions must be made clear; this diet is not appropriate for people with any Continue reading >>
Is The Ketogenic Diet Safe For People With Diabetes?
Is The Ketogenic Diet Safe for People with Diabetes? If you’ve been diagnosed with diabetes, chances are you’re looking for simple yet effective ways to control your blood sugar. And, if at all possible, without the use of daily shots or medications. As I’ve mentioned in earlier blog posts, exercise is one of the best natural ways to manage blood glucose. But perhaps the most obvious way to keep blood sugar at a safe and consistent level without insulin is to pay special attention to what you eat. And, in the case of diabetes, limiting your carbohydrate intake may be the key. What Is the Keto Diet? At first glance the ketogenic (keto) diet may seem like a crazy idea for type 2 diabetics. After all, many patients are put on diets to help them lose weight. The keto diet is high in fat, but it is very low in carbs, and this combination can help change the way your body stores and uses energy. With this diet your body converts fat instead of sugar into energy, which can improve blood glucose levels while reducing the need for insulin. Ketosis VS Ketoacidosis Ketosis and ketoacidosis are two very different things, which are often confused. But it’s very important you understand the difference. What is ketoacidosis? Ketoacidosis (KA) is a life-threatening condition in which your body doesn’t make enough insulin. This causes you to have dangerously high levels of ketones (substances occurring when the body uses fat stores for energy) and blood sugar. The combination of both makes your blood incredibly acidic, and this can, in turn, change the normal functioning of your internal organs such as your liver and kidneys. Patients suffering from ketoacidosis must get treatment immediately or they could slip into a coma and even die. Ketoacidosis can develop in less than 24 Continue reading >>
