diabetestalk.net

High Fat Insulin Resistance

A Practical Guide To Carb Tolerance And Insulin Sensitivity

A Practical Guide To Carb Tolerance And Insulin Sensitivity

One of the biggest reasons why people go Paleo is the metabolic benefits. Most people find Paleo to be very therapeutic for a whole cluster of carb-related problems: high blood sugar (or the rollercoaster of highs and lows), insulin resistance, and all the related issues. These issues can make weight loss difficult or impossible, but on the flip side, addressing them through diet can make it easier and more pleasant than you ever thought could happen! On the other hand, though, there are a lot of myths and half-truths floating around about diet, exercise, and carb metabolism. So here’s a quick review of what it all means, and the evidence supporting various different complementary strategies for improving your carb tolerance (preview: it’s so much more than dietary carbs). Note: This article is not written for diabetics. Diabetes is a very complicated disease and strategies that are right for other people might not be appropriate. If you have diabetes, see a doctor! What Is “Carb Tolerance”/Insulin Sensitivity? (If you already know how insulin and glucose work, this section has nothing new for you; just skip down to the next one) Very simply put, insulin sensitivity (or “carb tolerance” in everyday language) is a healthy hormonal state that allows your body to digest and store carbohydrates without a problem. In healthy people, here’s how it works: You eat something with carbs (let’s say a potato, but it could be anything). Your digestive system breaks down the starch in that potato into glucose. Glucose is a simple sugar – this is the form of carbohydrate that you’ll either use for energy or store as fat. Your blood sugar temporarily rises as the glucose enters the bloodstream. This is not a big problem, because… Insulin (produced in the pancreas) Continue reading >>

Fat Is Not The Cause Of Insulin Resistance

Fat Is Not The Cause Of Insulin Resistance

Fat Is NOT the Cause of Insulin Resistance Our Educational Content is Not Meant or Intended for Medical Advice or Treatment Fat is NOT the Cause of Insulin Resistance There isn't a relationship between eating saturated fats and diabetes. Insulin is a hormone that regulates blood sugars and lowers it. In the presence of insulin, you are not going to burn fat and it causes fat to be stored. Insulin resistance is different. As insulin connects to the cell, the cell does not absorb it anymore it blocks it. On the other side of the cell you have low insulin and the cell is starving of: Which then sends a signal back to produce more insulin. People with insulin resistance have 5 to 7 times more insulin than normal people. So many people have insulin resistance and dont even know it because it takes 10 years for it to develop it. It causes a stubborn belly fat and a fatty liver which cause insulin resistance. It's a huge ugly cycle. Guru's Give False Information About Diabetes There are gurus out there pushing this avoidance of saturated fats. Joslin Diabetes Center have 5 Myths on a section of their website that are bogus information.Some of the things they write as "Myths" are actualy true and what they report as "Facts" are way off. The following is from Joslin Diabete Center website under 'Diabetes and Nutrition': 5 Common Myths with People with Diabetes Debunked 1. People with diabetes have to eat different from their family, right? (Myth) "Fact: People with diabetes can eat the same foods their family eat. The Truth: Of course people with diabetes have to eat differently than their family. What if the family are eating sugar? 2. People with diabetes should never give in to food cravings. (Myth) Facts: If a craving does occur let yourself have a small taste of whatever y Continue reading >>

What's The Mechanism Behind High Fat Diet Model That Causes Insulin Resistance?

What's The Mechanism Behind High Fat Diet Model That Causes Insulin Resistance?

Krista's reference relates to LDL receptor metabolism so don't think that answers the question. Birgitte's article looks like it might speak to the various issues being considered but I only have access to the abstract at present (which only tells me what the article will tell me). It makes physiologic sense however that when lipids are prevalent in the bloodstream, they will be used preferentially as fuel and will signal the cells to reduce their glucose transport and metabolism thus resulting in insulin resistance. Should be a straightforward feedback loop. Samuel VT, Petersen KF, Shulman GI. Lipid-induced insulin resistance: unravelling the mechanism.Lancet. 2010 Jun 26;375(9733):2267-77. Lipids impaired insulin-stimulated glucose use by muscles through inhibition of glycolysis at key points. However, work over the past two decades has shown that lipid-induced insulin resistance in skeletal muscle stems from defects in insulin-stimulated glucose transport activity. The steatotic liver is also resistant to insulin in terms of inhibition of hepatic glucose production and stimulation of glycogen synthesis. In muscle and liver, the intracellular accumulation of lipids-namely, diacylglycerol-triggers activation of novel protein kinases C with subsequent impairments in insulin signalling. This unifying hypothesis accounts for the mechanism of insulin resistance in obesity, type 2 diabetes, lipodystrophy, and ageing; and the insulin-sensitising effects of thiazolidinediones Afonso et al British J Nutrition 2010, 104, 1450-1459 showed that a high fat diet caused reductionof meal-induced insulin sensitization (MIS) that progressed with duration of the diet and correlated with obesity. MIS is seen as a dramatic potentiation of the hypoglycemic effect of insulin pulses after a Continue reading >>

How Does Fat Affect Insulin Resistance And Diabetes?

How Does Fat Affect Insulin Resistance And Diabetes?

According to the Centers for Disease Control, 29 million people in America have diabetes and 86 million have prediabetes. Insulin resistance is recognized as a predictor of type 2 diabetes, heart disease, and obesity. But what causes insulin resistance? In this NutritionFacts.org video, Dr. Michael Greger talks about how fat affects insulin resistance, and about how the most effective way to reduce insulin sensitivity is to reduce fat intake. We’ve also provided a summary of Dr. Greger’s main points below. Insulin Resistance of People on High-Fat Diets vs. High-Carb Diets In studies performed as early as the 1930s, scientists have noted a connection between diet and insulin intolerance. In one study, healthy young men were split into two groups. Half of the participants were put on a fat-rich diet, and the other half were put on a carb-rich diet. The high-fat group ate olive oil, butter, mayonnaise, and cream. The high-carb group ate pastries, sugar, candy, bread, baked potatoes, syrup, rice, and oatmeal. Within two days, tests showed that the glucose intolerance had skyrocketed in the group eating the high-fat diet. This group had twice the blood sugar levels than the high-carb group. The test results showed that the higher the fat content of the diet, the higher the blood sugar levels would be. What Is Insulin Resistance? It turns out that as the amount of fat in the diet goes up, so does one’s blood sugar spikes. Athletes frequently carb-load before a race because they’re trying to build up fuel in their muscles. We break down starch into glucose in our digestive tract; it circulates as blood glucose (blood sugar); and it is then used by our muscle cells as fuel. Blood sugar, though, is like a vampire. It needs an invitation to enter our cells. And that invit Continue reading >>

High-fat Diets Cause Insulin Resistance Despite An Increase In Muscle Mitochondria

High-fat Diets Cause Insulin Resistance Despite An Increase In Muscle Mitochondria

High-fat diets cause insulin resistance despite an increase in muscle mitochondria We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. High-fat diets cause insulin resistance despite an increase in muscle mitochondria Chad R. Hancock, Dong-Ho Han, [...], and John O. Holloszy It has been hypothesized that insulin resistance is mediated by a deficiency of mitochondria in skeletal muscle. In keeping with this hypothesis, high-fat diets that cause insulin resistance have been reported to result in a decrease in muscle mitochondria. In contrast, we found that feeding rats high-fat diets that cause muscle insulin resistance results in a concomitant gradual increase in muscle mitochondria. This adaptation appears to be mediated by activation of peroxisome proliferator-activated receptor (PPAR) by fatty acids, which results in a gradual, posttranscriptionally regulated increase in PPAR coactivator 1 (PGC-1) protein expression. Similarly, overexpression of PPAR results in a large increase in PGC-1 protein in the absence of any increase in PGC-1 mRNA. We interpret our findings as evidence that raising free fatty acids results in an increase in mitochondria by activating PPAR, which mediates a posttranscriptional increase in PGC-1. Our findings argue against the concept that insulin resistance is mediated by a deficiency of muscle mitochondria. Keywords: mitochondrial biogenesis, mitochondrial dysfunction, PPAR, skeletal muscle, PGC-1 It has b Continue reading >>

What Causes Insulin Resistance? Lipid Overload

What Causes Insulin Resistance? Lipid Overload

Over the past year I have interacted with hundreds of people with diabetes, and have come to learn one very important lesson that has changed my view of diabetes altogether. This realization came to me early on in my career as a nutrition and fitness coach for people with diabetes, and continues to hold true. While insulin resistance is a condition that is most commonly associated with type 2 diabetes, an increasing body of evidence is now shedding light on the fact that insulin resistance is a common thread that underlies many health conditions previously unassociated with blood sugar, including (but not limited to) heart disease, diabetes, atherosclerosis, the metabolic syndrome, obesity and cancer. What that means is simple: insulin resistance significantly increases your risk for the development of a collection of health conditions that can significantly reduce your quality of life and decrease your life expectancy. Watch this video for a synopsis of the causes of insulin resistance: What is insulin and why should you care? Insulin is a hormone which is released by the pancreas in response to rising blood glucose. When you consume carbohydrates, the glucose that enters the bloodstream knocks on the door of the beta cells in the pancreas as a signal to make insulin. Insulin serves as the key that unlocks the door to allow glucose to enter body tissues. Insulin tells your cells “Yoo hoo! Pick up this glucose. It’s all over the place.” Without insulin, cells in the liver, muscle, and fat have a difficult time vacuuming up glucose from the blood. These tissues are capable to vacuuming up only a small percentage (5-10%) of the glucose in circulation without the help of insulin. When insulin is present, the amount of glucose that can be transported into tissues sign Continue reading >>

High-fat Diet-induced Insulin Resistance In Single Skeletal Muscle Fibers Is Fiber Type Selective

High-fat Diet-induced Insulin Resistance In Single Skeletal Muscle Fibers Is Fiber Type Selective

Skeletal muscle is the major site for insulin-stimulated glucose disposal, and muscle insulin resistance confers many negative health outcomes. Muscle is composed of multiple fiber types, and conventional analysis of whole muscles cannot elucidate fiber type differences at the cellular level. Previous research demonstrated that a brief (two weeks) high fat diet (HFD) caused insulin resistance in rat skeletal muscle. The primary aim of this study was to determine in rat skeletal muscle the influence of a brief (two weeks) HFD on glucose uptake (GU) ± insulin in single fibers that were also characterized for fiber type. Epitrochlearis muscles were incubated with [3H]-2-deoxyglucose (2DG) ± 100 µU/ml insulin. Fiber type (myosin heavy chain expression) and 2DG accumulation were measured in whole muscles and single fibers. Although fiber type composition of whole muscles did not differ between diet groups, GU of insulin-stimulated whole muscles from LFD rats significantly exceeded HFD values (P < 0.005). For HFD versus LFD rats, GU of insulin-stimulated single fibers was significantly (P < 0.05) lower for IIA, IIAX, IIBX, IIB, and approached significance for IIX (P = 0.100), but not type I (P = 0.776) fibers. These results revealed HFD-induced insulin resistance was attributable to fiber type selective insulin resistance and independent of altered fiber type composition. Skeletal muscle is the major site for insulin-stimulated glucose disposal1, and skeletal muscle insulin resistance is a primary and essential event in the progression to type 2 diabetes2. Even in the absence of type 2 diabetes, insulin resistance confers negative health outcomes3. It is important to understand the processes responsible for insulin resistance of the skeletal muscle to develop interventions Continue reading >>

High Fat Diet Induces Central Obesity, Insulin Resistance And Microvascular Dysfunction In Hamsters

High Fat Diet Induces Central Obesity, Insulin Resistance And Microvascular Dysfunction In Hamsters

Volume 82, Issue 3 , November 2011, Pages 416-422 High fat diet induces central obesity, insulin resistance and microvascular dysfunction in hamsters Microvascular dysfunction is an early finding in obesity possibly related to co-morbidities like diabetes and hypertension. Therefore we have investigated changes on microvascular function, body composition, glucose and insulin tolerance tests (GTT and ITT) on male hamsters fed either with high fat (HFD, n=20) or standard (Control, n=21) diet during 16weeks. Total body fat and protein content were determined by carcass analysis, aorta eNOS and iNOS expression by immunoblotting assay and mean blood pressure (MAP) and heart rate (HR) by an arterial catheter. Microvascular reactivity in response to acetylcholine and sodium nitroprusside, functional capillary density (FCD), capillary recruitment induced by a hyperinsulinemic status and macromolecular permeability after 30min ischemia was assessed on either cheek pouch or cremaster muscle preparations. Compared to Control, HFD animals have shown increased visceral fat (6.00.8 vs. 13.80.6g/100g BW), impaired endothelial dependent vasodilatation, decreased FCD (11.31.3 vs. 6.81.2/field) and capillary recruitment during hyperinsulinemia and increased macromolecular permeability after ischemia/reperfusion (86.45.2 vs.105.25.1leaks/cm2), iNOS expression and insulin resistance. MAP, HR, endothelial independent vasodilatation and eNOS expression were not different between groups. Our results have shown that HFD elicits an increase on visceral fat deposition, microvascular dysfunction and insulin resistance in hamsters. We have studied microcirculatory effects of high fat diet in hamsters High fat diet blunted arteriolar response to acetylcholine and induced iNOS expression in aorta. Continue reading >>

The Ketogenic Diet And Insulin Resistance

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 >>

Dear Mark: Does Eating A Low Carb Diet Cause Insulin Resistance?

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 >>

Effect Of High Fat Diet On Insulin Resistance: Dietary Fat Versus Visceral Fat Mass.

Effect Of High Fat Diet On Insulin Resistance: Dietary Fat Versus Visceral Fat Mass.

Effect of high fat diet on insulin resistance: dietary fat versus visceral fat mass. This article has been cited by other articles in PMC. The purpose of the present study was to determine whether chronic high-fat diet (HF) induces insulin resistance independently of obesity. We randomly divided 40 rats into two groups and fed them either with a HF or with a high-carbohydrate diet (HC) for 8 weeks. Whole body glucose disappearance rate (Rd) was measured using a euglycemic hyperinsulinemic clamp. Firstly, we defined whether insulin resistance by HF was associated with obesity. Plasma glucose and triglyceride concentrations were significantly increased in HF. Rd was decreased (10.6+/-0.2 vs. 9.1+/-0.2 mg/kg/min in HC and HF, respectively) and the hepatic glucose output rate (HGO) was increased in HF (2.2+/-0.3 vs. 4.5+/-0.2 mg/kg/min in HC and HF, respectively). Rd was significantly correlated with %VF (p<0.01). These results implicate that visceral obesity is associated with insulin resistance induced by HF. In addition, to define whether dietary fat induces insulin resistance regardless of visceral obesity, we compared Rd and HGO between groups 1) after matching %VF in both groups and 2) using an ANCOVA to adjust for %VF. After matching %VF, Rd in HF was significantly decreased by 14% (p<0.001) and HGO was significantly increased by 110% (p<0.001). Furthermore, statistical analyses using an ANCOVA also showed Rd for HF was significantly decreased even after adjusting %VF. In conclusion, we suggest that dietary fat per se could induce insulin resistance in rats fed with chronic HF independently of obesity. The Full Text of this article is available as a PDF (77K). Articles from Journal of Korean Medical Science are provided here courtesy of Korean Academy of Medical Sci Continue reading >>

High Fat Diet Induces Brain Insulin Resistance And Cognitive Impairment In Mice

High Fat Diet Induces Brain Insulin Resistance And Cognitive Impairment In Mice

Volume 1863, Issue 2 , February 2017, Pages 499-508 High fat diet induces brain insulin resistance and cognitive impairment in mice Consumption of high fat diet and sugary drink (HFS) leads to abnormal metabolic phenotype in mice Feeding of HFS also leads to impairment of brain insulin signaling linked with neuroinflammation. Insulin resistant due to HFS associated with biochemical changes in markers related with Alzheimer disease pathology. High fat diet-induced obesity is associated with insulin resistance (IR) and other chronic, diet related illnesses, including dementia. Alzheimer disease is the most common form of dementia, and is characterized by the presence of amyloid plaques and neurofibrillary tangles in brain. This study was designed to determine whether diet-induced changes in peripheral insulin sensitivity could contribute to alterations in brain insulin signaling and cognitive functions. Six week old, male C57BL/6NHsd mice were randomly assigned a high fat diet (40% energy from fat) with 42g/L liquid sugar (HFS) added to the drinking water or a normal chow diet (12% energy from fat) for 14weeks. Metabolic phenotypes were characterized for energy expenditure, physical activity, and food intake, and glucose and insulin tolerance tests. In addition, we examined the changes in protein expression related to brain insulin signaling and cognitive function. Mice fed HFS exhibited a statistically significant increase in obesity, and lower glucose and insulin tolerance as compared to animals fed the normal chow diet. In brain, HFS elicited IR as evidenced by a significant decrease in tyrosine phosphorylation of insulin receptor and an increase serine phosphorylation of IRS-1. These changes were accompanied by inflammatory (NFB, JNK) and stress responses (p38 MAPK, Continue reading >>

The Connection Between Insulin Resistance And The High-carb, Low-fat Diet

The Connection Between Insulin Resistance And The High-carb, Low-fat Diet

Dr. Tim Noakes, a well-respected scientist, researcher, physician and professor at the University of Cape Town, South Africa, is one of the world’s foremost experts on low-carb diets Legal action was taken to strip him of his medical license for promoting the low-carb diet. It’s the first time in history that a diet has been put before a legal jury to decide whether or not it’s correct A low-carb, high-fat diet is crucial for preventing or reversing insulin resistance and type 2 diabetes; treating type 2 diabetes with insulin is one of the worst mistakes you can make By Dr. Mercola Dr. Tim Noakes, a well-respected scientist, researcher, physician and professor at the Division of Exercise Science and Sports Medicine at the University of Cape Town, South Africa, is one of the world's foremost experts on low-carb diets. In fact, he was instrumental in getting the low-carb diet revolution off the ground. He's also an accomplished athlete. As a long-distance endurance runner with 70 marathons under his belt, he had long promoted high-carb diets, himself consuming 400 grams of carbs a day or more when preparing for a race. Eventually, he discovered this wasn't the best way to improve athletic endurance and health, and ended up writing a number of popular books on low-carb diets. From High to Low Carb Noakes graduated from medical school in 1974. At the time, he was also running, and this was when the high carbohydrate diet really started to become popularized. Following the advice of one of his professors at the cardiology unit where he worked, he changed to a high-carb diet and began promoting it in his writings, including the book, "Lore of Running," which was widely read. "There it says that you must eat lots of carbohydrates for both health and performance. I contin Continue reading >>

Fat Vs Sugar In The War On Insulin Resistance

Fat Vs Sugar In The War On Insulin Resistance

Fat vs Sugar in the war on insulin resistance Insulin resistance and the incidence of type 2 diabetes are on the rise. Dietary choices are implicated in increasing risk, but sometimes it is hard to know where to look when seeking advice on what to eat! But is it fat or sugar we should be more concerned about? Or both?It seems the answer to that question is a little complex. First, lets look at the action of insulin. Insulin impacts the synthesis and storage of glucose, fat and amino acids. It is primarily recognised for its regulation of blood glucose levels, and maintains balance of levels of sugar in the blood by: moving glucose from the blood into muscle cells or adipose (fat) tissue, and; inhibiting the formation of glucose from non-carbs, i.e. fats and proteins (a process called gluconeogenesis that takes place in the liver when blood glucose runs low).1 It then gathers excess glucose in the blood and stores it as fat. It also acts as an appetite regulator, and whilst its role is not well defined, once insulin acts to deposits fat into fat cells, leptin the hunger suppressant hormone is stimulated to release.1 In insulin resistance, it has been observed that glucose and free fatty acids are persistently high in the blood, likely due to resistant cells not heeding to insulins call, meaning less glucose uptake by muscle cells, and adipose cells no longer inhibiting free fatty acid release.1 This then results in higher levels of insulin being produced, and chronically high insulin is known as hyperinsulinemia. Liver and kidney cells do not become resistant to insulin-like the muscle and fat cells, and instead are hyper-stimulated to produce triglycerides and retain sodium respectively. This results in high levels of TGL in the blood, and high blood pressure.1Neither Continue reading >>

High Amounts Of Fat May Improve Insulin Sensitivity – New Study

High Amounts Of Fat May Improve Insulin Sensitivity – New Study

Studies show that calorie-reduced diets improve insulin sensitivity, regardless of their fat content. However, it’s unclear if this is due to the composition of the diet or weight loss. For this reason, a group of scientists compared the effects of high- and low-fat diets, while maintaining stable weight. Below is a review of their findings, published in the European Journal of Nutrition. BACKGROUND Insulin sensitivity refers to how sensitive the body is to the effects of insulin. Low insulin sensitivity, also known as insulin resistance, means the body doesn’t respond to insulin efficiently. This adverse condition characterizes type 2 diabetes and can lead to abnormally high blood sugar after meals. It’s unclear exactly what causes insulin resistance, but several studies have examined how diet composition affects insulin sensitivity. Two short-term studies compared the effects of diets high in fat (50–55% of calories) and low in fat (20–25% of calories) on insulin sensitivity. They found no significant differences in insulin sensitivity between diets. Another study in older individuals showed that a 4-week, high-fat diet (42% of calories), high in saturated fat (24% of calories), did not cause significant changes in insulin sensitivity. What’s more, an 11-day study found that a very-high-fat diet (83% of calories) had no effects on insulin sensitivity, compared to a diet that contained no fat. However, the evidence is not entirely conclusive. Some studies indicate that low-fat diets may improve insulin sensitivity. In short, it seems that eating high amounts of fat does not increase your risk of becoming insulin resistant, but more research is needed. ARTICLE REVIEWED Researchers from the University of Washington in the US compared the effects of a very hig Continue reading >>

More in ketosis