Insulin Sensitivity And Glucose Tolerance Are Altered By Maintenance On A Ketogenic Diet
The ketogenic diet (KD) is a low-carbohydrate, high-fat diet that is used for a variety of health-related effects. This type of diet is effective at suppressing seizure activity in children with refractory epilepsy (1) and has perhaps more commonly been implemented as a dietary strategy by which weight maintenance or weight loss is the desired outcome. It has been demonstrated that restriction of dietary carbohydrates results in positive effects on cardiovascular parameters. Consuming this type of diet favorably affects body adiposity and improves features of metabolic syndrome in humans (2,3,4,5,6). Although studies evaluating the efficacy and metabolic effects of KDs have increased in recent years, the effects of macronutrient-controlled diets remain controversial in the literature. Insulin has potent short-term and long-term effects on energy intake and glucose homeostasis. In the short term, insulin release is cephalic; the brain initiates insulin secretion by directing messages through the vagus nerves to the pancreas as opposed to direct pancreatic stimulation of insulin-secreting cells. Cephalic insulin is most readily observed at the onset of a meal and consists of a short burst of insulin that is preabsorptive with regard to the ingested food. After consumption of a meal, insulin secretion increases and is sustained, because one of insulin’s roles is to prepare the body for the increase in glucose that accompanies food intake and to control the increased levels and use of glucose (7). In the long term, insulin’s role as an adiposity signal is well known, with increased plasma insulin levels resulting from increased body weight. Together, the short- and long-term effects of insulin allow for proper glucose homeostasis and assist in the regulation of body wei Continue reading >>
- Effects of resveratrol on glucose control and insulin sensitivity in subjects with type 2 diabetes: systematic review and meta-analysis
- Effects of resveratrol on glucose control and insulin sensitivity in subjects with type 2 diabetes: systematic review and meta-analysis
- The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus
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 >>
Keto Diet Mastery: Your Comprehensive Guide To The Ketogenic Diet
What if you could train your body to burn fat more efficiently and speed up your metabolism without restricting calories? If you’re struggling to lose those last 5 pounds or wondering why the muffin top just won’t budge (despite eating clean and exercising), you may find the answers you’re looking for in this keto diet master guide. What Is the Keto Diet? The ketogenic (aka: “keto”) diet is a high-fat, low-carb diet that puts your body in a natural fat-burning metabolic state called ketosis (1). This is done by heavily restricting carbs and focusing on high fat, moderate protein meals (in some cases protein may be also be heavily restricted). According to PubMed, the classical ketogenic diet contains a 4:1 ratio of fat to proteins and carbs. In other words, the principle of the keto diet is to “eat fat to burn fat”. Now, the keto diet is often grouped with other high-fat, low-carb diets such as the Paleo or Atkins diets. But the reason these diets boast fat burning benefits in the first place is because they promote ketosis. Therefore, the ketogenic diet isn’t so much a “diet”, but more so the basis of these diets, and the biochemical reaction that occurs when you train your body to burn fat for fuel instead of carbs. While the ketogenic diet has become popular for weight loss, studies have also shown numerous other health benefits of following a keto diet. For example, studies have shown it may help reverse type 2 diabetes and reduce symptoms of Alzheimer’s disease, depression, and autism (2)(3). In fact, the keto diet was first used in the 1920s not as a weight loss diet, but a natural treatment to prevent seizures in epilepsy patients (4). With that said, let’s look closer at how the ketogenic diet can work for dramatic weight loss, and other Continue reading >>
Fibroblast Growth Factor 21, Ketogenic Diets, And Insulin Resistance
Dear Sir: I read with interest the article by Domouzoglou and Maratos-Flier (1), which summarizes current knowledge on fibroblast growth hormone 21 (FGF21) and provides insights into the potentially promising applications of this endocrine factor in the treatment of nonalcoholic fatty liver disease, obesity, and type 2 diabetes. Studies in mice fed a ketogenic diet greatly contributed to the understanding of the physiologic roles of FGF21. Domouzoglou and Maratos-Flier emphasize that ketogenic diets lead to weight loss and improvement in insulin sensitivity (1). Although I agree with the effect on body weight, I am more skeptical about the effect of ketogenic diets on insulin sensitivity. Indeed, using the hyperinsulinemic-euglycemic clamp technique, which is the gold standard to assess insulin sensitivity, we recently showed that mice fed a ketogenic diet developed profound hepatic insulin resistance compared with mice fed regular feed pellets, as reflected by decreased suppression of endogenous glucose production during the clamp (2). Importantly, this effect was observed with the same ketogenic diet used in previous studies (3, 4). In our study, hepatic insulin resistance could be attributed to a significant increase in hepatic diacylglycerol content, leading to protein kinase Cϵ activation and subsequent impairment in insulin signaling at the level of insulin receptor substrate-2 tyrosine phosphorylation, showing a key role of dietary fat intake in the development of insulin resistance (2). Interestingly, insulin resistance measured in mice fed a ketogenic diet did not correlate with indexes of insulin sensitivity such as the homeostasis model assessment of insulin resistance (HOMA-IR) and the quantitative insulin sensitivity check index (QUICKI). Indeed, these ind Continue reading >>
Keto And Metabolism, Part 5
Insulin resistance is a two-pronged problem closely and causally related to obesity and disease. Last week we discussed insulin, insulin resistance, and the first prong to why it’s so damaging to our bodies, oxidative stress. I encourage you to go back and refresh your memory on those points because this week we’re wrapping up our series on metabolism by talking about the second prong of the insulin resistance problem, and also the big kahuna for obese people everywhere: Fat Storage. One of the main reasons people turn to Ketogenic living is because they have body fat they want to lose, and keto is extremely efficient at burning it off during ketosis. How does all that fat get there anyway? Why is it that keto helps us not only burn fat but also reduce fat storage in the first place? When it comes to fat creation and storage, there are several factors involved, but the primary hormone that directs fat storage and accumulation is our old friend insulin. As discussed last week, insulin opens the door to our cells and forces excess glucose out of the blood and into the cells of our muscles and/or organs, and fat tissue. But that’s not all! It is also responsible for pushing any excess fatty acids floating around in our blood into the cells as well. So it not only puts extra sugar into our cells for storage (which can then be converted into fat molecules), it also puts fat into storage. A problem that the medical community is mildly baffled by is an inconsistency in our liver function caused by excessive insulin and insulin resistance. When insulin is released, it tells a normal liver to stop producing glucose from protein (via gluconeogenesis) and to also stop producing fat. In an insulin resistant liver, however, scientists have found that the presence of insulin do Continue reading >>
- International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #82: Insulin Actions In Vivo: Glucose Metabolism Part 9 of 9
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- Exercise and Glucose Metabolism in Persons with Diabetes Mellitus: Perspectives on the Role for Continuous Glucose Monitoring
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 >>
- Effects of resveratrol on glucose control and insulin sensitivity in subjects with type 2 diabetes: systematic review and meta-analysis
- Alpha Lipoic Acid: Improve Insulin Sensitivity & Fight Diabetes!
The Great Medical Disconnect
There is probably no greater disconnect in medicine than the root cause of obesity. Even if you think you already know the answer to this “obvious” question, it’s still worth reading on. The reason this question matters, of course, is clear to everyone. Obesity (and more broadly the syndrome we define as metabolic syndrome) predisposes us to virtually every disease afflicting us in the modern age. Above is a simple graphic from the journal Nature showing the linkage between obesity and all of its sequela. When you are obese, your risk of disease goes up. This is not disputed. Here is where the controversy starts…what actually makes us obese? Obesity is a disorder of fat accumulation – fat cells accumulate too much fat, relative to how much fat the body breaks down. Conventional wisdom, however, says obesity is a disorder of eating too much and/or exercising too little. These are not the same thing. Let’s turn to a well-respected source of medical information, Lehninger’s Principles of Biochemistry (the so-called “bible” of biochemistry). Go to the index and query, what makes fat cells fat? (the technical way of asking this question is, what causes adipose cells to accumulate triglycerides) and you’ll get the following response: “High blood glucose elicits the release of insulin, which speeds the uptake of glucose by tissues and favors the storage of fuels as glycogen and triacyglycerols, while inhibiting fatty acid mobilization in adipose tissue.” Let me translate this: Eating glucose (carbohydrates) increases insulin levels in our body. Insulin drives glucose into liver and muscle cells as glycogen (in small, finite amounts) and into fat cells as triglycerides (in unlimited amounts). Insulin also inhibits the breakdown and utilization of fat. Pa Continue reading >>
64: Keto Vs. Raw Vegan, Dry Eyes, Weaning Off Insulin, Rosacea, Mechanism Of Insulin Resistance
If you are interested in the low-carb, moderate protein, high-fat, ketogenic diet, then this is the podcast for you. We zero in exclusively on all the questions people have about how being in a state of nutritional ketosis and the effects it has on your health. There are a lot of myths about keto floating around out there and our two amazing cohosts are shooting them down one at a time. Keto Talk is cohosted by 10-year veteran health podcaster and international bestselling author Jimmy Moore from “Livin’ La Vida Low-Carb” and Arizona osteopath and certified bariatric physician Dr. Adam Nally from “Doc Muscles” who thoroughly share from their wealth of experience on the ketogenic lifestyle each and every Thursday. We love hearing from our fabulous Ketonian listeners with new questions–send an email to Jimmy at [email protected] And if you’re not already subscribed to the podcast on iTunes and listened to the past episodes, then you can do that and leave a review HERE. Listen in today as Jimmy and Adam tackle diet misconceptions and bring your weekly dose of good news on the low-carb, high-fat, ketogenic lifestyle in Episode 64. Here’s what Jimmy and Adam talked about in Episode 64: KETO COMFORT FOODS BY MARIA EMMERICK NOTICE OF DISCLOSURE: Paid sponsorship **Special THANK YOU to Ted, Becky, Timothy, Merril (G’day guys, Thank you both for your awesome hard work every week. I love your podcast – it is inspiring & makes me sound quite the expert when I pass on your knowledge to others. I love the pathophysiology content. Cheers! Merril Melbourne, Australia.), Jane from Denmark, Kate, Aisha, Pamela, Jana, Bruce, and Sarah (Hi guys!! Thank you so much for all your hard work and your informative and entertaining podcast! I’m a new listener and Continue reading >>
The Link Between Cancer, Insulin Resistance And A Ketogenic Diet
Research done by Dr Dominic D’Agostino, Dr Thomas Seyfried and Dr Gary Fettke has revealed that cancer is predominantly a metabolic disease and not a genetic one as previously thought. “Most cancer scientists have historically thought that cancer was a genetic disease, but only 5-10% of cancer is hereditary,” says Dr D’Agostino. A metabolic disease is one that disrupts normal metabolism, the process of converting food to energy on a cellular level. The mitochondria generate the energy that our cells need to do their job – and are often referred to as the powerhouses of the cells. When carbs (made up of glucose) are ingested, they cause the blood glucose levels to rise. The hormone insulin, responsible for regulating energy usage – in particular our relationship to carbs – is secreted by the pancreas because a high blood glucose concentration is toxic for human tissues as it damages the structure of all proteins. According to Dr Fettke, we can only metabolise about one teaspoon (4 grams) of glucose at once and the rest is stored in the liver and muscles as glycogen, or if this cannot happen, it is stored as fat. The more carbs ingested, the more insulin is produced, the more our body becomes resistant. Insulin resistance occurs when the body does not respond to insulin correctly. This results in increased blood glucose levels, which can’t be stored in the liver or muscles, so must be stored as fat. This is discussed in great detail, by Prof Noakes, in the Beginner Banting Online Program. Insulin is therefore the fat storing hormone, which leads to an expanding waistline. If a high carb diet is followed, and if unchecked, it can lead to obesity, metabolic syndrome (a combination of obesity, hypertension and gout) and to type 2 Diabetes. The long-term damag Continue reading >>
How Does Keto//os Affect Insulin Utilization And Sensitivity?
KETO//OS can enhance insulin sensitivity. In preclinical studies, exogenous ketones have been shown to do this. Richard Veech (scientist at the NIH) showed that feeding exogenous ketone supplements lowers blood glucose while simultaneously lowering blood insulin "research has demonstrated “ If more glucose is removed from the blood with less insulin that suggests that insulin sensitivity has been enhanced. We are experiencing this from testimonies of KETO//OS. As with any medical condition we recommend you consult with your physician. Continue reading >>
- Diabetes Care Management Teams Did Not Reduce Utilization When Compared With Traditional Care: A Randomized Cluster Trial
- How Does Fat Affect Insulin Resistance and Diabetes?
Does Long Term Ketosis Cause Insulin Resistance?
“It’s a snake.” “It’s a wall.” “It’s a rope.” “It’s a fan.” “It’s a tree.” “It’s insulin resistance.” I’ve always been fascinated by those describing a “new finding” in medicine. I am reminded of the story of 5 men who, never having seen an elephant before, were blindfolded and asked to describe what he discovered. However, each man was introduced to a different part of the elephant. Each of them had a dramatically different description of the elephant and each made a conclusion that was very different from the others. What is fascinating, is that we usually make our “blindfolded comparisons” to those things we have seen or about which we have some descriptive understanding. Observing and describing human physiology is much like examining an elephant while blindfolded for the first time. This week’s “blind-folded finding” is what has been interpreted by some as “insulin resistance” made worse by a ketogenic diet. Really? This perked my curiosity, because I’ve personally been following a low-carbohydrate/ketogenic diet for 10 years and have thousands of patients doing the same. To this day, I’ve never seen insulin resistance “get worse.” In fact, it gets better. Clinically, it seems to take about 18-24 months to improve, but, it usually gets better. THE QUESTION – I’ve had three people from around the world contact me this week and ask why, after being on a ketogenic diet and “in ketosis,” they suddenly get a notably large blood glucose spike when they cheat. By notably large, I mean that their blood sugars rise to over 200 mg/dl within 2 hours of a carbohydrate containing meal. Now, they admit to rapid glucose recovery within an hour or two, and their hemoglobin A1c levels are subjectively normal (l Continue reading >>
Ketogenic Diet Improves Insulin Sensitivity And Numerous Aging Markers
A physician conducted a decade-long experiment on the health effects of a ketogenic diet, using himself as the laboratory rat; he experienced improvement in insulin sensitivity, body fat, lipids, blood sugar, and other markers A ketogenic diet requires carbohydrate and protein restriction, with 50 to 80 percent of calories coming from fats; this forces your body to shift toward using ketones as its primary fuel source, instead of glucose Although your brain is more dependent on glucose than your heart, your liver can produce a ketone-like compound that your brain can efficiently use for energy Scientists extended the lifespan of mice by 20 percent by suppressing the activity of just one gene that helps control metabolism and energy balance; this is further evidence that longevity is tied to insulin signaling The best way to jumpstart your fat-burning/ketone-producing engine is by drastically reducing your consumption of sugar and grains, fasting intermittently, and maintaining a consistent exercise routine By Dr. Mercola We are just beginning to understand the biological intricacies of aging. A growing body of research is challenging the belief that aging is beyond your control, prompting scientists to begin thinking about ways we can slow our aging clocks to a slow crawl. Although this is a relatively new branch of science, there are some factors that appear to be key in controlling how quickly you age. One major factor seems to be insulin signaling and the metabolic "engines" you have running day to day, which are largely controlled by the foods you eat. In the first featured video, Dr. Peter Attia discusses how a ketogenic diet can optimize your metabolism. But before I discuss the specifics of this, I want to tell you about a remarkable mouse study, presented in the 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 >>
How Optimize Your Diet For Your Insulin Resistance
Lately, I’ve seen a number of common themes come up at low carb conferences and online. The contentious questions tend to run along the lines of: I did really well on a low carb diet initially, but my fat loss seems to have stalled. What gives? What should I do now? If protein is insulinogenic should I actively avoid protein as well as carbs if my goal is to reduce insulin because low insulin = weight loss? If eating more fat helped kick start my weight loss journey, then why does eating more fat seem to make me gain weight now? This article outlines some quantitative parameters around these contentious questions and helps you chose the most appropriate nutritional approach. Coming from a diabetes headspace, I’ve seen firsthand the power of a low carb diet in reducing blood glucose and insulin levels. As a Type 1 Diabetic, my wife Moni has been above to halve her insulin dose with a massive improvement in energy levels, body composition and mood. If your blood glucose levels are high, then chances are your insulin levels are also high. Insulin is the hormonal “switch” that causes us to store excess energy as body fat in times of plenty. Lower levels of insulin in times of food scarcity then enable us to access to the stored energy on our body. You can actively manage the fat storing potential of your diet by managing the insulin load of the food you eat. The chart below shows that our glucose response is fairly well predicted by the carbohydrates we eat. (note: The “glucose score” is the area under the curve of glucose response to various foods tested over the three hours relative to glucose which gets a score of 100%.)   Having high blood glucose levels is bad news. The chart below shows the correlation between HbA1c (a measure of your averag Continue reading >>
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 >>