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Low Carb Induced Physiological Insulin Resistance

Ketoadaptation And Physiological Insulin Resistance

Ketoadaptation And Physiological Insulin Resistance

This is where the magic happens. Rat pups, fed a flaxseed oil-based ketogenic diet from weaning onward – note the drop-off in ketones after 2 weeks (Likhodii et al., 2002): Patient history: these rats have been “low carb” their whole lives. Side note: flaxseed oil is very ketogenic! (Likhodii et al., 2000): Flaxseed oil-based ketogenic diet produced higher ketones than 48h fasting; the same can’t be said for butter or lard. PUFAs in general are more ketogenic than saturated fats in humans, too (eg, Fuehrlein et al., 2004): Crisco keto (adult rats) (Rho et al., 1999): At this point, please just note the stunning consistency in the drop-off of ketones. Experiment 1 & 2 (above) are adult rats; they went through a period of high carb chow dieting, unlike experiment 3 and the rats in the first study, who were weaned onto ketogenic diets. Still same phenomenon: ~few weeks after initiation of ketogenic diet = breakpoint; ketones decline. Ketoadaptation: why do ketone levels decline? This happened in both rat studies above, Phinney 1983, and in many “n=1” practitioners. Possible explanation 1 (ketoadaptation): rat milk is kind of like a low carb diet; high in fat, but not low enough in other stuff to be ketogenic. -Hooded seal milk is practically heavy cream: imagine the amount of suction pups must need to apply. Poor mom, that’s gotta hurt; fortunately, lactation only lasts 4 days. -Rat milk is super-high protein. Therefore, weaning to the flaxseed oil-based keto diet is what really initiates ketoadaptation… which seems to take 2-3 weeks (judging by the decline in ketones [this is explained further below]). Possible explanation 2 (physiological insulin resistance): free fatty acids released faster then they’re burned, accumulate in skeletal muscle, induce mil Continue reading >>

Physiological Insulin Resistance

Physiological Insulin Resistance

I’ve been meaning to do a deep dive into physiological insulin resistance for quite a while now, but the universe keeps conspiring to take my time. Because I haven’t had time to read, learn more and write about it, I thought I’d share the links I have accumulated thus far. Mostly because I’ve now been asked a variant of the following multiple times, or have seen the following posted on various forums for discussing nutrition, health, and low carbohydrate diets: “Why has my blood glucose gone up on a low carb diet?” Typically this is accompanied by a good deal of anxiety and fretting over glucometers. I should know, I watched my blood glucose increase by a few points as I’ve sustained my low carb diet. My understanding is that this is a known adaptation completely unrelated to the insulin resistance concomitant with diabetes. While I’m not the person you should ask about anything health related, I’ve wanted an answer to this question myself. The explanation I’ve read is that after going low carb, your muscle tissue becomes insulin resistant in order to preserve serum glucose availability for the brain. If your muscle tissue did not do this, reduced availability of glucose in the serum could (theoretically) put you in dire straights if your brain can’t meet minimal demand for glucose. (Mind you, even on a zero carb diet you can meet all your glucose requirements via gluconeogenesis. The point is, your body needs a way to tell your muscle mass to stop taking all the glucose it makes. This is that way.) Because of this physiological insulin resistance (which I should mention is a benign state that is not making your diabetic insulin resistance worse) you wouldn’t want to take an oral glucose tolerance test while you are low carbing. If you took a glu Continue reading >>

Glucose Numbers And Ketogenic Diet

Glucose Numbers And Ketogenic Diet

GLUCOSE NUMBERS and KETOGENIC DIET When eating a ketogenic diet, the most exposure to carbohydrates is overnight especially towards morning as the liver produces glucose to keep your brain fueled and to prepare you for getting up. Therefore, if you are eating a very ketogenic diet, the blood ketones go up during the day as you burn more fat for fuel (as apposed to a high carb diet where the opposite happens). Something to consider, a ketogenic diet rapidly induces insulin resistance. This is a normal physiological response to carb restriction. Carb restriction drops insulin levels. Low insulin levels activate hormone sensitive lipase. This breaks down fatty tissue into ketone bodies (blood ketones). Your muscles prefer to run on ketones and so they become insulin resistant leaving the glucose in your blood for other cells (like the brain). However, while muscles are in “refusal mode” for glucose any glucose put into your bloodstream, from food or gluconeogenesis (blood glucose made from protein or other tissues), will rapidly spike blood glucose. This is fine if you stick to LC in your eating. It also means that if you take an oral glucose tolerance test you will fail and be labelled diabetic. In fact, even a single high fat meal can do this, extending insulin resistance in to the next day. So if you are getting a blood glucose test, you can increase your carbs to 150 grams a day for 3 days prior and your blood glucose levels will show normal according to the standards. Otherwise, you can look at a better marker for metabolic syndrome which is you HbA1c levels. If these are low (5.5 or less is what a doctor will define as low diabetes risk, 5 or less is ideal), it doesn’t matter what your fasting blood glucose levels are. Also an interesting note, when mice in a r Continue reading >>

Physiological Insulin Resistance

Physiological Insulin Resistance

Back in mid summer 2007 there was this thread on the Bernstein forum. Mark, posting as iwilsmar, asked about his gradual yet progressively rising fasting blood glucose (FBG) level over a 10 year period of paleolithic LC eating. Always eating less than 30g carbohydrate per day. Initially on LC his blood glucose was 83mg/dl but it has crept up, year by year, until now his FBG is up to 115mg/dl. Post prandial values are normal. He wanted to know if he was developing diabetes. I've been thinking about this for some time as my own FBG is usually five point something mmol/l whole blood. Converting my whole blood values to Mark's USA plasma values, this works out at about 100-120mg/dl. Normal to prediabetic in modern parlance. However my HbA1c is only 4.4%, well toward the lower end of normality and healthy. That's always assuming that I don't have some horrible problem resulting in very rapid red blood cell turnover. I don't think so... I spend rather a lot of my life in mild ketosis, despite the 50g of carbs I eat per day. So I can run a moderate ketonuric urine sample with a random post-chocolate blood glucose value of 6.5mmol/l. What is happening? Well, the first thing is that LC eating rapidly induces insulin resistance. This is a completely and utterly normal physiological response to carbohydrate restriction. Carbohydrate restriction drops insulin levels. Low insulin levels activate hormone sensitive lipase. Fatty tissue breaks down and releases non esterified fatty acids. These are mostly taken up by muscle cells as fuel and automatically induce insulin resistance in those muscles. There are a couple of nice summaries by Brand Miller (from back in the days when she used her brain for thinking) here and here and Wolever has some grasp of the problem too. This is patentl Continue reading >>

Low-carbohydrate Diets: Nutritional And Physiological Aspects.

Low-carbohydrate Diets: Nutritional And Physiological Aspects.

Low-carbohydrate diets: nutritional and physiological aspects. Cerestar R&D Vilvoorde Center, Havenstraat 84, 1800 Vilvoorde, Belgium. Recently, diets low in carbohydrate content have become a matter of international attention because of the WHO recommendations to reduce the overall consumption of sugars and rapidly digestible starches. One of the common metabolic changes assumed to take place when a person follows a low-carbohydrate diet is ketosis. Low-carbohydrate intakes result in a reduction of the circulating insulin level, which promotes high level of circulating fatty acids, used for oxidation and production of ketone bodies. It is assumed that when carbohydrate availability is reduced in short term to a significant amount, the body will be stimulated to maximize fat oxidation for energy needs. The currently available scientific literature shows that low-carbohydrate diets acutely induce a number of favourable effects, such as a rapid weight loss, decrease of fasting glucose and insulin levels, reduction of circulating triglyceride levels and improvement of blood pressure. On the other hand some less desirable immediate effects such as enhanced lean body mass loss, increased urinary calcium loss, increased plasma homocysteine levels, increased low-density lipoprotein-cholesterol have been reported. The long-term effect of the combination of these changes is at present not known. The role of prolonged elevated fat consumption along with low-carbohydrate diets should be addressed. However, these undesirable effects may be counteracted with consumption of a low-carbohydrate, high-protein, low-fat diet, because this type of diet has been shown to induce favourable effects on feelings of satiety and hunger, help preserve lean body mass, effectively reduce fat mass a 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 >>

Insulin Resistance? - Low Carb Friends

Insulin Resistance? - Low Carb Friends

. I used to be insulin resistant before I started low carbing. I have a question. What has become of this condition? Is it reduced at all? Thanks guys im really concerned about this. Start Date: 01/2011, got lazy/married, rebooting FOR REAL 2014 When I first started, I had dark, velvety skin (Acanthosis nigricans) around my neck, between my breasts, and under my armpits, which was one of the signs of insulin resistance. I lost weight, and the dark skin went away completely. So yes, I'd say my condition was reduced. When I first started, I had dark, velvety skin (Acanthosis nigricans) around my neck, between my breasts, and under my armpits, which was one of the signs of insulin resistance. I lost weight, and the dark skin went away completely. So yes, I'd say my condition was reduced. I have this and never knew what it was till I looked up "dark skin under arms" on the net. I noticed it went away the first time I did Atkins (about 10 years ago), the second I stopped low carb and started chowing down on wheat again it came back. I love what Atkins does for my body even though I very rarely lose weight (my hair grows in nicely and my dark skin patches go away), unfortunatly I turn into super grump, my mood turns bad bad bad when doing strict low carb. I'm doing JUDDD with a low glycemic emphasis (just started the low glycemic) hopefully the marks will go away but havn't so far and have been doing JUDDD for 3 months, I have been eating very high carb though. If you are looking for a way to track this, have you had a doctor check you fasting insulin levels? That can give you a rough idea of your resistance. You could also ask your doc to provide a HOMA (homeostatic model assessment, which uses your fasting glucose and fasting insulin levels in a mathematical formula) or a 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 >>

Physiological Insulin Resistance = Low Carbohydrate Diet Induced Insulin Resistance

Physiological Insulin Resistance = Low Carbohydrate Diet Induced Insulin Resistance

I’ll admit to breathing a sigh of relief back in October of 2007, when Peter at Hyperlipid posted about “Physiological insulin resistance.” Curiously, looking at the post again, I note that he didn’t capitalize the second two words—as though it’s not a proper name for a specific condition. Back in mid summer 2007 there was this thread on the Bernstein forum. Mark, posting as iwilsmar, asked about his gradual yet progressively rising fasting blood glucose (FBG) level over a 10 year period of paleolithic LC eating. Always eating less than 30g carbohydrate per day. Initially on LC his blood glucose was 83mg/dl but it has crept up, year by year, until now his FBG is up to 115mg/dl. Post prandial values are normal. He wanted to know if he was developing diabetes. […] What is happening? Well, the first thing is that LC eating rapidly induces insulin resistance. This is a completely and utterly normal physiological response to carbohydrate restriction. Carbohydrate restriction drops insulin levels. Low insulin levels activate hormone sensitive lipase. Fatty tissue breaks down and releases non esterified fatty acids. These are mostly taken up by muscle cells as fuel and automatically induce insulin resistance in those muscles. Whew! Now I had something to tell my dad and others who’d been faithfully doing LC and became horrified, then scared, at fasting blood glucose measurements (which is primarily how the health community screens people for diabetes). I really didn’t concern myself with it again—for all these last almost 7 years. OK, so long as post-prandial is fine (caveat: AFTER AN LC MEAL!), nothing to worry about; and combined with good HbA1c, and the fact that so far as we know, this condition will reverse in normal people after a few days of carbage, Continue reading >>

Does Long Term Ketosis Cause Insulin Resistance?

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 And Physiological Insulin Resistance | Low Carb Diet And Dawn Phenomenon

Ketogenic Diet And Physiological Insulin Resistance | Low Carb Diet And Dawn Phenomenon

Dawn Phenomenon Ketogenic Diet and Dawn Phenomenon ketogenic diet Physiological Insulin Resistance low carb diet Dawn Phenomenon Low Carb Diet Physiological Insulin Resistance Physiological Insulin Resistance Dawn Phenomenon and Physiological Insulin Resistance Have you been on a low-carb or ketogenic diet for some time no and perplexed why your morning blood glucose readings are on the high end? Did you know that it is quite common for long-term ketogenic dieters to have morning fasted blood glucose readings that average 100-125mg/dl? This is rather common, albeit normal and sometimes referred to as Dawn Phenomenon or Physiological Insulin Resistance. Dawn Phenomenon is a natural rise in blood sugar because o a surge of hormones secreted at night which trigger your liver to dump sugar into your blood to help prepare you for the day. Another term for this is Physiological Insulin Resistance. A good description of this phenomenon comes from Chris Kresser, M.S., L.Ac: Very low-carb diets will produce elevated fasting blood glucose levels. Why? Because low-carb diets induce insulin resistance. Restricting carbohydrates produces a natural drop in insulin levels, which in turn activates hormone sensitive lipase. Fat tissue is then broken down, and non-esterified fatty acids (a.k.a. free fatty acids or NEFA) are released into the bloodstream. These NEFA are taken up by the muscles, which use them as fuel. And since the muscles needs for fuel has been met, it decreases sensitivity to insulin. So, if you eat a low-carb diet and have borderline high Fasting Blood Glucose (i.e. 90-105), it may not be cause for concern. Your post-meal blood sugars and A1c levels are more important. One of the clearest explanations of physiological insulin resistance Ive seen comes fromPaul Jamine Continue reading >>

Need Help With Insulin Resistance As A Result Of My Low Carb/vlc Diet. Anything Current?

Need Help With Insulin Resistance As A Result Of My Low Carb/vlc Diet. Anything Current?

I know there are other threads on this topic and I have read a lot of them. I just wonder if there is anything more current than this article from 2007 to help me understand this. Perhaps its still current and valid. Im unclear what to do exactly to reverse this, or do I even need to if its not "pathological". Summary: I am 5-8 pounds over-fat. 10-15 years of labs have all been good/very good for fasting Bg and insulin, until this recent one (the only one when I was low carb/vlc). My insulin was high at 9.00 on last fasting blood draw. Bg was 98 I have been eating high protein, high healthy fat, low carb or vlc. My current labs showed "pre-diabetes" 3 Foods to Remove from - The Fridge Forever Cut a bit of belly bloat each day, by avoiding these 3 foods nucific.com I got an at home glucometer. My Bg never goes too high but it doesn't recover either. Its stays around 100-111 after peaking at 123 or so. Oddly too is that every test is higher at 2 hours and even three than at one hour. Can somebody recommend one or two good resources for this issue. The frustration I'm having is that everything I read about insulin resistance says to "lower carb intake". That is what caused this issue it seems. Thank you. Edited to add: My A1C was not tested this time (arggg) although it was not optimal at all a year ago when it was tested and when my Fbg and insulin were way lower. A1C was 5.7 then. Thanks Continue reading >>

Metabolic Effects Of The Very-low-carbohydrate Diets: Misunderstood

Metabolic Effects Of The Very-low-carbohydrate Diets: Misunderstood "villains" Of Human Metabolism

Go to: The Ketone Bodies are an Important Fuel The hormonal changes associated with a low carbohydrate diet include a reduction in the circulating levels of insulin along with increased levels of glucagon. This activates phosphoenolpyruvate carboxykinase, fructose 1,6-biphosphatase, and glucose 6-phosphatase and also inhibits pyruvate kinase, 6-phosphofructo-1-kinase, and glucokinase. These changes indeed favor gluconeogenesis. However, the body limits glucose utilization to reduce the need for gluconeogenesis. In the liver in the well-fed state, acetyl CoA formed during the β-oxidation of fatty acids is oxidized to CO2 and H2O in the citric acid cycle. However, when the rate of mobilization of fatty acids from adipose tissue is accelerated, as, for example, during very low carbohydrate intake, the liver converts acetyl CoA into ketone bodies: Acetoacetate and 3-hydroxybutyrate. The liver cannot utilize ketone bodies because it lacks the mitochondrial enzyme succinyl CoA:3-ketoacid CoA transferase required for activation of acetoacetate to acetoacetyl CoA [3]. Therefore, ketone bodies flow from the liver to extra-hepatic tissues (e.g., brain) for use as a fuel; this spares glucose metabolism via a mechanism similar to the sparing of glucose by oxidation of fatty acids as an alternative fuel. Indeed, the use of ketone bodies replaces most of the glucose required by the brain. Not all amino acid carbon will yield glucose; on average, 1.6 g of amino acids is required to synthesize 1 g of glucose [4]. Thus, to keep the brain supplied with glucose at rate of 110 to 120 g/day, the breakdown of 160 to 200 g of protein (close to 1 kg of muscle tissue) would be required. This is clearly undesirable, and the body limits glucose utilization to reduce the need for gluconeogenesis Continue reading >>

Low Carbing And Physiological Insulin Resistance

Low Carbing And Physiological Insulin Resistance

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Low Carbing and Physiological Insulin Resistance On a T1 thread ( ), @azure , in past #35, you post: "I agree @Garr Eating a moderate level of carbs can give you a great HbA1C as long as you apply yourself. That way you also avoid the physiological insulin resistance that so,often comes with cutting out carbs and ketosis. You also usually don't need to bolus for protein when you have carbs with it. It's a total fallacy to say that LCHF is the only way to get good results. Controlling carbs, yes, but that doesn't mean you have to cut them out completely." I would be interested to learn what percentage of low carbers you believe develop physiological insulin resistance (PIR), as a result of the LC approach, and at what point they develop it? I started a new thread to prevent derailing the source thread, and think others could be interested too. For those reading who are T2 (or other non-insulin dependant members) who have not fully read the source thread, please note it is a T1 thread, so please do not post on there, unless you have something both relevant and on-topic. I would hate to be stimulating content at risk of editing or deletion. Edited to add that I have deliberately posted in this section for those of us who consider food to be our medicine' How do you know you have no physiological insulin resistance, unless you stuff your face full of carbs? Then, assuming you do go on the odd bender, and so prove you don't have physiological insulin resistance, you are an addict, and then it's a play on alcoholics anonymous. Well, my diet and blood numbers have pretty consistent, and (albeit badly) illustrated by my HbA1c. I have also used several Libre s Continue reading >>

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 >>

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