The Benefits of Insulin
I just got around to reading Matt Stone's excellent Befriending Insulin post. I highly recommend it to all my readers. I have a few factual issues with it (have been trying to comment there but will email Matt shortly), but on the whole it is solid. FWIW, I'm not so sure I could embrace Matt's methods of "undoing" VLC (I'm not into gaining ANY weight), but that's irrelevant, IMO, to the discussion.
I came late to the online LC party, relying mostly on my memory of Atkins Induction to fashion my plan beginning sometime summer 2007. I remember when I first started reading on the web something just didn't ring true to me about insulin and the way it was being demonized. Where did this come from, I wondered.
Insulin deficiency is a bad thing. It leads to elevated NEFA as well as hyperglycemia. I've blogged on the vascular actions of insulin that are positive in nature. So why would our goal be to achieve this state? As Matt points out, insulin is an energy usage hormone. It plays traffic cop for the utilization of substrates depending on dietary availability. The view that it is *the* fat storage hormone is overly simplistic by a mile. It is insulin RESISTANCE, not insulin that is bad. After all, the truly deficient, Type 1 diabetics, suffer from a variety of health issues.
If you haven't yet read it, read:
Insulin: understanding its action in health and disease (<-- hat tip LynMarie Daye of Adipo Insights blog)
I remember being shouted down rather loudly once when I suggested that long term low carbing seems to make people more sensitive to carbs. That was an anecdotally supported belief at the time. Now, it seems ever more clear to me from my research that the science backs this up.
The best long term approach, IMO, is to promote proper pancreatic function and employ strategies to maintain insulin sensitivity. IR is natural during certain phases of life (e.g. puberty, pregnancy and aging). The only carb that has been implicated for IR is the non-insulin stimulating fructose (don't drink 2L of Coke per day and you don't have to worry over the fructose). Saturated fats have been implicated in IR, but the research is far from conclusive on that one. High fat diets in the context of caloric balance or excess are culprits in the development of IR. Once you've lost a lot of weight on LC going lower and lower carb and higher and higher fat is a recipe for IR. Sadly, I think too many people have been brainwashed into thinking starch is the equivalent to rat poison or that fructose in whole food form is harmful. Neither is true. Diet aside, it seems that exercise/activity is the answer.
Comments
if i eat 1 banana there is absolutely no way (...completely absolutely...) i can refrain from eating another 10 or 20 (no kidding) or how many are there available until i'm stuffed and sick - the same issue is with any 'sweets' (including potatoes) - of course, i may be an unfortunate exception, but i tend to think that carbs screw one's appetite control
When I was a kid in the 60's & 70's bananas and potatoes were staples in my home. Sliced bananas in Rice Krispies with milk and add some sugar was a common breakfast at my Granny's house. My friends ate even more refined sugary foods like Sugar Frosted Flakes. Kids cereals would have contained more sugar if anything. Fruit rollups, Twinkies and saltines were favorite snacks. Yet we didn't get fat.
Certainly entire cultures have survived on potatoes w/o any obesity issues ... and don't get me started again on rice ;-)
Carbs have been around for a long time, and if they were truly physically addictive to the majority of the population, the traditional Pima wouldn't have been "sprightly", and my generation would have been fat.
Obviously, if this is the way YOU react to these foods, it is best for you to avoid them unless you think there might be some other reason for their triggering binging.
There was a time when I would binge on rice -- but fried rice from a Chinese restaurant or slathered with butter and soy sauce. If it were truly the carbs I was addicted to, then the plain white rice should have been my "drug" of choice -- I would have been able to snarf down way more starch w/o all the yummifying fat. Right? Just food for thought.
Let's assume that tissue that communicates through insulin can become insulin resistant. I guess that's about any tissue except RBC's. From the article I send recently we learn that impaired insulin signaling in bone cells induces systemic insulin resistance and several features of 'metabolic syndrome' in just a couple of weeks. Would it be far fetched to suggest that prolongued insulin resistance in any tissue (be it the liver, adipose tissue, bone cells or even the brain) will adversely affect the whole system?
I have probably missed it in your extensive writings, but have you seen evidence that elevated NEFA's cause insulin resistance, in stead of being an innocent bystander? Many people with stubborn overweight, glucose intolerance, etc. seem to do really well on a paleoish, low carb regimen. If anthing, their glucose tolerance improves. They must have 'elevated' NEFA's, but they get better insulin sensitivity. Or is this a wild assumption (I mean, are they 'secretly' insulin resistant while at the same time showing all the typical improvements usually associated with insulin sensitivity)?
On the other hand there are slim, fit, young people who become severely insulin resistant on a low carb diet. I was shocked by a test done by the Swedish lowcarb doctor Andreas Eenfeldt. He did a prolongued OGTT after eating a typical (high but not sky high carb) lunch at an obesity conference in Stockholm. His numbers were horrible, hovering aroud 8 or 10 mmol/l for hours, if I remember well. My biggest question is: is this (reversible) insulin resistance a bad thing? Will it trigger bone loss and other unpleasant things in the long run?
Often I don't even think twice about these foods, but sometimes the moment I take a bite I do get an almost overwhelming urge to just keep eating. I am not sure what is going on. I personally never had the problem with bananas (or any fruit), but certain foods at certain times really will set me off.
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