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Fats and Insulin Resistance

Discussion in 'Low-carb Diet Forum' started by Sean_Raymond, Jan 6, 2021.

  1. Sean_Raymond

    Sean_Raymond HCP · Well-Known Member

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    I cannot say enough that I am not discarding anyone's personal experience, reasons or explanations - that is not how I am wish to come across at all. Clearly my view is that the insulin hypothesis doesn't stack up whilst many here do. That is my view and in a way I am here testing it with you all because I would not disregard all of your evidence, some of which conflicts with my opinion. I see the people here as experts and do not wish to appear to be lecturing people who obviously know best their experience with their condition and diet. I am not doubting what people have done or achieved.

    I am aware of the limitations of my profession and that people here may have found some of my peers to be unhelpful (I have my own battle with Dr's/HCP's in my professional and personal life too). I am governed by a best practice policy and must use solid evidence and clinical guidelines which can straightjacket our approaches. Sadly the low carbohydrate approach still falls outside of what some would prescribe despite increasing evidence for them. This attitude is changing, I could better get away with guidance on a low carbohydrate diet than a few years ago (some departments/trusts less easily so) although I'd possibly lose my job if I trialled a keto diet for weight loss/blood glucose control. If I recommended a paleo diet I will have just committed career suicide. There can be a delicate balance between personal views, demand to adhere to professional clinical guidance and trying to be flexible and offer people safe alternative options whilst making sure I do not have my licence taken away! I am sorry if people in my profession haven't been helpful or disrespectful to what you have done.
     
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  2. Sean_Raymond

    Sean_Raymond HCP · Well-Known Member

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    This is really nice to read! Sometimes it is hard to make words reflect the spirit in which you write something. But this is how I'd like to be coming across. I am open minded, I'm considering everything people are saying and and being given much food for thought. I would certainly adopt any relevant approach to reflect any change of opinion. Whilst I cannot see how Insulin is the reason a person gains/loses weight I would be willing to change my mind on that. I really am on the side of everyone here and I have tried to find a way I can reconcile the Insulin idea with peoples testimonies here.

    I'll try and get around to writing in more detail why I feel the insulin hypothesis of obesity doesn't work for me so my thoughts can be examined by anyone interested. As a clinician, I have to understand the reasons of why something works or not for reasons explained. For a person getting results and not experiencing any deleterious effects it is understandable that how the reason may be less important.
     
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  3. zand

    zand Type 2 · Master

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    Maybe you haven't looked in the right places. Have you read the book that @bulkbiker recommended yet?

    I have had my fasting insulin level measured and it was way above normal. Does that not point towards circulating insulin being a problem for me?
     
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  4. Sean_Raymond

    Sean_Raymond HCP · Well-Known Member

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    There can be limitations to the eating less approach and it hasn't been effective for many. I have worked with people that it has been very effective in also and used low Carb diets which were not tolerable. However I recognise a low carbohydrate diet is a great alternative option as many do find it just works better for them in achieving whatever particular goal they have. There are ways of manipulating a specifically calorie reduced diet to provide bulk, mitigate effects on satiety etc but it is a challenging area. Hunger is indeed a major barrier with the eat less/consume less calorie idea.

    When we look at the diets of our ancestors, evidence typically favours diets that were higher in animal products than something like the 'eatwell' plate although tribes that come closest to hunter gatherers in the modern world do eat large amount sof plant foods (unprocessed).

    Gary Taubes believes Insulin stimulates hunger driving over consumption of foods however the body of evidence indicates that insulin promotes satiety as a part of its role in energy homeostasis. Some may dismiss what research finds and prefer to be guided by their lived results, which I understand, but Gary is no different to me in offering a hypothesis and research to back it up. But I haven't seen research that definitively backs up the notion insulin makes you hungry (frank hypos which insulin has a role in can stimulate hunger).

    The ease of access and availability to highly palatable high energy foods continues to increase and it makes sense that as a species which evolved seeking out high calorie foods to survive in an environment where food wasn't guaranteed we will be really attracted to them. Adding this to more sedentary behaviours is for me most likely the main factors driving the obesity epidemic rather than it being because of a particular macronutrient or hormone. We have not undergone a major genetic shift in just 50 years and I do not believe most people are inherently inflicted with greediness so maybe it is the unconscious aspects of the brain forged in a time of feast and famine that is what drives what are now unhealthy behaviours.

    The topic of saturated fat as a cause of heart disease is a rabbit hole. I do not hold a firm opinion that it is as bad as some say or benign as others. Evidence exists linking it to heart disease and other evidence suggest there is not. People then argue over the strength of the studies on either side. My view is that whilst people do respond differently to fat, generally saturated fat does raise LDL cholesterol (if a person is losing weight on a high fat diet this potential rise may be offset by the cholesterol lowering effects of the weight loss). I've looked at many low CHO v High CHO studies and LDL does tend to go up more than down.

    If we accept that saturated fat raises LDL cholesterol (as I do -many do not), it then follows that the next question should be, is this a risk for health? Again, we find studies that contradict each other over this. I cannot conclusively say either way. But even If we were to say it does a low CHO/high fat/sat fat diets also may cause an increase in HDL and decrease in TAG - so just because LDL went up have we increased our overall cardiovascular risk? Then we must consider that increasing LDL itself may not be as important as the number and size of LDL particles rather than the amount of cholesterol being carried. Large LDL particles may confer less atherogenic risk. When we look at MUFA/PUFA, in theory they do not raise LDL and so it is said that they are less likely to cause a furrying of the arteries. But, saturated fat in the arteries is unlikely to be oxidised because it is a saturated fat. This means the inflammation which sparks creation of plaque in arteries may not occur whilst MUFA/PUFA can be oxidised. So whilst unsaturated fats may be less likely to cause deposition of cholesterol in artery walls might be more readily oxidised if they do. Simply put - unsaturated fats may be more pro-inflammatory.

    Again, this all needs to be considered in the context of energy balance, weight, other factors etc. So, I do not fear saturated fat however I am not sure MUFA/PUFA are the disaster some say. Saying that, I do try to avoid processed vegetable oils and get MUFA/PUFA from nuts, olive oil for example. So it may be not so much the type of fat per se but a shift towards consuming more unnatural oils in replace of natural SFA which may have had some unhealthy effects. So I can find some agreement with you on unsaturated fats but maybe not in quite the way. Sorry if I went on there.

    The Randall cycle is interesting, it actually is closest to the topic I first raised about how dietary fat may exert an acute insulin resistant effect and consuming carbohydrate at the same time may mean the carbohydrate is less efficiently metabolised. This is in keeping with the Randall cycle principle but may not wholly be explained by it (this cycle looks at competition between fatty acids and glucose for fuel useage not acute insulin resistant effects of fat). If we look to our ancestors it is likely animal and plant foods were not generally consumed together (animal caught and eaten, berries forged and eaten). I think you do raise an interesting point here.

    Unfortunately as we progress advice changes and advice once taught as healthy is shown not to be.
     
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    #84 Sean_Raymond, Jan 11, 2021 at 5:56 PM
    Last edited: Jan 11, 2021
  5. Sean_Raymond

    Sean_Raymond HCP · Well-Known Member

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    This very well may be true, good evidence shows unrestricted LCHF diets are as effective if not more so than calorie restricted diets for weight loss. The reasons maybe due to macronutrient ratios which lead to a spontaneous reduction in overall calorie intake. Protein is generally regarded as the most satiating macronutrient - whether a low Carb diet typically contains more protein is debatable and pretty individual. It is still not clear that fat is more satiating than carbohydrate, many hold the view carbs are.
     
  6. bulkbiker

    bulkbiker Type 2 · Oracle

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    @Sean_Raymond

    "I am open minded, I'm considering everything people are saying and and being given much food for thought."

    this unfortunately doesn't quite align with your earlier statement

    "I personally wouldn’t buy anything by this Dr as I’ve seen enough interviews to know he is wrong."

    The "Dr" in question being as associate professor who studies insulin mechanisms and has done for years.

    https://lifesciences.byu.edu/https:.../2d5a532e40b88d5b820f1c8bf81b/bikmanvitae.pdf

    I rarely make "appeals to authority" but on this occasion I'm pretty sure I know who I'd believe...
     
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  7. Sean_Raymond

    Sean_Raymond HCP · Well-Known Member

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    Within the context of our discussion I did take that to be aimed at me. I was obviously wrong on that. Regarding our discussion, I do find it unreasonable to suggest I go and spend money on a book in order to further it. It would be much easier to simply pick one of the studies out of the 30 pages of research so I can look at it. I am not saying you should go buy and read books I could recommend. Having seen interviews with Dr Bikman I am not inclined to spend money to access the research which has led to what I consider to be an incorrect theory. I know what he says. But I am talking to you not him - I think it makes sense that you just back up the claim. I won't be buying his book and it has nothing to do with not being bothered.
     
  8. Sean_Raymond

    Sean_Raymond HCP · Well-Known Member

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    That is a bit different to expecting someone to buy a book to investigate a claim YOU made to me. I know what the Dr says.
     
  9. Sean_Raymond

    Sean_Raymond HCP · Well-Known Member

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    I'll need to find a reference for you, however not everyone gets fatty deposits at injection sites (I believe it is less than 30% in T1DM and under 10% in T2DM). Different type of insulin appear to be more or less likely to cause them. My view of this centres partially around the difference in administration of insulin subcutaneously verses peripheral release of insulin. Injecting insulin at the same site has been shown to cause an immunological inflammatory response leading to accumulation of inflammatory cells/scar tissue at these sites. They are not just composed of fat. In addition, as the site becomes inflamed/develops scar tissue absorption becomes less efficient and 'possibly' some of the insulin doesn't get fully administered into the blood. Also, the insulin is injected into subcutaneous fat from where it then enters the blood. Insulin does have anabolic fat building properties but this effect is under physiological regulation when released into the circulation however injected insulin into fat tissue which then may not be fully released into the blood means perhaps the method of administration causes some fat redistribution around the surrounding tissue. No more net fat is created but the anabolic effect of insulin in the subcutaneous area causes accumulation of fat into the fat cells around the site? This last part is entirely hypothetical and not proved as far as I am aware.
     
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    #89 Sean_Raymond, Jan 11, 2021 at 6:08 PM
    Last edited: Jan 11, 2021
  10. zand

    zand Type 2 · Master

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    Wow! Just wow! You won't buy a book that could help to you understand why you are wrong and that insulin really is the problem???!!! You are so sure that his theory is wrong that you won't spend a little cash to check? And all those pages of references that you supposedly want to see? You are a professional and you expect us who aren't professionals to waste time talking to you for free? And you won't buy a book? Gobsmacked by this.
     
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  11. Sean_Raymond

    Sean_Raymond HCP · Well-Known Member

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    This is one of the effects many people report which convinced me that some people will do better with a LCHF diet to avoid gaining weight and or lose weight. People are less hungry. Eating more regularly spaced out meals and less often will likely benefit your ability to clear fat and sugar from the blood. An issue with many current eating habits is that we are in the fed state for most of the day each and every day meaning our body is metabolising fat and sugar whilst adding more into the mix. Breaks from nutrition seem to confer positive metabolic benefits as seen in numerous timed restricting feeding and intermittent fasting protocols.
     
  12. Sean_Raymond

    Sean_Raymond HCP · Well-Known Member

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    Being willing or unwilling to buy a book on the recommendation of someone on the internet cannot be fairly used as evidence to show I am or am not interested in learning. I think it is much better to support your case rather than tell someone to go away and spend time and money on a book. Especially when the authors view on this particular matter I am aware of and disagree with. The poster told me to read a book to confirm the posters view but I am in a discussion with the poster not the author. They can just post the evidence that has convinced them.

    Regarding the insulin hypothesis of fatness, I do not find it is logical anymore and studies showing reduced insulin levels do not cause more fat loss supports this. I do not doubt that you logged your calorie intake meticulously and that HCP's, in response to a lack of their expected outcomes, said that you didn't log correctly etc. I'd find that infuriating too. And that you have found a diet that works for you to improve your health is amazing and these results to a diet that wasn't a part of my training and is still not generally recommended is part of why I am here. It is why I will use low carb diets and I can justify doing so. I am trying to work out the how and why more than to find out whether they work or not.
     
  13. HSSS

    HSSS Type 2 · Expert

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    Out of interest when you consider your weight loss/insulin position are you taking the fact that you are discussing this with mostly t2 hyperinsulemic insulin resistant people whose metabolism doesn’t operate optimally or normally and this may be a difference that is often forgotten yet fundamentally changes our experience of weight loss v a metabolically healthy person with no carbohydrate “intolerance” as in the text books?
     
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  14. HSSS

    HSSS Type 2 · Expert

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    I’d actually be interested to read this. Please do post once you’ve had a chance
     
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  15. lucylocket61

    lucylocket61 Type 2 · Expert

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    So having the links to studies won't help, will it. Your mind is already closed. I am reading so many posts about your opinion and beliefs, at the same time as you are saying you want our input. This is gaslighting - do you realize this?
     
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  16. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    I asked a similar question, but he hasn't replied.
    I do believe, that his belief, is based on research done on non diabetic patients were the imbalances in metabolic hormonal response to certain foods is normal..

    That is why I asked him about the best dietary recommendations for someone like me.

    Stay safe
     
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  17. Sean_Raymond

    Sean_Raymond HCP · Well-Known Member

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    There really is nothing gobsmacking at all. It seems some want to take issue with everything I say.

    I will repeat yet again that I am aware of what the author of the book says and I do not agree. There is nothing he will say in the book regarding his theory of insulin that will doesn’t say in the hour long interviews that I’ve seen. I know his views on insulin and I believe he is wrong. Just because a particular poster thinks the book is great does not oblige me to buy it.

    I’m having a discussion with someone on here - they can cite any piece of evidence from book and I’ll respond to it in kind.

    I do not expect you to talk to me at all- you do so at your own volition although you do not seem interested in constructive dialogue anyway.
     
    #97 Sean_Raymond, Jan 11, 2021 at 7:15 PM
    Last edited: Jan 11, 2021
  18. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    Hi, again.

    Just a query.
    Have you looked at the insulin index, I know this was designed for non diabetic patients and for industry.

    Why does certain meats get high insulin response numbers?
     
  19. Goonergal

    Goonergal Type 2 · Moderator
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    All, the tone of a number of responses this evening is heading towards bickering rather than constructive discussion/debate.

    There are some interesting points being raised here and it would be a shame for them to get lost in less helpful comments.

    Please refrain from making judgemental remarks about the motivations of others. Disagreement is fine, but please keep it civil.

    Any posts not meeting these criteria will be deleted.
     
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  20. Sean_Raymond

    Sean_Raymond HCP · Well-Known Member

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    Convincing evidence would be exactly that. My position on it isn’t fixed. I do not believe reducing insulin levels causes weight loss because the best studies I’ve seen show this whilst it also fits with the explanations for how various systems control energy expenditure. I would be happy to change my mind if the best evidence proved otherwise.

    As I said. Some of the people here seem as if they want to argue. The post I am responding presumes things that are completely incorrect and not reflective of anything I’ve said but gets lots of likes and wins.

    I’ll respond to genuine questions if I think it’ll be helpful but I’ll be avoiding posts like this.
     
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