T2 or NAFLD? ...or, a funny thing happened on the way to the surgery

[Chris24Main]

Oh, I think we left the piste a long time ago...

 

[Chris24Main]

Talking of which - can I take a minute to talk seed oils?

It's been higher than usual in the news recently, due to politics, and I've seen the usual barrages of pro and anti-propaganda. Personally, I've cut out all seed oils from my "nice" list, so that declares my bias, but on a YouTube channel of a source that I have a lot of respect for, the host was railing about the unnecessary attempt to reduce seed oils, "based on very poor science"... and that got me thinking.

Firstly - we don't all need to agree 100% on everything before we can discuss anything.

Secondly - what is the science? what is it that is bad about seed oils?. I know I have an opinion, but is there a simple way to express it, and is it just as easy to write it off as bad science and biased in some way?

So - As I often do in such matters, I turn to Dr Ben Bikman to make sense of it for me, and per usual, I'll try to translate rather than quote, though there are references: (link to the study, just as a reference - I don't suggest anyone read it, it's hard enough reading the title)

Accumulation of 4-Hydroxynonenal Characterizes Diabetic Fat and Modulates Adipogenic Differentiation of Adipose Precursor Cells - PubMed

Redox imbalance in fat tissue appears to be causative of impaired glucose homeostasis. This "proof-of-concept" study investigated whether the peroxidation by-product of polyunsaturated n-6 fatty acids, namely 4-hydroxynonenal (4-HNE), is formed by, and accumulates in, the adipose tissue (AT) of...

t.co

The simple version (at least I think it's simple) - is that the majority player in seed oils is Linoleic acid. (understand that all forms of oil and fat are composed of a mix of complex compounds - there is no such thing as just "saturated fat" for example, and the nearest thing is strangely enough, coconut oil). This is not a pro-animal or anti-plant thing.

Linoleic acid is absorbed, and your body incorporates it (first turning it into other compounds) - but the key thing is that when they are incorporated into fat storage cells, they limit the ability of the fat cells to reproduce, forcing them to expand. (why, I'll skip, but related to 4-HNE, which I'll skip).

Now - fat cells are designed to do be able to do this (or multiply, so you have more, smaller fat storage cells, which is better), and are much more "expandable" or "stretchy" than any other cell tissue, so that doesn't sound too bad... except that two things happen.

1 - think of a balloon expanding - it gets harder to blow - this is one direct form of insulin resistance (only one form, and I'm horribly over simplifying, but it is insulin doing the "blowing" and the cell pushes back). This directly drives insulin resistance all through the body because it becomes a positive feedback loop.
2 - the cells get further away from blood vessels, and as a coping mechanism, release inflammatory particles, designed to increase the building of new blood vessels - again, sounds fine, but this is a direct driver of chronic inflammation.

So - independent of anything else - seed oils directly drive 2 out of the 4 major markers of metabolic syndrome.
That's pretty good science as far as I'm concerned.

 

[Neverbloobloo]

Quick update on this last post.
It really is a distillation of at least 6 books on the history of the growth of various adjacent industries, diabetes treatment and the understanding of what diabetes is, as well as the history of the saturated fat - heart health hypothesis, and how that affects diabetes treatment as well as driving the focus of trials and funding for trials.

There is an obvious danger in trying to condense so much into a few paragraphs - and some points need to be clarified.

1 - if there is anyone who has read this and felt that I'm pointing the finger of blame for T2DM on them - I whole heartedly apologise; never my intention and not at all what I'm getting at.
2 - is it fair to focus on sugar, and what do I mean by that?. Surely diabetes is not a new thing after all.
3 - What about all the other possible cause of Diabetes, office jobs, sedentary lifestyles and the Body’s inability to burn off excess energy consumption, as examples.


So, as usual, in as much of a spirit of humility as I can muster, and this being a place for challenging each other and trying to learn - particularly trying to learn what are the commonalities that we can agree on...

1 - Blame.
No, not at all. Sugar, in the form that you can add it to something, as opposed to just sucking it out of fruits; refined sucrose (being a pair of glucose and fructose molecules) has been around for hundreds of years - the Egyptians were instrumental in developing the technique for refining it, so that's a fair amount of time. Almost all the time it has been around, it was considered to be something of a wonder drug - the cure for all ills, the reviving spirit, the essence of energy and joy (all my words, I try to write from my head rather than copy pasting from source). Not a food.
As the refining (as well as the control of growing and distribution, or more simply, empire) takes a more industrial form, it becomes more widely available, and the sense quickly becomes that this is indeed wonderful stuff, and that it would be a form of cruelty to withhold it, particularly from children, who clearly derive such pleasure from sugar.
There has always been a suspicion that the attendant rise in what we now know as Type 2 diabetes was linked to over consumption of sugar. A suspicion, because there has always been a corresponding cry that it cannot possibly have anything to do with something so beneficial as sugar. Both from well minded "influencers" and people deriving wealth from the sugar industry; I really tend away from conspiracy, and it's clear from the record that sugar was very highly thought of (personally, it's a dosage thing for me).
How this affects diabetes treatment, is that the priority has often been about allowing sufferers of diabetes to enjoy sugar as much as the rest of "us" do - rather than seeing it as an intolerance to sugar that is best served by avoiding it, and becoming well.

2 - Sugar, or other carbs.
So, in many of these pages, I've used the term "sugars and starches are fattening" - because that was how it was always put, historically speaking, and that is still true. However, having read more deeply on the sugar (specifically refined sucrose) industry, again, every time in history that a community of people have given themselves the ability to increase their consumption of sugar, diabetes has followed. It really is unique, and difficult to avoid the conclusion. Every single anomaly is explainable - World War sugar rationing, diabetes rates fall. Diabetes in the landed gentry classed of Victorian Britain, but also pre-empire India. Diabetes sweeping into every country that adopts the Western diet. And so on.
When you are trying to reverse T2DM and insulin resistance, I truly believe that you absolutely must consider all starches, because they will turn into glucose - but sugar; refined sugar - gives the body both the double whammy of glucose and fructose (which is metabolically unique, and turns into triglycerides, leading directly to insulin resistance in adipose tissue - this is the fatty liver route) as well as the emotional desire for more sugar. There is not a single case of a population gaining access to sugar and not increasing consumption at a rate higher than any other substance.

3 - what about all these other causes.
Well, yes - lifestyle is clearly a factor, and thinking about reversal of T2DM, I personally have raised my game on sleep, stress and exercise; so of course I cannot simultaneously claim that they are not a factor.
However, when you see the same line being put out time and time again; "it can't be sugar, the mental stress and corpulence of the upper classes is to blame" - two hundred years ago when sugar was the privilege of the rich; and really at every point since - it surely cannot be sugar, what about (insert modern reference)?
Yet, there was a reason the term Mellitus (meaning "honey") was added in the 17th century. There is a current line of thought that "all calories are equal" - but this thinking really predates the understanding of endocrinology, and that a calorie's worth of sugar will do different things in the body compared to a calorie's worth of protein or fat. (or that protein with carbs will have a totally different effect than protein without...).

As for exercise, one of the most notable groups of diabetes sufferers was historically slaves working in sugar plantations. Indeed, President John Adams was primarily excited about Maple Syrup because it could be produced without the large need for slaves to work the plantations. Now - is anyone going to volunteer that this population was too sedentary?

In many ways the way that the entire narrative is steered toward Carbs and not Sugars is interesting. Even the momentous 1977 congressional report that lead to the changing of dietary guidelines and that we should shift 20% of total energy from fat to carbs - (and I've only just gotten to the bottom of this, but it's been bugging me for months since I found the original report) -

View attachment 70556

Goal 5 clearly talks about reducing sugar consumption by 40% (and that's by 40% of what people were consuming in the seventies)

By 1980 (I think) - that had been dropped, and all we are really left with is the increase carbs, and reduce fat.
Think what available food would be like if we were all as fixed on limiting sugar to 40% of what was normal in the seventies...

Thoroughly enjoyed reading your post, makes me look at things with a different perspective. I do struggle a bit with sugar cravings particularly after a meal. When I look at my past before I was T2 diagnosed, a promotion suddenly meant that my occupation required me to entertain quite a bit! It was just a few years later when I got the news even though I considered myself to be active, fit and healthy?

 

[Chris24Main]

Many thanks @Neverbloobloo - much appreciated, though I should just stress as ever; I'm no expert on any of this, and in many ways the entire thread was a result of me getting angry at my own ignorance enough to start down the road of better understanding insulin resistance - and then sharing progress, and sometimes mis-steps in real time.

If I bring anything to this, it's just that my background is in attempting to make sense of complex mechanisms, and better control them - not related complex mechanisms, and none of that makes my opinion any more valid than anyone else's - and for me, I just get much more out of "learning in public" than I would by assuming that I understand a thing... trying to simply explain a complex thing is the best way to really learn about it - for me at least.

So, as long as there is an interest in reading this, I'll keep writing...

 

[AloeSvea]

@Chris24Main, how many medical professionals, let alone ordinary folks, let alone people with diabetes, do you think we all come across who exhibit the same as, or more, expertise than you on the details of blood glucose regulation and the various cycles and mechanisms at cell level in our lives? .

Certainly who are actively engaging on the topic.

Many thanks for doing this.

 

[Chris24Main]

/tips hat..
Awe shucks ... thanks..

But - in all honesty (and not false modesty, I do put a bunch of time and effort into this) - it is very difficult to know anything for sure.

That is a big part of the problem - it's hugely expensive, and often ethically difficult to prove anything running trials with actual people. And, anyone working in the field, is... working. It's their livelihood on the line if they produce results that go against the flow. Most of the money funding the research is compromised (in the sense that there are definitely conflicts of interest) - but that doesn't mean that each piece of research is compromised, and there is bias all over the place.

If you have the money, you can design a study that produces results that give you favourable headlines (whatever it is that you find favourable).

Where that leaves us - is a lifetime of conflicting headlines, so as simple people, we just learn to filter it out; we all know how to be healthy..
Except that it turns out we often don't.

Then, in the medical profession, again, it's your livelihood on the line if you can be shown to be going against the guidelines. Anyone can come to a conclusion about whether the guidelines relating to treatment are reasonable (given some time and a willingness to learn) - but that doesn't necessarily mean anything - I know that I`ve flat out lied to my GP many many times over my lifetime about various lifestyle choices - how on earth is she supposed to know that this time I'm being genuine? Why should she give any credence to things I say I'm going to do?

There is also a big question about the way that medicine is taught. I related an episode where my consultant reacted to something I was saying by leaning forward, smiling, and saying "well, I was taught the opposite of that in my second year" - and it was case closed. Except she was totally wrong. In much the same way that I would be wrong about many things if I stuck to what I was taught in my second year on many aspects of engineering that have evolved. In engineering, you appreciate, and are taught, the history of how things are discovered and evolve. In medicine you just don't have the time, you just learn things as givens. (that's a possibly unfair summary, but the gist of it stands) - there are many points in history where enormously influential people change the perception of a point of medicine, and then it gets stuck as being the truth.

In science, there is a constant effort to disprove working theories - but in medicine it isn't questioned in the same way... unless enough people die. The primary tragedy of diabetes (this totally my original opinion, so the weakest point I have to make, and only really meaning T2DM) - is that there is such a long time between cause and effect - that millions of people can die of the disease, but the cause is so long in the past that it can easily be mis-directed, obfuscated and explained away. There is a real, worldwide epidemic going on, but it's hidden. And, the real cause doesn't just lead to diabetes.

So, you turn to books, and videos - but almost everyone has an agenda, or a brand, or even just a specific speciality; it's enormously difficult to see the wood from the trees, and even if you believe you are being open minded - for sure you bring your own biases to bear; it's impossible to be truly objective, and each of us can only really say we have the experience of one person to rely on.

But - I still have a naive hope that there are universal truths - that if you put enough effort into understanding how the things work, at the cellular, organ and whole people scales.. then some things emerge that are difficult to resist, easy to follow, and can be genuinely useful and practical.

My overriding feeling is still that my own year or so of being mis-diagnosed and being on insulin when it was the opposite of what I needed - all of that experience put me in a place where I was willing to learn, and that learning has better prepared me for charting my path beyond middle age with confidence of good health, and so far at least, a year or so of putting that into practice has been a revelation in terms of how I feel (and not just better blood glucose control, which I see primarily as a pre-requisite, not a goal in itself).

If trying to share that (as opposed to just trying to sound clever, which I hope I don't) - and in doing so, I benefit, then why not?

 

[Chris24Main]

But - talking of tragedies - I think I may have lost my wedding ring (finger is just... thinner... and I keep putting off resizing the ring)
Would be the second time it's just slipped off, and I kind of promised last time when I found it, that I would get it resized, so I'm not expecting a great deal of sympathy..

 

[Chris24Main]

OK - time for another left turn...

Strategies and tactics - there has been something of an interesting discussion going on along the lines of "why would you not take metformin?" - and I'll tag @TheRealDrMundo so it's clear that me saying this is here mainly to avoid derailing his discussion, but also that I'm not kind of poking from behind a corner. I think it's a totally viable question, particularly with the way that the medication is described as being beneficial for insulin resistance.

But - I've been mulling over the way that insulin and glucagon work together and opposite each other recently - and I caught an interview between Thomas DeLaurier and Ben Bickman, where he, Ben, said "what most people don't realise, is that it's a state of constant war in the pancreas, and that people with type 2 diabetes also have chronically elevated levels of glucagon".

And another piece of the puzzle kind of fell into place - the thing I'd been confused about was - "all right, so we all understand that T2DM classically involves a period of gradually increasing insulin resistance, so that means at heart, an elevated level of insulin; needing more because it's not working as well which requires more, and so on - but how can this be matched by it's antagonist hormone, glucagon, being produced at the same level?"

and the answer is that it isn't - we produce more and more glucagon to combat the ...more and more insulin.

The insulin itself in the pancreas acts to stop glucagon being produced, and vice versa for glucagon - glucagon inhibits insulin. So, it stands to reason that if the pancreas is increasing insulin, if there is to be any balance; it must be producing more glucagon as well. This is where the concept of "small numbers" that Bernstein talks about is relevant - it's easier to control any system with small adjustments - the more of both hormones being produced, the less the system appears to be in control, and the more it slams from one extreme to another.

This is why we end up with phrases like "when I wake up, the dawn phenomenon means that my liver dumps glucose into my system" - it isn't designed to do this, it's just that when glucagon wins out during the night (with the assistance of Cortisol and Human Growth Hormone) - it slams the liver into massive production of glucose; it isn't "dumping" anything, it's only reacting the way you have taught it to.

Which is where strategy and tactics come in.
I'm just extending the "pancreas at war" metaphor; because the pancreas and liver are not just about sugar level control, there is a huge element of fat control, and part of that is turning excess sugar into fat, or excess fat into ketones, or even breaking down excess protein.

But - what is the plan?

Well, whenever there is a big question to ask "is this body ready to grow into an adult?" or "is this body ready to grow a baby?" - the answer is all about the availability of fat reserves - this is all done through signaling from fat storage cells (adipose tissue) to the brain in ways that are far more complex than medical science gave credence to fat tissue till quite recently - it's really very sophisticated.

On the other hand - smaller questions like "does this body have enough energy to keep running once we've jumped out of the way of this lion?" or "Can we do anything to fight this infection?" - all revolve around the provision of glucose.

Now, in any kind of long-term historical scope, it's simply ludicrous to think that there would always be a full store of sugar-based molecules in the body at all times - for most of human history, most of this glucose would be generated not released from short term storage.

In other words - (and here I leap from the "fact ledge" into the "chasm of opinion") energy strategy is all about management of fat - lipids to and from fat storage, whereas energy tactics is about provision of glucose. Short and long term, clean burning or fast burning, take your pick.

Then, realise that the majority player in the glucose-energy system is not about food - it's the sympathetic nervous system, the fight or flight response...

We are all drilled these days in the idea that this evolutionary system is good in the short term - essential for survival in the short term; but really bad if it's constantly engaged.

Then you have to understand that "inflammation" is really just part of this - the reason we are told not to sit still for too long, is that your body will go "hang on, I haven't moved for a while, I must be injured - send out the rapid response team; we could be bleeding to death!!" [pause to listen to myself and move my standing desk into standing position].

So - more and more, I'm coming to think of "tactical" energy provision - allowing the liver to produce glucose on demand - as a thing to correct something wrong.
"strategic" energy provision is about storing and releasing fat so that the body can operate optimally.

There are a few edge cases - the heart muscle operates differently (and mainly from free fatty acids, we haven't talked much about them) and your brain considers fat molecules as building blocks, not to be consumed for energy - so it cannot be fueled by fat (but can use ketones), and red blood cells have to work differently - if they "burned" fuel, they would be consuming the very oxygen they need to safely transport. Nerve cells are also very different.

but - by and large, my overriding hypothesis is that we have convinced ourselves that the tactical is the strategic - that we need to eat carbs to fuel the body - but the key thing that this does - (elevates insulin due to too much starch and sugar) is shut down the release of fat from fat storage cells (insulin is very good at blocking the release of fat molecules from fat storage - this is different to fat burning, which it also blocks; but you have to first release the fuel) - which of course has the effect of seeming to make it true - by limiting our ability to burn fat for fuel, we make our bodies more dependent on glucose energy.

Understanding this - it's clear what is needed - we just have to allow our bodies to be able to release and burn fuel.

This doesn't mean anything more than that - you don't need to be in ketosis, you don't have to be paleo, or carnivore or vegan, or anything... you just have to realise that when insulin is high, you are only in the business of storing and locking in fat. Almost everything else is negotiable.

Then - in reversing all of this, we need to realise that - even if the pancreas is working fully, it's out of control - wildly swinging between too much insulin and too much glucagon... it takes time to let that settle down, but it's almost always the answer to "why did my blood glucose go up when I expected it to go down...?"

 

[Chris24Main]

So, I caught a lecture at the weekend by Dr Ravi Gornall (on the Low-Carb down under YouTube channel, with possibly the most positive sounding intro music anywhere on the internet, it just gets me into a pleasant state of mind before anyone talks, it's lovely).

Anyway, I have to say this was especially pleasant, because it had almost nothing to do with carbs or diet directly, and was all about Leptin, and the Circadian cycle.

Now, the circadian cycle (your internal clock) has come up a couple of times before, how does the Liver know when to "dump" glucose into the bloodstream etc, and it's always a little confusing to understand how the liver and pancreas, stuck in this struggle to manage energy and blood glucose - how can they also be paying attention to the time of day? - but the answer is both simple and hugely complicated, but very satisfying - particularly in terms of what practical steps can we take...

So - the simple answer is that there is a relationship with Leptin. You may already have heard of Leptin - it's the "satiety" hormone, triggered by the small intestine to tell your brain that you've had enough food (assuming you've eaten food and not UFP food-like mush, but that's a different topic).

The telling point - is that it has a signalling pathway to the brain - you feel hungry because of direct changes in your brain. You don't feel anything at all if your blood glucose is in control - our usual suspects insulin and glucagon have no signalling pathways to the brain in the same way.

Leptin, then - also acts the opposite way around - you have receptors in your eyes and skin that register morning light, and let your brain know that it should release some Cortisol to get you going... and we're into familiar territory because that's the dawn phenomenon.

The key thesis of the lecture, was that there is such a thing as Leptin resistance, and that it can kind of act both as a precursor for and independent driver of insulin resistance, but can be thought of this way -

We are supposed to be in tune with our environment, doing morning stuff in the morning, activity in the afternoon, and preparing for sleep in the evening, then asleep when the sun is down. Our modern lives, and our screens, break that connection, and we become Leptin resistant, meaning in this case - all the complex signalling about what we should be doing and feeling, just gets lost - we feel tired and lacking in energy, hungry at the wrong times.

Just a quick aside - I've lived near the equator a few times in my life - within a couple of weeks, you just know what time it is, and you are always freakishly accurate, to within a few minutes. At midday the sun is directly overhead, and at 6 O'Clock, the sun goes down like a light is switched, and the reverse in the morning. You just don't need a watch, it's really something.

I've also been obsessive about sleep hygiene, not so much right now, but when I was; you can get to a point where at "sleep-time" you suddenly become unbearably tired, and if you have prepared, you can lie down and almost feel yourself fall asleep.

So - I'm all in on the "circadian rhythm is a real thing" - I've seen enough to know it's not just some kind of hippy nonsense...

The rest is kind of complicated, but you won't be surprised to learn that there is a secondary relationship with the liver, muscles and fat-storage tissue which have a huge effect on the balance of insulin / glucagon and mitochondrial function, as well as the management of inflammation and oxidative stress.

Practically - the things to do are simply become more connected to the day; watch the sun rise (feels impossibly difficult in the UK in late November, but you don't need to be out for hours, it is doable). Get a little cold in the morning (that is quite easy to do in late Nov UK weather) - get outside regularly, get some sun; avoid wearing sunglasses, don't snack between meals - avoid screens or block blue light in the evening, watch the sun set.. give yourself a couple of hours between last meal and bed.

Nothing fancy, difficult or expensive - and not a single word about foods (actually that isn't true, she was suggesting wild seafood..) and things that any one of us can immediately see things we can do.. and little things that are all a million miles away from "and now I need to give up this thing as well"...

 

[Melgar]

The circadian rhythm is definitely a real thing @Chris24Main and extremely fascinating. Your liver and your pancreas have internal clock cells, as do your skeletal muscles and in fact most of your cells. Then there is the master clock in your hypothalamus keeping your body in homeostasis. I have mentioned the role of your circadian clocks a number of times on here, especially in relation to the secretion of cortisol and growth hormones. I suspect these clocks cause that quick dip in your blood sugars around the 3am mark and the subsequent rise of blood sugars in preparation for daytime activity. How high those subsequent AM blood sugars go first thing is another matter. I have dug out a couple of papers demonstrating the extent your internal clocks control your daily rhythms and cycles.

https://pmc.ncbi.nlm.nih.gov/articles/PMC7613420/

https://pmc.ncbi.nlm.nih.gov/articl...s consists,adipose tissue and skeletal muscle.

 

[zand]

I disagree with the 'avoid wearing sunglasses' bit. I wish I had protected my eyes from the sun more.

 

[Outlier]

Most of my life I worked 12-hour shifts, often longer if the work was needed or we were short-staffed. I didn't eat when on shift so really a type of intermittent fasting as well. So I would say a lot of us are living apart from the regular hours of work/sleep/play/eat. We still operate a large part of the modern world, and of course those whose lives are entangled with caring for animals do as well. When one works shifts, there is usually a run of days, run of nights and some time off for which latter we revert to normal day/night behaviour. One advantage is that I have never suffered from jetlag! Although often I suspect I had drained my adrenalin stores and likely others as well.

So in your research, don't forget about us. We could probably add a lot to the discussion.

 

[Chris24Main]

I've done some shift work myself - never felt so energised as when I stopped. For the amount of stress it puts on you, I don't think the normal shift allowances are nearly high enough..

so - not forgetting @Outlier - but on shifts you know that there is a certain amount of management of rhythm that you have to do..

@zand - yes, it seems odd, doesn't it - we're all told to protect our eyes... but this was a serious thing; the most significant sensors we have to light in our entire body - is of course the eyes. There are some on your skin, but nothing like your eyes, obviously. So - this wasn't a recommendation to stare at the sun, but more about getting regular natural light onto your eyes (and I've done the total opposite of that myself today - sat at a screen the entire day)

Much the same with sun on skin - as long as you are not out in hot sun for hours - it's actually as "dangerous" as smoking - not getting any sun.. the effect that it has on vitamin D.

@Melgar - yes, totally; I should have explicitly mentioned that it was you who brought it up, and I don't think any of this is really in contention - this is more about how it all works - there are no "clocks" as such - so how does it work - well, light receptors pass signals to the brain depending on how much blue light there is, that triggers leptin, leptin triggers a response in the organs (this is only marginally less basic of course).. I'll read your articles again though.

 

[Melgar]

@Chris24Main I call them clocks, for my own ease of understanding. I had a paper which discussed how they worked, it went totally over my head. I do find the entire concept of the circadian system fascinating. I always thought that there was just one ‘ master clock’ system in the hypothalamus, probably from school biology lessons, so I was totally blown away to find these ‘clocks’ in the liver and pancreas, actually throughout the body. How they have a profound effect on the body’s metabolism cannot be overstated.

@Outlier, there were times when I had to work night shifts. My body hated it, swollen glands, nauseousness, couldn’t sleep during the day. I got cold sores on my lips. I also know some of my work colleagues loved night work. Sailed through it without a hint of discomfort. Slept soundly until it was time to get up. It shows how our bodies respond to differently to stressors.

 

[Chris24Main]

First article - hmmn - it is interesting; I do recall reading that the first time around and it going totally over my head too... now it's like listening to someone speaking a foreign language that I've spent time learning but have never become fluent in. I get the gist, but trip over the details...

So - clock cells - well, yes and no ... inside cells there are transcription factors with the acronym CLOCK. " Circadian Locomotive Output Cycles Kaput" - that's about as desperate a name as I've ever heard... but indeed; what's going on, is that due to signalling coming electrically from the hypothalamus, based on cells which are sensitive to the light spectrum (more when the light is blue, like in the morning) these transcription factors are activated, and what that means, is that they act like printing presses for genes - they copy and paste bits of genetic code - thus when people talk about gene expression. this is what is happening. That genetic code is then available in the form of proteins etc to become enzymes and have actual effects in the cells - driving the liver, for example; to go from "feeding" state, to "get rid of the toxins" state.

Ha, in that article is also the low-level detail of exactly what goes wrong in NAFLD and illuminates a few arguments that have been playing out - even on this thread - it's now easy to see how you can read it as being a lipid issue, but it still comes down to carbs and insulin resistance - but I digress. I'm certainly not going to try to explain that - but thanks for bringing that article up - that actually answers a bunch of hanging questions for me.

 

[Chris24Main]

Second article - yes - this is also saying all the same things - very quick version:

ignore almost all of this diagram, the key thing is that Leptin bit at the top being triggered in adipose tissue (so signalling from the fat storage cells) - the lecturer was essentially saying that this bit (the communication with the brain part via all that complicated signalling) happens first - I guess because it's all electrical - and you can become leptin resistant, so all the other signalling can break down, leaving all the rest just not working the way it should - so then you can scan around the rest of the diagram, and you can see that this basically means that the normal balance (homeostasis) between insulin and glucagon, is at best not going to be as smooth as it should be - even if you are not insulin resistant.

 

[zand]

I've done some shift work myself - never felt so energised as when I stopped. For the amount of stress it puts on you, I don't think the normal shift allowances are nearly high enough..

so - not forgetting @Outlier - but on shifts you know that there is a certain amount of management of rhythm that you have to do..

@zand - yes, it seems odd, doesn't it - we're all told to protect our eyes... but this was a serious thing; the most significant sensors we have to light in our entire body - is of course the eyes. There are some on your skin, but nothing like your eyes, obviously. So - this wasn't a recommendation to stare at the sun, but more about getting regular natural light onto your eyes (and I've done the total opposite of that myself today - sat at a screen the entire day)

Much the same with sun on skin - as long as you are not out in hot sun for hours - it's actually as "dangerous" as smoking - not getting any sun.. the effect that it has on vitamin D.

@Melgar - yes, totally; I should have explicitly mentioned that it was you who brought it up, and I don't think any of this is really in contention - this is more about how it all works - there are no "clocks" as such - so how does it work - well, light receptors pass signals to the brain depending on how much blue light there is, that triggers leptin, leptin triggers a response in the organs (this is only marginally less basic of course).. I'll read your articles again though.

I've done the natural light thing all of my life and now regret it. I've never stared at the sun. A white Winter sky is too bright for me. I have 4 separate conditions of my eyes now. Dr Gornall is just concentrating on circadian rhythms and is probably correct in that respect, but we need to remember that even experts give bad advice occasionally, especially when they are concentrating on just one aspect of health.

 

[Melgar]

Hence the reason why a disruption of your Circadian rhythms has a big impact on your metabolic processes. From a personal point of view, when I fly through multiple time zones - 8 time zones when I fly to the UK - my resting heart rate becomes elevated, like from 65 to around 80, I have night sweats, I can’t sleep, my bodily functions are messed up and my blood sugars rise. There are probably far more processes affected by this shift, but those are the ones I’m aware of. It would not surprise me if IR rises too, hence the rise in blood sugar.

Yes, the stability of equatorial sun light. I wonder how those communities go on in the far North where the sun barely rises over the horizon. I wonder how their bodies adapt or have they adapted and the disruption to their circadian rhythms are not so profound.

And who knew adipose fat cells have their own internal clocks ? I‘m using the word clock to describe the process, but @Chris24Main I acknowledge that they are not clocks as such. When you think about all these cellular internal clocks, they all have to be in sync else ones metabolic functions become messed up. No wonder fat gain is a product of disrupted sleep patterns/lack of sleep, shift work and frequent fliers.

https://pmc.ncbi.nlm.nih.gov/

https://www.genengnews.com/topics/o...e-clock-to-carry-out-key-metabolic-functions/

 

[Melgar]

“A disruption of circadian system, such as knockout of a circadian gene, altered light/dark cycle, shift work, and jet lag, contributes to obesity and its complications like hyperglycemia and insulin resistance, which brings a huge burden to health and economics . “

‘The emerging role of circadian rhythms in the development and function of thermogenesis fat’ , Xuemin and Yong Chen

 

[Melgar]

I've done the natural light thing all of my life and now regret it. I've never stared at the sun. A white Winter sky is too bright for me. I have 4 separate conditions of my eyes now. Dr Gornall is just concentrating on circadian rhythms and is probably correct in that respect, but we need to remember that even experts give bad advice occasionally, especially when they are concentrating on just one aspect of health.

I have Fuchs Endothelial Corneal Dystrophy . I can’t tolerate bright light, so I wear sunglasses. At night I have my own light show. I just have the one eye disease, not sure I could cope with four @zand.