Treat Insulin Resistance

I am beginning to think that weight loss diets should be designed to treat insulin resistance, not reduction in calories, which will likely result. Small meals, protein and fats, none or small amounts of added fats, and no more that 100 calories of unprocessed carbohydrate. Do not eat again until we are getting hungry. Check AM BG level, and when it gets to be stable at 4.7 (85) we should be allowing our livers to control our blood sugar from the low end. This should avoid cravings.

It is also my opinion that IR is the actuate condition, that if not treated with diet becomes obesity, diabetes, metabolic syndrome, etc.

Insulin Resistance

Stephan Guyenet at http://wholehealthsource.blogspot.com/2011/11/what-causes-insulin-resistance-part-i.html is doing a series on Insulin resistance.

I hope along the way he says something to confirm my opinions. Insulin is the energy regulation hormone, as well as the glucose gatekeeper. It also hogs Leptin receptors causing leptin signal blocking aka leptin resistance.

It appears to me that once we have two of three carbohydrate meals in a row, or a feast, our liver and muscles are filled with glycogen, and we become insulin resistant enough to push everything into the fat cells. The liver is the first to fill, due to the first pass effect, and it becomes insulin resistant, pushing more of the insulin and nutrients through the liver to the blood flow. Insulin resistance is a continuum, not a sudden onset issue. It occurs cell by cell, at a cellular level of decision making. It protects the cell from overfeeding.

As I understand it, the liver uses 50% to 90% of the insulin. The portal vein has insulin concentrations 2 to 10 times higher than the circulation. When the liver is full, it becomes insulin resistant, it must allow more insulin to pass, along with glucose and fats. Insulin controls glycogenesis and glyconeogenesis in the liver. As the concentration of insulin goes up these shut off, first glyconeogenesis where glycogen is made from odd amino acids, followed by the production of glycose from glycogen. Once the insulin is passing the liver faster, the body gets fed.

It appears to me that cravings are the result of cellular hunger during the insulin depletion stage of intermittent insulin resistance. That is the hell that I go through in the first days of any diet. It is my intention to never again overflow my liver by eating small meals, and low carbohydrate, until I get down to the point that my waste/hip ration is less that 1.0, perhaps 0.95. That is a good reason to not eat out if possible.

A comment like "I do not want to take a chance of inducing insulin resistance again and have to go through 5 days of the agony of  recovering from insulin resistance again." Take that ye old food pusher. 

Default Behavior

Eating and drinking have become default behaviors to many of us. We do them before anything else, any time we have time not accounted for or assigned to other activities.

Eating need to become just a necessary body function, to intake energy.

Insulin Resistance is a regular occurring condition anytime we overflow the liver and muscle cells with energy. That is we are insulin resistant, --- aka  --- insulin rising, as is blood sugar, in order to store glucose and/or fat in fat cells. This implies that we become insulin resistant after a feast, after any larger meal. The energy is sent beyond the liver. When we are insulin resistant, there is a lag time between insulin going down, allowing the release of fat and glycogenesis and the start of actual release.  This lag time may be the internal starvation, shortage of energy at the cellular level, window of cravings, something like turbo lag.

This suggest that small meals may be the way to avoid internal starvation cravings, by staying below the insulin resistance threshold, that is never overflowing the liver, and allow the liver to dole out the energy as it sees fit.

When we are insulin resistant, out body want to stay that way, possible due to a survival advantage of eating while there is food available. The trick is to fast or fat feed down to low insulin, and then stay there with small meals, to stay insulin neutral, and below the craving threshold, and above the hunger threshold. Four meals is sometimes required.

Causes of Insulin Resistance

A clear understanding of the factors that led to insulin resistance (IR) may be required to avoid it.  Overeating leds to IR, which leds to difficulty burning fat which leds to hunger which leds to overeating. IR is the first step in the cycle.

First, muscle and hepatic insulin resistance(IR) do not necessary happen together. Fat cells becoming insulin resistant is diabetes, more or less. But insulin resistance is the first step in putting fat on, at any time. The liver is full, muscle cells are full, it is time to store fat.

• Glucose in excess is the first cause of insulin resistance.
• Fructose causes insulin resistance
• Overeating of any kind - excess sugar will be turned into triglycerides and cholesterol. 
• Peat Ray says PUFA above a few grams cause IR
• Adrenaline - flight or fight response causes non-essential IR
• Branch chained amino acids (Cross linked), soy protein, corn fed beef, animals fed oils to fatten them- pigs, chickens
• Trans-fats, Omega 6 partly hydrogenated and others
• Omega 6 oils in excess, beware deep fryer, and oxygendised oils 
• a bunch of other odd proteins
• caffeine

Insulin other effects

• Insulin stops the use of fat as an energy source by inhibiting the release of glucagon.
• Anytime your cell is exposed to insulin, it is going to become more insulin resistant.
• When you are insulin resistant you will have trouble burning fat
and excess sugar will be turned into triglycerides and cholesterol.
• Insulin is the fat storage hormone. it locks fat into fat cells. 

reference: http://www.google.ca/#q=Causes+of+Insulin+Resistance&hl=en&prmd=imvns&ei=jMm5Tr_QG9Pq2wWv6s3RBw&sqi=2&start=20&sa=N&bav=on.2,or.r_gc.r_pw

Daily Intake

The daily intake of any vitamin or mineral is a continuum between none and a poisonous amount. The typical government recommended dose are often in the sub-clinical deficiency zone.  That should not be.

There is a second issue, that our individual dose varies with our size, how well we absorb the ingredient, and how much we individually need, and our storage of the constituent.  Most of us are short of magnesium, zinc, vitamin D, and iodine.

 Consider vitamin D, where the government recommended daily dose is 400 UI and to maintain a suitable serum level, many of us require 6000 UI per day. Now consider the sub-clinical effects, bone loss. Now, whatch ya going ta do? 

Consider Iodine, to much causes loss of appetite. Sub-clinical deficiency causes cravings, which led to overeating. In Canada, we have to go to health food stores to get iodine, to rub on a patch of skin, to allow it to be absorbed through the skin or over consume salt. That is one of the contributing factors to obesity. Iodine drives appetite. 

Consider all the industrial foods that are produced under government control and we need supplements. Turns out that much of the industrial food of the 20 and 21 Century is and will be vitamin and mineral deficient, more suited to storing and shipping than consuming. It is time to abandon all industrial food and look out for our own health. It is time to stand up for individual food producers, organic producers. The only foods fit to eat have not been processed much. 

I am getting militant? Is it time to join the occupy movement or the middle figure movement?      

Is it time to take personal responsibility for our health? Is it time to learn nutrition or to hire that service?

  

Lack of Satiety Signal

In both the Lustig via Dietdoctor and Kessler, the missing satiety signal is noted. Lustig says 18% have insulin resistance due to some defect, and that screws the satiety signal. When I was a kid, before extremely heavy widespread sugar consumption, there was about 20% heavy in my class at school, and I was by far the fattest. I was never full, aka no satiety signal.

For those who say insulin is part of the satiety signal, it is when it is low. But if it is high, locked on high, what is the satiety signal? So then I have no choice but to use diet to lower my insulin, low slow carbohydrates, no omega 6 oils, trans-fats, no corn fed beef, and exercise.

The missing Satiety signal is likely the key to weight loss and weight gain. Eat just enough to not get excessively hungry. No missing meals. Metered meals. There is no choice.

We cannot depend on our bodies to tell us when we have had enough. It will not do this for those of us who have no satiety signaling. Satiety is just a concept. We need to live with 100% of our meals metered, in some form, and yet be able to stop eating at that point. Record keeping, weighting of foods, preparation methods, and the like are the key for now. e need to eat enough that we can stop, and not so much that we gain weight. This is tight food control, much like Dr. Bernstein recommends for diabetics. The carbohydrates may also be one of the main keys, to keep insulin low.

Videos worth watching

Videos worth watching found here
http://www.dietdoctor.com/beyond-gluttony-and-sloth

http://weightmaven.org/2011/11/03/point-counterpoint/
Lustig is good, the other less so but some good information.

Get rid of fructose http://www.wheatbellyblog.com/2011/11/goodbye-fructose/





David Kessler, is his book The End of Overeating, makes the observation the 50% of obese, 30% of overweight and 15% of thin people share 3 characteristics, in a condition which he calls conditioned hypereating. These characteristics are loss of control of appetite (eat until it is gone) in face of highly palatable foods, lack of satiation during eating (no full indicator), and preoccupation with thinking about food, eating, getting, and the like (looking for more). Sound familiar?

He offers little as a solution, other than to follow an eating plan rigidly. I do not know about you, but if I could do that, I would not have the problem.

He has a bunch of statements in his presentation that I do not agree with that represent common beliefs of the public which others have debunked.

A video summarizing his book can be found at http://www.youtube.com/user/weightmaven#p/a/B87C02F016ECE119/0/A7M_mqXzpr8  

peptides

Clippings of papers

study/analysis that found that the pepsin hydrosylated of wheat gluten and casein contain peptides with opioid activity. 

a chart or drawing illustrates the substances that affect energy intake and expenditure, and opioids are included in that drawing (they could be endogenous or exogenous). 

snippets from http://www.childrensdisabilities.info/allergies/developmentaldisordersprotein7.html

Digestive enzymes break down proteins into these long chains of amino acids. Incomplete digestion of protein leaves short chains of amino acids referred to as peptides. 

some peptides can pass from the intestines into the blood stream where they may set up an immune reaction because they are considered foreign substances.

dairy products and grain have been associated with adverse reactions not all of which involve allergen-specific immune response as measured by typical diagnostic techniques 

Some of the peptides associated with digestion of dietary proteins (e.g., milk, wheat) are in the opioid family 

Opioids alter behavior because of their ability to bind to endorphin and enkephalin receptors in the brain. Endorphins and enkephalins are endogenous opioid-peptide neurotransmitters found in various parts of the brain and also produced by the pituitary gland. They are involved in the reduction of pain as well as in pleasure and reward

Exorphins, such as opioids generated from digestion, attach to the same receptors as the endogenous opioids and can inhibit the breakdown of endogenous peptides and change the level of endogenous opioids


FT - so wheat and dairy products are potentially addicting... one more paper saying this.

Many Causes of Obesity

It is my opinion that are many causes and/or contributing factors to obesity, not one single. There are many well educated people who are championing only a single cause and declining others. Don at http://donmatesz.blogspot.com/2011/11/fatty-foods-and-sugar-addictive-like.html is one such person.

In my mind there is no doubt that addiction is one of the factors. There is also no doubt that insulin resistance is one of the factors that come into effect when we are overweight, and for sure when we are obese. Different cells become insulin resistant at different times and possibly by different methods. First the muscle cell, then fat cells and them liver cells. But that does not preclude the original drive to eat, aka, appetite to be stimulated by addiction,taste, cravings, add your own list. Once we become insulin resistant, ( full time, seasonally, occasionally) all the other things start, leptin signaling blocking, etc. Then there is hunger and cravings. Such is life.

Some of us obese, ex-obese need to address insulin resistance first, and our addiction, reward, craving causes later or vise - verse. For complete recovery we need to address all the causes. My list can be found on the page, Causes of Overeating.

Note added Nov 5: Others opposed to Dons view:
Videos worth watching found here
http://www.dietdoctor.com/beyond-gluttony-and-sloth

http://weightmaven.org/2011/11/03/point-counterpoint/
Lustig is good, the other less so but some good information.


http://itsthewooo.blogspot.com/2011/11/simple-question.html


Please be advised that this represents my current opinion, and my views have and will change. I am just trying to understand this complex issue and maintain recover from obesity. Maintenance of recovery is proving to be more difficult that actual weight loss. Much is separating theory and reality by n=1 testing.

Ex-obese & Insulin Resistant.

As an ex-obese & insulin resistant person, it is very easy to have the craving - eat -crave cycle start, and then need to resist strong cravings for three days to get out of the cycle.

One over size meal with perhaps as little as 10 grams of omega 6 oil is all it takes. That is just a bit of salad dressing. Cravings. Willpower. Good orderly direction required. No wonder I went through life obese. It is no wonder about the failure of diets rate.

Omega 6 oils are evil, as are the people who promote them, and there spawn. In the Buddhist tradition, looking at ones livelihood is one of the areas of examination. All employment dealing with poisons are discouraged. That would include Monsanto, farmers of all the omega 6 feed stocks, processors, Mezola, and Rusty Butz. 

Anything that contains Omega 6 oil should probably be given up. Or at least anything that does not have at least 1/2 as much omega 3 as 6. That may be why braised beef is more filling than roasted beef... some of the oils have drained out... mainly omega 6 in partly grain finished beef, like is typical in Alberta.

Insulin resistance occurs at a cell by cell level, as each individual cell becomes full of glucose/glycogen. This is normal. What is not normal is eating starch to the point that all the muscle cells are full, and most (all ?) the fat cells are full. That is what medicine defines as insulin resistance.

Excess fat accumulation appears to be the first step toward diabetes. To much glucose and Omega 6 oils are the sure method of getting there. Sugars and grains provide to much glucose, plain and simple.

Cravings are correlated with the first signs of insulin rise in my case. How about that. Eat less than 50 grams of carbs and no (little) omega 6 and have no cravings. How about that.

What causes Cravings

What causes cravings for foods? N=1 test to find what cause my food cravings.

The dieting theory
This theory says we crave the foods we deny ourselves. No. When I am on low carb, eggs&potato & vitamins, fish and mayo, beef & greens, the cravings are gone.

The blood sugar theory
our blood glucose levels are likely to be low, triggering a high-calorie craving. 

No relationship to BG as measured

The memory theory
Our food cravings are often associated with pleasant memories and occasions. My childhood was rough. Not much pleasure.

The wisdom of the body theory
This theory suggests that our body craves what it needs. This may be true for some cravings, but it's difficult to lay too much credibility on this theory if you think your body needs a litre of ice cream. No chancie

The stress/anger/boredom theory
semi-retired, happy, not bored, craving. No.

The chronic stress theory
semi-retired.

Crap. It physical. Seems to relate to fats. If I add fats, burgers instead of beef, bacon, pork instead of beef, the cravings come back. This diet is low reward after a few days, but oh well.

Mineral or vitamin deficiency. Well I take a wide range, and this narrow diet removes the cravings. Not likely.   

Throughout my weight loss, my diet was mainly as above with variations.

Two insulin theory is as good as any explanation.    

Insulins

From my reading, it appears that we humans make two different insulins, one based on Omega 3 and one based on omega 6. The omega 3 based insulin is more efficient at clearing glucose from the blood than omega 6, so if we have mainly omega 6 in out diet, we need more insulin to get the glucose out of the blood. That may explain the general rise in insulin levels. But the other functions of insulin, getting fat into fat cells and keeping it there are not as effected by omega 6 base insulin. So when we get insulin resistant, fat can not get out of the fat cells until insulin gets lower, and our poor mitochondria get hungry, and send out the craving signal.

Another one suggests it is mono 18 and or total amount of fat. The first step in weight loss is to get Omega 6 and all manufactured food products our of our diet. That includes transfats, oxidized fats, glyconated fats, and hydrogenated fats. 

This implies that not only do we need to keep carbohydrate down, we need to keep omega 3 up to produce strong insulin, so that the insulin level can be low enough to release fat. Or perhaps it should be total fat that we need to keep down. What we need is insulin meters like glucose meter.

Something is not right in the literature. There is a relationship between cravings and fats, but what that relationship is is not clear. We have a three component equation, fat, carbohydrate and protein. This is a surface, not a line. In addition, the surface changes over time and exercise. It also depends it we are weight stable, losing, or gaining. It appears to me that weight stable is a knife edge we just need to keep crossing.

But what do I know? Reverse Engineering a diet is no easy task.

Insulin

Julianne at http://paleozonenutrition.wordpress.com/2011/10/30/nz-scientists-call-doctors-to-do-routine-omega-3-tests/  on a study calling for omega 3 testing. One quote is:

Their studies had shown omega-3 made insulin more effective and therefore improved carbohydrate and fat metabolism. That means people taking the right amount of omega-3 for their body could be less prone to developing type 2 diabetes, heart disease, or both. 

Does this imply that insulin does not have a uniform structure and is made from omega 3 or omega 6, but the stuff from omega 3 works better. Is this the "cause of obesity", more omega 6 based insulin required, aka, insulin resistance, and you know the rest of the story?

Just one more piece likely. The difficulty in maintaining a weight loss is more social- ever present food, and ever present hunger/cravings. The cravings are the worst, and nobody has a solution. Many will not even acknowledge there existence. Tobacco and alcohol cravings leave, but not food cravings. They may go for a day or two, but then these return, with a vengeance. It is the cravings that create the problem. Perhaps I must go live as a hermit, without eatable food present. Then I would be only me to drag any food home. No temptation, no cravings, no weight issue. Well maybe. 

In the weight loss cycle (lose, gain, repeat), the meals are small, far apart,and hunger is a constant companion. It is easier to deal with then the cravings. The meals are low reward, consistent, boring. That is how it must be for me to lose weight. Short cycles may be the answer to weight stability.  

Waste to Hip ratio

The waste to hip ration provides a good fat/ok evaluation. For men waste/hip should be < 0.95, and for the ladies <0.8 or perhaps <0.75 for the shapely, or <0.9 for the straights. At those levels, the size of the love handles will be apparent.

Dopamine

Dopamine is the feel good chemical that we crave. If we have available receptors, and the receptors are not blocked, any stimulus will do. We are simple addicted to stimulus. It does not matter what that stimulus is. Sound, TV, work, people, music, food, drugs; the effect is the same; stimulation. Some of the stimulus, also have unwanted effects... food, drugs, alcohol, in addition to stimulus. We just want the stimulus.

So why are we addicted to the stimulus? Well it produces dopamine. That is just the nature of the human, we want more dopamine. Perhaps that is the problem, we need other method of stimulation, perhaps work, or thinking, writing, to provide ourselves non-caloric stimulation.

Or perhaps, we should just let go of the need for stimulation. Meditation. The ultimate in letting go of stimulation.   What ever the solution is, I do not think using chemicals to increase the dopamine is a solution, long term. We become resistant to the stimulus, and is that not the definition of addiction; chasing a declining effect of a substance. We can move on to a new chemical with greater effect. Cleaner effect. But that is just changing our addiction to a different drug. We need to get back to getting high on just life.

For weight control, we could fast for stimulus.

Perhaps we should just look at all this as addicted to stimulation.

The percription

http://thatpaleoguy.com/2011/10/25/saturated-fat-carbohydrates-and-cardiovascular-disease-clever-dutchies

concludes


Dietary [saturated fats] belong to the many false triggers of inflammation that result from the conflict between our slowly adapting genome and our rapidly changing lifestyle, but among these many factors they are not the most important. A reduction in the consumption of [carbohydrate] with a high glycaemic index, trans-fatty acids and linoleic acid, and an increased consumption of fish, vegetables and fruit, and a reduction of inactivity, sleep deprivation and chronic stress seem more realistic approaches to fight the current pandemic of cardiovascular disease resulting from chronic systemic low-grade inflammation.


ELCMM once again

Insulin resistance

Dr, Su at http://www.carbohydratescankill.com/2863/carbohydrate-addiction describes it like this:


I think of it as carbohydrates produce insulin resistance, (high insulin) which also blocks leptin signalling, locks fat into the fat cells, sweeps the blood of energy, and leaves me craving. Keep insulin down is the solution. to do that, I cannot eat carbohydrates.