Insulin

Well, I fucked up.

Last year when I was eating low carb, I was doing it all wrong.  I think I was scared of all macronutrients except protein, and instead of following a diet plan that was ketogenic – allowing for the production of ketones to provide fuel to the body – I was following some random Atkins-esque plan.  I was losing weight (at first) so it seemed like the right thing to do, but when my weight loss stopped and my labs looked terrible and I started feeling tired and bored with my meat-and-vegetable diet I gave up.  I now realize that my focus was misguided.  I was targeting carbohydrates (keeping them low) when I should have been targeting insulin.

Thanks to my brilliant commenters I now realize that diet was actually fairly insulinogenic, and with all that insulin it’s impossible to use body fat for fuel.  I lost 15-20 pounds eating that way, which probably represented a reduction in my previous Peat-inspired insulin level of 27.9 two years ago.  I wonder if this is why people stall on low-carb diets…they manage to reduce their insulin level enough with their meat-and-veggies-only diet, but because the meat is actually insulinogenic the weight stops at the point that the insulin stops dropping.  So Atkins had it right up to a point…and for some people that’s enough.  Their insulin isn’t so chronically high, or their body isn’t so quick to toss insulin all over the place, and just cutting the carbs is enough to drop insulin low enough that their body can release stored fat for fuel.  I’m not one of those people.

For years I’ve had to be very careful of what I eat because everything seems to make me desperately hungry.  Coffee, rice, gigantic salads containing many ounces of skinless chicken – always with the ravenous hunger 1-2 hours later. 10 years ago I could eat a “low carb diet” of meat, eggs, and veggies and never feel hungry.  Now my blood sugar is much less stable than that, probably because insulin resistance has advanced and therefore insulin output has increased. When I was eating meat/eggs/veggies for 6-8 months last year I would have what seemed like a giant breakfast of steak and eggs – seriously, like 800-1000 calories, and I would be hungry 2 hours later.  I figured I was just broken and kept eating more and more to make the hunger go away.

When I originally started with Nourish Balance Thrive I met with their diet specialist, Julie, and she recommended a paleo diet that was 60-65% fat.  I think for most people that would probably work well.  I eliminated all starch and sugar from my diet and figured I was probably in the ballpark as long as I was eating fatty meats.  I really should have Cronometered it, because looking back I was probably getting only about 50% of my calories from fat…and that was not enough.  So I was putting myself in a state where I had no carbohydrates for quick energy and no ketones due to high insulin.  It’s really no wonder I stayed hungry, weight loss stopped, and I got tired. It seems the goal shouldn’t be low blood sugar – it should be low insulin, as discussed by Dr. Fung in Christopher Kelly’s podcast and Woo all over her blog (though, ironically the latter considers the former to be a menace who must be stopped).

So I’ve been learning over the last couple of days about insulin – how to lower it, how to keep it low, and how to fuel the body while doing that.  My goals, of course, are to lose body fat and improve metabolic markers (reduce blood sugar, cholesterol, triglycerides, blood pressure) while not starving and being irritable all the time.  I came across the Optimising Nutrition blog discussing an “insulin index” – much more useful to me than a “glycemic index” since my goal is shifting from low blood sugar to low insulin.  Contrary to my previous belief, carbohydrate density and insulin demand are not perfectly correlated.

The author states:

“The chart below [see it here] shows the relationship between the glycemic load and insulin index from the testing undertaken in healthy people.  Reducing the glycemic load does not guarantee a low insulin response, particularly when it comes to high protein foods.”

This graph, which is based on the data in this thesis: Clinical Application of the Food Insulin Index to Diabetes Mellitus (Kirstine Bell, September 2014 indicates that raisins create about as much insulin as cheddar cheese.

I know, right?

Click here and scroll down for a chart of Least Insulinogenic Foods along with their Food Insulin Index.  Suddenly my seemingly-random and incredibly-annoying hunger makes so much sense.   I was eating too much meat, and my insulin was too high.

So for the last 3-4 days I’ve been following these charts and eating things that are much less insulinogenic.  The steps I’ve taken:

  • Eliminated all dense forms of carbohydrate again (rice, sugar in all forms, etc) limiting carbohydrate intake to just vegetables
  • Drastically reduced meat intake to probably 4 ounces per day
  • Eliminated egg whites
  • Added high fat dairy including cream cheese, sour cream and mozzarella cheese (no milk), as well as olives, homemade low-PUFA mayonnaise, and raw macadamia nuts

The results so far: hunger has dropped about 80% and when it’s there it’s not the gnawing painful type. Irritability and fatigue are gone, unless I accidentally eat too much protein.  I learned today that egg yolks (not just the whites) contain a certain amount of protein and 3 of them – even without the whites – is really too much.  I’m still working out the details, but Cronometer tells me that even a seemingly high ratio of fat to protein+carb is not high enough to avoid the irritability and hunger that suggest too much insulin was generated.  For example, this morning breakfast was 3 egg yolks cooked in coconut oil with half of an avocado.  Here’s the macronutrient breakdown of this meal:

fat

So this meal had a ratio of about 2.6/1 fat to carb+protein.  About 90 minutes later I had that familiar hunger/irritability.  So I’ll be looking for more of a 3/1 or 4/1 ratio which translates to about 75-80% of calories from fat.  I ate a couple ounces of macadamia nuts and felt much better.

Further experiments to follow.

I feel really happy.  My mood has improved 100% since giving up the carbs again, and it happened on day 1.  This is probably related to discontinuing the eating of foods that cause endotoxin.  I hope I’m on the right track now.

A side note – taking the Metformin is going well.  My hot flashes went away a few days after I started taking it.  Things are looking up.

41 thoughts on “Insulin

  1. “wonder if this is why people stall on low-carb diets…they manage to reduce their insulin level enough with their meat-and-veggies-only diet, but because the meat is actually insulinogenic the weight stops at the point that the insulin stops dropping. So Atkins had it right up to a point…and for some people that’s enough. Their insulin isn’t so chronically high, or their body isn’t so quick to toss insulin all over the place, and just cutting the carbs is enough to drop insulin low enough that their body can release stored fat for fuel. I’m not one of those people.”

    ^^^THIS^^^

    some people just need to cut out sugar, or wheat, or HI GL carbs, and their insulin drops and they get their LS back. Others need to get rid of all carbs but can get by with some protein. Others need to get rid of carbs and protein. Everyone has different IS and insulin levels.

  2. Hi Lanie

    I just came across your blog the other day. Thanks for the link to the insulin index stuff.

    So glad the insulin index and insulin load concepts are working for you.

    Protein is great, but some people can overdo it, so it’s useful to find that sweet spot between maximising nutrition with nutrient dense protein and overloading your body with more than it can handle.

    Interestingly, I recently came to understand that the low insulin raisins is due to the fact that their sugar comes from fructose which has a low insulin response. There’s a new post coming out on that on that tomorrow.

    Along with the blog there’s also a Facebook group with some really smart people (including Chris Kelly from NBT) who might be able to help you troubleshoot any issues on your journey. It would be great to have you on board to share your interesting journey. It sounds like you’ve tried everything! https://www.facebook.com/groups/optimisingnutrition/

    Cheers

    Marty Kendall
    http://optimisingnutrition.com/

  3. Yeah well there is no way to do low carb “right”. Its just a abyss from which the climb takes years and progress is slow. No idea if the side effects are completely reversible. At this point I would say its not.
    Nuts have too much PUFA to be used regularly. And what was your hunger and blood sugar levels on rice and broth? 19gm is too low for a daily intake.
    Finally you are getting somewhere. Its not just about the insulin but insulin resistance. And that is directly related to endotoxin.
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4484635/pdf/12933_2015_Article_223.pdf

    And always with the Peat bashing eh 🙂 You dont want to give him credit when your TSH falls and LDL falls and CO2 climbs?

  4. BTW, did you see woo’s menu sample:

    “Here is what I ate today:
    Mamcadmia nuts and chocolate for breakfast.
    A pumpkin pie with heavy cream, s/f maple syrup, walnuts for another meal.
    I ate a lot of whipped cream.
    I just ate an extreeeemely delicious ketogenic deep dish pizza (the crust is a base of heavy cream, eggs, mozarella, some carbquick).
    I will eat more. I will eat probably >2000 calories. I have laid around ALL DAMN DAY.
    I’m staying slim.”

  5. Yeah. That one is not bad. Still more mono unsaturated than saturated. How is its insulin response?

  6. Forgot to mention, high protein can work for feasters (those that aren’t really hungry all the time, but find it difficult to stop eating after starting) since protein produces more satiety hormones like GLP-1 and PYY than fat/carbs do. If your only problem is satiety hormones, you’ll do better on higher protein. Won’t work for high insulin though.

  7. You should have seen me taking that quiz…I was all like, “Oh great…an internet quiz. Like this is really going to tell me something I don’t know.” I guess it did.

  8. Thank you Marty! Great work on the blog – you’re putting out some valuable information. I joined the FB group a month or two ago after seeing that Chris Kelly was a member – I guess I like following him around. Now that some of the pieces are starting to come together I’ll be spending more time there. 🙂

  9. I don’t know whether or not a ketogenic diet will be damaging the way generic low-carb was…but it makes sense to me that if the body is actually producing ketones there is fuel available. Low carb might be giving keto a bad rap because people like me are eating too much protein and keeping insulin too high to produce ketones, resulting in craptastic labs/thyroid.

    I agree my thyroid markers improved eating carbs per Peat’s recommendation, but my mood has been consistently below par (endotoxin due to starch) and my triglycerides were practically pancreatitis-inducing. I’m metabolically too far gone to use Peat principles. I do feed my child largely according to Peat’s wisdom though, and she’s thriving. Peat taught me about PUFA, endotoxin and red light, all of which have been huge for me. I just don’t think he’s right about everything.

    I wasn’t Peat bashing – that was my insulin level after 2 months of eating sugar. I don’t know what causes insulin resistance. When I was following a Peat diet and eating an easily digestible diet I felt great but my blood sugars were soaring high. Nothing was getting better. If it’s true that insulin resistance is caused by endotoxin, I would have been seeing improvement in blood sugars when endotoxin was low.

  10. Interesting…some of it is over my head, but it sounds like she’s saying that low thyroid function in response to a low carb diet is a normal adaptation of the thyroid to having less body fat and less insulin floating around, and that it doesn’t indicate thyroid disease. Is that how you read it?

  11. Not professional, but I’ve been following this stuff since the misc.fitness.weights and alt.diet usenet forums in the mid to late 90s. I remember when Will Brink and Lyle McDonald use to post there and Lyle and I would dig up papers and brainstorm a lot. To me its a big puzzle.

    Ironically, i recently found woo and she is one of the few to me who “gets it”, although I don’t necessarily like the way she presents it so much.

  12. Hi…brand new here (saw a link from the Optimising Nutrition FB group). Please excuse this question if you’ve written about it a ton somewhere else…like I said, I’ve only just “found you.” 😉 It looks like you had tried the AltShift Diet and were doing fairly well on it, at least, at first. Did it not work out for you in the long term? I’m curious, because so many people seem to be having success with it — in particular, the kinds of clients I’ve not had success with — women 30s-50s with very stubborn fat loss. Seems like many of these people have tried LCHF, keto, regular ol’ Paleo, etc., and AltShift is really the first (and only) thing that has gotten them results. Just curious about your experience. Thanks!

  13. Here’s a more detailed video of Lustig describing how insulin blocks leptin. While I don’t totally agree with him in that he focuses on fructose too much towards the end as the main cause of hyperinsulinemia,; I do agree that it is significant especially in people drinking sodas all day.

  14. Hi Amy – At the point I tried the AltShift diet I was really burned out from a too-high-protein low carb diet. I was feeling fatigued and my hair was coming out at a high rate. I think I might try it again at some point and I certainly wouldn’t discourage anyone from trying it, but I couldn’t face more low-carb at the time. Of course now I realize I was eating too much protein, preventing ketosis. If I was eating more of a LCHF diet I might have continued on with it.

  15. This one works…will watch when time permits. I always find it interesting when people blame sugar and fructose for diabetes and obesity. I was never into sugar that much, never drank sugary beverages. I was much more of a pasta freak – ate it for literally years every day. I think insulin resistance might just be hyperinsulinimia…I’m just not sure what causes it.

  16. IR -> HI –> more IR –> more HI

    Genetics, too many High GI carbs, too much fructose (especially when glycogen repleted–your typical kid), not enough fiber, lack of exercise, stress (cortisol), lack of sleep, etc. the usual suspects

    I think Lustig said average post-prandial insulin level is 125. 50 years ago or so it was 50.

  17. I can even think of more things like lack of Mg, snacking (constant insulin spikes—fewer meals = fewer spikes), btw, that’s how kruse’s leptin “reset” really works..

    50g of protein at breakfast produces lots of satiety from PYY/GLP-1. No snacking = fewer spikes. (if you can skip lunch, another spike) Don’t eat past 7pm no spikes until breakfast. 25g of carbs = keto = low insulin. As if it’s something magical–pfft

  18. My own personal experience is that diabetes is caused by:
    1) PUFA (all forms) will DESTROY your pancreas, both the beta cells and the hugely important pancreatic digestive enzymes.
    2) Starch especially from refined wheat.
    3) Chronically elevated cortisol from job/marital stress AND chronic gut infections/dysbiosis/parasites.
    4) Nutritional deficits from either a lack in the diet or poor intestinal absorption as a result of number three above: especially a lack of magnesium, potassium, vits. A, E, K and the B’s. Most likely you need far more than the recommended daily intake of some of these.

    Diabetes, morbid obesity, hypertension and hyperlipidemia AND mental illness are completely reversible, I’m proof. It takes several years to get rid of the stored toxic PUFA from your cells, this isn’t a quick fix…but it is a permanent cure.

    Some people’s brains (mine) need more ketones. You could try a diet of 100 grams of protein (your liver needs this to detox the excess estrogen), 100 grams of carb (mostly from green veg and small amount of whole fruit) and 100 grams of fat mostly from MCT and coconut oil, butter/ghee on veg, ruminant animal fats along with eggs….that’s like 1700 calories and if you eat fairly equal amounts of each macro split into three meals (no snacking) then your blood sugar will be quite stable and you will slowly and safely lose weight.

    Obviously I’m completely biased in my experiment of One. And while I think woo is quite bright, she doesn’t have it figured out yet….hence her chronic gut and mood issues along with the total inability to switch back to a normal well-balanced diet without huge issues.

  19. Forgot to mention that I also take a small amount of T3, progest-e and sit in front of 1000 watts of infrared lights in a sauna (that I built) daily. The sauna has AMAZING health benefits, I built this one from Dr. Wilson’s website:
    http://drlwilson.com/articles/sauna_therapy.htm

    Scroll down the page there’s free plans….HAPPY SWEATING, no exercise necessary 😉

  20. Every see a bodybuilder try to maintain their weight after a contest at 5% bodyfat? They don’t. They stuff themselves or go neurotic. That’s woo. Dieting down from 280lbs to 107lbs (maintaining 125lbish) like she is like a bodybuilder maintaining 5% year around. When you go morbidly obese (especially at or before puberty) or do binge cycles, you have many more fat cells than a normal person. When you diet down like that, your fat cells are much smaller than a never-obese person who never got fat in the first place. 2 50% size fat cells produce less leptin than 1 normal size fat cells. If you’ve seen some of her other writings, her leptin is something like 1 ng/dL…that’s barely more than what those kids with hypothalmic obesity that Robert Lustig treats experience

    To constantly live at that bodyfat year while leptin deficient year around requires a neurotic, OCD, autistic personality disorder of some type using an extremely low insulin (read ketogenic diet) so that even the tiny amount of leptin isn’t blocked which would otherwise cause ravenous hunger and binging– that or leptin injections. Or she could just get fat again. I’d assure you, to eat like you suggest, I doubt she could weigh less than 170-180lbs regularly which at 5’5″ is for her is too fat.

  21. Hello SWOT,
    I was morbidly obese for two decades. I’m a 5’3″ female, was 205 pounds and currently weigh 130 lbs. I initially lost the weight doing EXACTLY what woo does for 3 years. I was diagnosed with OCD at age 20 and have struggled with severe depression since I was a teen. Always a loner and surely somewhere “on the spectrum”, I did the whole spate of SSRI’s and counseling for years. Trust me, I too believed that my ketogenic diet was a truly a lifesaver. It was fantastic until I found myself having to restrict more and more, either due to complete brain malfunction or total gut rebellion. I was completely metabolically inflexible and exquisitely oversensitive to EVERYTHING.This was not homeostasis….

    I discontinued the diet when my thyroid crashed, my sleep/libido both tanked and my mood/neurological/cognitive function went into a steep decline etc etc etc. I’ll be 50 years old in July and take nothing but vitamins, progesterone and a bit of T3. At the rate I was going I probably would have been a demented person in diapers by the age 60 or 65 if I had not found the work of Ray Peat.

    YES, I gained a shit ton of weight after adding carbs back in, I zoomed right back to 170 pounds practically overnight….talk about horrifying!!! It was only through an insane amount of study and determination that I was able to ACTUALLY FIX my broken metabolism and heal my f*cked up brain. Some things I worked on: balancing major estrogen dominance with progesterone, major cortisol reduction, fixing severe gut issues, extinguishing the fire of excitotoxicity in my brain, SERIOUS PUFA depletion along with proper nutrients (deep nutrition) to balance my brain chemistry. Untangling the web was not easy especially because my brain was on fire. A huge factor in my success was a willingness to assimilate new information and change plans accordingly….

    I have kept the weight off for a year and a half now. I can eat what ever I want without my brain getting hijacked, no more hellacious food cravings/binge eating, no more guts blowing up and no instant weight gain. That is homeostasis……the body and brain CAN HEAL. Ray Peat, he may be odd, but that dude knows a thing or two.

  22. I’m not disagreeing that people who go LCHF for long periods of time, especially with other issues like gut dysbiosis and too much PUFA ever go crazy. Some do, some don’t. Woo would say the crashing T3 is simply a function of the weightloss. She’s been doing this for 12 years now, so that shows it can work for some people.

    That said, going from a BMI of 36.3 to 23 post-puberty is not in the same league as going from 46.6 to 20.0 where weight was gained during puberty and childhood is not in the same league. The adipocyte hyperplasia would be much worse and I’m willing to bet if you go tested, you’d find your leptin is much higher than hers.

    Even she says LCHF isn’t ideal in the sense of living–it’s nothing more than a medical “hack” to lower insulin.

  23. Hey Meme – I’m no where near being able to live on 1700 calories without feeling hungry all day long. I will follow any protocol to the letter – commitment is not a problem. But I refuse to be hungry. It’s physically painful. I can’t load up on low-glycemic high fiber filling foods because they make me depressed – either because of endotoxin or some serotonin problem. I admire what you’ve overcome and wish I could be just like you. However, each of us faces a unique set of problems and circumstances.

  24. Watched about 10 minutes…a little over my head. Ok, a lot over my head. Is he talking to a room of biochemists or something? I think I need the Leptin and Insulin 101 class first.

  25. I first learned about the insulin index from Dr. Eric Berg. He has a ton of videos on YouTube and wrote a book about eating for your body type and to ignite fat burning hormones. He says healthy people just don’t have excess fat. The various body types have to do with different hormonal or glandular issues and they do better with different ratios of nutrients. The thyroid and liver type do better with less protein, while the adrenal and ovary type do better with a little more, but certainly not as much as recommended on the Atkins diet. He’s super big on tons of green leafy vegetables and kale smoothies. I have found his book extremely informative and it makes so much sense. Just thought I’d mention it 🙂

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s