Insulin and Glucagon
David Ludwig is a physician/researcher at Harvard University who recently published a new study that shows that all carbohydrates are not created equal and therefore the calorie theory (calories in = calories out) is not the key to weight loss and weight control. Dr. Benjamin Bikman is a professor at BYU who studies the effects of insulin. The following are some of my notes from their 2018 and 2019 talks to the Low Carb Down Under conference.
Insulin is the dominant anabolic hormone. Anabolism = feeding and storing energy.
Glucagon does the opposite of insulin and is the dominant catabolic hormone. Catabolism = fasting and burning energy.
Insulin stimulates fat synthesis and storage.
Insulin also inhibits fat release and oxidation.
Increase in insulin leads to weight gain. Decrease in insulin leads to weight loss.
Dietary carbohydrate leads to increased insulin based on the Glycemic Load of foods.
High glycemic meals lead to increased insulin and decreased glucagon
Glycemic index is the key to controlling hunger. High glycemic index meals lead to increased hunger when compared to low glycemic index meals even when they have the same number of calories because it causes a drop in blood glucose below baseline after a few hours. This causes the brain to go into crisis mode and release epinephrine, causing patients in the study to consume hundreds of extra calories to try and correct the perceived metabolic problem.
High glycemic meals cause the nucleus accumbens in the brain to light up, similar to what happens after other high addiction activities such as cocaine, heroin, alcoholism, and gambling.
Study published in November 2018 that compared 3 groups that were assigned to different fat:carb ratios in their diet.
The type of calories you consume has a significant effect on the amount of calories you burn.
High fat diets resulted in more weight loss.
High glycemic load foods such as sugar, refined grains, and potatoes were associated with higher rates of weight gain.
They had to feed the low carb diet group 350 more calories every day to keep them at the same weight as the high carb diet group.
In muscle cells, Insulin drives glycogenesis and protein synthesis. Glucagon has no effect.
In fat cells, Insulin drives lipogenesis. Glucagon drives lipolysis.
In liver cells, Insulin drives lipogenesis and glycogenesis. Glucagon drives lipolysis, glycogenolysis, and ketogenesis.
When it comes to macronutrients in our diets
Fat increases glucagon and has no effect on insulin
Carbs increase insulin and decrease glucagon
Protein increases glucagon and increases insulin if we have high blood glucose levels
In a low carb diet, protein does not significantly change insulin
The Insulin:Glucagon ratio
High I:G = anabolic, leading to fat production and fat storage
Low I:G = catabolic, leading to insulin sensitivity, autophagy, lipolysis, and activation of Brown Adipose Fat
The Standard American Diet I:G ratio is 4.0 (anabolic) and increases to 70.0 when eating protein
In a Low Carb diet, the I:G ratio is 1.3 (catabolic) and does not significantly change when eating protein
In a fasting state, the I:G ratio is 0.8 (catabolic) and decreases to 0.5 when eating protein
How to maintain a low I:G ratio?
Control carb intake, and make sure the carbs you consume do not cause a significant spike in insulin.
Prioritize protein.
Eat healthy fats.
Metabolism is the sum of all anabolic and catabolic reactions in your body.
Mitochondria take fuel (carbs and fat) and oxygen to make energy. They produce ATP and heat (waste).
The cells use ATP to get work done.
Other notes about insulin:
The “apostat” is the body weight set point.
It takes a long time and a lot of effort to change an individuals apostat.
The root cause of obesity in many cases is hyperinsulinemia. Too much insulin in the blood is caused by eating high sugar and high carb meals and snacks - leading to chronically high glucose in the blood - leading to the release of high amounts of insulin to deal with all that glucose.
The insulin causes fats to be stored in fat, blocks the release of fat from fat cells, stimulates the generation of new fat cells, and causes the expansion of existing fat cells.
Hyperinsulinemia leads to insulin resistance. The cells stop responding to insulin causing more glucose to remain in the blood, causing the release of more insulin, etc. This is a perpetual cycle, leading to obesity.
Hyperinsulinemia also leads to leptin resistance. Leptin is the hormone that tells your brain you are full and to stop eating. When leptin resistance occurs, the body just thinks it should keep eating. This is also a perpetual cycle that leads to obesity.
These processes cause the body weight set point, the apostat, to continue to raise.
If you try to lose weight by the calorie in:calorie out theory, your body will naturally fight your efforts by trying to remain at the apostat, which is why it is so hard to maintain weight loss. The elevated apostat, insulin resistance, and leptin resistance all contribute to this problem.
The advice of eat less and move more, therefore, will not work in the long run. The odds are stacked against you.
An effective technique for long term weight loss is to lower insulin.
3 things to avoid in a healthy diet. No flour, no sugar, and no seed oils.
Food addiction, especially sugar addiction, is a real thing. It is a very hard addiction to break because of all the social and emotional components that accompany eating sugar.
People associate eating with fun and happiness and we often use food as a celebration, but it is important to understand the consequences of that.
Our palate changes as we change what we eat.
Keto and low carb is a front loaded lifestyle. It you suck it up at the beginning and eat as clean as possible, you can slowly introduce some things back into your diet and not be addicted to them.
It is important to allow insulin levels to come down in between meals and overnight. This can’t happen if you are constantly snacking. Foods consisting of refined carbs and seed oils cause high spikes of blood sugar and therefore insulin and take longer than low carb foods to return to normal basal levels.
When you are in a high insulin state chronically, your fat cells will maximally expand and no longer respond to insulin. This leads to fats leaking out of fat cells, causing high blood triglyceride levels.
When fat stores under your skin reach maximum capacity, the fat also spills over into the tissue between your organs, known as visceral fat. This is the most dangerous type of fat we can have in our body.
Metabolic Syndrome is the term used to described the increased risk of hyperinsulinemia-associated diseases.
Carb quality, Carb quantity, when and how often you eat all matter.
Eat food that is nutrient dense and low on the insulin index scale.
Large meals elicit a proportionally lower insulin response than small meals.
Try to eat carbs after lean meat and vegetables. Start your meal with a salad.
Exercise increases insulin sensitivity, but you cannot out-exercise a poor diet.