Good posts in attempting to answer the OPs questions. The observation that it would take as much time to reverse insulin resistance as it did to develop it is the one area where I disagree. I'm living proof. Just chant Thud's mantra and stay consistent with your LC eating, maybe avoid the feasts, as you have ultimate control over this and most at weddings and birthdays don't care what you eat. Yes, insulin control is the ultimate objective in all cases where one is trying to achieve health, and note that achieving health goes far beyond BG measurements and weight loss. I've had to slap myself upside the head at times when I've gotten too technical for my own good when attempting further protocols, analyses, and measurements. Can't measure insulin or insulin response easily? Fine, carry on with what you know is keeping you healthy, catcha wave, and enjoy the ride! All the best.
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It took me 30 years to go from ~170 to ~300. I'm hoping it won't take as long to get back :) |
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It most assuredly will not! You need to stay consistent and on plan, however, if you want anything good to happen. For those doing this and thinking it's a temporary period and all will go back to normal once a goal is achieved, surprise!!! It doesn't work that way and any achievement is sure to be temporary. All will go back to normal, the new normal that you're currently trying to change. |
I just finished "The Salt Fix" which mentioned that following the government-recommended reduced sodium levels can cause or exacerbate insulin resistance (and increased heart rate & increased sugar cravings, among other things, while having negligible effects on blood pressure). So get your salt! Those on very low carb & ketogenic diets need 1.3-2.67 teaspoons a of salt y.
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Even after all that I have learned about subject the past few years I'm still not sure that know exactly what insulin resistance is. I don't know if it is one thing or a combination of things. However, I do believe that it exists and that I suffered from its effects for years. I also believe that I have made significant headway in resolving - even reversing - my insulin resistance. It didn't happen overnight, though. When I first started testing my BG levels after 9 months of consistent low carb eating I was surprised to see how sensitive I still was to carbs - even just a few carbs. I went a little nuts with the BG tracking for a while - testing 5 to 10 time each day. I wanted to see how different foods affected me. While I was at it, I may have even captured the period where significant progress was made towards regaining my insulin sensitivity.
On the left side of the chart (January 2015) you see my average BG plummeting by about 20 to 25 points over a very short period of time. Coincidentally (or not) I had just started introducing IFs into my regular LC routine. I also eliminated snacking and that was giving me a 12 hour fast period on a daily basis. Anyway - after that BG lowering event I seemed to tolerate carbs much better. When I first started testing my BG in the fall of 2014 I would still get BG rising above 150 following a good, low carb dinner (10 to 15 net carbs). After this event, a 10 or 15 carb dinner often had little effect on my BG (rarely rising over 100 from a low carb meal). In fact, the higher readings seen in later periods on that chart include me testing out higher carb foods and higher carb (but still low carb) meals. I could have a 25 to 30 net carb dinner without having my BG spike much above 100. So what does this prove? I'm not sure. I do know that I am more insulin sensitive now and I was still quite obese when my insulin sensitivity returned. Staying consistent with low carb is what did that. Is my insulin resistance fully reversed? Am I as insulin sensitive as I was in my youth? If I returned to eating crap-for-food, would my insulin resistance return with a vengeance? I don't know the answer to these questions. I don't want to find out. I like staying on the insulin sensitive side of the fence. To do that I need to stay low carb. |
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Actually, my thinking is that I won't need to stick to only 20 carbs a day for the rest of my life. At 20 carbs per day I am losing over 3 pounds a week or a little over 1% of my total weight per week, (I'm hoping that continues, we'll see...), I expect at some point to be able to eat more carbs and maintain a stable weight. I don't plan on ever going back to the "normal" that made me obese to begin with. |
Yes, I also have a problem with the waist measurement method of checking for insulin resistance.
I have lost 28Kg (about 62 lbs) to date. My insulin resistance is no better now than it was when I started to lose the weight. My waist to height ratio was 0.62. Now it's 0.52. I keep coming back to the glucose tolerance test. I might experiment with the toast glucose tolerance test. Unfortunately, I don't think that insulin acts very linearly. Therefore, because the toast test uses 25g of carbohydrate, being 1/3 of the 75g for the full test, it is incorrect to say that glucose should only rise 1/3. The toast glucose tolerance test can only be used for a comparative test (ie. monitor progress maybe). Maybe do a toast glucose tolerance test every 2 or 3 months, have a blood test for fasting insulin level once a year and calculate for HOMA-IR. When HOMA-IR reaches normal, then maybe do a full glucose tolerance test a final proof of reversal. |
To some degree I agree with GRB5111. If keeping away from carbs at weddings and birthdays was possible, then maybe reversal of insulin resistance with just diet, in the shorter term (maybe a year) would be possible.
Unfortunately, I think that there are a lot of people like me and are not able to resist the carbs when they are so plentiful at weddings and birthdays. I know, I've tried for about 25 to 30 years without success. It is NOT realistic to believe that I will decide today to resist and be successful. I think that a better solution is to follow Dr Fung, who says that humans have always had feasts and always had fasts. Therefore, follow feasts with fasts and do intermittent fasts to bring down insulin levels to get the body used to low insulin levels. In this way, insulin sensitivity increases and resistance subsides. To reverse the traditional definition of diabetes II, ie. prevent glucose rising to high levels is simple. Just go on the LCHF diet. I've done it and fooled the doctor that I am ok. Yes, my glucose is ok as long as I stay on the diet. But the insulin resistance persists until I give the fasting more time (I think). |
The question of How to Measure Insulin Resistance comes up now and again, this seems a good thread to put Dr Naiman's new suggestion. (At least new to me ;) ) The studies related to accuracy of a TyG Index have taken place over the past ten years, but first time seen Ted Naiman suggest using it.
"TyG Index: easiest lab test for insulin resistance! IR == running out of energy storage space and then having too much in circulation. But you have measures of the energy in your bloodstream: glucose, and triglycerides!" It is a super simple Index from standard blood work, trigs and glucose. The confidence in its sensitivity compares well with the other methods like Trig/ HDL, HOMA-IR. With super low trigs, my Index result isn’t very sensitive, but adding this newer way to measure IR here....Maybe others can see a difference. The Index can also be used to identify people at Risk of NAFLD or Metabolic Syndrome. Dr Naiman has added a tab for it to this website, on Twitter, etc. http://www.burnfatnotsugar.com/TyGIndexCalculator.html The calculator itself was not loading onto my tablet, so I used this one: https://www.mdapp.co/tyg-index-calculator-359/ The Salazar study from 2014 that some refer to is: https://www.sciencedirect.com/scien...173509314001846 Though Salazar has others on same topic. |
Interesting new post by Amy Berger on the Personal Fat Threshold.
Answer for Ken on why insulin resistance does not make sense. http://www.tuitnutrition.com/2019/0...shold.html#more Quote:
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Thanks for the link Janet. Looks like good reading material for the coming weekend. BTW: I missed the previous post that you did in July about the simple IR calculator. Using the second link you provided I plugged in my numbers from the first year of this WOE (as shown in my Year two is in the books - Life is good milestone post). My March 2014 labs taken a few weeks into the diet gave positive results for IR and fatty liver -- agreeing with my T2 diabetes diagnosis and high ALT/AST results. My June numbers 3 months later indicated that I was still IR but had resolved the fatty liver issue - again agreeing with my pre-diabetes A1C and normal ALT/AST. This WOE can resolve fatty liver rather quickly. My results from March 2015 -- a year and 5 weeks into the diet and 150 pounds lost -- the calculator showed negative for IR and fatty liver. So for me that simple calculator appears to be a good indicator of where you are at in terms of health and healing.
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Insulin resistance is sort of problematic. Fung has used the idea that exposure to excess insulin causes insulin resistance. It's certainly a stimulus that we had better adapt to. If our fasting insulin doubles, and has the same effect that it would have had before it doubled, we'd be hypoglycemic.
I think insulin resistance is fine, but to be technically correct we have to be more specific. If you get fat, are you insulin sensitive? Certainly you were sensitive to the fattening effects of insulin. But at that point, a given unit of insulin will not be as fattening as it would have been before you became fat. At that point, you'll get less of a response to a unit of insulin, just about anywhere in the body. Go ahead and call it hyperinsulinemia if you will, but like it or not, it's still insulin resistance. And this insulin resistance can lead to accumulation of fat in and around the vital organs, due to compromised ability of the overloaded fat cells to regulate fatty acid levels in the blood. But you're not getting fatter, if you are, because you're insulin resistant in your fat cells. You might be getting fatter because you're insulin resistant centrally--or at least not responding to insulin appropriately, maybe due to dysfunction of the pattern of insulin secretion--in your pancreas and liver, which could lead to further fattening. There you're getting fatter to the extent that your fat tissue is sensitive to the levels of insulin, but the hyperinsulinemia is itself a consequence of the central insulin resistance. |
Ken,
That is all such good news! There is a new Podcast with Dr Robert Cywes where he claims to remove all the fat in the liver in something like 48 hours. Fasting plus some specific meals. http://lowcarbmd.com/episode-10-dr-cywes-lays-it-down I don’t know about that ;) but interesting. What Amy writes echos an old Woo post explaining how Jimmy M is wrong when he continues to claim he is oh so 'insulin resistant". Quote:
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Yeah, classic Woo.
I would say that fasting certainly did increase Jimmy's insulin sensitivity--at least in the readiness of his fat cells to take in nutrients and replete themselves. Jimmy's insulin levels--higher than what most doctors in our fold recommend as a target, but still not that high, I usually see him giving something in the mid-teens when he gets it measured. I think fasting does "work" for Jimmy in that it brings his insulin levels very low, bringing his insulin as low as he can while at or under maintenance, without discomfort, is what he needs to figure out how to do, if he can. |
I slipped up and increased my carbs with frozen meals during a long and exhausting bout of some virus infection. Thing is, I was still doing one meal a day. So I only gained a couple of pounds.
But this doesn’t mean I was getting away with anything. I wound up with the worst ever autoimmune flare with some serious signs of inflammation. This was still a “low carb diet” by most measures, but for my body it was disastrous. That is why we recommend “sticking with it” so much. These occasional cheats are not trivial, they keep cravings alive. |
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