“It is of interest that diets high in fibre-rich cereals and tuberous vegetables tend to result in an improvement in basal blood glucoses.”
p. 281
Burkitt, Denis, Hugh Trowell, and Kenneth Heaton. Dietary Fibre, Fibre-Depleted Foods and Disease. Academic Press: London
It is a common belief that starch, or any type of carbohydrate - particularly high-glycemic starches like potatoes, raises insulin. In the low-carb circles you see the idea floating around that carbohydrate ingestion raises glucose, which in turn raises insulin. Insulin increases fat storage, therefore carbohydrates make you fat and are the cause of the obesity epidemic.
Gross oversimplifications that the human mind can easily grasp are always popular - regardless of the what the oversimplifications are intended to explain. In the health sphere, they are prevalent. The carbs = insulin = fat myth is one of the greatest and most easily refutable. It's up there with the great fat = cholesterol = clogged arteries = heart attack theory that is simple, easy to follow, makes sense to those who don't study it, and is completely silly and a total misrepresentation of the etiology of heart disease.
As always, it depends on context. In my program designed to, among other things, restore insulin sensitivity (which it has in every case I'm aware of - shown by increased glucose clearance out of the blood after eating), I do not say "eat starch and you will live happily ever after."
Instead, I say something like... "Eat plenty of food, don't overexert yourself physically or mentally, get plenty of sleep, eat only saturated fats and keep omega 6 polyunsaturated fat ingestion to a minimum, get sufficient but not excessive amounts of quality protein, and eat plenty of high-glycemic starch at every meal."
This generally lowers the activity of the sympathetic nervous system, increases thyroid activity, improves glycogen storage, and starts shuttling glucose from ingested food into muscle cells where it creates muscle growth and the generation of heat and energy. This reduces insulin resistance. If you are insulin resistant and have high fasting insulin levels as a result of this insulin resistance, then insulin levels will fall dramatically on this program. For example, below is an email sent to me someone who has followed 180DegreeHealth for over a year now.
A traumatic childhood stress caused this person to suddenly become insulin resistant (as chronic stress hormone secretion is the primary root cause of insulin resistance) and gain something like 60 pounds in a year if I recall correctly from our email exchanges. She has had blood sugar regulation and thyroid problems ever since, which she tried to medicate with a low-carbohydrate diet to varying degress of restriction.
She has spent the last 4 years on a low-carbohdyrate diet, and her fasting insulin levels have varied between a VERY high 14 and 33 IU/m. But after just four months of loosely following my program to increase metabolism with special attention to eating high-starch and low-PUFA, her insulin has fallen all the way down to a perfect 4.7 IU/m. Her fasting glucose has fallen nearly in half to a level that probably scared the doc into thinking (mistakenly) that she was about to fall into a hypoglycemic coma (yet she no longer experiences high-adrenaline states indicative of crashing glucose levels like she did on a carbohydrate-restricted diet).
If I am not mistaken she did not lose a single pound of body weight during this time, so any drop in insulin cannot be attributed to weight loss or calorie restriction. Her calorie intake has not dropped at all. Following the next two very important sentences is the email she sent me.
If you are still under the influence of low-carb dogma, and believe that eating carbohdyrates will raise your insulin levels, snap out of it. In the right context, carbs are your best metabolic friend, and what passes as science and physiology in the low-carb realm is a complete scientific fairy tale...
"Just got some labs back and thought I’d share them with you.
I am still low in iron, which is surprising to me considering I eat red meat, but I think the high RT3 and celiac disease all play a part in this.
On the other hand I am quite pleased with my blood sugars and insulin levels.
For reference here are my PRIOR glucose and insulin labs:
October 2009:
Glucose 90 (60-110)
Insulin 17.9 (3-22)
March 2010:
Glucose: 87 (60-110)
Insulin 14.6 (3-22)
May 2010:
Glucose random sampling: 97.2 (50-140)
August 2010:
Glucose 95 (60-110)
Insulin: 33 (3-22)
December 2010:
Glucose random sampling 94 (50-140)
May 2011 (Four months of eating a high starch low PUFA diet - about 250 carbs daily)
Glucose: 49 (65-100) *
Adiponectin: 2.3 (>2.7)
Insulin: 4.7 (functional range <5.4 IU/m; normal lab range 3-22)
Pro-insulin: <5 (<42)
HBA1C: 5.9 (4-6)**
HOMA-IR: 0.6 (<2.8) ***
C-Peptide: 1.9 (<2.2)
Leptin: 21(<20) ****
*I have no idea why my glucose is so low. I did not feel even slightly hypoglycaemic. I generally feel fantastic in terms of hunger and cravings so am slightly puzzled. Still, if the test was performed using a normal lab range of 50-110; I would only be slightly under it. Still, I think a FBG of 49 is a HECK of a lot better than a FBG of 97!
**Not quite sure why my HBA1C isn't in the optimal <5.4 range if glucose and insulin are so excellent. HBA1C is an average of blood sugars over a three month period though, so the HBA1C may be lagging behind in terms of including blood sugars from the first few months of RRARF when my blood sugars were a lot higher than they are now.
*** My previous HOMA-IR was 4.1. HOMA-IR is a marker of insulin resistance and diabetes risk, so I was clearly extremely insulin resistant and now appear to have an extremely LOW level of insulin resistance.
***** I am leptin resistant obviously. Any cure/ideas for that? I have read that it is related to reverse T3, as reverse T3 makes the brain think it is starving and thus leptin resistance. Yet another reason I need to get T3 only. I will also be taking a herb that I read has reversed leptin resistance in some studies. I do have a lot of inflammation in my body (high CRP always and elevated liver enzymes at times), which I will be treating under the tutelage of a functional doc. Does inflammation contribute to leptin resistance?"
My mom, who is severely afflicted with the overeager advice-giving we discussed in the last post, put some butter on her potato last night and made a speech about how it was good because it slowed down the high GI-ness of the starch. And I didn't know how to respond - because if I say anything, even some wishy-washy stuff like "Well, it might, but that might not be a completely good thing," then she'd just end up thinking that I hate butter and think everyone should eat potatoes plain. It's very hard to discuss nutrition with people, because the actual "answers" are rarely as clear as the misconceptions such as "carb => insulin => fat."
ReplyDeleteProps to her.
ReplyDeleteDid I read that right, a fasting blood sugar of 49?! If she says she feels fine then you can't really argue but that seems to be at coma levels!
"Still, I think a FBG of 49 is a HECK of a lot better than a FBG of 97!"
ReplyDeleteI think 97 is pretty much in the optimal range. I think anything less than 70 is not good. Officially, anthything below 65 is considered to be hypoglycemic.
I got a random low FBG level at the doc once. It was an anomaly and did not signify any kind of trend. I sometimes check my FBG every morning for days or weeks on end and it's always in the 90s.
ReplyDelete"Gross oversimplifications that the human mind can easily grasp are always popular - regardless of what the oversimplifications are intended to explain."
ReplyDeleteThis is so true and well said. Should be up on the wall in plain view for anyone who's studying nutrition, or anything else.
I haven't measured my blood sugar or anything like that, but the awful blood sugar problems I was having as a carbophobe have absolutely vanished eating high starch and now fruit--I seem to be executing my personal 180 back to high-fruit land!
I hadn't heard that T3 was implicated in leptin resistance, but I guess it makes sense...
there is some lipophobic activity going on at Primal Wisdom. Don is arguing that a high fat diet increases blood clotting and reduces the normal flow of blood through vessels etc. I wonder what your thoughts are on his ideas. This whole 'saturated fat is harmless' mantra, pushed by so many low-carb fanatics, is becoming a little dogmatic.
ReplyDeleteI don't follow the 180 degree eating plan, but I agree with your comments on low carb, I never tried low carb, 7 years ago I was diagnoses with type 2 diabetes and already had hypertension, I started using the dash diet, stopped eating anything made with white flour, stopped eating white rice and rarely used sugar, I was off all medications in 4 months. I lost 150 lbs in a year and half and maintained that weight loss for 6 years. When I was diagnosed my a1c was 10.5 after three months on the dash diet It dropped to 4.8 and has been a constant 4.2 for 6 years. My hdl was 40 when is was diagnosed, now 68, triglycerides was 387 now 61. Total cholesterol is 164 ldl is 84. I occasionally
ReplyDeleteuse a website to gauge my calorie intake, it is roughly 20 % protein 60 % carbs and 20 % fat, and usually eat 300 to 400 grams per day.and 60 to 70 grams of fiber per day. I never have spikes in my blood glucose levels. My carb intake is a mixture of fruits vegetables and whole grains, whole wheat bread, oatmeal, quinoa , brown rice, etc. I've visited couple diabetes forum and it seems a large majority of type 2 diabetics are following low carb
and I'm definitely a minority when it comes to a eating a large amount of complex carbs.
Hi Anonymous
ReplyDeleteYes, I think the much maligned macrobiotic diet (whole grains and vegetables), tricked up and supplemented with some lean chicken, fish, shellfish, beef, is a good option, especially for diabetes, weight loss/ normalisation and some binge eating situations triggered by highly 'pleasurable' foods (as far as neuro-chemical responses go anyway)
The above eating plan is scant on exceptionally sweet, salty or fatty tastes.
Hello all. It's me of the 49 FG fame. I still think that HAD to be a lab error as my home tests are 75-85 in the mornings and I did not feel hypoglycemic when my blood was taken. I used to experience hypos on low carb, so I know how lovely they feel and I didn't feel like that.
ReplyDeleteI have read Peat's writings and know his views on blood sugar. However, I have also read the literature on diabetes and pre diabetes and I do not think a fasting blood sugar of 97 is optimal. No way.
J.R.-
ReplyDeleteYeah, "tricking" out a diet built around starch and vegetables with a little fruit, meat, seafood, and dairy is pretty much exactly what you see in Joel Fuhrman's stuff, who is right in line with the diabetic who commented above on the "dash" diet (including the provision to eat 60-70 grams of fiber daily). I can't really disagree with any of that when it comes to solid general dietary recommendations. Of course, different situations and different lifestyles call for any number of tweaks and tailorings to that.
Anonymous (the first one),
ReplyDeleteAgree completely about the "Saturated fat is harmless" thing. Saturated fat MAY be harmless for all people at all times in all amounts, but we certainly don't KNOW that - if we believe that, it's because we WANT to believe it.
We don't like to talk about it much, but obviously most of us at least start out researching the diet we want to be the best. I'm sympathetic to animal welfare, so I want to eat as few animal products as possible, and for a long time I only read stuff that promoted this as the healthiest diet. On the other hand, if I thought broccoli was gross and girly and an agent of the nanny state, then I could find a guru who told me it was also unhealthy.
Hi, Anonymous again, I believe that each person has to find a eating plan that fits their lifestyle. I would never say that the dash diet is the only way to lose weight or control type 2 diabetes.
ReplyDeleteExcellent point Jim.
ReplyDeleteJim,
ReplyDeletesure, there is always some guru that supports your own bias.
some of these pro sat fat folks who claim that saturated fat doesn't 'cause' heart disease (or degenerative disease in general) are so insistent they'll never change their mind no matter what. they oftenly resort to flawed logic, like: saturated fat MUST be harmless, because masai warriors don't drop dead from their 30% sat fat diet,
or: cavemen must have loved to explore all the fat tissue and organs of landanimals,
or: at the beginning of 20th century americans were eating generous amounts of butter and myocardial infarction was rare. now, all the sudden, MI is rampant,
or: butter is a great source of vitamin A and selenium (yeah sure, so is grandma's tampon tunnel. sorry, not eating it)
And I'm sure butter is relatively benign compared to processed vegetable oils+trans fat and I highly appreciate that WAPF (for example) is making people aware of the dangers of these foods. but heck, WAPF is just as extreme in pushing their dogmas on saturated fat as vegans are in condemning animal food. And of course, you have ‘science’ journalist Gary Taubes and doctor Malcolm Kendrick. But really, they come across as badass rebellions who see an opportunity to make a little cash out of controversies.
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ReplyDeleteAnonymous,
ReplyDeletePeople are insistent on both sides. The point is to find out who's right [or what's right]--if anyone wants to blindly follow a guru, too bad. The bottom line is that, with all the current evidence, the pro sat fat people are right; pro-vegan "gurus" are wrong; it's not a matter of opinion.
john,
ReplyDeleteForget about which people are right - which specific claims are justifiable and to what degree? The idea that you should eat as little saturated fat as possible - and that you should replace it with PUFA oils - seems like a terrible idea at this point. But there are lots of other possibilities remaining besides "Saturated fat is never bad." Maybe there's a point at which it becomes unhelpful. Maybe it depends on what else you're eating. Maybe it's fine, but some other foods are even better.
Let me add:
ReplyDeleteI haven't even read the Primal Wisdom post yet, and I have no information at all that indicts saturated fat. It's not about that. It's about believing things for good reasons. And "The other guys believe the opposite, and they're wrong" ISN'T a good reason when there are more than two choices. When you say "on both sides" you are severely limiting yourself. There are more than two sides.
There are at least three:
1) Saturated fat is always harmful
2) Saturated fat is not always harmful
3) Saturated fat is never harmful
We would all agree that 1 is false, but 1's falseness doesn't mean that 3 is true. It means that 2 is true, and it leaves 3 up in the air.
This comment has been removed by a blog administrator.
ReplyDeleteHI Matt,
ReplyDeleteI've been trying to get a summation of your diet plan and I'm finding it hard. I downloaded and read your eBook, but blog posts since then indicate that you've changed your mind on some things. COuld you give a brief (but more involved than the "Eat plenty of food, don't overexert yourself physically or mentally, get plenty of sleep, eat only saturated fats and keep omega 6 polyunsaturated fat ingestion to a minimum, get sufficient but not excessive amounts of quality protein, and eat plenty of high-glycemic starch at every meal." I'm confused about white flour and sugar in particular.
I think I have a high enough metabolism already. I can literally melt frozen meat in my own hand :) No joke either.
ReplyDeleteI like your whole balanced approach to eating in this article, Matt. I hope you stay that way :)
john,
ReplyDeleteforget about vegan gurus, they're not the issue here. The question is: do we know the long-term effect of a high sat fat diet? for instance, there are studies poppin' up all over the place that nut consumption is associated with a decrease in mortality. Still, research consistently shows that large quantities of PUFAs in the human diet plays a huge role in almost every disease known to mankind. the fact that we can't establish an association between sat fat consumption and heart disease and cancer, does that automatically mean sat fat is harmless??
Very interesting. I'm type 2 or close to it. I mostly do low carb and then treat myself to something high carb occasionally. And it always results in awful BG levels both pp and fbg. I'm really too nervous to try upping carbs. Any time I eat them I get inflammation in my hands and arms.
ReplyDeleteThis comment has been removed by a blog administrator.
ReplyDeleteSaponaria-
ReplyDeleteYou get inflammation in your hands and arms and awful BG numbers just like all of us here did (have problems of various kinds) anytime we ate carbs after being on a low-carb diet for a while. Low-carb dieting makes your body's ability to use glucose properly even worse. It is not a solution, and makes the root problem worse. The sooner you phase out of your low-carb diet the better, if you indeed have insulin resistant diabetes and still make adequate amounts of insulin.
Jim-
You also have to remember that there are 34 kinds of saturated fat. Saturated fat is not just one thing, which complicates making general rules even further.
My first impression of Peat when I read him was that he really liked ice cream, and because he noticed that it could be used as medicine against his migraine headaches he did his nutrition research with a subconcious pro-saturated fat, pro-sugar bias. Look hard enough, and you will find benefits to any and every food you are looking to "prove" is healthy.
Every food can be harmful in some circumstances, and in some quantities, and "saturated fat" is no exception.
Anonymous summation-
If I was pressed to come up with a summary to date that applies to the RRARF program specifically, I would say:
1) Probably better to eat more frequently, or at least have snacks between meals during recovery
2) Probably no need to fear juice and even less reason to fear fruit. Experiment to see whether you find sugar or starch or a combination of the two to be superior. I still prefer, for eating beyond appetite specifically, to eat starch.
3) Overfeeding with refined carbohdyrates, particularly highly stimulating foods like cookies, cake, doughnuts, and ice cream if probably a horrendous idea unless you are underweight and have no addictive eating tendencies.
4) Need for meat, dairy, fish, eggs, and other animal-source protein is really small during overfeeding. Carbohydrates should be strongly emphasized, especially if you are coming from a low-carb background. For a recovering vegan, lots of animal protein would be better for a while.
The idea should be counterbalancing the imbalance your other diets created.
No major changes really. RRARF basically states all these things, just not quite as directly.
Actually, no. I was on a higher carb diet for years with a ton of pain in my hands and arms. I had no idea my BG was high until I got a random blood draw and my BG was 199. After a couple of months low carb all my pain went away for about 10 mo. It didn't return till I started regularly cheating and eating higher carbs periodically. It goes away the lower carb I eat.
ReplyDeleteI don't know about my current insulin sensitivity. After 3 mo low carb I got some blood work done and my fasting insulin was 4. So either the low carb diet lowered it. Or my pancreas is sort of shot already. I have no idea, the joys of being uninsured. Either way I had a problem before low carb. But I'm finding I have a harder time now lowering my BG with low carb. I have to eat lower and lower carb.
I suspect there might be a cortisol issue because I was also sleeping very well when my BG was lower and under better control. I have not slept well in about a year now while my BG has also been more erratic..with diet cheats. I took some pregnenelone at one point and it lowered my BG dramatically. I know I have adrenal fatigue...though again my adrenals were shot and I had a serious health crisis all before going low carb. I'd LOVE to not spend my life on a low carb diet though. But my health was in the crapper before a low carb diet. I'm guessing it had something to do with poorly treated hypothyroidism in part.
Yes, there is always a physiological reason why you became insulin resistant, and it's not, like low-carb zealots suggest, because of the "carbs" in your diet.
ReplyDeleteTypically low metabolic rate is at the root of it, which can be caused by any form of physical or psychological stress, inflammation, infection, allergy, true glandular dysfunction, you name it.
But if I've learned anything, it's that you can run from carbs but you can't hide. Eventually you'll have high blood sugar on a zero carb diet and won't have anywhere to go from there. Not to mention many new health issues will probably arise for you the longer you continue eating a very carb-restricted diet. Autoimmune disease is one I see very often at the end of the low-carb line.
I don't have any explicit answers for you other than to be open to eating lots of carbohydrates once again but with overfeeding (to raise metabolism, pregnenalone, progesterone, etc.), strong favortism for saturated over unsaturated fats, and resting, relaxing, and sleeping all day.
This is how insulin sensitivity and thyroid function is best restored in those that haven't been irreparably damaged - as far as I know.
"You can run from carbs but you can't hide"
ReplyDeleteI kind of want to tattoo this on my forehead.
I kind of want you to also. It would be awesome. Especially when you go to Mark Sisson's Paleo talks n' stuff.
ReplyDeleteYay Matt!
ReplyDeleteI'm amazed at the number of otherwise intelligent folks, faced with the cold hard scientific "facts" (IOW to the best of our knowledge) that carbs enhance insulin sensitivity, continue to repeat that carbs -> insulin -> IR, and so forth. SIGH
There at least need to be t-shirts made that we can wear to the Ancestral Health Symposium...
ReplyDeleteWith a graphic of a huge banana chasing Grok.
ReplyDeleteI'm sure it's not carbs that caused my insulin resistance too. I know a lot of people who eat a lot more carbs in the form of white flour and sugar and they aren't borderline diabetic from eating it. If eating carbs or being overweight caused diabetes then all our ancestors would have been diabetic.
ReplyDeleteI'm not sure how to fix my problem however since I do not know what caused me to become insulin resistant. I'd like to treat the root of the problem. I've been reading some of your posts on body temp with interest. Back in elementary school my temp was normally 97.6. So I've had a low metabolism for some time.
However I'm already fat. I just can't fathom over feeding and not becoming morbidly obese doing it. I have to stay on a diet at all times just to not gain more weight as it is. I was very thin till my early 20's when I got some sort of virus and I became horribly tired and fatigued all the time and put on 40 lbs in 6 weeks. So I read with interest but I just can't imagine actually doing that.
Thanks a lot for sharing this nice information about this diet. I like to follow it. if your diet is perfect then almost all the over the health will be good . So Really this kind of article will help to all the person who do not have idea about perfect diet.
ReplyDeleteThanks a lot for this nice information. keep posting variety of articles.
Smith Alan
http://www.raymeds.com
Saponaria,
ReplyDeleteI think there is usually a trigger associated with sudden weight gain. I had a back injury (fracture) that lead to a 25 pound weight gain for me. I also think I had the beginnings of adrenal fatigue at the time of my injury and I was dieting so I had a very low metabolism. Getting injured was the thing that pushed me over the edge.
I gained 14 pounds on RRARF and it did eventually come off, but I haven't lost any more than what I gained. Good reads on this "When the Body Says No" and "Waking the Tiger".
@Matt:
ReplyDelete"You also have to remember that there are 34 kinds of saturated fat." I'm hair splitting here, but not all saturated fats are present in food, right? for example, very long chain fatty acids (more than 24 carbon-atoms, if i remember it correctly)are not in any items of food, which reduces the list.
Hi Matt and the 180 degree crowd, what is your take on physiogical insulin resistance and muscle gains? Aparently on low carb the muscles can become insulin resistant in order to save glucose for the brain.
ReplyDeleteI have had this effect myself when going VLC as observed from having high blood sugar readings in the morning despite "zeroing the carbs"
Anyway since this is a natural response this should probably be ok, but how could this effect muscle gains when training, if the muscles are resistant to insulin, what effect will this have on their nutrient uptake?
Or is there other pathways that are utilized for nutrient partitioning besides insulin?
I realize most folks here are anti-paleo but it would nontheless apreaciate your take on this issue
Best regards Albert
Hey Matt,
ReplyDeleteNew reader here. I read fast though;). I am wondering what on earth "overfeeding" means to you?
Thanks dude,
Chelsie
Chelsie-
ReplyDeleteThe mainstream would define overfeeding as eating beyond maintenance calories.
I don't define it like that at all. I define it as eating beyond appetite.
Or eating slightly more than what one would eat if eating ad libitum.
Do you feel overfeeding is helpful in some situations? If I was keeping up at all in some of the comments you made, I could have sworn you were saying that. If so, when and why?
ReplyDeleteAnd by the way, I seriously feel famous that you answered my question. Thank you.
Chelsie
Yes Chelsie-
ReplyDeleteI feel that overfeeding as I define it is good for those with long histories of restricted eating and the emotional issues surrounding food that revolve around that.
More than anything, it's great to increase body temperature in those with a body temperature lower than 98 degrees F first thing upon waking in the morning. this is incredibly common and a sign of a reduced metabolic rate. Reduced metabolic rate is the ROOT cause of many health problems - from constipation and the many digestive problems that stem from it (diverticulosis, hemorroids, varicose veins, etc.) to cancer (which is caused by a departure from a high intensity oxidative metabolism) to heart disease/metabolic syndrome and so forth.
"Overfeeding" as I define it is very useful for anyone with a low metabolic rate seeing to overcome that. To me, this is one of the first things that should be analyzed and combatted when any health problem is discovered. But again, this should be done on wholesome, unrefined, low-stimulation foods like simple meats, vegetables, whole fruits, starches, etc.
Matt,
ReplyDeleteThank you so much for taking the time to answer my questions.
Chelsie