This is How Insulin Resistance Starts (and how to stop it early)
30 Jan 2024 (8 months ago)
Intro
- Simon and Thomas discuss glucose, fat loss, and continuous glucose monitors.
- They mention Roy Taylor's hypothesis on insulin resistance and type 2 diabetes.
How Insulin Resistance Develops
- Roy Taylor's twin cycle hypothesis explains how insulin resistance develops and leads to type 2 diabetes.
- Excess energy or energy toxicity is at the center of this model.
- Some people have a better capability of storing excess energy in subcutaneous fat depots than others.
- Those with less capability of storing fat subcutaneously will have fat spilling over earlier into visceral fat.
- Visceral fat is fat in organs, particularly the liver and pancreas, and can also be found in muscle tissue.
- Ectopic fat refers to fat in the wrong places, such as visceral fat.
- Insulin resistance in the liver occurs when fat accumulates in the liver tissue, leading to an inability to turn off glucose release into the bloodstream.
- Insulin resistance in muscle tissue can also occur when excess fat is stored within muscle cells, impairing glucose uptake.
- As fat accumulates in the liver and pancreas, insulin resistance worsens, leading to elevated blood sugar and potentially type 2 diabetes.
- The personal fat threshold refers to the amount of fat someone can carry before developing insulin resistance and type 2 diabetes.
- There may be a limit to how much fat someone can gain, as visceral fat storage can deteriorate metabolic health.
- Visceral fat is a significant problem for insulin resistance, but the precise mechanisms, such as inflammation, are not fully understood.
- Excess fat stored in liver cells causes insulin resistance within the liver, with over 6% liver fat being a critical threshold.
- Insulin resistance can occur at different levels, including muscle cell resistance, glucose intolerance, impaired liver glucose regulation, and inflammatory responses.
- Type 2 diabetes involves various mechanisms of insulin resistance, and its diagnosis criteria may be loose due to different underlying causes.
How a Fatty Liver Contributes to Insulin Resistance
- Liver fat is a major contributor to insulin resistance.
- Energy toxicity, a diet providing excess energy, is the primary factor in the development of insulin resistance at the liver.
- Simple sugars and saturated fats drive hepatic fat more than unsaturated fats, even in a hypercaloric state.
- Saturated fats increase hepatic fat even at energy balance.
- Reducing visceral fat and liver fat below 6% is crucial for improving insulin resistance.
- Unsaturated fats are better than saturated fats, and unrefined carbohydrates are better than refined sugars.
Lowering Blood Sugar
- Reducing saturated fats and restricting calories can help reduce liver fat and improve insulin resistance.
- The type of diet that feels easiest and allows for sustainable weight loss is the best approach.
- Diet quality matters, with a focus on unrefined carbohydrates, unsaturated fats, and fiber-rich foods.
- Reducing glucose spikes may have an impact on reducing liver fat, but more research is needed.
The Best Diet For You
- There is no one-size-fits-all diet for insulin resistance.
- Personalization is critical in finding a diet that allows for a sustained calorie deficit and weight loss.
- Low-carb, high-fat diets and high-carb, low-fat diets can both be effective in managing blood glucose and insulin resistance.
- Avoiding processed foods, refined sugars, and excessive saturated fats is important.
- Finding a balance between macronutrients and focusing on food quality is key.
Early vs Late-Stage Insulin Resistance
- The degree of insulin resistance and the duration of type 2 diabetes play a role in determining the best approach.
- Early-stage insulin resistance may respond well to low-carb diets due to preserved mitochondrial function.
- As insulin resistance worsens, reducing saturated fats and improving mitochondrial health become more important.
- A personalized approach that addresses the underlying causes of insulin resistance is essential.
Low Carb vs Low Fat Diets
- Low carb diets may lead to slightly more weight loss than low-fat diets in the first 6 months, possibly due to water weight loss.
- Low carb diets can increase resting energy expenditure (REE) initially due to the body's response to the sudden lack of carbohydrates.
- The increased REE can contribute to more calorie burn, but it eventually plateaus.
- Weight loss success depends on what works best for each individual.
What Would Simon Do If Diagnosed With Type-2 Diabetes?
- Roy Taylor's research suggests a highly restricted calorie diet of 800 calories per day for 8-12 weeks can lead to significant weight loss in individuals with type 2 diabetes.
- After the initial weight loss, a gradual transition to a sustainable diet is recommended to maintain the weight loss long-term.
Is Losing Weight Fast Safe?
- Recent research indicates that losing weight fast is not necessarily worse or better than losing weight slowly.
- Losing weight quickly can be beneficial as it allows individuals to reach a healthier weight sooner and reap the positive health effects.
- However, it's important to consider lean body mass and ensure adequate protein intake to prevent excessive muscle loss.
Should You Exercise When Losing Weight Fast?
- The research group that recommended the 800-calorie diet advised against starting significant exercise during the calorie restriction period.
- Adding exercise can increase hunger, potentially hindering weight loss efforts.
- Resistance training may be considered to maintain muscle mass during calorie restriction.
Do This If Insulin Resistant
- Insulin-independent glucose uptake can be achieved by moving the body, regardless of the stage of insulin resistance.
- Finding a diet that encourages physical activity is crucial for weight loss and overall health.
Weight Loss Is More Than Just Selecting The Right Diet
- Weight loss involves more than just choosing the right foods and macronutrient ratios.
- Factors such as stress management, sleep quality, and relationship management also play significant roles in weight loss.
Simon & Thomas' Tips for Maintaining a Healthy Weight
- Keep saturated fat under 20% of total fat calories.
- Move the body every day through resistance training or other forms of exercise.
- Throttle carbohydrate intake based on activity level.
- Increase monounsaturated fats in place of saturated fats.
- Focus on protein for its thermic effect and ability to maintain glucose balance.
Carbohydrates
- Think about carbohydrates for performance and replenishing glycogen stores.
- Consume carbohydrates after a workout.
- Choose carbohydrates that provide fiber, prebiotic fiber, and different types of fiber to feed different strains of bacteria and increase short-chain fatty acids.
- Fiber can affect hunger, GLP-1 levels, and PYY levels.
Protein
- Ensure adequate protein intake, especially if following a plant-based diet.
- Resistance training is critical for maintaining lean mass.
- Protein intake of 1.3-1.6g per kg of body weight is optimal for maximizing strength.
Fats
- Saturated fat is not inherently bad, but the dose matters.
- High saturated fat intake can increase hepatic fat and apoB levels.
- Individual response to saturated fat can vary based on genetics.
- Monitor apoB levels and adjust saturated fat intake accordingly.
- Choose unsaturated fats such as olive oil, avocados, nuts, seeds, and tofu over saturated fat-rich foods like coconut oil and palm oil.
Other Factors
- Optimize sleep, stress management, and relationships for overall health and well-being.