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Lowcarb diets increase/decrease insulin resistance-which one is it?

by (20787)
Updated about 4 hours ago
Created October 09, 2010 at 4:28 AM

I have heard some say that insulin resistance is helped by low carb diets. I have seen studies showing improved fasting blood glucose levels after eating lowcarb for even only a few weeks. I have also heard some say that eating lowcarb causes increased blood glucose response to sugar intake which is a sign of increased insulin resistance. One popular guru advocates increased carb consumption starting several days before a glucose challenge test in order to ameliorate this effect beforehand. So does lower carb eating cause insulin resistance or does it help cure insulin resistance? Which one is it-explanation please!

E76821f1019f5284761bc4c33f2bf044
0 · May 04, 2012 at 7:45 PM

Peter at Hyperlipid did say that high morning FBG in a LC paleo dieter "just tells me they haven't eaten breakfast yet" (http://high-fat-nutrition.blogspot.de/2008/08/physiological-insulin-resistance.html)

96bf58d8c6bd492dc5b8ae46203fe247
0 · December 07, 2011 at 1:13 AM

@WCC Paul, that link doesn't work either.

96bf58d8c6bd492dc5b8ae46203fe247
0 · December 07, 2011 at 1:11 AM

@Kamal, that link to KH says "page not found."

21fd060d0796fdb8a4a990441e08eae7
0 · October 10, 2010 at 8:56 PM

That's right--it was the closest I could find about hepatic insulin resistance on a high fat diet, which was unfortunately a study on dogs eating tons of calories. On the other hand, I didn't find anything about fatty liver being caused by a low carb diet, only from a high calorie diet or a fructose overload. What Peter might implicitly be saying is that when trying to demonize high fat diets vis a vis liver dysfunction, researchers had to resort to a high calorie, uncontrolled diet.

47a42b6be94caf700fce9509e38bb6a4
0 · October 10, 2010 at 3:08 PM

But that doesn't answer your question, right? This is what happens when you eat a massively hypercaloric diet with both carb and fat, not what happens when you switch to low-carb. I thought that was your question -- because we wanted to figure out if there was some weird bizarro reversal with the liver like there is with the muscles. (I also looked at the link so I might be missing something.) (And you might have just been putting this up for interest not necessarily as an answer to the question.)

21fd060d0796fdb8a4a990441e08eae7
0 · October 10, 2010 at 5:27 AM

"...if, like me, you eat somewhere in excess of 2g per kilogram bodyweight of dietary fat every day DO NOT, under any circumstances, add 3000 kcal of carbohydrate to it. If you do this you will develop virtually complete hepatic insulin resistance within a few months. You will also get very very very very fat. Not in a week, but certainly in a couple of years. Thank goodness for this study, saved my liver."--Peter

21fd060d0796fdb8a4a990441e08eae7
0 · October 10, 2010 at 5:26 AM

Take your naps! Here is Hyperlipid talking about the issue, via a tongue-in-cheek response to a flawed insulin resistance study in dogs...http://high-fat-nutrition.blogspot.com/2009/09/hepatic-insulin-resistance-through.html

47a42b6be94caf700fce9509e38bb6a4
0 · October 10, 2010 at 4:52 AM

Or maybe two weeks worth of naps. Guess I don't know the answer, or don't know enough to be able to find out the answer. Sooner or later.

47a42b6be94caf700fce9509e38bb6a4
0 · October 10, 2010 at 4:07 AM

Yes, Eva, I believe that's right, how you have it in your first paragraph. Or at least your and my understandings are the same. Kind of a clever mechanism, isn't it? As for the FBG thing, I don't think Peter was working off of any studies, but rather his own experience and experiences he had had reported to him by other people. But if I see any links or studies I'll let you know.

47a42b6be94caf700fce9509e38bb6a4
0 · October 10, 2010 at 3:58 AM

When we get to paleo heaven (intentionally provocative formulation) we can get funding for experiments like these.

62ed65f3596aa2f62fa1d58a0c09f8c3
0 · October 10, 2010 at 2:23 AM

WCC Paul, now that would be an interesting piece of research that I'd like to see. You may be right, but we know so little, that it would be just as interesting if you were wrong. I can see some interesting groups and control groups, VLCer with metabolism that has always been healthy, VLCer that was diabetic range before VLC, diabetic on normal diet, diabetic on low fat diet. All groups are given glucose challenge test. What happens? Then all VLCers eat a bit more carbs for several days and then take another glucose challenge test. What happens?

47a42b6be94caf700fce9509e38bb6a4
0 · October 09, 2010 at 4:02 PM

Again, I think that's because there are two different things going on (to the best of my knowledge). Consider this scenario: if a long-time type-II diabetic goes VLC, then presumably he would have the same crazy reactions to eating half a piece of pie that any other VLC eater would, because of Peter's "physiological" insulin resistance. But at the same time he would be healing the more "systemic," chronic insulin resistance.

47a42b6be94caf700fce9509e38bb6a4
0 · October 09, 2010 at 3:53 PM

Good point. I'm going to look and see what I can find. Might need a nap first.

62ed65f3596aa2f62fa1d58a0c09f8c3
0 · October 09, 2010 at 3:34 PM

Well I figured it was something like this but I was having trouble digging up the links using google, so I figured it would make for a good question, plus save me some google time. However, I do think that for diabetics, LC does more than just avoid the problem as their fasting blood glucose actually does go down over time and stays lower for a while even after they go back on SAD. So there appears to be some actually healing going on for them, not just avoidance.

1f70da0b737e9c6e7679a248f4228a01
0 · October 09, 2010 at 12:05 PM

The answers below are awesome and technical, and they seem to lead to the same answer as I gave to someone asking this question: "if you are insulin resistant, VLC neatly avoids the issue since you will no longer trigger inflammatory and damaging insulin responses. However, you'll need to up your carb intake slowly if you choose not to stay VLC, since your system will be accustomed to running on fat." So I see the science as saying that it neither causes nor cures insulin resistance exactly, but avoids the issue for those who have it, and can cause similar symptoms for those who don't.

1f70da0b737e9c6e7679a248f4228a01
0 · October 09, 2010 at 12:05 PM

The answers below are awesome and technical, and they seem to lead to the same answer as I gave to someone asking this question: if you are insulin resistant, VLC neatly avoids the issue since you will no longer trigger inflammatory and damaging insulin responses. However, you'll need to up your carb intake slowly if you choose not to stay VLC, since your system will be accustomed to running on fat." So I see the science as saying that it neither causes nor cures insulin resistance exactly, but avoids the issue for those who have it, and can cause similar symptoms for those who don't.

D30ff86ad2c1f3b43b99aed213bcf461
0 · October 09, 2010 at 11:50 AM

Thanks for asking this - I've been confused about this!!

21fd060d0796fdb8a4a990441e08eae7
0 · October 09, 2010 at 7:56 AM

WCC Paul: quick question. Do you know what happens to the liver's insulin sensitivity on a low carb diet? KGH says it is separate from muscle insulin sensitivity, which makes sense because I presume the liver would use a little bit of it's own glycogen for fuel, and doesn't (normally) store fat. But that thread is kind of left hanging...higher fasting blood glucose is okay because daily average is lower, muscle insulin resistance is okay because they're running on fat, and liver [fill in the blank]...

47a42b6be94caf700fce9509e38bb6a4
0 · October 09, 2010 at 6:37 AM

Also this thread from KGH is good: http://www.paleonu.com/panu-forum/post/884770

47a42b6be94caf700fce9509e38bb6a4
0 · October 09, 2010 at 6:36 AM

And Eva look at the exchange with pfw that is the second thing in the forum thread that Kamal linked in the comment just above this one: there's that study again with the protein and the insulin, that our buddy Krieger and others are fond of.

21fd060d0796fdb8a4a990441e08eae7
0 · October 09, 2010 at 5:07 AM

Here's Kurt Harris answering a similar question to your's...http://www.paleonu.com/panu-forum/post/952698

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3 Answers

21fd060d0796fdb8a4a990441e08eae7
6
24523 · October 09, 2010 at 5:05 AM

While there's a lot to chew on for this topic, the good doctor Harris explains it well: "Peripheral (muscle) insulin resistance is a normal response to VLC as your muscles are running on fatty acids- otherwise you would get hypoglycemic. The confusion about IR is conflating glucose tolerance with pathologic insulin resistance. Insulin resistance per se is a physiologic adaptation. Insulin resistance in the liver on a high carb diet is pathologic. Many researchers seem to have no concept of the difference between peripheral and central (hepatic) insulin resistance."

Here's a sampling of important studies on the subject: Some studies show an improved insulin resistance, while others show worsened insulin resistance.

There's a problem comparing different studies, of which there are dozens. The populations are very different--obese, normal bodyweight, diabetic, nondiabetic, women only, etc.

An interesting note is that high fat diets composed largely of PUFA improve insulin resistance much more than high fat diets composed largely of saturated fats. Moreover, ketogenic diets (eh, in rats) worsen glucose homeostasis compared to a high carb diet.

96bf58d8c6bd492dc5b8ae46203fe247
0 · December 07, 2011 at 1:11 AM

@Kamal, that link to KH says "page not found."

21fd060d0796fdb8a4a990441e08eae7
0 · October 10, 2010 at 8:56 PM

That's right--it was the closest I could find about hepatic insulin resistance on a high fat diet, which was unfortunately a study on dogs eating tons of calories. On the other hand, I didn't find anything about fatty liver being caused by a low carb diet, only from a high calorie diet or a fructose overload. What Peter might implicitly be saying is that when trying to demonize high fat diets vis a vis liver dysfunction, researchers had to resort to a high calorie, uncontrolled diet.

47a42b6be94caf700fce9509e38bb6a4
0 · October 10, 2010 at 3:08 PM

But that doesn't answer your question, right? This is what happens when you eat a massively hypercaloric diet with both carb and fat, not what happens when you switch to low-carb. I thought that was your question -- because we wanted to figure out if there was some weird bizarro reversal with the liver like there is with the muscles. (I also looked at the link so I might be missing something.) (And you might have just been putting this up for interest not necessarily as an answer to the question.)

21fd060d0796fdb8a4a990441e08eae7
0 · October 10, 2010 at 5:27 AM

"...if, like me, you eat somewhere in excess of 2g per kilogram bodyweight of dietary fat every day DO NOT, under any circumstances, add 3000 kcal of carbohydrate to it. If you do this you will develop virtually complete hepatic insulin resistance within a few months. You will also get very very very very fat. Not in a week, but certainly in a couple of years. Thank goodness for this study, saved my liver."--Peter

21fd060d0796fdb8a4a990441e08eae7
0 · October 10, 2010 at 5:26 AM

Take your naps! Here is Hyperlipid talking about the issue, via a tongue-in-cheek response to a flawed insulin resistance study in dogs...http://high-fat-nutrition.blogspot.com/2009/09/hepatic-insulin-resistance-through.html

47a42b6be94caf700fce9509e38bb6a4
0 · October 10, 2010 at 4:52 AM

Or maybe two weeks worth of naps. Guess I don't know the answer, or don't know enough to be able to find out the answer. Sooner or later.

47a42b6be94caf700fce9509e38bb6a4
0 · October 09, 2010 at 3:53 PM

Good point. I'm going to look and see what I can find. Might need a nap first.

21fd060d0796fdb8a4a990441e08eae7
0 · October 09, 2010 at 7:56 AM

WCC Paul: quick question. Do you know what happens to the liver's insulin sensitivity on a low carb diet? KGH says it is separate from muscle insulin sensitivity, which makes sense because I presume the liver would use a little bit of it's own glycogen for fuel, and doesn't (normally) store fat. But that thread is kind of left hanging...higher fasting blood glucose is okay because daily average is lower, muscle insulin resistance is okay because they're running on fat, and liver [fill in the blank]...

47a42b6be94caf700fce9509e38bb6a4
0 · October 09, 2010 at 6:36 AM

And Eva look at the exchange with pfw that is the second thing in the forum thread that Kamal linked in the comment just above this one: there's that study again with the protein and the insulin, that our buddy Krieger and others are fond of.

21fd060d0796fdb8a4a990441e08eae7
0 · October 09, 2010 at 5:07 AM

Here's Kurt Harris answering a similar question to your's...http://www.paleonu.com/panu-forum/post/952698

62ed65f3596aa2f62fa1d58a0c09f8c3
2
20787 · October 10, 2010 at 3:43 AM

OK, so I think I get the gist now. Basically, if you eat very low carb, and so you don't have access to tons of glucose, so a lot of your cells switch to burning fatty acids instead of glucose and also these same cells which are now running on fatty acids become more resistant to taking up glucose in order to save it for use by those few cells that have to have glucose, like in the brain. Thus, it is a healthy saving mechanism. When glucose becomes more sparse, the cells that have the option of running on fatty acids, which is not sparse, choose to not use the glucose and instead use the fatty acids. Thus you can say those cells have become resistant to glucose, because they are saving it for other cells that really need it. But it is a healthy response designed to keep those few cells that need glucose having a good supply of it, and at the same time, it will maintain a healthy level of glucose in the blood. So this would be a type of insulin resistance that results in a healthy level of blood glucose.

The only problem comes if you eat very low carb for a while, and your cells adapt to this low level of glucose, and then suddenly you pound a ton of sugar into your system, and your cells are caught flat footed for a while. For a long time, they had adapted to a strategy of saving glucose and then all of the sudden, they are now awash in way too much glucose! Glucose glucose everywhere! But it will take them a bit longer to deal with all this sudden glucose because they were not adapted to it. Thus, it will take them longer to wake up and smell the coffee and realize they need to start sucking in the glucose again. End result is a higher blood glucose spike in response to a glucose challenge for those who have become very low carb adapted, than for those whose cells have not become so fatty acid using and glucose sparing. However, the good news is that after a few days of eating a bit more carbs, the fatty acid adapted cells can learn to be more flexible again and so their insulin resistance can easily be 'fixed.' Because they were never damaged, just adapted to one thing and then temporarily surprised by a sudden change.

Whereas in the case of pathologic insulin resistance brought on we think by long term high carb consumption, the problem is that something is damaged in the cells and cannot and will not adapt via more of the same. And the end result is too high fasting blood glucose instead of healthy levels of blood glucose. Big difference!

OK, so now the only thing I am left confused about is the mentioning on some of the links of vlc causing a higher FASTING blood glucose. I have not seen the studies on this. Any links on this one? All the studies I have seen have been on diabetics acquiring much lower and more healthy levels of fasting blood glucose via low carb. But all those studies were on diabetics, not on those starting in the healthy bg range. I have not (yet) seen any studies on anyone getting higher fasting blood glucose levels due to low carb. WOuld like to get some details on that one.

E76821f1019f5284761bc4c33f2bf044
0 · May 04, 2012 at 7:45 PM

Peter at Hyperlipid did say that high morning FBG in a LC paleo dieter "just tells me they haven't eaten breakfast yet" (http://high-fat-nutrition.blogspot.de/2008/08/physiological-insulin-resistance.html)

47a42b6be94caf700fce9509e38bb6a4
0 · October 10, 2010 at 4:07 AM

Yes, Eva, I believe that's right, how you have it in your first paragraph. Or at least your and my understandings are the same. Kind of a clever mechanism, isn't it? As for the FBG thing, I don't think Peter was working off of any studies, but rather his own experience and experiences he had had reported to him by other people. But if I see any links or studies I'll let you know.

47a42b6be94caf700fce9509e38bb6a4
2
9647 · October 09, 2010 at 6:17 AM

The rules are different for those of us who run on fat instead of on glucose. (Speaking loosely of course.) See Matthew's answer and then my follow-up answer on the old paleohacks thread: http://paleohacks.com/questions/4647/does-a-sugar-bolus-hit-you-like-the-flu/

The links to Peter are key. Though I'm guessing, Eva, that maybe you've already read them judging by what you said. Also I guess I'm more or less agreeing with Kamal via KGH here.

96bf58d8c6bd492dc5b8ae46203fe247
0 · December 07, 2011 at 1:13 AM

@WCC Paul, that link doesn't work either.

47a42b6be94caf700fce9509e38bb6a4
0 · October 09, 2010 at 6:37 AM

Also this thread from KGH is good: http://www.paleonu.com/panu-forum/post/884770

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