Science

Diabetes and Insulin Resistance

3 Reasons It’s Harder For People With Type 2 Diabetes To Lose Weight - Dr Sarah Hallberg - Virta

"Approximately 90% of people with type 2 diabetes are overweight or obese. While obesity often contributes to the development of diabetes, the bigger driver of weight gain is the high insulin levels that are found well before the diagnosis of diabetes.There are some good reasons why the standard advice of “eat less, exercise more” doesn’t deliver results for people living with type 2 diabetes.

Reason #1: With type 2 diabetes, insulin is high, and insulin is a fat-storage hormone"

[Read more about Diabetes and Insulin Resistance]

Diabetes is a vascular disease - Dr. Joseph R. Kraft, MD

"Dr. Kraft’s test is similar to the oral glucose tolerance test (OGTT), but it runs longer and includes insulin measurements. He confirmed and standardized the measurements using 14,384 subjects of all ages (a rather huge sampling). He identified one distinct normal insulin pattern (I) called “euinsulinemia” and three abnormal patterns (II-III-IV) of hyperinsulinemia, also called diabetes “in-situ”. Pattern (V), consistent with low insulin, type I diabetes and loss of beta cell function was also identified but is not discussed here. Diabetes in-situ identifies diabetes at its earliest stage, illustrating how hyperinsulinemia manifests itself before hyperglycemia. Insulin resistance, a more common term used today, can be used interchangeably as both describe a similar metabolic defect."

Heart Disease and Insulin Resistance

It's the Insulin Resistance, Stupid - Prof. Timothy Noakes

"When medical scientists propagate a false hypothesis, two things happen, and both of them are bad.

First, the wrong idea causes direct harm to those who adopt practices based on that incorrect hypothesis. Second, the wrong idea suppresses any attempts to discover the correct hypothesis. Such suppression occurs as a result of (enforced) scientific consensus."  [ Read more about Insulin resistance and heart disease]

Read Part 2 of this series

Read Part 3 of this series.

Read Part 4 of this series.

Understanding the Total Risk ‘Forest’ Rather than Focusing on the ‘LDL Tree’- Dr Stephen Phinney (and others) - Virta.

"For the last 5 decades, most medical and nutrition scientists have focused on low density lipoprotein (LDL) cholesterol as a primary cause of coronary heart disease. Characterized as ‘bad cholesterol,’ literally thousands of studies have been done using drugs or diet to reduce LDL cholesterol and thereby hoping to reduce heart attacks and mortality. While cholesterol lowering therapy has become the standard of care for some individuals with well-defined heart disease risk, this focus on cholesterol in general—and LDL cholesterol in particular—remains very controversial." 

 

[Read more about Ketogenic Diets and Blood Lipid change]

Dementia and Insulin Resistance

In Alzheimer Research, Glucose Metabolism Moves to Center Stage - Bridget Kuehn  - JAMA

"Areas or patterns of reduced glucose metabolism are often seen in brain scans of patients with Alzheimer disease and other dementias. Now, a growing body of evidence suggests that glucose hypometabolism may be more than just a biomarker on brain scans: it may be a key player in dementia pathology." 

 

 [Read more about how metabolic disease affects dementia]

Reversal of Cognitive Decline - Dr. Dale Bredesen  - Journal of Alzheimer's Disease and Parkinsonism

"The first examples of reversal of cognitive decline in Alzheimer’s disease and the pre-Alzheimer’s disease conditions MCI (Mild Cognitive Impairment) and SCI (Subjective Cognitive Impairment) have recently been published. These two publications described a total of 19 patients showing sustained subjective and objective improvement in cognition, using a comprehensive, precision medicine approach that involves determining the potential contributors to the cognitive decline (e.g., activation of the innate immune system by pathogens or intestinal permeability, reduction in trophic or hormonal support, specific toxin exposure, or other contributors), using a computer-based algorithm to determine subtype and then addressing each contributor using a personalized, targeted, multi-factorial approach dubbed ReCODE for reversal of cognitive decline.

[Read More about how Metabolic Medicine positively affects Dementia]

More Science

Dr. David Ludwig - Ludwig is a professor at Harvard Medical School[1] and a professor of nutrition at the Harvard School of Public Health. Effects of low carb diet on energy expenditure during weight loss. BMJ 2018;363:k4583.

 

This study's findings are consistent with the carbohydrate-insulin model that lowering dietary carbohydrate increased energy expenditure ( metabolic rate) during weight loss maintenance.  This study had 16 participants over a 20 week period and this metabolic effect may improve the success of obesity treatment, especially among those with high insulin secretion.   

This is a great article reviewing many books and science published on the subject of Ketogenic Diets that also offers assistance navigating the overwhelming subject matter.

Why Low-Fat Diets Fail

Howard BV, et al. Low-fat dietary pattern and weight change over 7 years: the Women's Health Initiative Dietary Modification Trial. Journal of the American Medical Association, 2006.

Howard BV, et al. Low-Fat Dietary Pattern and Risk of Cardiovascular Disease. Journal of the American Medical Association, 2006.

Multiple Risk Factor Intervention Trial: Risk Factor Changes and Mortality Results. Journal of the American Medical Association, 1982.

Why Sugar is Unhealthy

Stanhope KL, et al. Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. Journal of Clinical Investigation, 2009.

Stanhope KL, et al. Adverse metabolic effects of dietary fructose: results from the recent epidemiological, clinical, and mechanistic studies. Current Opinion in Lipidology, 2013.

Ludwig DS, et al. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. The Lancet, 2001.

Schulze MB, et al. Sugar-Sweetened Beverages, Weight Gain, and Incidence of Type 2 Diabetes in Young and Middle-Aged Women. Journal of the American Medical Association, 2004.

Bostick RM, et al. Sweetened beverage consumption and risk of coronary heart disease in women.Cancer Causes & Control, 1994.

Fung TT, et al. Sugar, meat, and fat intake, and non-dietary risk factors for colon cancer incidence in Iowa women. The American Journal of Clinical Nutrition, 2009.

Low-Carb Diets are Healthy

Westman EC, et al. Low-carbohydrate nutrition and metabolism. American Journal of Clinical Nutrition, 2007.

Hession M, et al. Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities. Obesity Reviews, 2008.

Santos F, et al. Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors. Obesity Reviews, 2012.

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