Metabolic Syndrome and Insulin Resitance

My last post discussed why keto works while other diets fail.  This post will get into some of the root cause issues that keto helps to treat.   That would primarily be metabolic syndrome and insulin resistance.

Metabolic Syndrome, sometimes referred to as Syndrome X or insulin resistance syndrome, is a group of related risk factors / symptoms such as high blood pressure, high blood sugar, bad cholesterol levels and abdominal fat.  There is growing evidence that one of the main causes, if not THE main cause, of metabolic syndrome is insulin resistance.

To understand insulin resistance, it is important to understand how insulin works in your body.  Insulin is a hormone produced by the pancreas that allows your body to use or store glucose resulting from food (particularly carbohydrates) eaten. When you eat something with carbohydrates, your blood sugar rises and your pancreas releases in
sulin into your bloodstream.  The insulin acts as a key to “unlock” your fat cells and allow the blood sugar to be stored as fat or burned as fuel.  If you don’t have insulin resistance, then your body will produce just enough insulin to process the glucose, and your insulin will be back to low levels shortly thereafter and all is right with the world.

If your blood sugar starts to rise too often, then the insulin will start to damage the “locks” on your fat cells.  It will take more insulin to store the same amount of blood sugar.  This is where the vicious cycle begins.  Your pancreas will start to produce more insulin in an attempt to reduce your blood sugar.  This is necessary because excess blood sugar is bad for you, and can cause damage to your nerves, blood vessels and organs.  However, with the extra insulin comes extra damage to the fat cells which means you will require even more insulin to lower your blood glucose.  If this progresses far enough, then you get a diagnosis of type 2 diabetes.  If this continues, your pancreas can burn out and you will be unable to produce any insulin at all.  At which point you go from being a type 2 diabetic to a type 1 diabetic. 

Remember that the cause of insulin resistance is too much insulin, so it is somewhat ironic that one of the main treatments for type 2 diabetes is extra injectable insulin.  This can accelerate the insulin resistance, even if it does help keep the blood glucose levels under control.  Instead of treating type 2 diabetes with extra insulin, it makes more sense to reduce the need for insulin by keeping the blood glucose from going high in the first place.  This is where keto comes to shine.   To understand why keto helps we must first look at how the body responds to each of the macronutrients.

There are three main macronutrients: fats, proteins and carbohydrates.  Consuming fat causes a very low rise in your blood sugar and therefore doesn’t cause your body to produce much of an insulin response.  Protein causes a moderate rise in your blood sugar and therefore results in your body producing a moderate insulin response.  On the other hand, carbohydrates produce a large blood sugar spike and results in a large insulin response.  In summary, fat causes a small insulin response, protein causes a moderate insulin response and carbohydrate causes a large insulin response.

So if you are insulin resistant what should you eat to give your body a break from insulin?  If you said fat, you’d be largely correct.  You can’t eat just fat because your body needs to ingest some protein in order to maintain health. In fact, it is vital for you to consume both fat and protein in a healthy diet because both contain essential nutrition for your body.  This is why the keto diet is often described as very low carb (usually less than 20-50 grams), adequate protein and then fat to satiety.

The amount of protein necessary on a ketogenic diet is still somewhat controversial.  The Recommended Dietary Allowance (RDA) says adults should have 0.8 grams per kilogram of body weight or about 0.36 grams per pound of body weight.  For a 150-pound person that’s about 54 grams.  Some experts say this number is too low, others too high.  And it likely depends upon your activity and goals.  All experts agree that some protein is important to maintain health.  So why not eat high levels of protein? The problem is that protein causes a moderate insulin response, so there is some motivation to keep the amount of protein from being too high.  Also very high protein diets can be hard on the kidneys.  Particularly if you tried to eat a high protein, low fat diet.  So this is where keto settles in on an adequate, yet moderate, amount of protein.

As it turns out there is no requirement for people to ingest any carbohydrates in their diet.  The body is capable of creating all the carbohydrates it needs from fat and protein.  This is why it is safe to reduce the carbohydrates in your diet as low as you can.

So eating keto limits the amount of glucose that enters your bloodstream and reduces the need for insulin.  This will give your body a break from high levels of insulin, which will hopefully result in your body improving its insulin sensitivity. In fact, a study has shown that about 10% of a person’s fat cells are replaced every year.  Assuming this happens at a regular pace, that means it would take about 10 years for all of the fat cells in your body to be replaced.  So it is possible that 10 years of keeping your insulin low might result in fat cells that have never been exposed to extremely high levels of insulin and are no longer metabolically deranged.  I’ve heard speculation about this on some of the podcasts I listen to, but I don’t know that there is adequate science yet to confirm this hypothesis.

This all explains why the ketogenic diet is an excellent choice for diabetics.  If you lower the number of carbs in your diet, it reduces the need for and presence of insulin.  This will allow type 1 diabetics to take less injectable insulin, and allow type 2 diabetics to heal some of their insulin resistance.

My next blog post will explore the ways that exercise is good for you.  You can also read my last blog post that discusses why keto works while other diets fail.


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