In starvation or ketosis, protein should have NO EFFECT on blood glucose level, not RAISE it.

From Blood Sugar is Stable:-

In a healthy person, BG (blood glucose) is held at a fairly constant value with slowly-varying glucose inputs (except after high-GL meals, which produce rapidly-varying glucose inputs) by a NFB (negative feed-back) loop. See Blood Glucose, Insulin & Diabetes.

When protein is eaten, this produces a glucagon response from pancreatic alpha cells, which tries to raise blood glucose level by stimulating the liver to convert liver glycogen plus water to glucose. Protein also produces an insulin response from pancreatic beta cells, which tries to lower blood glucose level by a) increasing glucose uptake from the blood and b) inhibiting HPG (hepatic glucose production). The net result is no change in BG level.

In extended fasting or on VLC (very low carbohydrate)/ketogenic diets, there's no liver glycogen left after ~1 day.
∴ The glucagon response has no effect on HGP.

The insulin response still has an effect, until physiological IR* develops.
∴ Blood glucose tries to decrease, but the HPAA keeps it steady by raising cortisol level.

RE How eating sugar & starch can lower your insulin needs: Blood glucose level on a VLC/ketogenic diet can be RAISED, due to the BG NFB HPAA (hypothalamic pituitary adrenal axis) loop not having a precise set point with the cortisol/adrenaline response (hyperglycaemia is not fatal, whereas hypoglycaemia can be fatal, as the brain always needs some glucose to function (~50%E from glucose)).

So, how come people on LCHF (low carbohydrate, high fat) diets can have normal or slightly low BG levels?

1. Luck. The BG NFB HPAA loop isn't very precise.

2. Excessive intake of Booze. Ethanol inhibits HGP (dunno about RGP (renal glucose production)).

3. Insufficient intake of Protein. This deprives the liver & kidneys of glucogenic amino acids (Alanine & Glutamine are the 2 main ones), forcing BG down and making the HPAA run open-loop and raise cortisol level. There's another source of Alanine & Glutamine available - Lean Body Mass. Uh-oh!


Consuming more protein on extended fasting or a VLC/ketogenic diet can result in higher BG level for three reasons.

1. It allows the HPAA to run closed-loop, as it's supposed to.

2. The lack of a 1st phase insulin response in people with IR/IGT/Met Syn/T2DM* results in a temporary BG level spike with the intake of rapidly-absorbed proteins e.g. whey. There's an unopposed glucagon response, until the 2nd phase insulin response begins.

See http://care.diabetesjournals.org/content/early/2015/11/29/dc15-0750.abstract

*Long-term drastic carbohydrate restriction kills the 1st phase insulin response! See http://carbsanity.blogspot.co.uk/2013/10/insulin-secretion-in-progression-of.html

P.S. This only applies to people who have sufficient liver glycogen, due to them eating some (50 to 100g/day, say) carbohydrate.

3. Hepatic Insulin Resistance results in the insulin response inadequately suppressing Hepatic Glucose Production. As 50g of protein (an 8oz steak, say) yields ~25g of glucose from glucogenic amino acids, there's an increase in the amount of glucose entering circulation, which raises BG level.

See http://bja.oxfordjournals.org/content/85/1/69.long

Low-carbohydrate High-fat diets: Green flags and Red flags.

Fun with flags. But first, a poem!

Atkins Antidote


Eating low carbohydrate what threat that poses

Do my friends think I’m suffering from halitosis?

I’ve got these sticks for measuring ketoacidosis

I’m taking supplements but I don’t know what the dose is

I’m trying hard to keep in a state of ketosis

I’m not sure what the right amount of weight to lose is

I’m sure I’ve put on a pound just through osmosis

Is eating this way risking osteoporosis

Are my kidneys wrestling with metabolic acidosis

My store of liver glycogen I don’t know how low is

Who knows what the glycemic load of oats is

Does anyone know if I can eat samosas?


Ian Turnbull

I do. The answer's "No!" :-D

From https://forum.nationstates.net/viewtopic.php?f=23&t=13567&start=8925

The Green flags...

1. For a person with Insulin Resistance, an ad-libitum low-carb diet results in more weight loss than an ad-libitum high-carb diet.

See How low-carbohydrate diets result in more weight loss than high-carbohydrate diets for people with Insulin Resistance or Type 2 Diabetes , for an explanation.

2. For a person with Type 1 Diabetes Mellitus (T1DM), a lowish-carb (~100g/day), highish fat diet results in minimal disturbances to blood glucose levels and minimal bolus insulin doses.

See Diabetes: which are the safest carbohydrates? , to see which foods should comprise the ~100g/day. N.B. As ~50% of dietary proteins can be converted into glucose by gluconeogenesis, ~100g/day of slow-digesting proteins such as meats, eggs & cheeses can contribute ~50g/day of glucose towards the ~100g/day total.

3. For a person with LADA or MODY, see 2.

4. For a person with Type 2 Diabetes Mellitus (T2DM), a LCLF 600kcal/day Protein Sparing Modified Fast can normalise BG in 1 week and reverse T2DM in 8 weeks (provided there are sufficient surviving pancreatic beta-cells).

See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168743/
"After 1 week of restricted energy intake, fasting plasma glucose normalised in the diabetic group (from 9.2 ± 0.4 to 5.9 ± 0.4 mmol/l; p = 0.003)."

"Maximal insulin response became supranormal at 8 weeks (1.37 ± 0.27 vs controls 1.15 ± 0.18 nmol min−1 m−2)."

After 8 weeks, transition to a diet based on whole, minimally-refined animal & vegetable produce.

See also http://www.fend-lectures.org/index.php?menu=view&id=94

As Insulin Resistance is multi-factorial, ALL of the potential causes need to be addressed. Once this has been done, IR should be reversed, allowing restrictions on dietary carbohydrate intake to be lifted. See also Can supplements & exercise cure Type 2 diabetes?

The Red flags...

The low-carb diet is a temporary patch to ameliorate IR/IGT/Met Syn/T2DM, a bit like replacing a failed circuit-breaker by sticking a nail in its place, to allow the house to function while you fix the problem by buying a new circuit-breaker. Although the house functions fine with a nail in place of a circuit-breaker, you wouldn't want to spend the rest of your life without a working circuit-breaker protecting the house.

So, why do low-carbers seem to want to spend the rest of their lives using a temporary patch to ameliorate their IR/IGT/Met Syn/T2DM?

Long-term use of very-low-carb, very-high-fat diets is not recommended.

1. Cortisol level can gradually increase, resulting in increasing fasting BG level. See How eating sugar & starch can lower your insulin needs.

2. If you do too much high-intensity exercise, you may momentarily black-out, fall and hurt yourself. See "Funny turns": What they aren't and what they might be.

3. Some people seem to gradually go bat-shit crazy. See Can very-low-carb diets impair your mental faculties? Read the comments in https://www.facebook.com/TheFatEmperor/posts/1633434020253792. Do the behaviours of Ivor Cummins & Gearóid Ó Laoi seem normal to you?

4. Insulin Resistance is bad, mmm-kay? See Lifestyle-induced metabolic inflexibility and accelerated ageing syndrome: insulin resistance, friend or foe?

5. Dyseverything elseaemia isn't addressed. See Type 2 diabetes: between a rock and a hard place , Type 2 diabetes: your good signalling's gonna go bad and When the only tool in the box is a hammer.

6. Dietary deficiencies may develop. See Rigid diets & taking loadsa supplements to compensate for them.

7. High-fat diets with no energy deficit result in high postprandial TG's. Postprandial lipaemia is atherogenic. See Ultra-high-fat (~80%) diets: The good, the bad and the ugly.

There may be more but I'm knackered, so I'm Publishing!

Doctor in the House – Watch Diabetes Not Being Reversed Using Low Carb on BBC, While LCHF'ers Freak Out.

This post is about Doctor in the House – Watch Diabetes Reversed Using Low Carb on BBC, While Old-School Dietitians Freak Out.

The YouTube videos may be gone, but the image lives on!
Available to view in the UK on iPlayer 'till 19.12.15 at http://www.bbc.co.uk/iplayer/episode/b06q6y95/doctor-in-the-house-episode-1

In Dr. Eenfeldt's blog post, he makes some schoolboy errors.

1. T2DM (type 2 diabetes mellitus) Reversed with LCHF (low-carb, high-fat) diet. Uh, nope!
a) Sandeep's HbA1c fell from 9.0 to 7.0, which is an improvement but by no means a reversal, as Dr. Chatterjee agrees in https://twitter.com/drchatterjeeuk/status/669875378568171520.
b) Sandeep has T2DM, not T1DM. See When the only tool in the box is a hammer...
Sandeep's BG (blood glucose) went down on LCHF, but what about his dyseverything elseaemia? *sound of crickets chirping*

2. Old-school dietitians freak out. Uh, nope!
In BDA alarmed by controversial and potentially dangerous advice in BBC’s ‘Doctor in the House’, Dr. Duane Mellor sounds pretty cool, calm & collected (though I expect that he sustained injuries from all of the eyeball rolling, as he had to refute for the umpteenth time yet another load of LCHF bullshit).

3. He plays the Shill Gambit card.

Oh, the comments! In typical echo-chamber fashion, LCHF commenters praise Eenfeldt's flawed points. I wonder how long my comment will stay up for?

My comments on the programme (c/p'ed from Facebook):-
"6 minutes in. I think that Priti is deficient in Magnesium (Mg), from her stress levels, anxiety, headaches and difficulty in getting to sleep. Blood tests are useless, as they don't correlate with Mg stores. Need CSF (cerebrospinal fluid) test (lumbar puncture - very painful).

12 minutes in. Priti's blood test results normal. Sandeep has hypovitaminosis D, which is a cause of IR (insulin resistance, it's what caused mine). This important fact is not mentioned. unsure emoticon See http://www.ajcn.org/content/79/5/820.full.pdf

16 minutes in. Talked about sugar in foods & drinks but ignored the large amount of cheese that Sandeep ate earlier. Cheese is *very* energy-dense. Sandeep has been in positive Energy Balance for *way* too long.

24 minutes in. Priti's getting sugar cravings in the morning. Lack of Magnesium also causes IR & poor BG regulation. See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4549665/

29 minutes in. HIIT (high-intensity interval training) for Sandeep is good for increasing his IS, but little use for reducing his VAT (visceral adipose tissue). You can't out-run your fork.

33 minutes in. Walking for Priti to lose weight? You can't out-walk your fork. If 1,000 steps takes 10 minutes and burns an extra 40kcals, then 10,000 steps takes 100 minutes and burns an extra 400kcals = one chocolate bar.

33:47 minutes in. Sareena has had a full-time job working indoors for the last year. Less sun exposure = falling Vitamin D3 level = deteriorating immune system, deteriorating mood & deteriorating IS. See http://nigeepoo.blogspot.co.uk/2008/12/vitamin-d.html

I don't think that I can watch much more of this programme!"

followed by:-
"In conclusion:-
1. Anyone who suffers from chronic anxiety is probably deficient in Mg.

2. Anyone who lives in the UK (United Kingdom :-D) and has coloured skin and/or works indoors is probably deficient in Vitamin D3.

3. ~85% of people who have T2DM have excessive VAT. Asians who were skinny in early adulthood have limited SAT (sub-cutaneous adipose tissue) hyperplasia, resulting in small skin-folds but large bellies. A LCHF diet is not suitable for over-fat people with T2DM. It should be a LCLF diet i.e. a low-calorie diet, to deplete over-full cells. Calories count.

4. You can't out-walk/run your fork.

5. Dr Chatterjee has a strong bias. This is not a good trait for someone who's supposed to be practising Evidence Based Medicine."

It's interesting that Priti is fatter than Sandeep, yet Priti doesn't have T2DM and Sandeep does. Priti was most likely fatter than Sandeep in their respective childhoods, for whatever reasons. Priti had more SAT hyperplasia than Sandeep, so she has more storage capacity for dietary fat than Sandeep does. Priti can gain more SAT, which protects her from developing T2DM. Sandeep can't, so he gains VAT, which has limited storage capacity and is more metabolically-active than SAT.

See also Adipocyte Hyperplasia - Good or Bad? and A *very* special dual-fuel car analogy for the human body that I just invented.

Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 4.

Cont'd from Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 3.

"You tend to get what you accept" Tillerman (don't ask). The following music video sums it up.


If you give someone an inch, they'll take a mile. Why do people put up with the following piss-takes?


If you accept crap, you get crap. Therefore, insist on non-crap.

I used to think that I couldn't do certain things, e.g. perform in public, due to extreme shyness.
Now I do things like this...


Almost anything is possible, if you put your mind to it.

FIN.

Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 3.

Cont'd from Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 2.
 
Derren Brown shows how easy it is to manipulate your thoughts, by the use of subliminal images.


I may have mentioned it somewhere on this blog, but everyone is different. The reactions of the kids in the "I ate all your Halloween candy" video in the previous blog post varied from total melt-downs, through feigned deaths, through tears, to "That's all right!". Candy/sweets have different importance to different people and people's suggestibility varies from "Very easy to manipulate" to "Very hard to manipulate".

There's engineering of foods to be as moreish as possible. "The trouble is, they taste too good!" (Crunchy Nut Cornflakes), "Bet you can't eat just one!" (some savoury snack made from refined starch, salt & flavourings) and "Once you pop, you can't stop!" (Pringles). As Harry Hill once said "The problem with heroin is, it's rather moreish!" Although addiction to pure table sugar isn't a thing, addiction to hyperpalatable foods is a thing (which can be blocked by Naltrexone). See Food cravings engineered by industry and Sugar addiction: pushing the drug-sugar analogy to the limit.

Then there's the incessant marketing, including sponsorships, product placements, celebrity endorsements, cartoon characters on packaging to appeal to kids etc. See The Money Spent Selling Sugar to Americans Is Staggering and It’s Not Your Imagination: Celebrities Hawk Pretty Much Only Junk Food.

Then there's the bribery lobbying of government to:-
1. Water-down Dietary Guidelines so that crap-in-a-bag/box/bottle (CIAB) meets them. As people get fatter and fatter, the Guidelines and government get the blame.
2. Subsidise the ingredients of CIAB so that it's cheaper than produce.

Then there's corruption of science e.g. getting doctors to advertise cigarettes years ago. Organisations with vested interests are created, to promulgate conflicting dietary information. Is it any wonder that the public distrust science and scientists?

Edward Bernays' manipulation techniques have worked exceedingly well. If you're too fat and someone says to you "Nobody made you over-consume that crap", point out the above.

What can you do? You can't sue Food Product manufacturers, as their products don't immediately harm you. See How Ultra-Processed Foods Are Killing Us. Hit them where it hurts i.e. in their bank accounts, by eschewing CIAB and basing your diet on whole, minimally-refined animal and vegetable produce. CIAB should be treat foods, not staple foods.

Finally, here's a nice video on how to form good habits for life.


Cont'd on Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 4.

Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 2.

Cont'd from Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 1.

Remember the video "YouTube Challenge - I Told My Kids I Ate All Their Halloween Candy 2015"?


Some of those kids reacted as if their life had just come to an end!

Disclaimer: I don't know anything about psychotherapy, so I don't know how accurate the information is in Hypoglycemia and Neurosis.

Please don't pacify crying babies/toddlers/children with sugary crap.

Cont'd on Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 3.

Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 1.

Cont'd from Public Service Announcement: Calling all Low-carb, Low-fat and Veg*n advocates.

I feel a music video coming on! It's Not Safe For Work!


Start of clarification.
I've noticed some confusion over the term "Crap-in-a-bag/box/bottle" (CIAB). My previous post received the following comment, which I'll annotate.
"Is highly processed the problem? Yes.
Tinned tomatoes are processed, what's wrong with including those in your diet. Nothing, other than the fact that they're too salty for me if they're tinned in brine.
What about low sugar baked beans? Nothing, other than the fact that they're too salty for me.
What's wrong with a burger if all it is, is minced beef? Nothing.
Other processed food:
Smoked mackerel Fine.
Frozen peas Fine.
Milled porridge oats Fine.
Parma ham Fine.
Cheese Fine.
Nitrate free bacon Fine.
Prunes Fine.
Almond butter Too calorie-dense & moreish for me.
Filtered milk Fine.
Low sugar jam Fine.
Roasted chestnuts Fine.
Haggis Fine. I think."

CIAB is stuff like French fries/chips, chips/crisps, "fast food", take-aways, pizzas, biscuits/cookies, chocolate, sweets/candy, sugar-sweetened beverages, sugary cereals etc.
End of clarification.

In How to lose weight and get slim by eating "fast food" for 180 days. I showed that it's possible to be healthy on a diet of fast food, if you have a plan and you stick to it. The vast majority of people who eat fast food don't have a plan!

Between the ages of 5 & 8, I spent my 12d/week (that's 5p/week, for those of you who are too young to remember £,s,d.) on sweets. Aniseed balls were 4 for 1d. I also ate French Fancies (small sponge cakes covered in fondant icing) and drank Corona Lemonade (~15% sugar content) at home.

How did I get such a ferocious sweet tooth? Here's the probable answer:- Farley's Rusks.

Look at the health-washing on the Heinz web-site.
"Farley’s Rusks have been loved by mums and babies for generations. Each rusk is lovingly baked using baby grade ingredients."

Let's take a look at the baby grade ingredients:-
"Wheat Flour, Sugar, Palm Oil, Raising Agents (Ammonium Carbonates), Calcium Carbonate, Emulsifier (Monoglycerides), Niacin, Iron, Thiamin, Riboflavin, Vitamin A, Vitamin D."

The first three ingredients are refined starch, refined sugar and refined fat. The refined sugar content is 29% by weight. Perfect food for a baby! The previous sentence may contain traces of sarcasm.

Cont'd on Free will? It's just an illusion! How the Food Product Industry gets people to dance to their tune, part 2.