https://nutrita.app/article/insulin-index
High-carb meal: insulin shoots up, glucagon drops
After eating a high-carb meal, blood glucose rises, promptly followed by a rise in insulin. In this scenario, as long as insulin is high, glucagon is low. As soon as blood glucose and insulin levels drop, glucagon goes up. Glucagon stimulates the breakdown of glycogen into glucose and thereby ensures that blood sugar levels keep stable.
It’s important to know that insulin does more than lower blood glucose. It’s also, or primarily, a storage hormone, which promotes fat storage. Glucagon on the other hand, triggers the breakdown of fat (lipolysis) [34]. For fat to be used as energy, it has to be broken down into smaller parts (fatty acids and glycerol). In this regard, lipolysis does not equal fat burning, but it is an essential first step in making stored fat accessible, so that the body (e.g. muscle cells and other organs) can use it as a source of energy.
Eating a lot of refined carbs is therefore a very efficient method to inhibit lipolysis – especially when the time between meals is short, such that insulin hardly has time to come down in between meals. Carb-rich foods – especially refined carbs like sugar and flour – trigger people to snack and lead to fat gain [35].
The scenario looks different when insulin is raised by protein.
Protein-rich meal: insulin and glucagon are released
Let’s first clarify why protein stimulates insulin release. Insulin does not only facilitate the uptake of glucose from the blood, but it is also needed for the absorption of amino acids (the building blocks of proteins) [36]. Because protein does not cause a direct increase in blood sugar, this insulin release would cause a drop in blood sugar. To prevent this, protein does not only lead to a rise in insulin but also in glucagon [37]. Glycogen is broken down, and glucose is released into the blood.
Indeed, a diet that is relatively high in protein and low in carbs is known to improve insulin sensitivity [38, 39, 40]. By raising glucagon, eating protein-rich foods keeps fat stores accessible. This may be one of the reasons why protein is very satiating and provides also a high level of satiety [41]. A protein-rich meal makes you feel full (it’s satiating) and at the same time keeps you full for a long time (it provides satiety). This makes it easy to extend the time in between meals – not eating anything is the safest way to make sure that insulin stays low.
In this regard, the insulin/glucagon ratio is more important than the absolute insulin level [42, 43]. While a high insulin/glucagon ratio inhibits the release of fatty acids and the breakdown of glycogen, a low insulin/glucagon ratio stimulates the mobilization of stored energy.
So for a given rise in insulin from carb-rich versus protein-rich foods, there are different metabolic consequences. What explains that? Lets use an example to understand the difference.
If you’ve looked up white fish in our app, like cod for instance, you might notice that it’s high up on the insulin index (40%) – so does that mean it’s bad for you? No, because although it does elevate insulin substantially it does so within a different hormonal and metabolic context. Hormones like glucagon are strongly stimulated with the cod but not, say, peas. The cod thus leads to an overall healthier metabolic response than the peas [44]. This is why codfish is labelled as Moderate, while peas with an insulin index of 40% are labelled as Poor.
Our scoring system thinks this through for you. You get a simple label to let you know if, overall, this food is in line with your dietary or health goals or not.
Did you know?
There is a common misconception that goes something like this: ‘amino acids from protein can be used to make blood sugar, so protein raises blood sugar, and thus diabetics should avoid protein’. Actually, gluconeogenesis is a very energy-intensive process and the body does not convert amino acids into glucose simply because they are available. Gluconeogenesis ensures that blood sugars are kept stable and sufficient to meet obligate glucose needs [45, 46].
Amino acids (protein) simply participates in that important process. In fact, a large amount of protein from a steak, say, barely raises blood glucose. And any small elevations from it isn’t really due to gluconeogenesis but rather to the breakdown of liver glycogen to ensure a stable blood sugar.
This is also why protein-rich food with an elevated insulin index can still have a pretty decent keto score, because the rise in insulin is accompanied by the activation of other, counter-regulatory ‘fat burning’ signals.
Rest assured though, even if the mechanisms still aren’t totally clear, that’s OK – Nutrita makes it easy for you with its labelled scores and clearly set daily target and limits to reach your goals, whether that’s ‘lower blood sugars’ or ‘lose fat’.
Conclusion
The insulin index is a useful estimate of how much insulin is released in response to a certain food. Keeping insulin low and not stimulating it too often throughout the day is an excellent strategy to prevent a whole host of diseases. Eating foods that are MODERATE or GOOD on the insulin index is smart. However, not all foods that raise insulin substantially are bad (e.g. fish) and not all foods that keep insulin very low are healthy (e.g. high omega-6 seed oils). For this reason, it’s important to check what label Nutrita gives to a food’s insulin index, as well as choose foods within a wider context (i.e. use the nutrient density alongside it).
..........................https://optimisingnutrition.com/food-insulin-index-2/
Gluconeogenesis is actually a highly energy-intensive process, and your body would much rather get its energy from fat or carbs than protein. We lose about 25% of the energy from the protein we eat in the conversion to usable energy (ATP). By comparison, we only lose about 8% of the energy from carbohydrates and 3% of the energy from fat. So, although protein can be used for energy, your body would much rather not have to convert protein to energy.
In fact, due to the strong satiety effect of protein, foods and meals with a higher percentage of protein tend to help us eat less, so we tend to lose body fat and actually reverse our insulin resistance over the long term when we consume foods that contain a higher percentage of protein!
We often think of insulin as an anabolic hormone (to build things up). However, it can be more helpful to think of insulin as anti-catabolic (to stop your body from falling apart).
Your body uses insulin to control the flow of energy from storage (via the liver) into your bloodstream when there is plenty of food coming in from your diet. When there is less energy available from food, glucagon stimulates the release of stored energy and balances the effects of insulin.
When you consume more protein than you need for essential bodily functions (muscle protein synthesis, neurotransmitters etc.), your pancreas will raise insulin to shut off the release of stored fuel from your body while you use up the extra energy.
Although fat doesn’t require as much insulin over the short term, all food triggers an insulin response.
Before you assume fat is a free food because it doesn’t raise insulin, it’s important to note that the food insulin index testing was undertaken over only two hours, so it underestimates the insulin response from protein (which actually elicits a rise over approximately eight hours) while fat raises insulin for a much more extended period.
so imp-
The chart below shows the changes in insulin levels across a 24 hour period.
If we only consider the insulin response in the two hours after meals we don’t account for the significant amount of insulin released across the other 16-18 hours of the day, particularly from low carb diets.
We can’t simply assume that because the insulin rise after meals is low that our total insulin secreted across the day will also be lower.
The reverse may actually be the case.
(sam notes: which means carbs infact could be secreting relatively less insulin)
Insulin and oxidative priority
Our insulin response to the different macronutrients appears to be proportional to their oxidative priority (i.e. the order in which they are burned), how easy they are to keep in storage and how much storage capacity we have for each of them.
- We only have limited space to store carbohydrates in our body. It has to be burned off quickly, so the body raises insulin sharply to hold back your glycogen and adipose tissue in storage.
- Any excess protein needs to be burned off fairly quickly, so we get a lower insulin response.
- However, fat is easy to store, and your body is more than happy to store it, so we get a much smaller insulin response to fat over a more extended period.
If your blood sugars are rising by more than 1.6 mmol/L or 30 mg/dL, then you should reduce the carbohydrates in your diet to get off the glucose rollercoaster to avoid the hangry feeling that comes from constantly rising and falling blood sugars.
In our 6 Week Nutritional Optimisation Masterclass, we guide people to dial back their carbohydrate intake if their blood sugars are going too high after meals. But, as with most things, it’s crucial to find the right balance between extremes.
The chart below from our analysis of our series of nutrient-dense recipe books shows that we maximise nutrient density when we have 15 to 20% of our energy from non-fibre carbohydrates.
There is no need for most people to be concerned about carbs from non-starchy vegetables that can actually be quite nutritious, and avoiding carbs altogether may make it harder to get the nutrients you need.
Does protein raise blood sugar?
As shown in the plot of protein vs glucose below (see Tableau version here), high protein foods will raise your blood sugar a little, but much less than low protein foods that contain refined carbohydrates. As a general rule, consuming a higher percentage of protein will lower your blood glucose.
When you eat protein, you release both glucagon and insulin. In most people, insulin and glucagon are balanced, so your blood sugars remain stable after a high protein meal. But if you are insulin resistant, this signal becomes imbalanced and leads to a more dominant glucagon response from the liver and some elevation of blood sugars (see Why do my blood sugars rise after a high protein meal).
If you are injecting insulin, you may need to top up with some extra insulin so you can metabolise the protein to repair your muscles while also keeping your blood sugars stable. Avoiding protein can lead to a reduced metabolic rate and reduced satiety.
The good news though is that increasing the percentage of protein in your diet tends to lower your overall energy intake and hence reduce your body fat levels.
This, in turn, will lower basal insulin requirements (i.e. the insulin that you need when you are not eating) because you have less body fat to try to keep in storage.
So, unless you require a therapeutic ketogenic diet (for the management of Alzheimer’s, dementia, Parkinson’s or epilepsy), there is no need for most people to worry about eating “too much protein”. For people with a functioning pancreas (i.e. you are not injecting insulin), focusing on reducing carbohydrates should be adequate to stabilise blood sugar levels without worrying about cutting back on the protein in their diet.
Fat is the last macronutrient to be burned (after alcohol, ketones, excess protein and carbohydrate). Fat is easily converted to energy or stored, so only a small amount of insulin is required to store any fat that is left over.
Some people like to believe that they can lower the insulin load of their diet to lose weight (a bit like someone with uncontrolled type 1 diabetes). If you are making your own insulin, your pancreas will not produce any more insulin than is required to hold your fat in storage while you use up the energy coming in from your mouth.
As shown below, our insulin levels across the day are proportional to the amount of fat we are carrying.
Similarly, your fasting blood glucose levels are also proportional to your weight.
The more body fat you have, the more insulin you will require to keep your body fat locked away in storage.
This is why many people who are obese also have high fasting insulin levels. It is not that insulin is causing them to be fat
but rather that their pancreas is working overtime to keep insulin high to hold their fat in storage.
This is why many people who are obese also have high fasting insulin levels. It is not that insulin is causing them to be fat but rather that their pancreas is working overtime to keep insulin high to hold their fat in storage.
If your goal is fat loss, then you need to find a way of eating that allows you to be satisfied with less energy. Your fasting insulin levels will reduce as your body fat levels decrease.
But in reality, it is a little bit more complex. It’s actually:
low satiety nutrient-poor foods -> increased cravings and appetite -> increased energy intake -> fat storage -> increased insulin
Hence, the solution to managing your diabetes, blood sugar, insulin levels and avoiding the myriad of complications of metabolic syndrome is:
high satiety nutrient-dense foods and meals -> decreased cravings and appetite -> decreased energy intake -> fat loss -> lower insulin levels
Putting it into action
So hopefully you can see that managing the insulin load of your diet is important to help you stabilise your blood sugars and insulin after meals. However, if you want to reduce your insulin across the day and reduce your fasting blood sugars, you also need to prioritise high satiety nutrient-dense foods that will promote satiety and help you to lose weight. To help you apply all this we developed a number of tools.
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https://www.livestrong.com/article/411739-i-am-skinny-but-have-problems-with-a-fat-stomach/
Visceral fat releases chemicals known as "cytokines" that increase your risk for heart disease. The Mayo Clinic, in research published in 2010 in the European Heart Journal, found that normal weight obesity is associated with a high prevalence of cardiovascular disease factors in both sexes and may increase the risk of death from cardiovascular complications in women particularly. A study published in Progress in Cardiovascular Disease in 2014 confirmed that patients who have coronary artery disease, but are of normal weight with belly fat, have the highest mortality risk when compared to other patterns of fat distribution.
Those who are skinny fat also display cytokine markers that suggest a higher chance of becoming obese later in life or developing metabolic syndrome, which is a cluster of symptoms such as high blood pressure, high blood sugar and increased risk of developing type 2 diabetes. These findings were reported in a 2007 study published in the American Journal of Clinical Nutrition.
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keto probs
The keto diet could cause low blood pressure, kidney stones, constipation, nutrient deficiencies and an increased risk of heart disease. Strict diets like keto could also cause social isolation or disordered eating. Keto is not safe for those with any conditions involving their pancreas, liver, thyroid or gallbladder.
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