Tuesday, October 25, 2011

Insulin Resistance

 Why are so many of us overweight, and what links does obesity have to diabetes and other major disease of our time, like heart disease and cancer? Even the "experts" agree that these diseases are all linked - its called the "Metabolic Syndrome," and that insulin plays a major role.

The part that is unclear to most nutritionist and doctors is the cause and effect. Most health care professionals believe that obesity is caused by simply eating too many calories and that its the obesity itself that causes insulin problems in the body. I believe they have it backwards.

Insulin is a hormone in the body that plays many roles. Its primary job is to enable us to use glucose as fuel for our cells. It is, in fact, the only hormone that causes fat to be stored. We have insulin receptors on our cells - all cells. Heart, liver, adipose (fat), muscle, and brain all have insulin receptors that sense the presence of glucose in our blood stream, and allow the addition of GLUT4 receptors on the cell membrane to uptake the glucose into our cells.

When the body is overwhelmed by the presence of carbohydrate, the insulin receptors begin to stop being as productive. They become resistance to the presence of glucose. (Fructose as well, which is a major cause of the problem, and I'll get to that in a little bit.) Sometimes the receptors work properly, but they are unable to signal the introduction of the GLUT4 receptors that actually absorb the glucose into the cell. Either way, the body responds by releasing additional insulin from the "islets of Langerhans" cells in the pancreas. This additional release of insulin has tragic consequences.

Frequently, the first cells to become resistance to insulin, and thus become unable to use the glucose as fuel, are the muscle cells. Usually adipose tissue is less insulin resistant. So the body responds to this additional insulin by dumping fat and protein into the fat cells. See, its not even the glucose that gets stored. Many in the field of nutrition talk about glucose as being the "preferred fuel" but that doesn't make sense, as glucose is simply empty calories. The body is poisoned by the glucose because it raised blood sugar levels, which have to be kept within strict limits - between 4-6 mM. Because the body wants to be rid of the glucose, it stores the fat and protein in the blood stream for energy use after the glucose is burned off. And any excess glucose is stored as well.

Fructose is even more poisonous to the body. It only exists in the wild in very small amounts in fruit. Most fruit grows in the summer, or in tropical climates, when there is ample sunlight available to also produce large amount of vitamin D in the body. Vitamin D plays a big role in the digestions of carbohydrates and the release of insulin, although this relationship is not well understood. Fructose is digested exclusively by the liver, and has to be packaged into very-low-density-lipoproteins (VLDLs) to be carried through the blood stream. These VLDLs have strong links to heart disease. Also, the fructose often get stored in the liver, and has strong links to fatty liver and liver cirrhosis, also known as "non-alcoholic fatty liver disease." Fructose makes up half of the sugar molecule, as well as about half of high-fructose corn syrup (HFCS), and has never been present in the human diet in the amounts seen today. Mainly this consumption comes from soda (which I call the "cigarette of the future"). There is a growing body of evidence that the fructose itself is what causes the insulin resistance in the first place, and creates the situation where the body can't effectively digest glucose.

So how do we improve our insulin sensitivity, especially in the muscle cells? How do we get our bodies to begin to use the glucose in our blood streams as fuel, rather than storing it as fat, along with the dietary fat and protein? How do we lose weight?

There are a number of things we can do. The first and most obvious, which I have written about extensively, is to cut our carbohydrates, especially sugar and other forms of fructose like HFCS and excessive fruit. A little fruit is not the problem, but it's also not the health food it's made out to be. It's meant to be eaten in the fall at harvest time, in order to store fat for winter, or eaten in tropical climates with 8 hours a day of sunlight on the skin.

In addition to vitamin D (which is needed in much larger amounts in places like Minnesota -I take 10,000 IUs a day), the other less obvious solutions include supplements of magnesium and fish oil. The long chain fatty acids in fish oil improve our cell membrane structure, and allow the body to heal from insulin resistance.

And most importantly, we can engage in a type of exercise called "interval training". This includes small periods of high heartrate-inducing exercise, followed by periods of rest. Usually about 60 seconds on, and then 75 seconds off. This is more effective than long periods of cardio, which is suspected to be hard on the heart and nervous system. It's not so much the "calories" burned by the exercise, as it is the increased insulin receptors that the exercise creates on the muscle cells. When we have additional insulin receptors on our muscle cells, our body is able to use the (small) amount of glucose that we consume as fuel, rather than only storing it and the food we eat with it, as fat.

This not only enables us to continue to safely eat a little carbohydrate, but it helps us lose weight and improves our resistance against metabolic diseases, which are the number one killer in our society!

Thursday, January 27, 2011

What Should We Eat?

So once we realize that the food pyramid has been upside-down our whole lives, what do we eat? We pretty much have to re-think everything that goes in our mouths. They have literally turned the truth completely upside-down on us! They tell us that sugar is innocent and that animal fat is killing us, and the exact opposite is true. Sugar and grains are killing us and animal fat is the healthiest food we can eat. Saturated fat is absolute health food! The Inuit (Eskimos) are the healthiest people we've ever found and they eat 80% animal fat. There is an amazing researcher responsible for this discovery, Vilhjalmer Steffansson. You can read his book, My Life With the Eskimo, on google books.

Basically this man went to live with the Inuit mulitple times for months or years at a time, spending more than 5 years of his life living with them. He adopted their diet and then studied himself and brought Inuit people into the lab as well, taking blood samples and measuring all kinds of disease parameters and nutrient levels. Off the chart healthy. They eat nothing but animal foods for almost 9 months of the year, and show no deficiencies, no disease. They do have some health problems, like high infection rates, which is attributed to their close living conditions and the unsanitary nature of living in a small ice house with many people.

The question people most often ask me is, What should I eat? So here is a list of meal and snack ideas.

Breakfast: easy peasy, as long as you love eggs and bacon. If you don't, it's time to learn. After a couple days of eggs for breakfast, you will start to crave them right when you wake up. Eggs have an amino acid profile of 100. They essentially set the standard for all other proteins. Plus they are full of extremely healthy cholesterol (doesn't cause heart disease, that is a huge myth), other healthy fats, and vitamins. For some reason, I just love pork products in the morning. Beef, chicken, or fish for breakfast just seems gross, but bring on the bacon, sausage, and ham for breakfast! Then eat beef and fish for lunch and dinner, since they are healthier than pork. I also have a quarter or half of a grapefruit most mornings, or some berries with yogurt, or maybe a piece of grain-free toast (the gluten-free bread from the Wedge makes better toast than any wheat bread) if I want a carb serving in the morning, which lately I usually don't.

Frittata: 8 eggs, 1 cup of cheddar cheese, half cup cream, 10 pieces of bacon or sausage or both, any other ingredients you want like mushrooms, scallions, tomato, garlic, onion, spinach. Fry up the meat and veggies in some butter or bacon fat, then stir in the beaten eggs, cream, and cheese, then bake in the oven for 20-30 mins at 350 degrees until cooked through. Delish.

Another amazing breakfast recipe that can be premade and frozen to have something quick to grab in the morning: Bacon Muffins! These are fabulous.

Lunch or dinner ideas:
Wild caught salmon burger (frozen), on a bed of greens with melted cheese, dill, and lemon

Pizza toast - Gluten free bread with pizza sauce, pepperoni, sausage, and mozzarella in the oven for 10 minutes. Great for kids.

Brats with kim chi or sauerkraut and mustard, with cheese melted on top

Grilled summer sausage and cheese sandwich on GF bread.

Coconut curry -  soup or stirfry with any veggies or meat you want, fish sauce, ginger, garlic

Shepard's Pie, heavy on the meat and non-root vegetables and light on the potatoes

No pasta lasagna - julienned zucchini, artichoke hearts, olives, diced tomatoes and spinach instead of pasta with the usual meat sauce, ricotta, parmesan and mozzarella layers

Spaghetti with meat sauce and spaghetti squash instead of noodles - just cut the spag squash in half, rub with olive oil and bake cut-side down for 20 mins in the oven at 350 or so. Then scrape with a fork and instant spaghetti noodles!

Any big piece of meat like a steak or some oven baked chicken, with a green vegetable side like asparagus, broccoli, brussel sprouts, swiss chard, kale, etc. My favorite new way to cook green veggies is sprinkled with o.o. and salt/pepper, then baked in the oven. They get all crispy, like green potato chips. Yum. Baked chicken is really good with herbs, garlic, and butter smeared on it before you bake it.

Pot roast. So easy and so good. Brown the roast in a hot pan with some bacon fat or o.o. in it, then pour broth over the top, add celery, onion, garlic, and a couple carrots and cook on low heat for many hours. Maybe add some baby portobellos toward the end for the last half hour or so.

Three awesome dessert ideas:
These first two can be made with stevia, and hardly anyone could tell it wasn't made with sugar. I especially like the Sweetleaf Stevia, although it has inulin in it, so don't eat it if you struggle with candida.
Panna Cotta. The best recipe is Giada's, just use 1/4 of the sugar she calls for (a good rule of thumb for any dessert recipe, if you get your tolerance down, you won't even notice after a short adjustment time) or a little stevia. No, honey, maple syrup, and agave are not better for you than sugar. Just the same, or even higher in fructose, which is worse for you than glucose.

Egg Custard. So good and so easy, I could make it in my sleep. I eat this constantly. You can use 4 cups of cream instead of the cream and milk if you are trying to lose weight. Milk has lactose - milk sugar which is half glucose and will cause a insulin release, which causes fat storage.
8 eggs, 2 cups cream, 2 cups whole milk, a little bit of some sweetener (or better yet, a teaspoon of stevia), 1 t vanilla, couple dashes of nutmeg (I like to add some before mixing and also dust some on top) and a dash of fine salt. Wisk or hand-mix, then set your custard cups or large glass bowl in a slightly larger cake pan and pour an inch of hot water in the bottom, and place the whole thing in the oven at 325 degrees (not above 350 so the water doesn't boil much) for about 35-40 mins.

Best cookies ever, and they are gluten-free. No one will ever know. So yummy. Just skip the weird grapeseed oil and use room temp butter, and you can go easy on the raisins, or even better, use dark chocolate chips instead! And you don't even need the full quarter cup of sugar - I usually aim for less than 5 grams of sugar per cookie. Stevia doesn't work so well with chocolate, almond flour, or other flours. Stevia is best with dairy and eggs. Best to just use a little sugar here and skip your fruit or other carbs for today.

Hope that gives you some good ideas to get you started! Remember calories don't exist, they only truly measure carbohydrates. Keep your carbohydrates below 50-80 grams/day for weight loss - about 2 or 3 small servings, spaced throughout the day. Then eat all the beef, bacon, sausage, chicken, cream, yogurt, eggs, and fish that you desire and watch the pounds fall away! Happy eating!