Gluconeogenesis, blood sugar, and protein

(Patrick B.) #1

I know this goes against the things I’ve been listening to on the 2KD podcast.

She claims that …“protein does not affect blood glucose levels” and lists several studies that she believes proves that (or maybe she’s not saying what I think she’s saying).

So earlier in the article, she says that you would have to take 180g a day of protein to label the diet a “high-protein diet” (simplified) but then in order to prove that eating a high-protein diet doesn’t cause kidney disease, she gives for example a 1984 Nyberg study in which 3 groups were given “an average protein intake of >80 g/day (~16–17% of daily calories), with no relationship between the amount of protein ingested and the progression of kidney disease, The results of this study were confirmed in duplicate studies by Watts in 1989, Ekberg in 1994, and Jameel 1999. Case closed.”

That doesn’t sound like a high-protein diet. I guess I’m looking for the science behind the first part and thoughts on the second part.

Gluconeogenesis, blood sugar, and protein – we need to stop having the same conversations over and over…

#2

idk what you want to rebut?

I know that richard has said that based on his observations gluconeogenesis from protein is demand based not supply based.

(Patrick B.) #3

Rewrote it to clarify my thoughts…

#4

This is correct, high-protein is only proven to be a problem for people with existing kidney problems, it will not cause kidney problems.

This is probably correct and I think the confounding factor that makes it appear like GNG is supply-based is that people who are eating low-carb, high-protein are not eating enough fat, so eating this way results in their blood glucose raising through GNG because the body doesn’t have what it needs to supply it’s demands with fat.

Since fat doesn’t stimulate GNG and BG only raises indirectly through the release of glycerol during fatty acid oxidation, eating more fat supplies the body with what it needs without affecting it. I think only about 10% of the energy in fat can come from glycerol, but I don’t know if it directly affects BG, just that the body can use it.

This means that it’s probably not about the absolute amount of protein in a meal, but the relative absence of the energy from exogenous (dietary) or endogenous (bodyfat) fat that triggers GNG in a low-carb diet.

In one meal I eat asparagus and a lean sirloin steak and results in low-carb, high-protein and some fat, but there isn’t enough fat to fuel ketogenesis, or it isn’t enough to meet my energy demands in general, but the brain and red blood cells still need glucose, so the amino acids from protein get converted to glucose through GNG because the body does need some glucose.

In another theoretical meal with asparagus where the protein grams from a fatty ribeye also includes plenty of fat, the abundance of fat will meet my energy demands so the amino acids won’t be needed to fuel GNG.

So I’ll speculate that when people claim that they ate too much protein and it knocked them out of ketosis, they probably ate too little fat and the body was forced to create glucose from the protein they ate.

Why would this happen in some people and not others? Or some people are more sensitive to eating protein?

I think Hormone Sensitive Lipase (HSL) can be a factor because it is probably relatively deficient/impaired in those people who seem to suffer from elevated blood glucose after ingesting higher amounts of protein because they aren’t mobilizing fats as efficiently as others, so in the dearth of carbohydrates, the brain needs energy from something and turns to protein.

Just my speculation and opinion, but I think there’s scientific and anecdotal evidence to support it.

(Richard Morris) #5

I think the point she should have made is that there is not a dose dependant relationship between dietary protein and circulating glucose.

Not my observations, but the case made by Bill Lagakos showed that new glucose production is driven by glucose demand, not by available raw materials. The clinical observations were Dr Adam Nallys who has observed that his patients have less circulating glucose and more ketones when they restrict protein.

I made the case on our protein controversy show and the following blog post that a brain running on ketones is leveraged to demand 4x more glucose if there is a drop in ketone availability, and that one particular amino acid (Aspartate) becoming abundant will decouple ketone production. So eating protein could alter the demand for glucose.

However it’s worth pointing out this recent paper discussion on truly high protein diets that they appear to over drive new glucose production and that causes them to act just like high carb diets.

🍖 == 🍰[quote=“richard, post:1, topic:5987”]
if you get high enough protein (65% of energy) on a low carb diet, it becomes a regular glucose burning diet and no longer meets many of the other standards of a low carb diet. Of course you don’t make ketones with FFA and insulin at those levels.
[/quote]

WTF - I've gained 6 pounds and DID NOT CHEAT!
(John Nunez) #6

It’s seems the argument she’s attempting to emphasize the most is that ingested protein does not raise blood glucose levels. However, the point I am about to make she seems to briefly mention towards the end of the article but I wish to elaborate.

“It is also speculated that the insulin stimulated by dietary protein causes the glucose formed to be rapidly stored as glycogen in the liver and in skeletal muscles. This glucose can then be released when insulin levels are low or glucagon levels are elevated.”

In my humble opinion, when one exceeds their protein demand for the day, the liver does perform GNG and store the glucose as glycogen. Common sense then would say “Of course there isn’t a BG rise since it isn’t being circulated in the blood but being stored!” Where I think this effects weight-loss is our bodies will always preferentially use up the glycogen first before it touches body fat stores. Therefore, it’s not so much that protein raises insulin (although it has been shown that some amino acids are very insulinagenic) but that excess protein will replenish the “wrong” fuel tank and we MUST empty this tank before we move on to the “better” fuel…our fat stores.

(Richard Morris) #7

We burn protein directly too. We don’t have to make it into glucose first. So when your labile pool is full it is just rerouted into your cells to be used for energy. This also displaces fat burning, which stops ketone production, which in a ketogenically adapted brain means a 4x increase in glucose demand … which now more of that labile pool of amino acids is redirected into the production of new glucose.

Fat really is a superior fuel. Protein is a building ingredient and an inferior tertiary choice of fuel after the primary 2 fat and glucose.

split this topic #8

A post was split to a new topic: Ribose supplementation

(Ril) #9

Ive been conflicted in this arena with how much protein then do i specifically need. As all calculations of protein for me feels like too much eating wise…and i almost have to force feed myself in a day to reach my minimum protein i take…and when i eat beef chicken or pork for ny evening meal it makes me “carb crash” about 15 minutes after i eat and i get so sluggish i have to lay for a nap for about 45 mins to an hour. It totally throws me out of ketosis and in last 3 weeks…ive gained 4 pounds being diligent in keto. I gain 2 percent in fat.

Due to this i started looking into preoteins insulin index after i heard you guys talking about it in a podcast (with jason fung i think)

So ive been switching my protein to lesser fii like eggs and fish and avoiding beef and pork and chicken so much…in fact ive decides to go zero carbs for a bit and trail a wae im calling LowFiiZC.

I’m so sick of the ketoncycling the stall in fat loss and passing out after i eat dinner like i did when i was full on T2D and still eating pasta.

The protein recommendations just seem to be all over the place depending on who you read. And any of them seem to be too much for me…or I’m just THAT metabolically deranged still.