Insulin index more important than eating LCHF?

insulin
(Tiffany Jonas) #1

I’m not sure which forum category to put this into, but I’m still a keto newbie so I’ll put it here. Moderators, feel free to move it elsewhere if there’s a better fit!

I listened to a ketogenic podcast in which Dr. Jason Fung, who seems to be highly respected in some ketogenic circles due in part to his work on fasting, mentioned that the insulin index is more important than eating very low carb/high fat. (Here’s a blog post authored by him that expands more on this idea: https://intensivedietarymanagement.com/insulin-index/)

I looked up the insulin index and found a list here: https://en.wikipedia.org/wiki/Insulin_index

To my surprise, things like bran cereal, porridge, and brown pasta are lower on the insulin index than beef, fish, or cheese. (!) Apples have the same score as fish; oranges are just one point higher.

I’m not looking for an alternative to the ketogenic diet, which I’m starting to get the hang of after many n=1 experiments, but I also wanted to make sure I’m not cutting out foods I don’t need to.

Does anyone know anything about this or have experience trying out some of the less keto-traditional, low-insulin-index foods while on a ketogenic diet?

Tiffany

(Solomom A) #2

People say a lot of stuff, your meter is your best friend. The whole point of the diet is to keep insulin low so that you can use ketones rather than glucose. You might have heard some cautioning about dairy etc., it’s because they can keep your insulin up without the glucometer showing it. It’s not: ketones or low insulin, we want both.

Some have higher carbs, but keep their insulin low with frequent fasts.

(Richard Morris) #3

The insulin index is I suspect bad data dressed up as science. The scientists at the University of sugar … I mean of Sydney used the study to create the glycimic institute which get’s paid a fee from the food industry every time they advertise low GI food. So for example when Kelloggs ADDS sugar to cereals to LOWER the glycemic index of the cereal … the people who sign off on that health halo (and get paid a juicy licensing fee) is the Glycemic institute at the University of Sydney.

So the data was collected for each sample food by testing 3 students chosen at random from a pool of students who did not have diabetes (confirmed by an OGTT at the start of the test) and they then averaged the results. Each food was tested by a different 3 students because it would take too much time to test the same people for all the food samples - because they would need to fast several hours in between data collection.

I’m sure everyone can see the flaw in this study, which is of course that they did not establish the insulin dynamics of the individuals under load for a baseline, and individual human variability in glycemic response was a giant confound.

On the insulin index Potatoes are the 3rd most insulinogenic food behind Mars bars and m&ms. I suspect the day they tested pototoes they used their 3 most hyperinsulinaemic students who were able to pass an OGTT 3 months ago.

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Jennie Brand-Miller who lead the study and then founded the glycemic institute and their licensing program that now funds a lot of the university’s nutritional studies used to be a Paleo researcher but became a great defender of sugar, and co-wrote the Australian Paradox paper which described how Australians ate less sugar while becoming more metabolically sick … a paper which has later been quietly retracted.

Also you will have seen her and her partner in sugar defense Alan Barclay around the place arguing that sugar is not a problem.

http://www.theaustralian.com.au/news/health-science/a-spoonful-of-sugar-is-not-so-bad/news-story/1f78f8d76736b77a9abab0363504ccfe

(Tiffany Jonas) #4

Oh, good grief. How disappointing is that! And yet with the name of a reputable university and researcher (not to mention Dr. Fung), it looked totally legitimate. I’m glad I asked, and even more glad you answered! Many thanks, @richard

(Dustin Cade) #5

The idea of low carb high fat is to eat foods that help lower insulin spikes by not causing a high glycimic response. At least how I see it, broken down to its most simplistic form.

(Robert) #6

I just finished a book by Dr. Fung and he does not support the adding of sweeteners, including Stevia. In his book he references studies saying that high fat and low carb diets work better than the alternatives.

What I get from his book is that insulin directly effect your bodies set point, as pertaining to weight. Many things affect insulin, glucose one of the major ones. spikes in insulin are less important than sustained high levels of insulin. Basically few big meals with fasting is better than grazing.

My question is how does fasting affect insulin sensitivity? Fung’s view is basically to eat, spike glucose and insulin, 1 to 3 times a day and then spend 12+ hours fasting. I am trying this now because of his explanation, Richard and Carl did their explanations and I couldn’t make sense of it.

Does the time of meals and fasting matter? I do not have a schedule so I have been trying to maybe eat 2 meals withing 8 hours and then spend 14+ hours fasting. On about 4 days and my blood pressure got down to 125/80, usually I am about 145/95 or so.

How has fasting affected your insulin levels and sensitivity?

Since Richard and Carl are software people I thought of the insulin thing like Googles data usage when they were a start up. Google needed to send data to other data centers. From what I understand the top 10% of data usage is not calculated in there bill, so they would spike the data usage one night a billing period, which would make their bills rather cheap. Basically spiking data was cheaper than a sustained data load, grazing. Billing = insulin levels. Oh well it struck me as a funny comparison.

There’s more but I am tired of typing.

(Richard Morris) #7

Dr Fung is correct. A ketogenic diet is a low insulinogenic diet. That is it is designed so that you need to make the least insulin as you can.

Yes. I also suspect that is the case (although I don’t believe anyone has shown this effect experimentally).

it makes you more sensitive in the short term.

We each make a different amount of insulin for the same amount of a challenge … let’s say glucose. If we are insulin sensitive we only need to make a little. If we are resistant we make a lot to deal with the same amount of glucose.

One thing that appears to increase insulin resistance is insulin … so the more often we make it, the more our cells ignore it and we have to make more … and that is obviously a vicious circle.

It’s kind of like when you enter a quite room, you can whisper to someone and they can hear you. But the more people enter the room, the more the noise level increases and you have to start speaking louder to get across your message. Eventually everyone is shouting.

So eating few meals is like having fewer conversations in the quiet room. You are requiring fewer big spikes of insulin so your body can become more sensitive … but it will be a slow adaptation over a long time just like the adaptation to the high insulin environment took years to develop.

That’s actually a good measure of lowering of insulin.

wow I have never heard that story but yes that is similar to how it works. A short sharp spike is better on your system than hours of elevated insulin.

(Nick) #8

How disappointing and ascetic.

(Carpe salata!) #9

Once you get off them, you will realise they are a bit yucky after all :sunglasses:

(roxanna) #10

Well that’s horrifying!

(Carpe salata!) #11

@roxanna what was so horrifying?

I think it was a bit sneaky of them to list ‘Yogurt’ as confectionery. There are so many different kinds of yogurt. I went on a supermarket label-reading mission the other day and checked yogurt and didn’t end up buying any. If I had the ‘Greek Yogurt’ is the one with the lowest carbs. I try to check the labels looking for sugars and carbs. Also with cheese I try to get the highest fat ones :slight_smile:

I don’t eat anything else on that lost that Richard posted.

(roxanna) #12

Everything about the study described. 3 students, no diabetes. Also the information about the University being paid for being able to advertise low GI food.

#13

While I do not fully understand it, the carbs in full fat plain greek yogurt suppossedly do not count because the bacteria eat them before you do?! Not sure if that is true but I have infrequently eaten it and it has not knocked me out

(Nick) #14

Not all the carbs listed on pots of plain yoghurt count, because they’ll continue to be fermented even once potted. The amount of sugar left will depend on the brand, the amount of culture added etc. The divergence of listed carbs from your spoon-in-pot reality is particularly large if you buy brands listed with “live” cultures. After all, what do you think the culture is living on :slight_smile:

As a rule of thumb, the tarter and more tangy the yoghurt, the more work those bacteria will have done to convert the last remnants of milk sugar into lactic acid - which is what you’re tasting in that yoghurty sourness.

Of course, we are just talking about plain yoghurt here, where the milk sugar was there as bug food and nothing more. If you buy yoghurt where they’ve added sugar AFTER fermentation, to transform it into a pot of sickly pudding, you’d better believe the carby label :wink:

(Todd Allen) #15

I think there is merit to the idea of an insulin index but I’d like to see it pursued by people without any conflicts of interest. And it also needs to be done for a wider range of unprocessed foods. So far the focus seems to have been on testing highly processed crap.

Kirstine Bell, a student of Jennie Brand-Miller, does have some interesting results in her PhD thesis. In general it appears that fat when eaten with protein reduces the insulin response. Fatty meats have lower insulin index scores than lean meats, a nice counter argument the next time you hear someone advocating “heart healthy lean meats”. And fat when eaten with carbs makes the total insulin response significantly greater. This may be a factor in the demonization of fat. If you are eating a high carb diet adding fat to it may make things worse, at least if you aren’t replacing carbs with fat.

But other than contributing a little general understaning to how things work, I don’t think charts of numbers like these are going to be the best way for any of us to choose what to eat. In addition to insulin there are many other factors in play like leptin, thyroid, etc. and we each have our unique balance of responses. There’s really no substitute for tracking how you respond to what you do.

For myself, I have found I have little tolerance for sugars and flours and processed foods containing them even in modest amounts. Fruit juices are also bad. But I can eat a lot of carbs from veggies, even things like garlic and onions with little problem, especially when I’m in a caloric deficit. But when I’m eating a caloric excess I have to be strict about keeping carbs and protein restricted.

#16

From what I understand there is another problem with Insulin Indexes, or concentrating exclusively on insulin in general, that being that it doesn’t account for the behavior of the whole system. What particular comes to mind is another blog from Dr. Fung actually where he talks about Fructose and why it’s still a problem even though Fructose itself turns out to not spike insulin directly: https://intensivedietarymanagement.com/fructose-fatty-liver-insulin-resistance-t2d-28/
Essentially, while it won’t raise insulin or glucose in the blood much, it will damage the liver and fat will build up in the liver, and the end result will be increased insulin resistance (bad summary, of course, for brevity).

#17

Some studies about fructose discussed here:

In episode 13 Gabor and I review a 2011 study looking at the metabolic consequences of rhesus monkeys being fed a grain-based diet supplemented with 500mL of fructose loaded Kool-Aid a day over a year. http://breaknutrition.com/episode-13-happens-fructose-fed-monkeys/

Spoiler alert: They developed diabetes.

(Nick) #18

I happen to disagree with Fung there. So long as your liver is not replete with insulin, fructose will be preferentially converted to hepatic glycogen.

So if you fasted, or were a depleted athlete, I’d dare say there’d be very little harm in ingesting some pure fructose, especially compared with sucrose of even glucose.

#19

Then you aren’t disagreeing with him actually. Not sure if he mentions it in that part or in the preceding part of that 3 part series on Fructose, but he discusses a bit how the dosage and consistency is the problem, not that Fructose will instantly cause you harm that will never resolve or anything. Again, I’m simplifying for brevity, but the whole thing can be read on it’s own.

That said, it’s likewise true that ingesting some sucrose or glucose, depending on the conditions, dosage, etc, can do very little harm as well.

(Robert) #20

I keep hearing that yogurt is a great food but the stuff you find on the shelves is a poor substitution for it. Where can you find real yogurt?