LP-IR Score & FASTER Study

[ggv]

Noticed this LP-IR score in one of Volek’s presentations.
This is pretty amazing if it’s what it appears to be.

Both sets of athletes (High Carb & fully keto adapted Low Carb groups) test as highly insulin sensitive. The Keto adapted group was off-the-charts insulin sensitive however!

Questions:

Is this a result of keto adaptation alone?

Is this produced by a combination of exercise + long term keto adaptation?

Have any of you had your LP-IR measured? If so what was it and what are your exercise habits?

[ggv]

GOt a response from Dr. Tim Noakes via Twitter on this question…Interesting.

[atomicspacebunny]

That is fascinating! I know ACV increases insulin sensitivity. (just wish they would include those types details about the keto side of the study subjects dietary methods “are you taking ACV?”) From the looks of the research below a Ketogenic metabolism (LCHF) is doomed (long-term) without ACV? Anybody care to elaborate further that has more information on the particulars of this? My theory is that it has more to do with insulin spiking (how many times you are spiking insulin in one day?) within a circadian cycle when you eat!

The role of acetic acid on glucose uptake and blood flow rates in the skeletal muscle in humans with impaired glucose tolerance. CONCLUSIONS: In individuals with IGT, vinegar ingestion before a mixed meal results in an enhancement of muscle blood flow, an improvement of glucose uptake by the forearm muscle and a reduction of postprandial hyperinsulinaemia and hypertriglyceridaemia. From this point of view, vinegar may be considered beneficial for improving insulin resistance and metabolic abnormalities in the atherogenic prediabetic state. https://www.ncbi.nlm.nih.gov/m/pubmed/25626409/

Remission of recently diagnosed type 2 diabetes mellitus with weight loss and exercise. https://www.ncbi.nlm.nih.gov/m/pubmed/25636149/

Skeletal Muscle Insulin Resistance: Roles of Fatty Acid Metabolism and Exercise https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2579902/

Skeletal Muscle Insulin Resistance Is the Primary Defect in Type 2 Diabetes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811436/

Mechanisms underlying skeletal muscle insulin resistance induced by fatty acids: importance of the mitochondrial function https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312873/p

Fat in the liver and insulin resistance. https://www.ncbi.nlm.nih.gov/m/pubmed/16179270/

The Role of Insulin Resistance in Nonalcoholic Fatty Liver Disease https://academic.oup.com/jcem/article/91/12/4753/2656230

What Causes Insulin Resistance?
Michael Greger M.D. FACLM January 6th, 2017

“…Same thing happens to adolescents. You infuse fat into their bloodstream. It builds up in their muscles, and decreases their insulin sensitivity—showing that increased fat in the blood can be an important contributor to insulin resistance.

Then, you can do the opposite experiment. Lower the level of fat in people’s blood, and the insulin resistance comes right down. Clear the fat out of the blood, and you can clear the sugar out of the blood. So, that explains this finding. On the high-fat diet, the ketogenic diet, insulin doesn’t work as well. Our bodies are insulin-resistant.

But, as the amount of fat in our diet gets lower and lower, insulin works better and better. This is a clear demonstration that the sugar tolerance of even healthy individuals can be “impaired by administering a low-carb, high-fat diet.” But, we can decrease insulin resistance—the cause of prediabetes, the cause of type 2 diabetes—by decreasing saturated fat intake. …” https://nutritionfacts.org/video/what-causes-insulin-resistance/

[ggv]

On the high-fat diet, the ketogenic diet, insulin doesn’t work as well. Our bodies are insulin-resistant.

That’s pretty much what Noakes was saying, yet the results from Volek’s FASTER study with long term keto adapted endurance athletes was just the opposite!

[atomicspacebunny]

Maybe excercise or level of physical exertion is the/a factor?

Hmmm?

[ggv]

Could be…or might just be noise too I suppose but to have all the LCHF group be down in the 1 percentile range would be quite the coincidence! I’m due for a physical so I think I’ll go in and ask for this lipid test myself.
I suppose this could imply that combining LCHF with endurance training might have some unexpected health benefits!

[atomicspacebunny]

Me too, getting tested tomorrow!

[ggv]

Nice! What do you do for working out?

[atomicspacebunny]

Using a BOWFLEX cross trainer for HIIT and real metal ankle weights (hate sand) for jogging and lift weights!

[atomicspacebunny]

This is the last test my doctor ordered (I think he was looking for signs of insulin resistance) when he found out I was doing keto! These were all abnormal before!

[atomicspacebunny]

“… Clear the fat out of the blood, and you can clear the sugar out of the blood. …” - Dr. Michael Greger M.D. FACLM

If their is sugar to clear? Low Carb vs. High Fat (LCHF)*?

Is your fasting blood glucose higher on low carb or keto? Five things to know By Anne Mullens, Dr. Andreas Eenfeldt, MD (editing) – Updated November 2017

”…1. Relax, it is normal — call it “adaptive glucose sparing” “We definitely see that in people who are doing low carb long term, the majority will find that their fasting blood glucose becomes their highest value of the day,” says Dr. Sarah Hallberg. “They are not actually having issues with blood sugar. They are doing really well. But if you are looking at a log of 24 hours of blood glucose you will see a high first thing in the morning and then a steady decline throughout the day, with no big excursions [in glucose levels] EVEN AFTER MEALS.”

The scientific name is “physiologic insulin resistance” and it’s a good thing…

The scientific name is “physiologic insulin resistance” and it’s a good thing — unlike “pathologic insulin resistance.”
As regular visitors will know from Dr. Jason Fung, Dr. Ted Naiman, and Ivor Cummins, the “pathologic” kind of insulin resistance is caused by higher and higher levels of insulin — hyperinsulinemia — trying to force glucose into over-stuffed cells. That insulin resistance is a prominent feature of type 2 diabetes, polycystic ovarian syndrome (PCOS) and other chronic conditions.

So let’s call physiologic insulin resistance instead “adaptive glucose sparing,” a name that has been proposed by many TO REDUCE THE CONFUSION. Dr. Ted Naiman describes it as muscles that are in “glucose refusal mode.” …” https://www.dietdoctor.com/low-carb/fasting-blood-glucose-higher

*References:

The Ketogenic Diet and Insulin Resistance

The Ketogenic Diet and Insulin Resistance | Ruled Me

23 Studies on Low-Carb and Low-Fat Diets — Time to Retire The Fad https://www.healthline.com/nutrition/23-studies-on-low-carb-and-low-fat-diets

Low-Carb, High-Fat Diet vs. Low-Fat Diet: Which Helps You Live Longer? https://draxe.com/low-carb-high-fat-diet-vs-low-fat-diet/

Problems Combining Low Fat With Low Carb http://healthyeating.sfgate.com/problems-combining-low-fat-low-carb-11543.html

The Low-Fat vs. Low-Carb Diet Debate Has a New Answer http://time.com/4919448/low-fat-v-low-carb-diets/

[Dipper_Actual]

What Causes Insulin Resistance?
Michael Greger M.D. FACLM January 6th, 2017
“…Same thing happens to adolescents. You infuse fat into their bloodstream. It builds up in their muscles, and decreases their insulin sensitivity—showing that increased fat in the blood can be an important contributor to insulin resistance.
Then, you can do the opposite experiment. Lower the level of fat in people’s blood, and the insulin resistance comes right down. Clear the fat out of the blood, and you can clear the sugar out of the blood. So, that explains this finding. On the high-fat diet, the ketogenic diet, insulin doesn’t work as well. Our bodies are insulin-resistant.

@atomicspacebunny Greger doesn’t differentiate between liver and peripheral insulin resistance when he speaks this broadly. Plus his conflict of interest will not allow him to ever recommend eating animal products as healthy. Most generously I’d say he’d be on board with a vegan keto diet, (talk about not-sustainable…) but most times I just scratch my head and wonder if he really understands that a high carb diet will drive Trigs up. (the same serum fat that Greger would have us clear from out of our blood to improve IR [yes, I know they aren’t the same fatty acids in there])

Then Marty Kendall goes and does this:

Dr Greger’s How Not to Die Cookbook (review)

[Dipper_Actual]

I’ve had 2 NMRs in 2017 and I’m not sure about this score thing. Throughout the year I would take 1 or 2 taekwondo classes per week. I’d imagine training for endurance rather than fast twitch and bodyweight strength would improve the score faster.
Started keto strictly on 1/1/17…
on 4/20/17 LP-IR: 47
on 7/23/17 LP-IR: 46

I may get another one next April just for anniversary’s sake.

[atomicspacebunny]

Just wish that differentiation was discussed more frequently, it is so confusing!

[Dipper_Actual]

It’s an easy way for the orthodox to say that the keto WOE is the devil. They can point to all the crap observational/associational/epidemiological studies where the participants are asked what they ate over the last 4-6 years, nod their heads, and say that of course the extra rasher of bacon you had per week is going to clog your arteries, or in Greger’s opinion, marble your muscles.

We all here know better, but we all here took the red pill. There’s legion out there who still believe that that pasty, beta, smug type know anything about nutrition or how to actually let food heal you.

[atomicspacebunny]

Even what I cited in my post …“The scientific name is “physiologic insulin resistance” (adaptive glucose sparing) and it’s a good thing…”
Does not distinguish between peripheral or liver?

[Dipper_Actual]

And seriously, @Marty_Kendall this guy damages my calm. I don’t need you to go out of your way to find redeeming qualities

[Dipper_Actual]

Yes, Physiologic here would mean the peripheral insulin resistance, where muscle tissue appears to develop resistance when on keto for a while. The while being defined I assume as the time it takes to become keto-adapted. This doesn’t cause any disease.

The bad kind from the liver is referred to as pathological since it does cause disease, metabolic syndrome.

The physiologic insulin resistance should be accounted for if you have to take a OGTT though. Carb up for I think it was 3 days, and then you may have a normal test.

But now you got me thinking about the LP-IR score. I wonder if that is why mine is borderline and if I were to carb up a few days before the next NMR if my score would appear better?

[atomicspacebunny]

That would be interesting to see!

[atomicspacebunny]

Also thinking of contacting the author to find out a little more about the “adaptive glucose sparing” and if what is being discussed is liver or peripheral or both?.