Six common beliefs addressed, Part 1

1. Are foods that cause an insulin spike "bad"?

All foods cause insulin "spikes" (release). A chronically high insulin level is what's "bad" because it drops fasting blood glucose too low. The most common cause of chronically high insulin levels are carbohydrates, which dysregulate blood glucose and cause prolonged insulin release postprandially.

The body is supposed to have insulin spikes after it eats. Insulin regulates how your body uses glucose and nutrients. If this doesn't occur, you die. Insulin also regulates glucagon. If it wasn't for this regulation, glucagon would eventually break down every part of your body into glucose and ketones. Insulin helps build muscle and muscle is the most metabolically active organ in your body. Muscle helps clear glucose from the bloodstream.

But, insulin was meant to be released by the body in pulses, not constantly. It is supposed to go up after eating (postprandial) and then come back down during periods of not eating (fasting). When you eat foods that do not disrupt blood glucose homeostasis, insulin is allowed to work in these pulses. So, the spike is not what matters, as long as insulin is allowed to come down again to very low levels when fasting, so it doesn't drop fasting blood glucose too low.

• The most insulinogenic foods, on the planet, are dairy proteins. When you drink a cup of milk, it causes an initial, very high, insulin spike, but it lowers shortly afterwards. Though it causes a large insulin spike, it does not cause prolonged insulin release. By the time your next meal comes around, your insulin has already lowered. You are able to maintain normal fasting blood glucose.
• When you drink a glass of orange juice, which is mostly sugar, the disruption to blood glucose causes for insulin levels to rise and remain that way, for a prolonged period of time, afterwards. In this case insulin must remain high, because it is desperately trying to clear out the high dose of glucose caused by the orange juice. By the time your next meal comes around, insulin is still high and will now go even higher after you eat again. All of this insulin will drop fasting blood glucose too low, overnight. You are unable to maintain normal fasting blood glucose.

The milk is not obesogenic, but the orange juice is because when you cannot maintain normal fasting blood glucose, the body will begin to store body fat. To control this obesogenic hormonal state you do not avoid insulin release, you avoid prolonged insulin release. The body disposes of insulin pretty quickly, but not when glucose continues to go high postprandial. Glucose is the signal, for the body, to keep its insulin levels elevated. Eat foods that do not cause abnormally and prolonged high glucose levels and you will automatically be on a low insulin diet.

2. Is milk better than cream?

Neither one is better than the other. Reduced fat or skim milk is what you should avoid.

When you take away the fat in milk, you concentrate its protein and carbohydrate, making it an unnatural, man made drink which can disrupt blood glucose homeostasis. Milk is naturally mostly fat and must be consumed in its whole form. If milk's naturally, high fat profile is something you wish to avoid, then avoid milk itself, but do not revert to drinking altered varieties.

A recent study has shown that the neuroprotective benefits of a ketogenic diet are not derived from the presence of ketones themselves, but from the metabolism of the fatty acids in MCTs (medium chain triglycerides). The vast majority of these beneficial MCTs are found in dairy fat, goat dairy having the highest concentrations of these fats like decanoic acid.

Whey protein, found in milk, which is highly insulinogenic, is the most powerful stimulator of glutathione. Glutathione is the most potent antioxidant in the body. This can be found in full fat cottage cheese.

There is no question that those of us who consumed dairy had an advantage. All dairy has benefits, not just cream. The dairy you choose just has to be full fat and preferably organic and grass fed, in order to obtain the maximum benefit from its fat and protein profile.

3. Can using a blood glucose meter help you lose weight?

Yes. 

A blood glucose meter can help you determine if you are on your way to metabolic dysfunction or already have it. This is because it allows you to view, in real time, changes in your blood glucose regulation and what could be causing it.

4. Are foods that contain the most fat, the best to eat?

No. 

The foods that do not disrupt your blood glucose are the best to eat. Because fat has a minimal effect on blood glucose, it is often perceived as the best choice but fatty foods come with their own negative metabolic effects, particularly if you have leptin resistance. Fat also has an effect on insulin, in the long term, because it still has to be stored.

5. Does how much you eat determine your body's weight set point?

Weight set point is determined by the communication between leptin, your fat cells and your brain. Leptin communicates how much stored fat you have and at what rate it's being used. It is the body's weight thermostat and it is controlled through insulin regulation. Two abnormalities occur in high weight set points and each one is a direct result of the other:

• Too Much Body Fat - The person has fat storage that goes well beyond their personal fat threshold. The more fat cells you have, the more leptin is created. Chronically elevated leptin develops "leptin resistance". This is especially true in a sedentary state.
• Chronically High Insulin (Hyperinsulinemia) - When insulin levels remain chronically high, they interfere with leptin signaling in the central nervous system and cause fat mass to remain set to high. This causes for the body to fight to preserve its fat mass, at this higher weight set point, regardless of the person's efforts to lower it or their current state of obesity. Even a trivial amount of weight loss is enough to trigger a metabolic reaction of slow down, when insulin levels remain elevated.

There is debate in the literature as to the sequence of events in this pathology. Some believe the problem lies primarily in leptin, some in the fat cells, some in the brain itself. As far as you're concerned, whatever the reason and whatever came first, the result is the same. The body is having a starvation response, when it shouldn't be having one, as it still has plenty of fat mass and is far from starving. The communication with leptin has obviously broken down, at some level. What is actually stored, is not being communicated to the brain, so it's not being burned and even further storage occurs instead.

More than likely, the miscommunication in leptin signaling is caused, primarily, by hyperinsulinemia and/or abnormal insulin expression at the fat mass. This chronically elevated/expressed insulin causes a metabolism that is set to conserve energy, not burn it, as all obesity is mitigated through insulin receptors at the fat tissue. Insulin resistance is always greater at the muscle and liver, than at the fat mass.

This means that you need to keep insulin normal and the only way to do that is to maintain proper blood glucose regulation. Blood glucose is the first domino that drops, causing a very complex, system-wide pathology afterwards. Stable blood glucose helps insulin normalize and improves leptin signaling, since insulin has a profound influence on leptin.

6. Should nutrient density be the main focus of a diet? 

Proper blood glucose regulation is the only metric of a good diet. 

If you have scurvy, beriberi or some other nutritional deficiency disease, then you would need to address those with the right supplementation. Obesity and metabolic dysfunction are not nutrient deficiency diseases. They are diseases of improper blood glucose control.

Metabolic dysfunction often leads to the inability to properly use certain vitamins, like B vitamins, but eating more does not solve this problem. You must correct the underlying metabolic dysfunction, which is the root cause, in order for the body to use these vitamins again.

Focusing on nutrient density, without a properly formulated diet, causes for two obesogenic dietary practices to occur:

• Incorporation of foods that are falsely labeled as being "nutrient dense", but which are really carbohydrate dense instead.
• Eating more than you need to in order to ensure you are getting enough nutrients.

The hunt for nutrients, in this way, will only help you find obesity. Only a doctor can perform the necessary tests required to determine if you have a nutrient deficiency. Do not assume that you are nutrient deficient and then attempt to eat your way to good health.