Previously in this series, we've discussed the role of cellular energy excess, inflammation, brain insulin resistance, and micronutrient status in insulin resistance. In this post, I'll explore the role of macronutrients and sugar in insulin sensitivity.
Carbohydrate and Fat
There are a number of studies on the effect of carbohydrate:fat ratios on insulin sensitivity, but many of them are confounded by fat loss (e.g., low-carbohydrate and low-fat weight loss studies), which almost invariably improves insulin sensitivity. What interests me the most is to understand what effect different carbohydrate:fat ratios have on insulin sensitivity in healthy, weight stable people. This will get at what causes insulin resistance in someone who does not already have it.
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Sunday, 15 January 2012
Thursday, 12 January 2012
New Obesity Review Paper by Yours Truly
The Journal of Clinical Endocrinology and Metabolism just published a clinical review paper written by myself and my mentor Dr. Mike Schwartz, titled "Regulation of Food Intake, Energy Balance, and Body Fat Mass: Implications for the Pathogenesis and Treatment of Obesity" (1). JCEM is one of the most cited peer-reviewed journals in the fields of endocrinology, obesity and diabetes, and I'm very pleased that it spans the gap between scientists and physicians. Our paper takes a fresh and up-to-date look at the mechanisms by which food intake and body fat mass are regulated by the body, and how these mechanisms are altered in obesity. We explain the obesity epidemic in terms of the mismatch between our genes and our current environment, a theme that is frequently invoked in ancestral health circles.
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Monday, 9 January 2012
What Causes Insulin Resistance? Part IV
So far, we've explored three interlinked causes of insulin resistance: cellular energy excess, inflammation, and insulin resistance in the brain. In this post, I'll explore the effects on micronutrient status on insulin sensitivity.
Micronutrient Status
There is a large body of literature on the effects of nutrient intake/status on insulin action, and it's not my field, so I don't intend this to be a comprehensive post. My intention is simply to demonstrate that it's important, and highlight a few major factors I'm aware of.
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Micronutrient Status
There is a large body of literature on the effects of nutrient intake/status on insulin action, and it's not my field, so I don't intend this to be a comprehensive post. My intention is simply to demonstrate that it's important, and highlight a few major factors I'm aware of.
Read more »
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Ground meat treats: Beef and bison meatza
At the time of this writing, there was no Wikipedia article for the term “meatza”, which surprised me a bit given the number of recipes on the web. In fact, I could not find anything concrete about the dish’s tradition or history.
Another thing that surprised me about this dish is how much my family and I like it. It has become a regular weekend treat for us for quite some time now.
The recipe below is for a meal that feeds 4-8 people. Like in my previous recipe for a zucchini and onion meatloaf (), the ground beef used here has little fat, and thus a relatively low omega-6 content. Most of the fat comes from the ground bison, which has a higher omega-3 to omega-6 ratio.
- Prepare some dry seasoning powder by mixing sea salt, parsley flakes, garlic powder, chili powder, and a small amount of cayenne pepper.
- Mix 2 lb of very lean ground beef (96/4) with 1 lb of ground bison.
- Add the dry seasoning and a whole egg to the ground meat mix.
- Vigorously mix by hand until you get a homogeneous look.
- Place the mix into a sheet pan coated with olive oil. Richard’s suggestion of creating edges helps keep the sautéed vegetables on top, when they are added later ().
- Preheat oven to 375 degrees Fahrenheit.
- Bake the meatza for about 15 minutes.
- Grate 1 lb of aged cheese.
- Slice one tomato, half an onion, and one green bell pepper, and sauté them in olive oil.
- Drain the meatza after if comes out of the oven, and add the sautéed vegetables to the top, together with half a can of tomato sauce.
- Add the 1 lb of grated aged cheese on top of the vegetables and tomato sauce.
- Return meatza to the oven, still at 375 degrees Fahrenheit, and bake it for about 10 minutes.
The photo montage above shows a side dish of baked potatoes and zucchini. That is optional, as the meatza has vegetables added to it. I usually cut the meatza into 8 rectangular pieces. Each rectangle will have about 50 g of protein and 20 g of fat. The fat will be primarily saturated and monounsaturated (both healthy), with a good balance of omega-3 and omega-6 fats. Each piece of meatza will also be a good source of vitamins B12 and B6, niacin, calcium, zinc, selenium, and phosphorus.
Another thing that surprised me about this dish is how much my family and I like it. It has become a regular weekend treat for us for quite some time now.
The recipe below is for a meal that feeds 4-8 people. Like in my previous recipe for a zucchini and onion meatloaf (), the ground beef used here has little fat, and thus a relatively low omega-6 content. Most of the fat comes from the ground bison, which has a higher omega-3 to omega-6 ratio.
- Prepare some dry seasoning powder by mixing sea salt, parsley flakes, garlic powder, chili powder, and a small amount of cayenne pepper.
- Mix 2 lb of very lean ground beef (96/4) with 1 lb of ground bison.
- Add the dry seasoning and a whole egg to the ground meat mix.
- Vigorously mix by hand until you get a homogeneous look.
- Place the mix into a sheet pan coated with olive oil. Richard’s suggestion of creating edges helps keep the sautéed vegetables on top, when they are added later ().
- Preheat oven to 375 degrees Fahrenheit.
- Bake the meatza for about 15 minutes.
- Grate 1 lb of aged cheese.
- Slice one tomato, half an onion, and one green bell pepper, and sauté them in olive oil.
- Drain the meatza after if comes out of the oven, and add the sautéed vegetables to the top, together with half a can of tomato sauce.
- Add the 1 lb of grated aged cheese on top of the vegetables and tomato sauce.
- Return meatza to the oven, still at 375 degrees Fahrenheit, and bake it for about 10 minutes.
The photo montage above shows a side dish of baked potatoes and zucchini. That is optional, as the meatza has vegetables added to it. I usually cut the meatza into 8 rectangular pieces. Each rectangle will have about 50 g of protein and 20 g of fat. The fat will be primarily saturated and monounsaturated (both healthy), with a good balance of omega-3 and omega-6 fats. Each piece of meatza will also be a good source of vitamins B12 and B6, niacin, calcium, zinc, selenium, and phosphorus.
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Sunday, 8 January 2012
What Causes Insulin Resistance? Part III
As discussed in previous posts, cellular energy excess and inflammation are two important and interlinked causes of insulin resistance. Continuing our exploration of insulin resistance, let's turn our attention to the brain.
The brain influences every tissue in the body, in many instances managing tissue processes to react to changing environmental or internal conditions. It is intimately involved in insulin signaling in various tissues, for example by:
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The brain influences every tissue in the body, in many instances managing tissue processes to react to changing environmental or internal conditions. It is intimately involved in insulin signaling in various tissues, for example by:
- regulating insulin secretion by the pancreas (1)
- regulating glucose absorption by tissues in response to insulin (2)
- regulating the suppression of glucose production by the liver in response to insulin (3)
- regulating the trafficking of fatty acids in and out of fat cells in response to insulin (4, 5)
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Saturday, 7 January 2012
What Causes Insulin Resistance? Part II
In the last post, I described how cellular energy excess causes insulin resistance, and how this is triggered by whole-body energy imbalance. In this post, I'll describe another major cause of insulin resistance: inflammation.
Inflammation
In 1876, a German physician named W Ebstein reported that high doses of sodium salicylate could totally eliminate the signs and symptoms of diabetes in certain patients (Berliner Klinische Wochenschrift. 13:337. 1876). Following up on this work in 1901, the British physician RT Williamson reported that treating diabetic patients with sodium salicylate caused a striking decrease in the amount of glucose contained in the patients' urine, also indicating an apparent improvement in diabetes (2). This effect was essentially forgotten until 1957, when it was rediscovered.
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Inflammation
In 1876, a German physician named W Ebstein reported that high doses of sodium salicylate could totally eliminate the signs and symptoms of diabetes in certain patients (Berliner Klinische Wochenschrift. 13:337. 1876). Following up on this work in 1901, the British physician RT Williamson reported that treating diabetic patients with sodium salicylate caused a striking decrease in the amount of glucose contained in the patients' urine, also indicating an apparent improvement in diabetes (2). This effect was essentially forgotten until 1957, when it was rediscovered.
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Friday, 6 January 2012
What Causes Insulin Resistance? Part I
Insulin is an ancient hormone that influences many processes in the body. Its main role is to manage circulating concentrations of nutrients (principally glucose and fatty acids, the body's two main fuels), keeping them within a fairly narrow range*. It does this by encouraging the transport of nutrients into cells from the circulation, and discouraging the export of nutrients out of storage sites, in response to an increase in circulating nutrients (glucose or fatty acids). It therefore operates a negative feedback loop that constrains circulating nutrient concentrations. It also has many other functions that are tissue-specific.
Insulin resistance is a state in which cells lose sensitivity to the effects of insulin, eventually leading to a diminished ability to control circulating nutrients (glucose and fatty acids). It is a major contributor to diabetes risk, and probably a contributor to the risk of cardiovascular disease, certain cancers and a number of other disorders.
Why is it important to manage the concentration of circulating nutrients to keep them within a narrow range? The answer to that question is the crux of this post.
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Insulin resistance is a state in which cells lose sensitivity to the effects of insulin, eventually leading to a diminished ability to control circulating nutrients (glucose and fatty acids). It is a major contributor to diabetes risk, and probably a contributor to the risk of cardiovascular disease, certain cancers and a number of other disorders.
Why is it important to manage the concentration of circulating nutrients to keep them within a narrow range? The answer to that question is the crux of this post.
Read more »
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