Interesting article- high protein diet for weight loss does not help insulin resistance...?

Found this article pretty interesting. It is just one study, so don't read too much into it. The study found that post menapausal women who lost weight eating a high protein diet (1.2g protein per kilo of weight) were not improved in the insulin resistance department. On the other hand, women who lost weight with the recommended level of protein (.8g per kilo of weight) both lost the weight and became more sensitive to insulin (in a good way). Interesting. 

Makes me wonder if, at goal weight, if I went the specified time of the article if my insulin resistance would improve? For sure though my a1c is down a lot compared to pre-surgery.  I wonder. 

Protein stimulates insulin production, actually, and can in significant ways.  This is because protein gets broken down into amino acids when we digest it, and insulin stimulates protein translocation. Excess protein has to be stored by the body, and it is converted to glucose by the liver via a process called gluconeogenesis.

The difference is that carbohydrate spikes it more severely.  Protein causes a gradual rise.  Even fat (technically) also stimulates insulin, however, it does the least of all the three macronutrients.  Some proteins, whey in particular, are suspected to spike insulin far more than, say, dense animal protein.  Why?  That I'm not sure... my biochem notes are at home.

The difference is also that while carbohydrate raises blood sugar, protein appears to not do this, even though it may increase insulin.  Why?  Reasons are unclear.

The main reason eating more protein is beneficial, I'd argue, is that it's harder to break down.  It takes more effort from the body. Carbohydrate starts being metabolized in the mouth (digestion actually begins in the mouth).  Amylase in human saliva is an enzyme that immediately begins breaking down any carbs, regardless of type.  However, protein needs stomach and pancreatic acids to process completely.  Protein and fat also stimulate satiety hormones more than carbohydrate; one theory from evolutionary biology is that we evolved to desire carbs for quick energy because we evolved without grocery stores and mini marts--food was dang hard to catch!  Fat and meat were sometimes all they had.  

Most of this is current research, but here is everything you probably never wanted to know about insulin. 

Pure fat does not stimulate insulin. You claim it does...do you have study on that? 

I apologize for the pedantry below in advance.

In theory, even if you are eating pure fat, eventually you would spike insulin, yes, because your body needs to store a minimal amount of glucose to function.  It is impossible to store glucose without insulin.  Much like protein, it is not a direct increase.  What happens is when it is, rarely, converted to glucose, that raises the serum insulin to transport and/or store it if necessary.  

I don't have a specific study perhaps in the manner you want.  Studies such as this strongly infer it via the gluconeogenesis route, but below there is an article with resources.  I learned this in my biochemistry classes which exclusively taught this, and this is what the textbooks teach - that fat stimulates it the least of all, protein is next, and the greatest is, of course, carbohydrate.  Unfortunately, I don't consider the studies I'm aware of which conform this are valid due to confounds.  For example, most are based on diabetic research, of whom a significant number take insulin, so there are many confounds (like this study).  Regardless, the effects are minimal at best, in terms of spiking insulin.   There are actually many studies that examine whether or not fat should be used to calculate the insulin bolus for type 1 diabetics, because for them fat does appear to spike insulin more dramatically than the typical population.  

Nutritionists state is more dramatic than not.  Pure biochemistry is more conservative.  It also depends on whether or not the subject is in ketosis, as ketosis changes the metabolic hormonal state, as in the article above.  It's unlikely in the average joe it would occur.  If you are in ketosis or on a low carb diet it is more likely due to the alternations ketosis engages in to maintain TCA.

Also, we know less about biochemistry than we actually think we know.  For example, my old textbooks say it's impossible for fat to convert to glucose.  However, fatty acid metabolism is complex.  (Acetone can be converted to pyruviate which can be converted to glucose.  It's inefficient, but it happens.)  In Ketosis it's possible to convert fatty acids to glucose.  Is it likely?  No.  However, yes, it's possible.  That is what causes the insulin spike, much as protein's conversion does, rather than the protein directly.  If someone eats over a certain fat threshold on a ketogenic diet, likely they are converting some fat to glucose, as 50% of the brain, the adrenals, and bone marrow still require it to function.  I forget the percentage from my neuroscience classes, but just over 50% of the brain actually prefers to use ketones (random tangent: the heart muscle also likes ketones).  That is part of why it is so effective for weight loss, as well as for the improvement of many neurological insults and issues.

I went searching for a more palatable source and found this one which is useful for anyone on a low carb/high fat diet who is curious.  The studies he cites are valid and also predominantly current.

Thank you. I really appreciate the detailed explanation and studies. More stuff to read.. Thanks..

I do follow mostly low carb, moderate proteins and higher fat when I try to lose.  While still trying to "balance my meals." . and even on higher fat diet - I need to limit calories to lose. 

It's one of the only times I get to use the half of my bachelors I never get to these days, so I'm sorry if I got too excited, lol.

I actually followed a zero carb diet for a few years.  It's what got me under 500 pounds.  I still think high fat is one of the better ways to go.  It is a shame that fat takes up so many more calories.  You can argue it's not sustainable.  There are many people in the keto FB groups who have done it for years uninterrupted.

Hala, have you ever read about Vilhjalmur Stefansson?  Check out his work if you are curious.  He pioneered some of the first scientific low carb studies based on indigenous diets.  You might also like Jason Fung's website if IF interests you, though he is anti-WLS, sadly.  Fung though has written a lot about how visceral fat can be reduced via fasting.  It's interesting, despite the fact he misses the mark on WLS by a wide margin.

I honestly appreciate your comments. Really. I am constantly searching for answers. Trying to understand....

The more I research the easier for me is to understand my body reaction to foods.

There was a time, app year 3 and 4th post op, that I had uncontrolled RH and had a problem with gaining weight. The more I was trying to restrict carbs, fat and calories the worse my RH would get and I had to eat carbs sugars... Thennsome mentioned the food insulin index, Dr Bernstein work about diabetes and some other issues. I try to reaserach and understand that.  Thats how I realized that there still are more questions than answers...

And so many options and the whole food body connection is so complex. Plus as individuals - our hormons - all of them regulate so many things...that it is close to impossible to predict how the body is going to reacts to food.

How some food or lack of it will affect us can depends on a time of day, hormonal cycle, how much sleep we had , what other foods we ate a day or even a week before that....our gut condition,.   Etc etc etc etc etc etc...

The more I learn - the least I know... 

I always believed that my beginning of understanding things is when I know what I don't know...that I can ask questions and start looking for answers.

Ignorance is when we don't know what we don't know. 

I worry because I do run at the mouth when I find something interesting.  Please tell me if it's annoying.

We really do not understand as much as people want to know, and there is a weird dissonance between conventional biochemistry and what is taught by nutritionists.  All of what you say is absolutely right and if it was easy to find it would be better for so many of us.  The best scientists admit they know less than they do... so I would basically say you are an excellent scientist, Hala. :)

I always appreciate my ignorance because it means there is something new I can learn, and that is an exciting place to be. I learn so much from people here, for instance.

I hope that you are able to uncover more research.  If I can ever help, let me know.

Same back at you...

BTW- I know you had VSG but I find very interesting the RNY daily support tread...if nothing else - some great ideas for food..

I don't post for daily intakes...but I do respond to some posters.. Try to share what I learned...to help others ..since I was really helped on OH..

What I also find out on here- to have an open mind...and if someonebputs a statment like you did about "fat turing into glucose" - to ask a question vs just blow it off as another person ignorance...though we have plenty of that here on OH. 

BTW - I started IF Keto like to help with my IBS and SIBO.. Following that I lost my last 10lbs regain +5 More lbs.. Recently I had to incease carbs to stop losing... 

Because of my adrenals ( Secondary adrenal insufficiency-  SAI ) I could not follow real Keto diet...I had to do more balanced adding some low gycemic load carbs (but relatively low fiber) to help my adrenals.  

Eliminationg fast absorbed proteins (Whey, other processed protein powders ) really helped stabilize my BS and blood protein levels..more complex proteins mixed with fat and some carbs works best for me.

Thanks for links. 

BTW - I often follow IF for 12-14 hours. Sometimes I do 16 or 18...But not often.  My moderate approach to IF , Keto...plus food choices slowly helps healing my gut and body. My Pituatary are slowly recovering...and adrenal function slowly improving...and not only I got to back to goal - but my body composition is great...at 21% body fat (DEXA scan) , with strong bones, and good muscle mass.