Diabetes and Insulin Resistance

I am going to save you a lot of time by summarizing “Good, Bad, and Ugly” foods. Pictured above are some of the healthiest fats we have in our diets. Missing from this picture is pure butter, especially if it is derived from grass-fed cows. It is an excellent source of C15. You should include eggs, and for the most part, disregard any concern regarding the cholesterol found in the yolk. Virtually all mono-saturated oils such as olive oil are healthy…even coconut oil, which is about 90% saturated fat because it is mainly comprised of medium chain triglycerides that make up the majority of the cells in our brain and peripheral nerves.

The new rule of thumb is that natural fats from almost any source are good for you, including red meat (yes, that’s what I said). Conversely, you should avoid any food marketed as “Low Fat”, because it has been modified from its natual form, or it may be loaded with processed carbohydrates.

LATEST SCIENTIFIC FACT: If you have a choice of Fat, Protein, or Carbohydrate to eat, primarily choose FAT.  Apart from the brain, every tissue in the body prefers to run on fatty acids, especially the heart. Eaten in moderation they are NOT fattening. However, so many of us are convinced by decades of “brain washing” that fats are bad for us, when in reality processed carbohydrates are the worst thing we can eat!

On the other side of the fence are fats and oils once thought to be good for us, but are now recognized as unhealthy, perhaps even dangerous. These include virtually all seed oils, even corn and canola oil, once considered healthy (and incorrectly labeled “vegetable oil”). Depending on the method of manufacture, these can go from bad to worse if heat is used to extract the maximum amount of oil, because heat changes the properties of these unsaturated fats. Cold-pressed oils are always preferable. Not only that, but ALL unsaturated, and particularly poly-unsaturated oils are vulnerable to peroxidation, otherwise known as becoming rancid.

 Therefore, if you must use these oils, they should be tightly capped and kept in a cool dark place as much as possible. It is also wise to purchase these oils in small bottles that are used quickly and not allowed to linger for months or years in partly full containers. Also, if you enjoy fried food, the use of saturated fats is preferable to unsaturated, especially poly-unsaturated oils due to their tendency to become oxidized by heat.

One final note that you don’t often hear. When cooking with any oil, including monosaturated oils such as olive oil, you should always take care to use the lowest possible heat. When oil begins to smoke, it is a sign that it has reached its maximum “safe” cooking temperature. The point at which the properties of the lipids that make up the oil begin to change favoring the formation of “trans fats” that should always be avoided. Because coconut oil is almost 90% saturated, it can tolerate the highest heat of any mono-saturated oil. That is why it is preferred for high heat cooking such as popcorn and baking.

I realize that several of the things I have just told you, regarding fats, fly in the face of past conventional beliefs. You must trust me…it might take 20-30 years for these new truths to become “gospel”, as is often the case with scientific findings. As an example, it took several decades for trans fats to be recognized as dangerous, and there is still work to be done to eliminate them from the global food supply. To expand on this, I am going to include a short (5:45) podcast featuring Dr. Annette Bosworth. “Dr. Boz” who is considered a keto guru gives you a number of tips to lower insulin resistance.

Reverse Insulin Resistance Once and For All (click to view)

One other thing…there are two-edged swords you need to watch for. Everyone knows that omega-3s are beneficial. This is particularly true of wild-caught fish as opposed to farm-raised. Here’s one piece of advice you don’t often hear…try to avoid predatory, long-lived large fish such as tuna and swordfish from your regular diet because they accumulate higher amounts of mercury than smaller fish, like sardines or herring.  Also look for supplemental fish oils stating that their mercury content has been reduced. Always store them in a cool dark place to avoid oxidation and throw them away when they exceed their expiration date. Incidentally, omega 3s from algae do NOT contain mercury and are considered vegan and sustainable because they do not require harvesting of fish.

Going down into the basement we encounter the metabolically Ugly food that did not exist hundreds of years ago. This includes ALL hydrogenated fats (once used in more snack foods than you can imagine) because they remain fresh on the shelf for much longer. Refined sugar, at one time only used to sweeten tea and coffee and occasional baked goods. What most people don’t realize is that sugar (sucrose) is made up of two sugars (a disaccharide) one being glucose, generally good and the other fructose, a.k.a. the kiss of death. But there is something even worse…high fructose corn syrup, the kiss of death on steroids.

There is also another common additive that doesn’t fit neatly into a food category that is extremely unhealthy and found in dozens of foods. Maltodextrin is used as a food additive in many products, including beverages, ice cream, and peanut butter. It's made from plant starches, such as corn, wheat, rice, potato, or tapioca, that are chemically processed to create a water-soluble powder with a neutral taste. Read ingredient labels before purchasing…try to avoid this substance as much as possible.

Another “A-Lister” is sugar sweetened soda. These are particularly devastating for our children and grandchildren because they are almost inescapable in their peer-based lifestyle and the preference for these drinks sticks with them throughout their life.  I guess I don’t have to warn you about sweetened cereal. There’s almost nothing good about their use of sugar or the grains they are made of. This is another one that is tough to avoid due to their addictive taste and convenience.

Non-Alcoholic Fatty Liver Disease or NAFLD as it is sometimes termed, was first recognized in the 1980s as a common condition by the Mayo Clinic, but its prevalence has increased significantly since then. From 1990-2006 the global prevalence of NAFLD was 25.3%. Now it is the most common chronic liver disease in the world with a prevalence exceeding 40%. It is characterized by the accumulation of fat in the liver and is closely associated with metabolic comorbidities like type 2 diabetes, high cholesterol, hypertension, and obesity.

Its cause is almost exclusively the result of insulin resistance. This results from high levels of sugar/fructose intake, most often from sugar sweetened soft drinks, candy and just about any form of refined sugar. In general, its severity is closely linked to obesity. Fortunately, its progression can be halted and even reversed. Treatment usually starts with weight loss initiated by eliminating soft drinks and fructose from the diet as much as possible. Limiting portion sizes, in addition to exercise, is always beneficial. If type 2 diabetes is present, the use of GLP-1 agonists is recommended.

Finally, I will discuss the role that insulin resistance plays in neurodegenerative diseases, which are usually attributed to genetic factors for which there are no known cures. Insulin resistance can contribute to the development of several neurodegenerative diseases, including: 

• Alzheimer's disease (AD)

Some studies suggest that AD is a metabolic disease caused by brain insulin resistance. People with type 2 diabetes are more than twice as likely to develop AD as people without diabetes. Sometimes age-related dementia and AD is claimed to be the result of “Type 3 Diabetes” which is a name given to this causative metabolic condition.

• Parkinson's disease (PD)

Insulin resistance is a factor in the development of PD, which is the second most common neurodegenerative disease. 

• Huntington's disease (HD)

Insulin resistance is also a factor in the development of HD, a progressive disease that primarily affects middle-aged and elderly adults. 

Other conditions that may be affected by insulin resistance include: Amyotrophic lateral sclerosis (ALS), Multiple sclerosis (MS), Down syndrome (DS), and Autism. 

Insulin resistance occurs when normal or elevated insulin levels don't produce the expected biological response. This usually leads to the production of additional insulin by the pancreas, which is termed “Metabolic Syndrome”, where continuous over-production of insulin is responsible for several negative effects such as increasing obesity.

Even though there are presently no known cures for these conditions which are caused by a myriad of genetic and environmental factors, there are a plethora of treatments that significantly improve symptoms. At a later date, I can discuss some of these if my readership has sufficient interest (leave a comment). In the meantime, taking steps to reduce insulin resistance which is involved with each of these conditions will slow progression and improve prognosis.

Another factor that I feel obliged to mention is the effect of neurodegenerative diseases on the cost of healthcare, now and in the future.  The direct and indirect cost of brain disease is significant. One study estimated the economic burden of major neurologic diseases to be approximately $800 billion annually in the United States. Alzheimer's disease and other dementias are the largest contributors to this figure. If the prevalence rate of dementia remained at its 2010 level, the aggregate annual care cost is estimated to increase to $379–$511 billion by 2040, or to $1.5 trillion by 2050...

If you found this week’s newsletter overwhelming, my sincere apologies. Because of the subject matter, I knew it would be massive, and I wasn’t wrong…But there is a reason…One that might not occur to you immediately. In fact, it even surprised me. It is something that I have never heard voiced by anyone, and yet there it was, hiding in plain sight… The entirety of all the diseases discussed in this week’s offering are the result of evolutionary forces at work on the human body.

Much of this has to do with our superior intellect and our ability to change our physical world, and hopefully adapt to it. But what we fail to realize is that our ability to “adapt” is primarily a function of our intellectual perception and reaction…our way of thinking. Regrettably, this is NOT true of our BODIES. Our human physiology has evolved over millions of years though the slow process of evolution. This is true for every living species on earth. We are also aware that thousands of species have not survived changes in environment, from dinosaurs to woolly mammoths. Perhaps we are no different…

I believe we are at a crossroads between our past and our future. Because of our intelligence and superior adaptability as compared to other species, we have made enormous strides in science and technology in the past 150 years and have developed ways to communicate globally with books, newspapers, radio/TV, and the internet. All of which has had a huge effect on our social evolution, such that we have begun to adopt the food and customs of other societies and countries. And the reverse is true of other countries with respect to their adoption of our western diet and lifestyle. Consider what Hollywood has done to promote our way of living. Think about it…no other species has ever done anything like that. But now I wonder if we haven’t gone beyond our ability to adapt physiologically to our current dietary habitat. After all, our bodies were built by evolution to function in an environment that existed more than a million years ago.

In order to solve this problem, we need to recognize that proliferation of these age-related diseases is directly related to our diet and lifestyle. The speed of this social evolution is such that our bodies cannot adapt to these changes fast enough to prevent them from affecting our health. One possible solution is to use our latest medical discoveries to slow and minimize the symptoms of these chronic diseases in order to buy time. But more importantly and possibly more difficult, is to alter our diets by choosing foods that were available before the industrial revolution.

Even though this would be difficult and certainly less convenient, we should try as much as possible to return to more traditional dietary habits, that will eventually improve our health. It is critical that we eliminate as many refined sugars, starches, and processed foods from our diet as possible, choosing instead to eat whole foods where available. To be successful in this effort, we must remain vigilant, realizing that our success as a species may depend on it. In addition, we should never forget about the value of “exercise” which is essential to keep our bodies and minds in optimal condition.

The image above is of Sardinia Italy…Why am I showing you this? Because it was the first “Blue Zone” to be discovered. If you are unfamiliar with the term “Blue Zone”, allow me to explain. There are five such zones in the world where people regularly live to 100…or older. In fact, Sardinia is home to more men older than100 years of age than any other place on earth!  So, you have to ask yourself, what are they doing right? I’ll try to show you. Coincidentally, study of their culture and lifestyle led to the discovery of the significance of pentadecanoic acid, otherwise known as C15, that I mentioned earlier in part one of this newsletter. (see the DeLauer Podcast).

In the simplest of terms, Sardinia's residents live a traditional, laid-back lifestyle, eat simply; and spend lots of time with family and friends. They also have a strong sense of belonging and social cohesion. The Sardinian diet is both plant and animal based with a high percentage of dairy (from goats, sheep, and grass-fed cows) and a somewhat lower amount of meat. Their diet also includes whole-grain bread, beans, fruits, and vegetables. Testing has revealed that Sardinians have exceptionally high levels of C15 in their blood, in some cases, three or four times the level of other populations.

Sardinians stay active all day long, especially in their culinary pursuits. They tend to their sheep, milk their goats, forage for wild greens, cook, clean and garden. While you most likely won't be herding sheep or searching for mushrooms, you can still find ways to stay active throughout your day. To complete the discussion of the Sardinian lifestyle I am including another podcast by Thomas DeLauer, a well-known fitness and dietary consultant. He moves quickly in this 12:22 video but gives you an excellent overview of Sardinian life that in part explains their improved lifespan and healthspan.

9 Foods the Sardinians Eat to Live Longer & Stay Under 15% Bodyfat (click to view)

I think that wraps it up for this long but important newsletter. I realize that in total I am giving you a lot of information to consider, but I wanted to show you that all the diseases and conditions discussed are more than individual diseases. They are, instead, part of a bigger picture that is difficult to recognize up close. I believe that if you step back and look at all of these, you will see, that with the exception of type 1 diabetes, all have a common thread…Insulin Resistance. What this means in basic terms is that Insulin, a peptide that is the product of millions of years of evolution, is not working properly due to dietary changes. And more significantly, that this is a relatively new phenomenon.

These changes have only come about since human food has become abundant. What does this tell us? I have tried to suggest some possible solutions, but I wonder if that is enough. Even if it is not, I do believe that actively adjusting our diet and eating habits to better suit our physiology will certainly improve our health…

Until next time, take care and stay positive… Dr. G