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Insulin Resistance and Weight Loss

Carbohydrates are often villainized as the culprit for our weight gain, but it’s more complex than this.  It is constantly elevated levels of the hormone insulin that actually makes you fat and keeps you fat.  Since carbohydrates cause a short-term increase in insulin levels, this has led to the carbohydrate-insulin theory of obesity, or the idea that the solution to our growing obesity crisis is to cut out carbohydrates.

It’s not that simple. Insulin is a hormone that helps regulate the amount of glucose, a breakdown product of carbohydrates, in our blood required for optimal brain function as well controlling enzyme activities, gene expression and the distribution and storage of energy. Under normal metabolic conditions, insulin levels rapidly rise and rapidly fall in response to our intake of carbohydrates.  This all changes as you develop insulin resistance.

With insulin resistance, insulin is less able to tell our cells (primarily muscle) to quickly remove glucose from the blood.  As a result, the higher levels of circulating glucose make the pancreas secrete higher and higher levels of insulin to accomplish the task. These constantly elevated insulin levels are a result of insulin resistance, which in turn is caused by increased cellular inflammation. So it is not insulin per se that makes you gain weight, but the constantly elevated levels of insulin caused by insulin resistance that is the problem.

How Insulin Resistance Makes You Fat

It is constantly elevated insulin levels that makes you gain weight, and keep the weight on. The reason is that if the muscle cells are not taking in enough glucose from the blood, the increased insulin levels drive that glucose into the fat cells instead and that accelerates the storage of dietary excess calories as stored fat. This makes you gain weight. Furthermore, these increased insulin levels prevent your fat cells from releasing stored fat to be used as energy for the body. This keeps the weight on.

What Causes Insulin Resistance?

There are several factors that play a role in insulin resistance, but cellular inflammation is the biggest culprit. Cellular inflammation results from an imbalance of two key fatty acids in our blood, Arachidonic Acid (AA) and Eicosapentaenoic Acid (EPA). When the levels of arachidonic acid are in excess it leads to the generation of hormones known to be pro-inflammatory. This inflammation makes it difficult for insulin to communicate with our cells in the liver, muscle, and adipose tissue. In an effort to increase communication, more and more insulin is produced resulting in high circulating levels and with that comes the excess weight.

It is the dietary factors below that over the long term lead to increased cellular inflammation, making it more likely to become insulin resistant.

  1. An imbalance of protein to carbohydrate at each meal.
  2. Excess dietary caloric intake causing oxidative stress.
  3. Excess dietary intake of omega-6 fatty acids.
  4. Excess dietary intake of the saturated fatty acids, especially palmitic acid.
  5. Lack of dietary intake of omega-3 fatty acids.
  6. Lack of dietary intake of polyphenols to activate anti-oxidative genes to reduce oxidative stress.
  7. Lack of dietary intake of polyphenols to promote gut health.
  8. Lack of dietary intake of fermentable fiber to promote gut health.

How to Tell If You Have Insulin Resistance

You can’t determine your level of insulin resistance by looking in the mirror as about 16% of healthy, normal weight Americans have severe insulin resistance (1). However, if you have diabetes (30 million Americans) or pre-diabetes (86 million Americans), you are guaranteed to have severe insulin resistance. More than 80% of obese Americans have severe insulin resistance.  This high prevalence of severe insulin resistance goes a long way to explaining our obesity epidemic. The higher your levels of insulin resistance, the more likely you are to gain excess body fat and have difficulty in losing it. It also means that that you are likely to regain all the lost body fat unless you reduce the underlying cause which is not carbohydrates, but insulin resistance that is caused by cellular inflammation (2).

Blood Tests for Insulin Resistance

There are blood tests to know whether you are insulin resistant. Measuring insulin levels can get expensive, yet the triglyceride (TG) to high density lipoprotein cholesterol (HDL) ratio can be used as a surrogate marker for insulin resistance and is commonly performed in your routine blood work. Insulin resistance is typically associated with an increase in body fat, so it makes sense that the first place you can measure its start is in the liver. This is because the liver is where dietary fats are repackaged into lipoproteins which transport triglycerides and cholesterol to cells. When insulin resistance develops, triglyceride levels rise, HDL levels decrease, and LDL (low-density lipoprotein) becomes smaller and denser. If you’re one to avoid blood testing, we have developed a simple quiz to gauge whether you may be insulin resistant or on the road to becoming it. You can access our insulin resistance quiz here.

How the Zone Diet Can Help

The Zone Diet was developed to help control insulin levels in the body. This is achieved by balancing the protein-to carbohydrate ratio at each meal coupled with the use of small amounts of monounsaturated fats know to be anti-inflammatory. Since diet is one of the main reasons we develop insulin resistance, it’s also one of the easiest changes we can make to help reverse it. Within 4 days of following the Zone Diet, it has been shown clinically to reduce insulin resistance (3). With our new Zone Foods, we’ve tried to make it even easier for individuals to stick to the Zone eating plan with minimal thinking to help reverse insulin resistance quicker. Using the Zone Foods (e.g. Zone Cereal and PastaRx) at every meal has been clinically show to decrease insulin resistance 24 times more effectively than using their gluten-free equivalents (4). 

Summary

  • Constantly elevated levels of the hormone insulin can make it difficult to lose body fat.

  • High insulin levels are a result of insulin resistance, which in turn is caused by increased cellular inflammation.

  • Insulin resistance can be reversed within 4 days of following the Zone Diet. 

As we age it becomes more and more difficult to lose excess body fat due to insulin resistance and increased levels of cellular inflammation. By bringing the focus back to choosing the right foods and ensuring the appropriate balance of protein to carbohydrate at each every meal along with adequate intake of omega-3 fatty acids and polyphenols we can keep insulin levels in check and keep us on the path to continued wellness.{{cta('daffa570-1055-4766-af51-e09d66a17e47')}} References

  1. McLaughlin T, Allison G, Abbasi F, Lamendola C, and Reaven G. “Prevalence of insulin resistance and associated cardiovascular disease risk factors among normal weight, overweight, and obese individuals.”  Metabolism 53:495-499 (2004)
  1. Sears B and Perry M. “The role of fatty acids in insulin resistance.”  Lipids Health Disease 14:121 (2015)
  1. Markovic TP, Jenkins AB, Campbell LV, Furler SM, Kraegen EW, and Chisholm DJ. “The determinants of glycemic responses to diet restriction and weight loss in obesity and NIDDM.”  Diabetes Care 21:687-694 (1998)
  1. Johnson CS, Sears B, Perry M, and Knurick JR. “Use of novel high-protein functional food products as part of a calorie-restricted diet to reduce insulin resistance and increase lean body mass in adults:  A randomized controlled trial.” Nutrients 9:1182 (2017) 

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062524---Keto-Blog

Ketogenic Diets and Aging

Chances are, you or someone you know has tried the keto diet at some point in time. This high-fat, very low-carbohydrate eating plan appeals to many due to its promise of rapid weight loss. In this blog, Dr. Sears explores some of the latest scientific findings on ketogenic diets and provides caution before hopping on this trend. What is a Ketogenic Diet? The ketogenic diet is a high-fat, very low-carbohydrate eating plan. This significant reduction in carbohydrates to induce a metabolic state is called ketosis. This only occurs when there is not enough carbohydrates in your liver to completely convert fatty acids to carbon dioxide and water. The normal conversion generates the chemical energy (ATP) that keeps us alive. In the absence of ketosis, each fatty acid generates 108 molecules of ATP when oxidized in the mitochondria. Ketone bodies make less ATP when they are metabolized by mitochondria. How much less? About five times less. This is like switching the gasoline in your car from high-octane fuel to low octane fuel as ketone bodies increase in the blood. Furthermore, contrary to popular belief, ketones are not an ideal energy source for the brain, as glucose remains the preferred fuel for ATP production in brain cells. Lack of blood glucose is a highly stressful situation for the brain. This is why the body secretes the stress hormone cortisol from the adrenal glands during ketosis to breakdown protein and convert the amino acids into glucose for the brain. This explains why even under complete starvation for 38 days, the blood glucose levels never dropped below 68 mg/dL. This is still considered as a normal blood sugar level. Where did this blood glucose come from if there was none in the diet for 38 days? The answer is neo-glucogenesis primarily using lean body mass. Ketogenic Diets Pros and Cons Interest in ketogenic diets rises and falls about every 20 years. They’re very low-carbohydrate diets that claim that carbohydrates make you fat and keep you fat. This is simply not true. It is not carbohydrates per se but a disrupted metabolism that makes you fat. To be more specific, it is the inhibition of AMPK, the master regulator of your metabolism that makes you fat. Why? As AMPK activity increases, you burn stored fat faster. Frankly, I’ve always been amazed by the re-emergence of ketogenic diets. Eighteen years ago, I published the premier clinical study demonstrating that, under equal calorie intake in which all the food was provided to the subjects for six weeks, the Zone Diet was better than a ketogenic diet in reducing total weight, excess body fat, and inflammation. Now, a recent study revealed some more very concerning findings about the long-term effects of ketogenic diets. This new study indicated that following a keto diet causes a rise in senescent cells, popularly known as “zombie cells.” Zombie Cells are damaged cells that no longer divide but don't die. That’s bad enough, but zombie cells continue spreading inflammation throughout the body. As the number of zombie cells increases in your body, they become a living nightmare. Why? Zombie cells accelerate aging because they cause the earlier development of many chronic diseases. In this study they found that zombie cells in the animals began to appear while they were on a ketogenic diet. The zombie cells then disappeared when researchers changed the diet to a “non-ketogenic diet” (i.e., the Zone diet). And when the animals were given a Keto diet again, the zombie cells reappeared. Notice a trend? If you want to hear more about this study you can listen to our recent podcast at Dr.Sears.com. Based on earlier blogs, this adds to the list of downsides for following a ketogenic diet versus the Zone Diet. PROS Rapid initial weight loss: This is primarily due to the loss of retained water from the glycogen stores in the liver, which is rapidly used up to maintain blood sugar levels. Since these glycogen stores in the liver contain significant levels of retained water, much of the initial weight loss is water rather than stored body fat. If your main goal is loss retained water, this can be seen as a benefit. Of course, going to a sauna would also work. Reduced hunger: Ketogenic diets are rich in protein. Any increase in protein intake can help reduce hunger. CONS Production of acetone: One of the ketone bodies produced during ketosis is acetone, which is also the main chemical in nail polish. Increased calcium loss: A ketogenic diet can lead to higher calcium loss from bones. Limited fat utilization: High levels of dietary fat reduce the likelihood of using stored body fat for energy unless you also significantly restrict calories. Reduced energy levels: The lack of ATP production on a ketogenic diet can lead to easier fatigue during mild exercise. Damage from cheat meals: After seven days on a keto diet, a single high-carb cheat meal can damage blood vessels. Lack of polyphenols: This makes it difficult to activate genes that optimize metabolism by improving mitochondrial efficiency in converting fat into ATP. No long-term weight loss advantage: Long-term studies show no difference in weight loss between a ketogenic diet and a low-fat, high-carb diet. No short-term metabolic advantage: Careful studies demonstrate that fat loss on a ketogenic diet is the same as on a low-fat, high-carb diet with the same caloric intake. Compromised gut health: A lack of fermentable fiber from carbohydrates can lead to poor gut health and an increased risk of developing a leaky gut, which can cause significant inflammation. Furthermore, short-chain fatty acids (SCFA) are the metabolic product of fermentable fiber. These SCFA are powerful epigenetic signaling agents that enhance gene transcription. Ketosis generates a different type of hydroxylated short fatty acid (3-hydroxyl butyrate, that has no effect on gene transcription. In addition, the lack of SCFA has significant negative consequences on the gut-brain axis. Cortisol build-up: To produce glucose for the brain, cortisol levels increase to breakdown protein to make sufficient glucose via neoglucogenesis. Excess cortisol can lead to insulin resistance that cause regain of some of initially loss body fat. In addition, increased cortisol levels cause a depressed immune system as well as destruction of memory cells in the hippocampus. The initial benefits of following the ketogenic diet result in some initial weight loss (primarily water weight rather than fat loss), long-term studies show no significant differences in overall weight loss. Now new findings show a ketogenic diet may lead to significant adverse health consequences by accelerating the formation of zombie cells. Call me crazy, but I feel the key to longevity and wellness comes down to better metabolic control instead of living in a constant state of ketosis. Following Metabolic Engineering® for a lifetime provides that pathway of losing body fat without ketosis. References 1. Johnston CS, Tjonn SL, Swan PD, White A, Hutchins H, and Sears B. “Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets.” Am J Clin Nutr 2006 83:1055-61. 2. White AM, Johnston CS, Swan PD, Tjonn SL, and Sears B. “Blood ketones are directly related to fatigue and perceived effort during exercise in overweight adults adhering to low-carbohydrate diets for weight loss: a pilot study.” J Am Diet Assoc. 2007 107:1792-1796. 3. Sung-Jen Wei, Joseph R Schell, E Sandra Chocron, Mahboubeh Varmazyad, Guogang Xu, Wan Hsi Chen, Gloria M Martinez, Felix F Dong, Prethish Sreenivas, Rolando Trevino Jr , Haiyan Jiang, Yan Du, Afaf Saliba, Wei Qian, Brandon Lorenzana, Alia Nazarullah, Jenny Chang, Kumar Sharma, Erin Munkácsy, Nobuo Horikoshi, David Gius. Ketogenic diet induces p53-dependent cellular senescence in multiple organs. Sci Adv. 2024 May 17;10(20):eado1463. doi: 10.1126/sciadv.ado1463. 4. Owen OE, Felig P, Morgan AP, Wahren J, Cahill GF Jr. Liver and kidney metabolism during prolonged starvation. J Clin Invest. 1969 Mar;48(3):574-83. doi: 10.1172/JCI106016. 5. Chriett, S., Dąbek, A., Wojtala, M. et al. Prominent action of butyrate over β-hydroxybutyrate as histone deacetylase inhibitor, transcriptional modulator and anti-inflammatory molecule. Sci Rep 9, 742 (2019). https://doi.org/10.1038/s41598-018-36941-9. 6. Silva YP, Bernardi A, Frozza RL. The Role of Short-Chain Fatty Acids From Gut Microbiota in Gut-Brain Communication. Front Endocrinol (Lausanne). 2020 Jan 31;11:25. doi: 10.3389/fendo.2020.00025. 

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050824---Tofu-Blog

Tofu: Tips and Recipes Ideas

I have been eating tofu for a very long time, much longer than the 30 or so years I have been following the Zone Diet. Back then many of my favorite recipes came from the Tassajara cookbooks by Edward Espe Brown, the celebrated chef from the kitchen at California’s famous Zen Mountain Center, and cookbooks by Louise Hagler, a.k.a. Wendy Louise, a well-known authority on vegetarian cooking who is associated with a community in Tennessee known as The Farm. Those books are still among the best resources for tofu recipes. My mantra has always been if you don’t like something, don’t eat it. Keep this in mind if you’re new to tofu, start slowly by combining it with flavors and foods you like.    Tips and Suggestions    Firm-sprouted tofu is my preference for the Zone Diet. Unlike traditional tofu, which contains significant amounts of both protein and carbohydrate, sprouted has almost no carbohydrates. It’s lighter tasting, refreshing, and very filling.   Freezing tofu results in a chewy, sponge-like texture. I don’t recommend freezing, but some people prefer it when using tofu to substitute for meat in a recipe.    Baked tofu comes in a variety of flavors and makes an excellent quick meal with some vegetables and fruit added. It’s also great in salads.     Tofu made it into the book “The Top 100 Zone Foods” by Barry Sears.    Some recipes call for draining the tofu first. I find that usually isn’t necessary.   Tofu takes on the flavor of whatever is added to it.    Add nutritional yeast flakes to give a cheesy flavor to vegan tofu scrambles and dips. It’s also rich in protein and vitamin B12.   Cherry Vanilla Tofu “Ice Cream”   Tip: This doesn’t freeze or store well, so prepare only the amount you plan to serve immediately.   Using an immersion blender or a food processor blend equal parts of frozen dark cherries and firm tofu, plus some vanilla extract (preferably alcohol-free for best flavor). Serve immediately.  Tofu Scramble  This is great for breakfast, lunch, or dinner, and we’ve even brought it on long day hikes for a snack.   Crumble some firm tofu and stir in a generous amount of seasonings, taking care not to overdo it with the salt. Heat in a well-seasoned or nonstick skillet with a little Zone-friendly oil to the desired doneness.    Optional: If time allows, sauté some chopped onion in the skillet before adding the tofu and seasonings.    My favorite seasoning combination for this dish at my house is onion powder, garlic powder, turmeric, paprika, some oregano or thyme, nutritional yeast flakes, salt, and ground black pepper. The yellow color of the turmeric makes it somewhat like scrambled eggs.   Tofu Veggie Almond Pasta Salad   Dressing: Thin some smooth almond butter by stirring in some water, a little vinegar, and either soy sauce or Bragg’s Liquid Aminos (an unfermented soy sauce found in the health food section of most grocery stores).    Toss together cooked Dr. Sears’ Zone PastaRx Fusilli, tofu cut into cubes, matchstick cut red bell pepper, chopped green parts of scallions (a.k.a. green onions), and the almond butter dressing. Serve immediately or chill to serve later. It will keep well in the fridge for two or three days.   Use your imagination and see what you can come up with.  Experiment and have fun with it. Try using tofu to make cheesecakes, whipped desserts, tofu chocolate pudding, tofu “cream” based soups, tofu pot pie (think chicken pot pie), tofu burgers, tofu burritos, Buffalo tofu (like Buffalo wings), layered Mediterranean dips, tofu “meatballs”, grilled tofu, and more.    Enjoy! 

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