Type 2 Diabetes & Insulin

Type 2 diabetes can be summed up as too much sugar in the body, rather than just blood sugar that’s too high. This happens USUALLY by consuming too much sugar and carbohydrates too often and this ends up with the body having no where to put the extra sugar that is eaten. A bit like trying to stuff more clothes in a suitcase that is already full, so the clothes spill out, a bit like the sugar spilling out into the blood, giving high blood sugar which then leads to insulin resistance where the body ‘ignores insulin’.

Insulin lowers blood sugar by moving it into different cells, but if the cells are already full of sugar they can’t take anymore sugar, like trying to get on the tube in London when its packed.

The liver can make this extra sugar into fat which can be stored on the body or in the liver (non alcoholic fatty liver). This means a lot of people with fatty liver which often comes with insulin resistant should be cutting out sugar and carbs, rather than  good fats.

Pre-diabets, type 2 diabetes and fatty liver can be ‘reversed’ by fasting, ketogenic diet or just calorie restriction as it will force the body to use up its sugar supply and help with insulin sensitivity. Insulin sensitivity is where the body responds properly to insulin, rather than ignoring it.

When insulin and sugar levels are high in the body, mTOR is activated and this is the main growth pathway in the body, so it will cause all cells to grow, including cancer cells. mTOR is not bad at all if it is not on all the time, but if mTOR is on all the time and the person is in ‘growth and storage’ mode all day then this makes a favourable environment for cancer to grow in. Cancer is complicated and it is not just about mTOR, sugar and insulin but this is why some people choose to fast, limit calories or sugar for health reasons.

People can also get insulin resistant / Type 2 diabetic due to stress, lack of exercise prolonged poor sleep and lack of/loss of muscle mass so it is not diet alone.

Plant molecules or neutraceuticals

As type 2 diabetes is multi faceted there are certain plant molecules that can help and have other benefits even if you don’t have insulin resistance as long as they are used in conjunction with other lifestyle changes.

Berberine  can modulate autophagy in adipose tissue to help prevent weight gain  and metabolic syndrome (pre diabetes) as well as protect against atherosclerosis (blocked arteries) . Berberine activates AMPK  inhibits mTOR and upregulates PPARγexpression. Berberine helps regulate glucose metabolism by increasing insulin sensitivity. Berberine also increases production of new mitochondria, which are what use fat and glucose in the body to make energy.

Metformin also activates AMPK and inhibits mTOR, which is why some biohackers use it for its potential anti-ageing and anti-cancer effects. Metformin works to inhibit AMPK and lower blood sugar  by slightly different mechanism to berberine.

Metformin has some gut related side effects like diarrhoea and  wind as well as possibly lowering B12 levels, where as berberine can help with some gut issues. Berberine has bad bioavailability so better used in liposomal form.

Cinnamon activates AMPK which then activates glucose utilisation and improves fat burning (if in a calorie deficit or in ketosis). Cinnamon improves metabolism by lowering fasting blood glucose levels and Hemoglobin HBA1c, a measure of average blood glucose levels over time. Cinnamon contains a key bioactive compound, trans-cinnamic aldehyde, which decreases bacterial survival by activating autophagy in microbial invaders, which can help ward off infections.

Milk Thistle is well-known for its liver-protective properties and Silibinin &  silybin from milk thistle inhibit mTOR  Silibinin activates AMPK, and can restore NAD+ levels in non-alcoholic fatty liver as fatty liver and type 2 diabetes come together most of the time.

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We are socially conditioned to fear hunger, told fasting is dangerous  and we have been told by ‘who knows who’ that we need to eat regularly, to ‘keep our metabolism going’.

This is not only wrong but it is promoting insulin resistance that leads to type 2 diabetes, obesity, hormone imbalances and in some cases cancer. Insulin is released every time we eat and insulin  is a storage and growth hormone and humans are not supposed to be in growth and storage mode all day. There are numerous studies that link calorie restriction and fasting to longevity.

Why Going Without Food For a Bit is A Good thing

• Firstly, it is not possible to burn fat when the body is in storage mode and insulin is high, this has been demonstrated over and over in studies.
• Secondly, if insulin is high all day the body starts to ignore it and become ‘insulin resistant’ which is the 1^st step in becoming a type 2 diabetic, some children as young as 10 are insulin resistant already.
• Thirdly, when food is around or ‘nutrient abundance’ a out bodies main growth switch mTOR is on all the time and mTOR will stimulate the growth of everything, including some cancers. mTOR is not bad at all,  but it is if it is on 12/7.

Our ancestors would have gone without food for up to days at a time and the body makes specific biological changes to adapt to this, so our are genetics are geared for fasting.

• Firstly, during a fast or in the absence of food the body switches from using  glucose to ketones as fuel which come from body fat.  Ketones are not only a great energy source for the brain, but the are also anti-inflammatory. Learn more about ketosis HERE
• Secondly to protect muscle, growth hormone increases during fasting so you don’t ‘waste away’, growth hormone also heals tissue and helps the body break down and burn fat. If our ancestors got weak during times of no food we wouldn’t be here.
• Thirdly, brain derived neutrophic factor (BNDF) increase during a fast and this is our natural anti-depressant and it also improves cognitive functions. Our ancestors needed to keep their mental faculties sharp during food shortages.

Why Fasting Is Good for Your Health

During periods where our body is energy nutrient deprived, autophagy acts a survival mechanism to make energy.

Japanese cell biologist Yoshinori Ohsumi won the Nobel Prize in Medicine in 2016 for his research on autophagy.

Autophagy is key for

• Removing old damaged cells , organelles & proteins
• Removing damaged mitochondria ‘The power house of the cell’ (Mitophagy)
• Reducing plaques in brain & atherosclerosis
• Lipophagy fat breakdown and connective tissue around fat cells
• Removing unwanted cells eg pre cancerous, rouge immune cells
• Activating longevity genes like FOXO & surtuins

Autophagy is like a spring clean, or ripping out an old kitchen to put a new one in. Not enough autophagy is linked to many diseases, simply because people are constantly in a ‘fed state’

I feel deeply saddened that people have been mis-informed about food and fear fasting or being hungry as it is evident in society the impact of food being forced at us wherever we go.

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Ketosis is a perfectly safe metabolic state where the body has shifted from using glucose as the primary fuel source to ketone bodies (ketones). Ketone bodies are made from fat in the liver.

This happens when the liver glycogen (sugar)  stores are used up. The liver stores between 100 and 150g of glycogen or about 2000 kcal of ‘sugar’ energy .

Both carbohydrates (starch and sugar) and fats can be used as fuel. The body will preferentially use carbohydrates because of its easy access and fast absorption, although burning fat is less inflammatory.

When switching to use fat as fuel, a period of adaptation needs to take place. This is called becoming ‘fat adapted’ or ‘keto adapted’ as the body has to break down fat, make ketone bodies and use the ketone bodies. The length of it takes to become fat adapted depends on how dependent a person previously was on glucose and how well their body accepts this new fuel source.

Ketosis occurs either over a prolonged period of fasting or by restricting carbohydrate intake significantly to 20g or less a day (about 5% of daily calories from carbohydrates). Ketosis means your body is using ketone bodies as fuel so there are different levels of ketosis. A mild state of ketosis can be obtained during exercise, sleep (body is in a fasted state) and calorie restriction.

Is Ketosis Safe?

It’s important to not confuse ketosis with medical ketoacidosis, like with untreated Type 1 diabetes which causes the pH levels in the blood to drop and become acidic.

Nutritional ketosis is perfectly safe and a great metabolic state to be in. This process is perfectly normal and is an adaptive response. During periods of famine, going into ketosis enabled humans  to survive and maintain vitality. Instead of relying on glucose for fuel we can to use our own body fat and thrive instead of starving to death.

Ketone bodies have the following properties;

• Suppress appetite
• Are muscle sparing
• Are great brain fuel
• Possess anti-inflammatory properties.

Is it Unnatural To Be On a Ketogenic Diet?

The Inuit in Northern America have no available source of glucose in their habitat and their diet is consists of  mainly fatty fish and meat. The Masai tribe in Africa live on pasture lands and drink raw milk and eat the animals they farm. There is a very low occurrence of disease, obesity and cancer in these indigenous people and they live on ketogenic diet. Fat in of itself is actually a lot better for us, as long as it is not eaten at the same time as carbohydrates, due to something called the ‘Randle Cycle’.

The indigenous people with their unprocessed high animal product diets were perfectly healthy until hey came in contact with refined sugars/starches and processed seed oils from the West. After that cases of tooth decay, obesity, heart disease and diabetes sky rocketed.

In summary there are many benefits to being in ketosis and this is why there are some many benefits associated with fasting and a ketogenic or low carb diet.

Thank you for reading

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Our brain chemistry is based on the balance of neurotransmitters like dopamine, oxytocin,  serotonin and noradrenalin which do play a big role in how we feel and can easily be knocked out of balance leading to addiction, depression and anxiety.

There isn’t and will never be such thing as a happy pill or any compound which can give us all the elements of happiness. The correct balance of neurotransmitters can lead to wonderful experiences like ‘Flow States‘.

In addition different things make different people happy as 50% of our neurological wiring in the brain  is the same and the other 50% the wiring depends on life experiences. This means that different things excite, interest and please different people.

Dopamine is an important neurotransmitter that is involved in what we perceive as enjoyable, but there are other factors. Dopamine is involved  pleasure, learning, movement, motivation, addiction and boredom.

Too much dopamine is bad and is linked to psychotic episodes and too little results in Parkinson’s diseases,  It is about balance or the ‘goldilocks amount’.

Dopamine and Pleasure

When we do something pleasurable,  dopamine is released and our brain learns what that stimulus was and motivates us to do more of it to get more pleasure. Your brain will then prompt you to seek out this enjoyable experience again, which if allowed to go out of control can lead to addiction. Unfortunately your brain can associate all sorts of things with pleasure and some of them are not socially acceptable or healthy.

Cocaine, sugar, exercise, pornography, video games, shopping, sex, gambling, arguing, shouting,  getting likes on social media, eating junk food, smoking cigarettes, giving people gifts, helping people,  watching sport and  extreme sports are some activities which tend to give a good dopamine hit. Not all of these are bad of course, particularly in moderation!

The problems also comes down to dopamine floods and dopamine drips. activities which create a dopamine flood like a sugar rush, cocaine and the exhilaration of gambling are a big problems as the dopamine receptors get used to the flood so you need more and more to get the same effect. Over time things which you used to find fun or pleasing like having a bath, a cuppa and a laugh with friends or a nice walk become boring, as your brain has become de-sensitised to simple pleasures. This will have an impact on your happiness.

The dopamine pool needs time to refill, so there will be a horrible low while this happens after a dopamine flood. You can’t feel exhilarated or totally amazing all the time, our brain chemistry doesn’t have the capacity or resources.

However,  you can feel content and happy most the time if you let the dopamine drip out at a slow steady pace and have the odd dopamine flood now and again for fun. 

That was a little bit about some of the biochemistry of happiness and pleasure.

Do you have an addiction or something you feel might turn into one?

Is your habit impacting your relationships or affecting how you function as a human being?

Is it stopping you from doing other things you enjoy?

Is it making you feel like a bad person ?

Are you keeping secrets about how often or how much you are spending on your habit/hobby from friends and family?

Are you rushing home to have a drink,  a joint, go online or play a video game rather than doing something social?

What do if you think you are addicted to something

You do not necessarily need to see a therapist as you can manage things yourself. In general there is the pulling the plaster off in one go or pulling it off gently, but the plaster has to go.

Fasting does not only apply to food, you can have social media fasts, Netflix fasts,   dry January etc.

Fasting from food  is very helpful for overcoming junk food and sugar addictions as your taste buds and brain will re-sensitise over time and normal food with start to taste amazing again. This is true for other activities if you do them all the time, they are no longer special.

However if you do seek therapy, a good therapist wont judge or laugh and could well have been addicted to something themselves. Therapists specialise in different addictions so you can seek out one who specialises or has experience of yours.

Get in touch if you would like some help

Sara

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Should older women do intermittent fasting with the same eating windows and macros as men? Do women need the same macro nutrients as men on a  low carb or ketogenic  diet?

Women in general as well as those who are approaching the menopause, going through it or have been through it have different hormonal circadian rhythms to men and younger women. Many women find a cyclical ketogenic/low carb diet works well to manage cortisol levels and thyroid hormones. This would be a period of following a low carb/ketogenic diet then having a break and eat meals containing protein and carbohydrates for a day. The length of the low carb window can vary from several weeks to five to six days and trying out different variations is the only way to find what works for you. 

Anecdotal data and emerging studies suggest that older women struggling with weight loss do better when they eat in the morning / earlier in the day, then fast until the next day, rather than fasting for the morning / early afternoon then having the eating window later in the day. This traditional method of OMAD, 16/8 or 20/4 (fasting in morning, eating in early evening) works well for men but not for all women. Particularly if the woman is not insulin resistant. 

In addition for women who are not insulin resistant and are  fat adapted, eating more protein and less fat (appx 30% of calories from protein, 60-65% fat ) find that this can also kick start weight loss that has plateaued on a keto / fasting way of eating. 

Because they are not insulin resistant and not carb burners, the insulinogenic effect of protein is less pronounced so they don’t need to worry about protein and gluconeogenesis as a carb burning insulin resistant woman. 

With anything we all vary slightly but I am going to try reversing my eating window, lowering fat and prioritizing protein to see what happens in my n=1 experiment 

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