The big 5 of health is an out dated concept

the metabolic big 5 of health

If you imagine your biology, like a trip to the game reserve….. it is tempting to focus on the metabolic big 5,  while insulin levels are largely ignored.  This is a BIG MISTAKE

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the metabolic big 5 of healthIf you imagine your biology, like a trip to the game reserve…..

There is always lots to see, but a lot of attention is paid to high sugar and high cholesterol, while insulin levels are largely ignored.

The focus is on THE BIG FIVE.

Big bellies.  High cholesterol and high triglycerides. High sugar levels.  High blood pressure.

Now don’t get me wrong, they bring problems – with a capital P.  But, most of the time, the reason they’re high is you’ve got HIGH INSULIN,  ALL THE TIME.

The comings and goings of the small fry

In the metabolically healthy, insulin rises following a meal, but drops back down and stays down, once the meal has been processed.  This is not what happens in the metabolically challenged.

Insulin levels are high ALL THE TIME, including AT NIGHT.

The high at NIGHT, is most PROBLEMATIC, because this is when insulin should be “sleeping”  and your body should be running it’s “rest and repair” programmes.

Insulin makes this hard to do……

Insulin is a “go & grow” hormone

So,  step number 1 in improving high sugar, high cholesterol and high blood pressure, is to LOWER insulin, especially AT NIGHT !

If you’re thinking – well that’s what my anti-diabetes drugs do.  Right ?

pill not actually pulling insulin levels down

 No………… at this stage at least, there is no pill you can swallow to do this.

NOTE : There are pills that increase insulin.   This makes them pretty good at lowering sugar levels, but they never actually “fix” the body chemistry.  This is why type 2 diabetes seldom improves – it is a slow slide to the grave.

biology with a shot gunTo actually lower insulin levels, you’ll have to use biology.

Biology tricks to lower insulin

  • Since the big signal for insulin to put in an appearance is the presence of sugar.  If you can lower the amount of sugar, doing the rounds, you automatically lower insulin.  . In fact, this is what low carb diets do.
  • Intermittent fasting does the same thing. When there is no food coming in, insulin levels are going to be lower, because beta cells get time off.
  • A third way to lower the levels of insulin needed is to exercise. Because exercising muscles take up more sugar, so less insulin is needed.

All of these ideas concentrate on lowering insulin secretion.

It’s not always an insulin production issue

But, the reason insulin levels are high, is not always because the beta cells of the pancreas are trigger happy.   A lot of the time, the liver is not removing the insulin, at the rate that it should.  Ideally 50-80 % of insulin should be STOPPED by the liver.

Problems with clearance, means more insulin does the rounds.

The situation creates some “gnarly” chemistry.

And as an up shot of this, less insulin does what insulin does, in the liver…..

So what does insulin do in the liver  ?

Lots, among the things are two pretty important tasks.

Task 1

Is to help to signal  the liver to stop making sugar.

NOTE : There are other players, the  fail  in this signalling system is the reason why people with type 2 diabetes, manage to have sky high sugar levels, despite eating NOTHING.  Learn more here.

Task 2

The other important thing that it does, is it signals to the liver, to stop making fatty acids. It does this by discouraging fatty acid synthetase activity, via via.

Insulin activates three transcription factors, SREBP1c,  ChREP and LXR.  These guys form the  team of transcription factors that turn the free fatty acids into esterified fats, that are then shipped out of the liver, to meet cells energy requirements.

insulin handing out a sugarBasically….insulin is putting away the groceries.

The prime directive is to put away sugars

If there are excess sugars, he wants them to be HANDLED…..

And since the liver can turn sugars into fats, the switch off of fatty acid synthesis in the liver, directs the liver to process the sugars into fats.

And then to ship them out.

Hopefully !

Unfortunately, when there is metabolic snafoes, the fat doesn’t always “leave the building” – it accumulates inside the hepatocytes and get’s up to all sorts of mischief.

 

We call this – hepatic insulin resistance.

fatty liver and a fat filled hepatocyte

So is there a way to improve insulin clearance ?

Yes, it’s just been “discovered”, by a team of researchers based at Yale Pediatric Obesity Clinic.  Discovered might be a bit of a grand term for what happened, the team stumbled upon it.

Their actual mission was to figure out a way to help obese youngsters battling fatty liver, lose the liver fat.

They were particularly interested in helping kids with a specific version of the PNPLA3 gene.  The variant they were interested in, is the most common variant (rs738409). This variant has been  associated with fatty liver disease in adolescents, in several GWAS studies.

To help their charges – they put the youngsters on a special diet….

A low omega 6 diet

On this special diet – calories were not cut.  This was deliberate, our team didn’t want weight loss to muddy the water of their findings. What they did change was to  drastically lowered the levels of omega-6.

They took the ratio from 15 : 1, down to 4:1.

NOTE : This is the levels “we” used to consume a hundred or so, years ago – before we worried about “heart healthy fats” etc.   

It was not a low carb diet

the macros for the low omega 6 diet

Carbs  came in at  50-55 % of daily total calories.  Proteins made up 20 % and fats,  made up the last  25-30 % of daily total calories.  The fat component, consisted of  8- 10 % was saturated fat and 8-10 % was unsaturated fat.

To make it do-able, the kids got food parcels, packed with kid friendly items such as pizza and burgers, that had had the ratio, doctored.

12 weeks later…..

Fatty livers were better

The liver fat content was down in the vast majority of participants, with rs738409 carriers all being RESPONDERS.

The hepatic fat percentage (HFF% in 17 obese adolescents before (week 0) and after (week 12) a 12-wk low n–6:n–3 PUFA ratio dietary intervention.  Inset Box plot distribution by patatin-like containing domain phospholipase 3 (PNPLA3) rs738409 variant genotype for HFF% © 2020 Michelle A Van Name et al.

  And this translated into other metabolic improvements, most notably insulin levels were lower.

After meals and at midnight !

The figure shows changes in glucose and insulin during an OGTT in the entire cohortbefore (week 0) and after (week 12) a 12-wk low n–6:n–3 PUFA ratio dietary intervention. © 2020 Michelle A Van Name et al

Remember what happens at midnight MATTERS.

This finding sparked a return to the lab to work out why…………

Probing the insulin drop

The team went reached into the freezer and took another look at the samples they had collected : adding C-peptide levels to the mix of data.  Armed with this additional parameter, they crunched the numbers, to find out WHY insulin levels had dropped.

scientist pipetting into epindorf tubes to analyze C-peptide

The insulin kinetic studies showed, the insulin drop was due to  improved insulin clearance.

It seems the so called heart healthy fats are hurting the liver !

Omega-6 fats are poisoning the well

Exactly how they’re doing it, will still need to be worked out – but if you’re insulin resistant, you need to sit up and take notice and work at reducing the omega-6 levels in your diet.

It’s relatively  easy to do….

AVOID those so called heart healthy fats, when cooking.

And cut out processed foods, these are the oils used to make processed foods.

Need more science to make this shift in your diet ?   Click here to visit  the vegetable oils library to unpack more of the science.

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A Low ?-6 to ?–3 PUFA Ratio (n–6:n–3 PUFA) Diet to Treat Fatty Liver Disease in Obese Youth. J Nutr  (2020) 150(9):2314-2321. Michelle A Van Name,Mary Savoye, Jennifer M Chick, Brittany T Galuppo, Ariel E Feldstein, Bridget Pierpont, Casey Johnson, Veronika Shabanova, Udeme Ekong, Pamela L Valentino, Grace Kim, Sonia Caprio, and Nicola Santoro

A low n-6 to n-3 polyunsaturated fatty acid ratio diet improves hyperinsulinemia by restoring insulin clearance in obese youth. Diabetes Obes Metab (2022) Domenico Tricò, Alfonso Galderisi, Michelle A Van Name, Sonia Caprio, Stephanie Samuels, Zhongyao Li, Brittany T Galuppo, Mary Savoye, Andrea Mari, Ariel E Feldstein, Nicola Santoro. 

Further reading

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Author: Taylor Payne