It's commonplace among lowcarb(LC) aficionados to blame weight gain on insulin and nothing else but insulin. Taubes, the infallible LC messiah (you gotta admit, some people would take his farts to be the word of God), wrote some cool stuff regarding the fat/cholesterol hypothesis, but he went on to create his own carbohydrate hypothesis, which people seem to take as a given. Apparently some people get the impression that eating prodigious amounts of fat/protein will not lead to weight gain because they don't haz the insulinz.
So I just read this series about insulin: Insulin???an Undeserved Bad Reputation. There are 4 parts to it and links to the next section are at the end of each article
I read some of the studies he cited and he doesn't seem to be grossly misinterpreting the information. I didn't look at all of 'em though..
My overall impression from it: The body is complex. Insulin plays a big role as an anabolic hormone, but it doesn't exist in a vacuum, which is how many people think of it. One example that comes to mind is ASP (acylation stimulating protein), which is released in response to fat intake, and can drive fat storage independently of insulin.
Taubes has blatantly ignored research that contradicts his carb hypothesis. Ward studies show that carb heavy and fat heavy diets (equal calories) produce identical weight loss. People also ignore the fact that protein also heavily stimulates insulin release, but they get the green light.. He also dismisses the more simple hypothesis for obesity: excessive caloric consumption, which he claims is false based on studies in the 60s/70s that used self-reporting of caloric intake in obese people. His claims that exercise doesn't do anything for fat loss is also based on laughable evidence (gym memberships, please..)
There seems to be a biochemical reason to believe that there is more to it than just insulin. Looking at it from a paleo perspective, do you really think that our bodies are incapable of storing fat in the absence of insulin? Why should the body not be capable of storing energy from a particular macronutrient under hypercaloric conditions? That sounds incredibly maladaptive to me.
So, is it time to reconsider, or is this just garbage?
asked bypaleohacks (78467)
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on September 27, 2010
at 05:49 AM
OK, Now I will start to go over Krieger's material in more detail. Let's see how far/long this post gets before I get tired of making corrections! (get ready for super long) First, in the primer section, some issues. Unlike what Krieger says, insulin release actually first starts when you start to put the food in your mouth. Just looking at it makes for a small surge of insulin. Sweetness in the mouth can start the next small surge. Then the stomach senses how much is in there and regulates further surges. And the process continues as the body works to fine tune the insulin release. It is wrong to say that insulin secretion starts only after the glucose is already in the blood.
OK, now myth1:"A High Carbohydrate Diet Leads to Chronically High Insulin Levels" But this is not what we say. We say high carb and especially high intake of refined unnatural carbs leads slowly to damage of blood sugar management which THEN leads to high insulin levels. So he has the first tenet of the theory wrong already. Therefore, it is easy to knock it down. Yes, insulin secretion is healthy in healthy individuals. I will not argue that. No one ever argued that. The argument is about what leads to unhealthy individuals, but Krieger doesn't talk at all here about the rising tide of metabolic syndrome and high insulin sufferers.
Myth2"Carbohydrate Drives Insulin, Which Drives Fat Storage" Yeah, I agree basically. His 'fact' answer:"Your Body Can Synthesize and Store Fat Even When Insulin Is Low" Yes, I agree his fact is true, but it does not counter the supposed 'myth.' Our argument is high insulin tends to drive fat storage. We never said the body is physically incapable of storing any fat whatsoever without high insulin ever. Just becuase he comes up with an example that could happen does not change the fact that insulin tends towards fat storage. Similar to just because some astronauts once made it to the moon does not change the fact that the moon tends to be hard to get to. Just because something is possible does not change the fact that it tends not to happen much.
Then next he talks about how he can't consume 5000 calories of pure table sugar as an argument that carbs are hard to consume. But I bet many people can consume 5000 (or a lot) of pasta with sugary sauce on it. Or cake. I can eat a giant friggen hoard of pancake with syrup (at least I cold before paleo). But I can't do the same with steak. I can never eat steak fat or steak to the point of feeling sick. My mother commented on that the other day. On paleo, she always feels good after a meal. Whereas with carbs, you can easily overconsume hoards of calories and feel sick afterwards. I bet if you make a challenge for anyone to consume 5000 calories to steak fat and 5000 calories of pancake with syrup, the pancake will be much easier to accomplish. But by using table sugar, which is not tasty by itself, he makes it out like it can't be done. Believe me, 5000 calories of carbs can be eaten all at once much easier than 5000 calories of fat or protein.
Next myth "Insulin makes you hungry" Yes I agree, but it makes you hungry because it leads to insulin swings and hypoglycemia a few hours later. No one is arguing it doesn't make you feel full for a while. If it didn't work for a bit, then we would all probably eat nonstop, LOL! Again, Krieger is not understanding the argument correctly and is therefore arguing against something no one ever said. And of course, no matter how high the insulin, if your blood sugar crashes you will get hungry. Type 2 diabetics are still often hungry even though their blood sugars are constantly high. IF insulin is so good at satiating, then why do these diabetics still feel hungry?
Another myth: "carbs are singularly responsible for driving insulin." But no one said this! We said carbs are the most to blame for driving insulin and causing metabolic syndrome. Big difference. Again, he makes a false version of the low carb story such that it will be much easier to knock down. Then he cites a study that was actually designed to tests satiation and says that 75 grams of carb at one meal is 'low carb.' No it is not. If you want to test protein vs carb, then don't put tons of carb in the 'protein' group. But this study was never designed to test this so of course it doesn't work well. Of course, other studies have tested protein against carb and those studies how that carb spikes insulin a lot more than protein. Too bad I can't see the whole study or might have more to say, but I also noticed Krieger blasts past the fact that the higher carb meal had much higher blood sugar response, as if this was unimportant.
Then he wants to show that protein stimulates insulin response and he does this by giving data on shakes that contain 11 grams of carb in them. Now he is accusing us of saying that low carb does not cause any insulin release or something? I can't quite figure out what his point really is here. I can't get any info on the shakes because the citation requires a password to even look at the abstract and the other link leads to a long meandering chain of links at the end of which, leads to a broken link. No clue what was in the shakes, but no one is going to argue that a shake with protein and carb in it, designed for weightlifters, is not going to elicit an insulin response.
But wait, there's more! Then he says that 'some' might say it is due to gluconeogenesis. Really? WHo would need to argue that when their drink has CARBOHYDRATES in it already! You don't need to make new carbohydrates when you just ate some. And no one said low carb means NO insulin, we only said it means less insulin than high carb. Show me some good studies that show high carb makes for less insulin than truly low carb, and then well we'll talk. Because all the studies I have seen to test exactly that have shown that high carb and high-glycemic foods cause more insulin release. I mean come on, no one even bothers to argue that one anymore! I can't believe Krieger is here trying to say that protein causes more insulin release than sugar! And I don't really see how comparing various types of protein is relevant to a discussion about comparing carbs to protein. Cuz it's not.
Another study originally designed to compare thermogenesis between fat rich and protein rich meals (FYI, protein rich created more thermogenesis), but Krieger is using the study only for its info on insulin rise in obese vs nonobese patients. (Weird that he keeps getting his data out of studies that were designed to test something else than what he wants to know about. Why not use studies that actually studied what he is talking about?) The weirder thing is this study actually shows what we argue, ie that obese people have higher insulin response to the same meal compared to nonobese. This will be true of both protein AND carbs but he only talks about protein here. Thus supporting our argument that insulin drives weight gain. (That would be the argument that Krieger claims to have already debunked as myth.)
Then he cites another study that he says shows that beef stimulates just as much insulin as brown rice, as if to insinuate that protein is such a potent insulin stimulator that it is the same as carbs. But brown rice is fiber-rich and slow to digest and beef is easy. (Hard to say more cuz I can't see the whole study. In fact, every single study he cites seems to be unviewable by the general public.) Also, the study itself in the abstract says that carbs and sugar intake was positively related to mean insulin scores and PROTEIN AND FAT INTAKE WERE NEGATIVELY RELATED TO MEAN INSULIN SCORES. So the study itself says protein elicits less insulin than carbs and sugar, contrary to what Krieger is trying to insinuate with his beef/rice speech.
Then he cites a study that is supposed to show that lipolysis is not increased when glucagon is present. But what the study really shows, as best as I can tell (someone tell me if I am wrong), is that it does not increase lipolyis over other groups at fasting levels of glucagon. So if you have fasting levels of glucagon already, adding more glucagon will not increase lipolysis. This study does NOT show that glucagon does not increase lipolysis, it only shows that it does not increase it beyond fasting levels. Also, in one of the groups, they infused glucose and kept glucagon constant and lipolysis did not change from the other groups. So this study actually shows the exact opposite of Krieger's claims. He says glucagon in the face of insulin will not help with lipolysis but this study shows that glucogon in the presence of glucose will still keep lipolysis in action. The second study he cites does not have enough info in the abstract for me ot really say much. The abstract is a bit scattered, starting off talkinga bout in vivo but then about in vitro. I don't know if it was done on a fasted state or not. Anyway, one point is that just because something does not increate lipolysis in one situation does not mean you can say it has no effect in all situations. Lowcarbers argue that glucagon helps generate lipolysis in presence of protein induced insulin rise. To debunk this, you would need to use a study that deals with that condition. (and in fact the first one sorta does and sorta supports the lowcarbers argument)
OK so then we go to page 2 (yes I am getting tired now, are you?), where he argues that insulin spikes are good because they control blood glucose spikes. These are the same blood glucose spikes he skated over quickly on the first page when talking about high-carb meals being similar to high protein meals (glossing over the blood glucose spike issue) Of course, he is totally missing the obvious point that if you don't eat high carb, you don't have high glucose spikes so you don't need a ton of insulin to take care of them. But I guess he feels he has already 'proven' that protein is kinda sorta almost maybe insinuated as just as bad as carbs so if you believe that, then you need that insulin spike even if you eat low carb cuz protein will, supposedly, also give you a giant insulin spike. (Anyone here have the same insulin spikes on high protein as high carb? - I bet not) (and he claims 'no one would advocate high fat' thus totally dismissing that issue without needing to supply research because 'NO ONE' would ever say such a thing! DUH!
So according to him, you need insulin spikes becuase you WILL have blood glucose spikes and these are bad. Of course, forget that his earlier citation showed the high carb makes for bigger blood glucose spikes which would make for higher insulin need. Because he has already proven (supposedly) that blood glucose and insulin spikes are not related, at least not on page one. But on page two they are intimately related as one creates the need for the other.
And here is another piece of Krieger logic. Diabetics have weakened insulin spikes in response to meals. And there is a drug that can both restore ability to spike insulin and also helps control overall blood glucose levels. Therefore, insulin spikes are good for you. Wha? I don't get that train of logic at all. However, he also argues that since this drug both increases insulin spikes AND causes mild weight loss, therefore insulin cannot be responsible for weight gain. But what he does not mention is this drug directly affects brain receptors causing a feeling of increased satiety, which could also influence weight gain or loss. And the insulin response decreases rapidly after a few hours. Of course, you would not even need this weird drug that came from a protein in the saliva of gila monsters if you did not eat such a high carb meal in the first place! Plus it causes nausea in 57.1% of people who take it. I think I'd rather just eat low carb. Anyway, I am tired, way too tired to proofread, so I hope that made some sense.
on September 26, 2010
at 03:18 AM
As to Gary Taubes's claim that fat cannot be stored in the absence of carbohydrate: he has revised his view on this. It may or may not make it into print (his new book is supposed to be greatly simplified, and so there is probably no discussion of it at all), but he discusses it in his recent interview with Jimmy Moore. The earlier theory of his, which was checked at the time with the experts on this very subject, was that there was something called glycerol 3-phosphate which greatly limited the production of glycerol -- and the glycerol was necessary for storage of fats, since in every triglyceride there is glycerol attached to the three fatty acids, as the "backbone." And, the supposition was, no significant amount of glycerol could be produced in the absence of dietary carbohydrate. But it turns out that a significant amount can be produced in the absence of carbohydrate -- i.e., the body can accomplish "glycerolneogenesis" in this way -- and thus that there can be a significant amount of fat storage in the absence of carbohydrate. And Taubes points out that this makes perfect sense: your body will release at any given time fatty acids for fuel in excess of its muscles' and organs' needs; and there would have to be a way to return those fatty acids to storage.
So, he corrects his earlier error. But, the glycerol 3-phosphate argument was never necessary for his thesis. The "carbohydrate thesis" -- basically, carbohydrate drives insulin drives fat storage -- still stands. He wanted to have a little extra support for the thesis. Alas, he couldn't get that support. But this does not destroy the thesis. Insulin still has an overwhelming effect on body composition.
on September 26, 2010
at 03:40 AM
I can only say this: as a type 1 diabetic, I am in a great position to actually monitor my insulin usage. Obviously, if I eat less carbs, I need less insulin. But, whether I lose weight or not, when I eliminate all grains, my insulin use goes down even when my carb intake stays the same or increases (via fruit or even candy). Also, when I lose weight, I need less insulin. When I eat lower (~100-150g/day) carb, my blood sugars stay rock-solid in non-diabetic range -- pretty damn impressive for someone with no beta cell function.
Less carbs = less insulin. Less insulin (for me) = less weight. Less weight = less insulin. And so forth.
on September 26, 2010
at 02:43 AM
I am sure Taubes got some things wrong as everyone does and we don't have enough knowledge yet to know for sure. However, before you critique Taubes, you should AT LEAST understand what he said. He did not say calories don't matter. Of course they matter! The question is, what drives people to eat more calories than they should? Such is not natural. His argument is higher than healthy spikes of insulin drive cravings and hunger by tipping the balance excessively towards storage. What causes higher than normal amounts of insulin? He claims it is the neolithic higher than natural glycemic loads of high carb foods. He claims the solution is to fix the cause of the unnatural hunger so that you do not wish to overeat.
Yes, protein also stimulates insulin, but it is approx 1/3 the level that high carbs stimulate it. YOu can decide if the term 'heavily' applies to that level of stimulation. Protein is also a natural required food for humans in order to survive. Fat is also required for life. Carby foods are not at all required.
As for exercising helping with weight, he did not say that it does nothing at all. What he said that there are several things that act to counterbalance weight loss via exercise. One is that it tends to increase appetite. You burn more but it's only a little bit more and it's easy to eat a bit more and make up for it. I tend to believe this myself as I notice it myself. His argument is that long term, it is not sustainable to only exercise and not address other issues. He did not say don't exercise.
And certainly, and actually, yes it is likely you cannot store fat in absence of insulin. because insulin is required for moving glucose into cells. With out insulin, you either slowly die or shoot yourself with insulin from a syringe. Insulin is always present in a healthy individual. Taubes' beef is when insulin levels that are too high. I think what you have gotten confused about is that Taubes DID say that he felt you could not store fat without carbohydrates. In fact, he could well be wrong on this one. This is another biologic pathway that could be used to store fat even when no glucose is eaten. However, it's damn hard to gain much fat in absence of carbs. I have't seen it done, but I would imagine it is possible. I think Taubes made an error on that one but it is the only one I know for sure he is likely wrong on.
Edited to add: Reading the linked article, much of this guy's argument has serious flaws. I could write 10 pages on describing them one by one and probably still miss a lot. However, the most obvious is follow this guy's citations and the first 3 or 4 of them exactly contradict his very own claims! He must be assuming people are too lazy to read the abstracts. He is probably right. But the first one I read said that researchers found that the higher protein meal provided a higher level of satiation and wellness after 4 hours than the high carb low protein meal. But that is opposite of what Krieger claims in his article. However, all other citations I followed also lead to abstracts that contradicted the claims. The nerve of this guy! His citation that supposedly shows that low density foods are more satiating lead me to a study on intake of different kinds of BREAD!! The study was not at all about food density and there was no 'high density' food present. Bread is not high density in my book, especially when the subject of discussion is protein and fat intake. Comparing types of bread intake cannot be extrapolated to the difference between protein and carb intake. Taubes may be biased (we all are) but this guy, James Krieger, is far worse. The nerve!
on September 26, 2010
at 03:57 PM
At Matthew's recommendation, I had another look at the Krieger. It is in fact interesting, and I think he's onto something. I have a few thoughts of a preliminary nature, which I would put in a comment, if comments were allowed to be much longer and more formatted.
A very interesting exchange begins in the comments section to the post here, when a fellow named Todd represents some of our own intuitions in the debate, and gets some interesting responses from Kreieger (and it's all in the spirit of the acquisition of truth). In Todd's penultimate post he writes this:
You argue that, from an evolutionary standpoint, the view that insulin leads to increasing hunger does not make sense: ???Elevated insulin represents a fed state. The idea that a hormone that reflects a fed state will cause hunger under physiological conditions is not a logical conclusion.??? But I don???t see a problem here. First, I agree that a moderate insulin response, sufficient only to ???cover??? a modest meal, will typically not cause hunger. However, there are at least three situations in which an insulin response will cause hunger: (1) the case of insulin ???overshoot??? in which insulin is secreted in excess of what is required, bring the glucose levels back not merely to basline, but below baseline. This is not atypical, but is often experienced when eating a large meal meal of sugary or high glycemic foods, resulting in a reactive ???crash???; (2) the case of an insulin resistant individual who tend to overconsume because of an impaired ability to uptake glucose, again resulting in insulin overshoot, and a subsequent crash; and (3) the case of a hyperactive cephalic phase insulin response to aromas or appetite cues, which is in fact acknowledged in several of your references in at least some cases.
First note that there is something of a consensus they've reached: that in general it wouldn't make sense for insulin to cause hunger under normal conditions. And so we shouldn't demonize insulin in a knee-jerk kind of way (assuming Krieger is right about the insulin response to protein meals -- on this just a moment). But note next that even if this is the case you're still going to get in trouble with sugar, and you're still going to get in trouble with insulin resistance.
But as for the insulin response to high-protein meals: in the situations Krieger is referencing, people are eating weird stuff: very high protein and very low carbohydrate, and basically no fat. We would never eat things like that. And my intuitions are on board: a meal comprising nothing but, say, four skinless chicken breasts and some steamed veggies is one of my personal visions of hell -- high in calories maybe, but totally unsatisfying. When someone brings this up to Krieger, he cites the study in which beef produced the same insulin response as brown rice. But one has to wonder what cut of beef that was. Along these lines there's another great comment in the thread, right at the end:
Scott says: September 21, 2010 at 4:41 am
Excellent information, the LC crowd needs to see this one.
???The fact is that insulin is not this terrible, fat-producing hormone that must be kept as low as possible. It is an important hormone for appetite and blood sugar regulation. In fact, if you truly wanted to keep insulin as low as possible, then you wouldn???t eat a high protein diet???you would eat a low protein, low carbohydrate, high fat diet. However, I don???t see anybody recommending that.???
Actually, I???d say this is the most recommended type of diet I???ve seen in the paleo world:
http://homodiet.netfirms.com/ http://www.paleonu.com/panu-weblog/2009/8/27/how-to-lose-weight.html http://freetheanimal.com/2008/12/animal-fat-protein-paleo.html http://www.rawpaleoforum.com/journals/lex%27s-journal/ http://www.marksdailyapple.com/how-much-is-too-much/ http://www.biblelife.org/stefansson3.htm
Finally, I saw briefly somewhere else on the site that Krieger does not say he is completely opposed to low-carb eating. He thinks it could be helpful for some people. But in general I sense that there might be some of the usual confusion about Taubes's very "analytic" point about weight loss and weight gain. Taubes wouldn't deny that a calorie surplus would lead to weight gain; he would just rephrase that statement: A calorie surplus, once everything is factored in, is tautologically equivalent to weight gain. So the question is just what is causing the calorie surplus, and whether calories-in and calories-out are independent variables -- again, the usual things about Taubes that take a little while to sink in. I'll have to read more on Krieger's site to come to any conclusions about this.
And indeed I'll have to read more on his site to figure everything else out, too. Apologies for the length and the tentative quality of my post; I thought it better to share what I had found so far than to wait the two years it will take for me to figure everything out.
on September 26, 2010
at 01:27 AM
LOL! Yeah, it's always more complicated that any simplification - by definition! Insulin isn't a "bad guy". It's a hormone and has multiple roles to play in the body. One of them is to reduce excess blood glucose and pack away fat. I don't think you'll find anyone on any variation of the paleo/primal diet/lifestyle telling Big Pharma that they need to develop an insulin reducing pill.
on September 27, 2010
at 04:04 PM
You ask a good question Spencer. Questioning peoples deeply held beliefs is always interesting.
James Krieger has a couple more articles on Taubes that make an interesting read:
Edit: James Krieger now has some responses to critisisms of his insulin series, they are worth reading - Insulin: An Undeserved Bad Reputation, Part 5: Addressing the Critics
This is also a quote from one of those articles:
Of course, I already sense a bunch of strawmen coming my way, including accusations that I am somehow against low-carbohydrate diets. I am not. In fact, I have attended the Nutrition & Metabolism Society conference (an organization that is heavily interested in low carbohydrate diets), been a reviewer for their journal, and have either met or know high-profile scientists in the low-carbohydrate arena, including Eric Westman, Marie Vernon, Richard Feinman, Jeff Volek, and others. I have also published research on low-carbohydrate diets myself. Low-carbohydrate diets are certainly an effective strategy for some people intending to lose weight???but they are not the only strategy, nor are they the best strategy for everyone. And they do not work for the reasons that some people think they work.
What I am against is an incomplete presentation of scientific data, which can be misleading and can result in erroneous conclusions. I consider the latter half of Taubes???s book to be an incomplete, highly selective presentation of the data, and I intend to provide a more complete picture here.
There are a couple of other blogs out there with similar topics that you may find interesting. Both are well worth reading:
Adipo Insights has some interesting posts:
My Carb Sane-Asylum also has a few:
on September 26, 2010
at 01:51 AM
The reason the low-carb crowd blames insulin is because they don't want to believe that calories are why people lose or gain weight. There has to be some superiority of the low-carb diet for them, and that is that carbs make you fat. And they ignore the many thin people on high-carb diets, people who lose lots of weight on high-carb diets.
It's not as bad if they claim that a low-carb diet is healthier. Calorie denial is just a pet peeve of mine. Calories exist, you can't eat with reckless abandon just because you're eating no carbs. That's just dumb. Weight loss "experts" who focus on restricting carbs are not teaching a sustainable lifestyle, they're teaching people to ignore the whole concept of energy and how the body uses it.