3

votes

Is Elevated Insulin Bad (or Is It Really Sugar/Fructose That's Bad)?

Answered on August 19, 2014
Created May 31, 2011 at 7:49 PM

We all know the "safe starch" argument: safe starches such as white rice, yams, sweet potatoes, yuca/cassava, taro, and even white potatoes are okay as long as you avoid sugar/fructose and harmful starches (such as wheat). Thus, tribes that subsisted on such safe starches thrived: the Kitavans, the Irish, the New Guineans, the Southeast Asians, the Japanese, etc. These tribes did not suffer from diabetes, heart disease, autoimmunity, and other degenerative diseases.

Could we extend the same argument to insulin elevation? Elevated insulin is supposedly bad because it promotes cancer development, inflammation, diabetes, AGEs and glycation, oxidative stress, and accelerated aging. Yet I wonder if the term "elevated insulin" is precise enough.

Is the issue really elevated insulin or is it elevated insulin caused directly by sugar/fructose? Compared to someone eating a low-carb diet, someone who eats a moderate to high carb diet will have more insulin, since BG will skyrocket after a meal. To bring the BG under control, insulin will have to be deployed and, within 2 hours, the BG should return to the fasting level of 85 or so.

Of course, the insulin could be elevated in LC and ketogenic diets from protein consumption. But the overall level of circulating insulin will be much less than in a moderate to HC diet.

If that's the case, is insulin elevation necessarily bad? Or is it only bad when sugar/fructose and harmful starches are involved?

Another issue is that LC and ketogenic diets are often touted by those treating cancer and neurological diseases. By flatlining insulin, it is said, you're minimizing tumor growth and cancer development. But is that really the issue or is it really sugar, which the cancer cells supposedly feed on, that's the problem (a la Gary Taubes).

Is the problem here not being precise enough in analyzing what's behind insulin elevation? Or is insulin elevation itself (whether caused by sugar or safe starches) really the problem?

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on June 01, 2011
at 06:48 AM

I dunno Phelps might have high fasting insulin, but it would be better if he had low fasting insulin with regards to overall health, which I am also biased towards, and rarely thinking about performance when I answer questions unless it's specific. If Dr. Quilt disagrees with that, in that there might be a benefit to high fasting insulin with regards to performance, or that it might be benign in some contexts, then I don't know what he's talking about, but I wouldn't be expected to. If we mean simply eating a lot of carbs in a day and then it goes down at night, then I agree that's not so bad.

47a42b6be94caf700fce9509e38bb6a4

(9647)

on June 01, 2011
at 06:38 AM

Ok, Quilt, I think I gotcha now. When you said "there are very few" in your first comment that should have been understood as "there are in fact a few." I think Stabby was also confused. But I think there's still some disagreement: do you think Michael Phelps has a high *fasting* insulin? Because Stabby wouldn't be ok with that. It all depends what one means with the word "chronic." If Phelps's insulin is going up and down (NB: *and* down) all day and he doesn't have a high fasting insulin then should we call this chronically elevated insulin?

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on June 01, 2011
at 02:11 AM

Ah I get it. In that case I agree. High insulin due to metabolic syndrome: bad. Lots of insulin because the dude is training for marathons: good context, he needs that insulin and the carbs that produce it. Perhaps I should have said high fasting insulin, since the marathon runner won't tend to have high fasting insulin, but the guy with metabolic syndrome sure will, that's the distinguishing element.

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on June 01, 2011
at 02:09 AM

Ah I get it. In that case I agree. High insulin due to metabolic syndrome: bad. Lots of insulin because the dude is training for marathons: good context, he needs that insulin and the carbs that produce it.

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on June 01, 2011
at 02:02 AM

Ah I get it. In that case I agree. High insulin due to metabolic syndrome: bad. Lots of insulin because the dude is training for marathons: good context, he needs that insulin and the carbs that produce it. I'm pretty much completely longevity/anti-degeneration biased so I'm rarely thinking of Anthony Colpo's bias of sweet bod.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on June 01, 2011
at 01:22 AM

i directly measure them on patients who need it. I also use GI testing to see what is happening at mitochondria and in TCA intermediates as my treatment progresses. There is a lot to do if you know what your looking for. But that is a talk for clinicians. Patients just need to know we can check for a lot when they hit a plateau for some reason

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on June 01, 2011
at 01:20 AM

And most people who post here already believe that otherwise they would not be paleo to begin with. This site focuses too much on what we dont have in common instead of what we do have in common. I think when we talk about the key drivers of why we do paleo it supercedes.....the how the what. Those detail differences drive Patriks site. Honestly......I am not into that. I know the science therefor I comment upon it. But my paleo goals are to share my beliefs in how to optimize ones life based upon the situation one is in now. And what to do as it evolves. I rarely down vote.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on June 01, 2011
at 01:16 AM

WCC very simple. Read the first line. He says its bad ALL the TIME. See my initial response to the question asker. I made the point it can be ok in certain circumstances. I am a man of context which you should clear see by now. So when Stabby saw all......he got a minus one. But I agree in principle with him there are few times that high insulins are good. Longevity is my specialty......and this is an area paleo blogging is not deep on. My views there and IGF1 signaling are all about context as you will soon see. The more important aspect in understanding Why its critical

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on May 31, 2011
at 10:35 PM

But suppose you get a carb-loading endurance athlete who doesn't age well, it may not be that it was necessarily due to insulin, it could be the endurance athletics itself, or over-reliance on wheat-based carb snacks and other conventional wisdom junk. Wheaties! Junk-in-a-box.

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on May 31, 2011
at 10:31 PM

I'm sure we both agree that chronically elevated insulin is bad. Dr. Quilt observes that some people can tolerate eating carbs all day and not suffer from the effects of hyperinsulinemia, I think that his examples aren't really cases of hyperinsulinemia like we would see in metabolic syndrome due to the nature of endurance athletics. Endurance athletics profoundly upregulates the GLUT-4 transporters so that less insulin is needed. Plus if there is minimal insulin resistance there will be less insulin needed to do its job. It's certainly not that chronically elevated insulin isn't bad

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on May 31, 2011
at 10:25 PM

I'm sure we both agree that chronically elevated insulin is bad. Dr. Quilt observes that some people can tolerate eating carbs all day and not suffer from the effects of hyperinsulemia, I think that his examples aren't really cases of severe hyperinsulemia like we would see in metabolic syndrome due to the nature of endurance athletics. Endurance athletics profoundly upregulates the GLUT-4 transporters so that less insulin is needed. Plus if there is minimal insulin resistance there will be less insulin needed to do its job. It's certainly not that chronically elevated insulin isn't bad, it is

47a42b6be94caf700fce9509e38bb6a4

(9647)

on May 31, 2011
at 10:03 PM

Yeah, but what are they disagreeing about?

100fd85230060e754fc13394eee6d6f1

(18696)

on May 31, 2011
at 09:29 PM

Even I agree with the Quilt on this one.

Medium avatar

(19469)

on May 31, 2011
at 09:12 PM

I'm pretty sure that insulin levels are not directly measured, but rather your bodies response to glucose. High fasting glucose indicates either insufficient insulin production (as is the case in type 1 diabetes) or insensitivity to the insulin that your body is producing (high insulin levels and type 2 diabetes).

Af1d286f0fd5c3949f59b4edf4d892f5

(18452)

on May 31, 2011
at 09:02 PM

yah and regardless... I am just glad to see Stabby and Quilt disagree on anything.

Af1d286f0fd5c3949f59b4edf4d892f5

(18452)

on May 31, 2011
at 09:00 PM

my personal experience supports quilt's comments here.

47a42b6be94caf700fce9509e38bb6a4

(9647)

on May 31, 2011
at 08:36 PM

So maybe you were objecting to something else in the answer, Quilt? Perhaps a distinction we're missing? Or is it a question of drawing a line in a different place? I'm interested to see this worked out.

47a42b6be94caf700fce9509e38bb6a4

(9647)

on May 31, 2011
at 08:33 PM

I commend Quilt for fessing up to his downvote, but I don't really understand it. Stabby was explicit about distinguishing chronic insulin elevation from occasional insulin elevation. And Quilt seems to be making the same exact point in his comment. If I remember correctly, Kitavans don't have chronically elevated insulin.

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on May 31, 2011
at 08:27 PM

So it's not always bad? But the cytokines and IGF-1? I don't mean chronic consumption of carbohydrate all day, I mean chronically elevated insulin due to the metabolic syndrome. Indeed some people like Phelps can probably eat carbs all day, but would he really have chronically elevated insulin or would GLUT4 transporters be in such good shape that there wouldn't be much insulin at all?

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on May 31, 2011
at 08:25 PM

Elevated insulin long term is associated with mamny epithelial derived cancers. And Given what we learned about the family history of these carb loaders it will be interesting to see how they fair as they age.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on May 31, 2011
at 08:24 PM

First Time I have given you a minus one. I think there are very few people who can tolerate chronic elevations of insulin. Anthony Colpo and Tim ferriss are two off the top of my head. Maybe Mike Phelps in his prime But that ability gets tougher as one ages due to changes in hormones.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on May 31, 2011
at 08:22 PM

if your super fit chronic elevation of insulin is tolerable because your burning what comes into the cell right away. This is why weightlifers and body builders can graze all day. Its also a great way to get fat if you are not leptin sensitive because chronic elevation of insulin allows fat storage all day long with the carbs you are not able to burn.

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4 Answers

2
Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on May 31, 2011
at 08:10 PM

Chronically elevated insulin is always a problem no matter how it arises. Like you said, high insulin in the blood stream for too long does nasty things. It doesn't matter whether it was caused by sugar or deficiencies or inflammation, it is always bad, and removing a great deal of carbohydrates from the diet can help that, although it doesn't always. You do get the case of people with such dire leptin resistance that even gluconeogenesis to fuel their brain in ketosis still elevates insulin, although most people find that less carbohydrate helps everything.

It is important to distinguish between post-prandially elevated insulin and chronically elevated insulin. In the case of good insulin sensitivity eating carbohydrate does not produce as much insulin and it doesn't stay elevated, the Kitavans can handle carbohydrate well because they eat an anti-inflammatory and nutrient-sufficient diet and have a good lifestyle. You see more circulating insulin in people with metabolic syndrome on low carb diets.

Sugar tends to feed some cancer cells, but the degree to which fructose circulates in the blood stream is questionable. It does but not in significant quantities so I don't know how much it actually "causes" cancer. My guess is not much simply by the fact that fructose can act as fuel for cancer cells.

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on May 31, 2011
at 10:31 PM

I'm sure we both agree that chronically elevated insulin is bad. Dr. Quilt observes that some people can tolerate eating carbs all day and not suffer from the effects of hyperinsulinemia, I think that his examples aren't really cases of hyperinsulinemia like we would see in metabolic syndrome due to the nature of endurance athletics. Endurance athletics profoundly upregulates the GLUT-4 transporters so that less insulin is needed. Plus if there is minimal insulin resistance there will be less insulin needed to do its job. It's certainly not that chronically elevated insulin isn't bad

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on June 01, 2011
at 02:02 AM

Ah I get it. In that case I agree. High insulin due to metabolic syndrome: bad. Lots of insulin because the dude is training for marathons: good context, he needs that insulin and the carbs that produce it. I'm pretty much completely longevity/anti-degeneration biased so I'm rarely thinking of Anthony Colpo's bias of sweet bod.

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on May 31, 2011
at 08:27 PM

So it's not always bad? But the cytokines and IGF-1? I don't mean chronic consumption of carbohydrate all day, I mean chronically elevated insulin due to the metabolic syndrome. Indeed some people like Phelps can probably eat carbs all day, but would he really have chronically elevated insulin or would GLUT4 transporters be in such good shape that there wouldn't be much insulin at all?

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on June 01, 2011
at 01:16 AM

WCC very simple. Read the first line. He says its bad ALL the TIME. See my initial response to the question asker. I made the point it can be ok in certain circumstances. I am a man of context which you should clear see by now. So when Stabby saw all......he got a minus one. But I agree in principle with him there are few times that high insulins are good. Longevity is my specialty......and this is an area paleo blogging is not deep on. My views there and IGF1 signaling are all about context as you will soon see. The more important aspect in understanding Why its critical

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on May 31, 2011
at 08:25 PM

Elevated insulin long term is associated with mamny epithelial derived cancers. And Given what we learned about the family history of these carb loaders it will be interesting to see how they fair as they age.

47a42b6be94caf700fce9509e38bb6a4

(9647)

on May 31, 2011
at 08:36 PM

So maybe you were objecting to something else in the answer, Quilt? Perhaps a distinction we're missing? Or is it a question of drawing a line in a different place? I'm interested to see this worked out.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on June 01, 2011
at 01:20 AM

And most people who post here already believe that otherwise they would not be paleo to begin with. This site focuses too much on what we dont have in common instead of what we do have in common. I think when we talk about the key drivers of why we do paleo it supercedes.....the how the what. Those detail differences drive Patriks site. Honestly......I am not into that. I know the science therefor I comment upon it. But my paleo goals are to share my beliefs in how to optimize ones life based upon the situation one is in now. And what to do as it evolves. I rarely down vote.

47a42b6be94caf700fce9509e38bb6a4

(9647)

on May 31, 2011
at 10:03 PM

Yeah, but what are they disagreeing about?

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on June 01, 2011
at 06:48 AM

I dunno Phelps might have high fasting insulin, but it would be better if he had low fasting insulin with regards to overall health, which I am also biased towards, and rarely thinking about performance when I answer questions unless it's specific. If Dr. Quilt disagrees with that, in that there might be a benefit to high fasting insulin with regards to performance, or that it might be benign in some contexts, then I don't know what he's talking about, but I wouldn't be expected to. If we mean simply eating a lot of carbs in a day and then it goes down at night, then I agree that's not so bad.

47a42b6be94caf700fce9509e38bb6a4

(9647)

on June 01, 2011
at 06:38 AM

Ok, Quilt, I think I gotcha now. When you said "there are very few" in your first comment that should have been understood as "there are in fact a few." I think Stabby was also confused. But I think there's still some disagreement: do you think Michael Phelps has a high *fasting* insulin? Because Stabby wouldn't be ok with that. It all depends what one means with the word "chronic." If Phelps's insulin is going up and down (NB: *and* down) all day and he doesn't have a high fasting insulin then should we call this chronically elevated insulin?

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on May 31, 2011
at 10:25 PM

I'm sure we both agree that chronically elevated insulin is bad. Dr. Quilt observes that some people can tolerate eating carbs all day and not suffer from the effects of hyperinsulemia, I think that his examples aren't really cases of severe hyperinsulemia like we would see in metabolic syndrome due to the nature of endurance athletics. Endurance athletics profoundly upregulates the GLUT-4 transporters so that less insulin is needed. Plus if there is minimal insulin resistance there will be less insulin needed to do its job. It's certainly not that chronically elevated insulin isn't bad, it is

Af1d286f0fd5c3949f59b4edf4d892f5

(18452)

on May 31, 2011
at 09:02 PM

yah and regardless... I am just glad to see Stabby and Quilt disagree on anything.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on May 31, 2011
at 08:24 PM

First Time I have given you a minus one. I think there are very few people who can tolerate chronic elevations of insulin. Anthony Colpo and Tim ferriss are two off the top of my head. Maybe Mike Phelps in his prime But that ability gets tougher as one ages due to changes in hormones.

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on June 01, 2011
at 02:11 AM

Ah I get it. In that case I agree. High insulin due to metabolic syndrome: bad. Lots of insulin because the dude is training for marathons: good context, he needs that insulin and the carbs that produce it. Perhaps I should have said high fasting insulin, since the marathon runner won't tend to have high fasting insulin, but the guy with metabolic syndrome sure will, that's the distinguishing element.

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on June 01, 2011
at 02:09 AM

Ah I get it. In that case I agree. High insulin due to metabolic syndrome: bad. Lots of insulin because the dude is training for marathons: good context, he needs that insulin and the carbs that produce it.

47a42b6be94caf700fce9509e38bb6a4

(9647)

on May 31, 2011
at 08:33 PM

I commend Quilt for fessing up to his downvote, but I don't really understand it. Stabby was explicit about distinguishing chronic insulin elevation from occasional insulin elevation. And Quilt seems to be making the same exact point in his comment. If I remember correctly, Kitavans don't have chronically elevated insulin.

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on May 31, 2011
at 10:35 PM

But suppose you get a carb-loading endurance athlete who doesn't age well, it may not be that it was necessarily due to insulin, it could be the endurance athletics itself, or over-reliance on wheat-based carb snacks and other conventional wisdom junk. Wheaties! Junk-in-a-box.

1
B383982420d8cb1bfaace4f7fbc5d1e2

on May 31, 2011
at 09:32 PM

hopefully one day some clever inventor will create an insulin / leptin secretion monitor that can be used the same way home glucose meters are used. That would answer SO many questions ans change the medical world as we know it ~ lowcarbJC

1
669790861549f3c6d54d88a65296ed19

(452)

on May 31, 2011
at 08:51 PM

How do you know your insulin is elevated without something to monitor/measure it? Are there certain symptoms and/or feelings one can notice in their body?

Medium avatar

(19469)

on May 31, 2011
at 09:12 PM

I'm pretty sure that insulin levels are not directly measured, but rather your bodies response to glucose. High fasting glucose indicates either insufficient insulin production (as is the case in type 1 diabetes) or insensitivity to the insulin that your body is producing (high insulin levels and type 2 diabetes).

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on June 01, 2011
at 01:22 AM

i directly measure them on patients who need it. I also use GI testing to see what is happening at mitochondria and in TCA intermediates as my treatment progresses. There is a lot to do if you know what your looking for. But that is a talk for clinicians. Patients just need to know we can check for a lot when they hit a plateau for some reason

0
B5f0573fe1960bdb0415f7fa7a87dbbc

on February 03, 2013
at 01:39 AM

High triglycerides are a good indication of high insulin, if high, then the insulin level should be checked. Most lab scales are 0 to 10 for a normal range. If you are over 10 then this increases risk for CAD by 4-5 times. High insulin is known to be atherogenic, directly. I say most all chronic diseases have a link to high insulin and doctors hardly ever check it. I'm a type 2 diabetic and the regular fasting glucose tests didn't catch it until I went in for pheripheral neuropathy and I had to tell them to check my glucose because they didn't have a clue as to what might be causing my neuropathy. The doctor said my blood sugars could have been at diabetic levels for over 10 years because I already had neuropathy. Doctors should really be checking insulin levels, and if high, then do an HbA1c to see how high your glucose levels have been over the past 90 days. Then you go to the doctor with super high insulin levels and they give you drugs that raise your insulin levels even more, which only makes the insulin resistance worse. Using drugs to treat a nutritional disease is a scam that only sells more drugs, which eventually kills the patient. But not to worry about diabetes business, the latest estimates are 70% of the adult American public is in pre-diabetes right now - having an HbA1c between 5.0% and 6.9%.

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