This evidence suggests that type 2 diabetes does not have to be a progressive

[madyogi]

Yes. As you know, all digestible carbohydrates will always be broken down into sugars, eventually becoming glucose. If that's all one is consuming, and they're consuming a significant amount of them, they'll go through blood sugar spikes and the subsequent insulin spikes. Since our cells have a finite capacity for energy production, the hormonal signaling kicks in to store the remaining glucose as glycogen. Muscles and liver have a finite glycogen storage capacity so the liver converts excess glucose to triglycerides (that's why we see high triglycerides in poor metabolic health). The cells become less and less responsive to the insulin, the pancreas has to produce even more, etc... Eventually it can't produce enough. Blood sugar is elevated at all times which is exactly what T2D is.

So, this is true, as far as I can tell. That said, I can't be sure if this happens unless there's a caloric surplus. I don't know if "insulin resistance" really develops in conditions of proper energy balance (calories in matching calories out), combined with almost entirely carbohydrate energy intake. I also don't know how much the "finite capacity for energy production" figures into this. It seems like our cells can produce all the energy we need to do most things, so the variance would be more dictated by demand vs intake than overall capacity. I remain unconvinced that a diet based primarily on carbohydrates (with very low fat), given sufficient energy demand would lead to T2D. I think that has other problems that make it sub-optimal, but I don't believe it leads to T2D the way a mix of fats/carbs (as in the SAD) inevitably seems to.

 

[not2big]

As far as I am concerned, I inherited a predisposition for T2 from my ancestors and would have developed insulin resistance and low insulin production no matter which diet I adopted..

 

[Johnny D]

So, this is true, as far as I can tell. That said, I can't be sure if this happens unless there's a caloric surplus. I don't know if "insulin resistance" really develops in conditions of proper energy balance (calories in matching calories out), combined with almost entirely carbohydrate energy intake. I also don't know how much the "finite capacity for energy production" figures into this. It seems like our cells can produce all the energy we need to do most things, so the variance would be more dictated by demand vs intake than overall capacity. I remain unconvinced that a diet based primarily on carbohydrates (with very low fat), given sufficient energy demand would lead to T2D. I think that has other problems that make it sub-optimal, but I don't believe it leads to T2D the way a mix of fats/carbs (as in the SAD) inevitably seems to.

The problem with viewing it from the perspective of the simplistic CICO model, is that it doesn't take into account the complexities and nuances of metabolic and hormonal responses to different food types. It creates a false assumption that everything is being "burned up" as long as there's not an "energy surplus" so there's no build-up of BG. Not the case. Even if one is in "deficit" (I'm not a big believer in CICO) the continuous metabolism of carbohydrates still causes a continuous release of insulin, which leads to pancreas beta cells being overworked, still leads to de novo lipogenesis, and still leads to oxidative stress and insulin resistance. There are multiple pathways, in addition to the Randle Cycle and metabolism can't be reduced to CICO. It's hormonal.

As far as I am concerned, I inherited a predisposition for T2 from my ancestors and would have developed insulin resistance and low insulin production no matter which diet I adopted..

Many many many people have reversed T2D through a zero-carb diet and I've never heard of anyone developing it when their nutrition is purely animal-based.

 

[Pegasus]

I don't intend to watch further Bart Kay vids other authors have the info I need and are far clearer .

So the info re the surgury I believe can be generalised to stress in general .

 

[madyogi]

I don't intend to watch further Bart Kay vids other authors have the info I need and are far clearer .

So the info re the surgury I believe can be generalised to stress in general .

I believe so. My surgery was just an acute example of the effect in realtime. Chronically elevated Cortisol is not good.

 

[madyogi]

The problem with viewing it from the perspective of the simplistic CICO model, is that it doesn't take into account the complexities and nuances of metabolic and hormonal responses to different food types. It creates a false assumption that everything is being "burned up" as long as there's not an "energy surplus" so there's no build-up of BG. Not the case. Even if one is in "deficit" (I'm not a big believer in CICO) the continuous metabolism of carbohydrates still causes a continuous release of insulin, which leads to pancreas beta cells being overworked, still leads to de novo lipogenesis, and still leads to oxidative stress and insulin resistance. There are multiple pathways, in addition to the Randle Cycle and metabolism can't be reduced to CICO. It's hormonal.

Yeah, I agree here. CICO can be a useful heuristic, but its sorely inadequate if one really wants to understand what's going on.

We don't consume calories, nor do we burn them. We consume mass, and run the machinery of our bodies with the byproducts of the mass we consume (and the mass we have on hand). So again, the composition of the mass we consume matters, and will be reflected in our body mass composition, as well as our metabolic state.

 

[Pegasus]

We really have not got into a important point and that is calories and especially excess calories . In the absence of excess calories t2d is rare as are many opther issues .

So far as I can tell fasting/calorie restriction is a more common way to send bg issues into remission than any other . Mind you zero/low carb diets can(and often are) seen as a method to reduce calories.

 

[Johnny D]

We really have not got into a important point and that is calories and especially excess calories . In the absence of excess calories t2d is rare as are many opther issues .

So far as I can tell fasting/calorie restriction is a more common way to send bg issues into remission than any other . Mind you zero/low carb diets can(and often are) seen as a method to reduce calories.

Perhaps in your experience, but that has not been what I've seen at all. In fact, I know 2 people who developed T2D, lowered their total intake, and still have T2D. Maybe you've seen it more commonly as an effective method, but I haven't. What I have seen (though probably wouldn't be "common" since few will do it) is the elimination of carbs as very highly effective. And I've seen literally no cases of T2D in anyone who eats purely protein and fat, regardless of how much they consume.

 

[madyogi]

Perhaps in your experience, but that has not been what I've seen at all. In fact, I know 2 people who developed T2D, lowered their total intake, and still have T2D. Maybe you've seen it more commonly as an effective method, but I haven't. What I have seen (though probably wouldn't be "common" since few will do it) is the elimination of carbs as very highly effective. And I've seen literally no cases of T2D in anyone who eats purely protein and fat, regardless of how much they consume.

So, I have to agree with Johnny here. The CICO methodology can "work," but it is a poor representation of what's really going on.

A calorie is a measure of heat, and our bodies don't actually use heat to move muscles or drive any other metabolic processes. Our bodies use ATP for such things. This involves a chemical reaction, not so much a thermal reaction (though some heat is undoubtedly produced), so calories are misleading as a means of understanding metabolic demand.

Further, 1g of carb and 1g of protein have the same "calories" but do they have the same effect on the metabolism of the body?

Not really.

Dietary carbs are either oxidized to make ATP or stored as fat.

Whereas proteins are almost entirely broken up into amino acids and used as structural building blocks, not as a source of "energy" (whether immediately oxidized or stored as fat). I know Johnny might disagree here, because of the large bolus of protein triggering gluconeogensis, so yes, some dietary protein will be funneled through the liver and turned into glucose under certain circumstances.

Dietary fat can be oxidized from chylomicrons in the blood to make ATP for immediate use, as well as utilized in the formation of hormones, the support of cell membranes, and of course storing fat for future use.

Whatever the case, dietary carbohydrates are generally unnecessary and contra-indicated in the context of a human diet, such that one could probably eat a "surplus of energy" from protein and fat, in the absence of dietary carbohydrates, and be perfectly healthy.

 

[Johnny D]

So, I have to agree with Johnny here. The CICO methodology can "work," but it is a poor representation of what's really going on.

Agreed. While the calorie can be a somewhat helpful proxy to measure overall intake, since it's what everyone learned and is familiar with, it's not even close to telling us what happens from the time we consume food until the time that fuel becomes energy. I actually find it far easier (and, of course, more accurate) to know how many grams of protein and fat I need.

Whereas proteins are almost entirely broken up into amino acids and used as structural building blocks, not as a source of "energy" (whether immediately oxidized or stored as fat). I know Johnny might disagree here, because of the large bolus of protein triggering gluconeogensis, so yes, some dietary protein will be funneled through the liver and turned into glucose under certain circumstances.

I disagree only to the extent that gluconeogenesis is a constant metabolic pathway as glucose homeostasis is a priority. Also, even though protein needs will fluctuate based on activity, etc we're always turning over protein. Meaning we continuously break down and rebuild proteins. Amino acids from consumed proteins are stored in the amino acid pool and our cells draw from this pool for various needs, in addition to new structural proteins. Some amino acids are used to build new muscle, but others might be needed to make enzymes, hormones, or other molecules.

 

[Pegasus]

A high rate of sucess to send recent t2d into remission is a simple gastric bypass . How does it work calories.

Look this whole concept that the human body is not meant to handle whole classes of food like carbs or meat I am not going to bother with you guys can carry on .

I am more interested in Yogi statement re calorie balance . A reduction in calories without change in food source frequently has positive impact on bg.

 

[madyogi]

I disagree only to the extent that gluconeogenesis is a constant metabolic pathway as glucose homeostasis is a priority. Also, even though protein needs will fluctuate based on activity, etc we're always turning over protein. Meaning we continuously break down and rebuild proteins. Amino acids from consumed proteins are stored in the amino acid pool and our cells draw from this pool for various needs, in addition to new structural proteins. Some amino acids are used to build new muscle, but others might be needed to make enzymes, hormones, or other molecules.

I really don't think we disagree here. I understand gluconeogenesis occurs more or less all the time, but it's not always a direct utilization of dietary protein. The liver uses other substrates like lactate and glycerol as well. And like you said, there's a pool, from which amino acids can be utilized for gluconeogenesis, as well as structural components of various things. They are not directly used in any metabolic pathway that creates energy (ATP), at least not that I'm aware of.

My main point was that "calories of dietary protein" can't really be equated to "calories of dietary carbohydrate" the way most people imagine within a CICO framing.

 

[Johnny D]

A high rate of sucess to send recent t2d into remission is a simple gastric bypass . How does it work calories.

There's much more to it than a reduction of calories. The surgery alters the gut microbiome pretty significantly which results in changes to glucose metabolism and insulin sensitivity. Also, because of the rerouting, there is a big increase in GLP-1 production and insulin response. There is a lot that goes on with the surgery and metabolism is affected pretty drastically. And, yes, total consumption is reduced but carbohydrate consumption goes WAY down. Post surgery patients are prescribed a pretty strict diet, are they not? And their dietary carbohydrates are considerably reduced.

Look this whole concept that the human body is not meant to handle whole classes of food like carbs or meat I am not going to bother with you guys can carry on .

It's not a concept. I'm simply describing the metabolic science.

I am more interested in Yogi statement re calorie balance . A reduction in calories without change in food source frequently has positive impact on bg.

A reduction in total consumption is probably a proportionate reduction in macros and, therefore, reduction of dietary carbohydrates.

 

[Pegasus]

OH Johhny the mental stunting and gymnastics.

Yogi the protein being turned to energy certain conditions you refer to include a lack of carbs .

 

[Johnny D]

OH Johhny the mental stunting and gymnastics.

You're more than welcome to show where anything that I have said is incorrect. I'll wait...

 

[Pegasus]

I don't spend time on argument on things like religon which is what you have here Johnny ,
I will leave it to anyone reading to draw their own conclusions , I will say to anyone reading that a greatdeal of what you have said is very far from the mainstream scientific position and to do their own research from multi sources .

I would like to draw everyones attention to this article which though dense does have a point to make .

https://www.sciencedirect.com/science/article/abs/pii/S1043276024001243

 

[Johnny D]

Religion?!! Everything I’ve stated is scientific fact. Provable and (though you don’t care to do so) disprovable. Not mainstream? Fine - I don’t disagree with that. And if you prefer mainstream over science, that’s your prerogative. But if you’re going to claim I’m wrong or, worse, spouting religion, have the decency and consideration to back your claims with supporting facts about the science.

 

[Pegasus]

Umm Johnny anyone can look up the mainstream science that wants to go to the effort I am not interested in tribal conflicts that abound in nutrition .
For instance I would not be interested in argument with a vegan either who could very well use the same words .

I intend at some point to lay out my understanding of metabolism as it relates to t2d . However my understanding is still developing , so for instance the link in post 236.

 

[Johnny D]

What tribal conflict? You've accused me of mental stunting, mental gymnastics, and spouting religion. If you're not interested in arguing, perhaps don't lob those kinds of insults at me. Otherwise, as I've said, show me where anything that I've said is incorrect.

 

[madyogi]

Look this whole concept that the human body is not meant to handle whole classes of food like carbs or meat I am not going to bother with you guys can carry on .

It's more about how we evolved than what we're "meant to handle." Bottom line is humans evolved eating a diet that was comprised primarily of animal meat and the associated fat. What carbs we ate were relatively few. This is just the reality of the thing. What you do with that information is your business, obviously.

No one here is arguing humans can't "handle" dietary carbohydrates. I have made the argument that dietary carbohydrates are completely unnecessary, and potentially harmful. I have argued that the presence of a moderate level of both fat and carbohydates in the diet creates a conflict in the cellular machinery that contributes to elevated blood glucose and the appearance of insulin resistance, and that reducing or eliminating this conflict will have a positive impact on bg.

I am more interested in Yogi statement re calorie balance . A reduction in calories without change in food source frequently has positive impact on bg.

Yes, reduced consumption means fewer dietary carbs. I would expect circulating blood glucose to go down in the presence of fewer dietary carbs.