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Old 12-19-2006, 08:59 AM   #1
Steve Shafley
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Default Insulin Sensitivity vs Insulin Resistance

Kelly Baggett (see the Fitness and GPP forum) had this interesting bit to say about insulin sensitivity vs resistance. This was in the comments of the latest Poliquin article on T-mag.

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Actually people get confused because they think being extremely insulin sensitive is a good thing. What most think of as carb tolerance is actually a form of carb intolerance. Hypoglycemia is an example of extreme insulin sensitivitity (hypersensitivity actually). Someone who can eat a big ass carb meal (like pancakes) and not get a blood sugar crash is actually probably resistant to insulin....their blood sugar goes up and stays elevated. An extreme example of that is diabetes.

From that perspective, african americans naturally tend to be at one end (the more resistant end) and american indians at the other end (the hypersensitive end). Sensitivity predicts weight gain. Someone who is insulin resistant is in a state that their body is basically rebelling against further nutrient storage..actually giving them an advantage for burning fat.
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The same things that make a person achieve leanness and muscularity with hardly any effort can also make them succeptible to obesity. Basically they develop reistance to insulin and leptin at a lower level of fatness. Once the resistance has set in, the metabolic regulation becomes such that the brain thinks it's starving even though it's well-fed.

A person can become fat due to either underactivity of various hormones and neurotransmitters in the brain or overactivity. Insulin and leptin resistance are examples of the latter. Hypoglycemia is an example of the former.

People with higher natural levels of fast twitch muscle fiber have a greater risk of IR and obesity later in life.....but if you train them and keep them somewhat lean they are the true freaks...lean, muscular, strong.

To understand why a certain level of IR can be desirable for an athlete think of what happens when you bring a person with a big beer gut into the gym and start training them for the first time. They build muscle and burn fat like there's no tomorrow. But what happens when that same person sits on their butt? They develop even more obesity and health problems.
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Metabolic predictors of weight gain.Ravussin E, Gautier JF.
Clinical Diabetes and Nutrition Section, National Institute of Health, NIDDK, Phoenix, Arizona 85016, USA.

Human obesity is the result of both environmental and genetic factors. In this manuscript, we briefly review the metabolic factors predicting body weight gain in Pima Indians, a population prone to obesity. The metabolic predictors of weight gain are: 1) a low metabolic rate, 2) low levels of physical activity, 3) low rates of fat oxidation, 4) insulin sensitivity, 5) low sympathetic nervous system activity, and 6) low plasma leptin concentrations. In contrast, obesity is associated with high metabolic rate, high fat oxidation, low insulin sensitivity and high plasma leptin concentration. This observation emphasizes the need to conduct prospective studies to obtain a better understanding of the etiology of obesity. In addition, genetic studies will help to identify new pathways involved in the pathophysiology of obesity.
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Old 12-19-2006, 09:00 AM   #2
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In the same discussion, Lyle McDonald makes this point (this is a discussion of IF that's happening on Lyle's board)

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generally speaking, as obesity develops, insulin resistance tends to develop

quite in fact, some think that insulin resistance is an adaptation to try and prevent further weight gain. given what insulin resistance actually means (and the signal to the brain that chronically high insulin levels are at least trying to send, insulin tending to decrease appetite when it sends a proper signal to the brain), this makes logical sense.

additionally, if folks would take the time to think about it

a. the easiest time to lose weight is when you're very fat which is typoically when you're most insulin resistant
b. the easiest time to gain weight is at the end of the diet when you're insulin sensitivity has gone up

one recent review drew a distinction between
a. an inappropriate insulin secretion following a meal
b. whole body insulin resistance

in terms of prediliction towards weight gain. they argued that 'a' tended to be associated with weight gain while 'b' is clearly associated with resistance to further weight gain
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Old 12-19-2006, 09:01 AM   #3
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Another comment by Lyle regarding insulin levels and blood pressure I found interesting:

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wrt: high blood pressure, one function of insulin is to incresae sympathetic tone (a big part of the thermic effect of eating is due to this) so chronically high insulin = increased sympathetic tone

among other things, this tends to increase blood pressure

the insulin resistance of obesity is likely related to a bunch of different stuff

one of them is that when muscle gets packed full of nutrients (carbs, triglyeride or even aminos), it tends to become insulin resistant

when fat cells get full, they start releasing a host of chemicals (leptin, TNf-alpha, resistin which doesn't seem to do much in humans, adiponectin goes down, probably lots of other stuff) to
a. limit further calorie storage in fat cells
b. try to increase fat oxidation elsewhere (i.e. leptin drives fat oxidation in muscle).

also, since fat cells are not longer accepting nutrients, you get high blood fatty acid levels in the bloodstream, which also causes insulin resistance

a lack of activity plays a role

genetics plays a role
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Old 12-19-2006, 10:07 AM   #4
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Good stuff Steve, thanks.

I truely believe Insulin levels/Insulin resistance is the most important hormone/condition to understand and control. It can be extremely anabolic......or it can lead us down the road to sickness and obesity. It's just all in how we understand and use it...plus other lifestyle factors that can help out such as IF.
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Old 12-19-2006, 12:33 PM   #5
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Good Thread Steve.

I watch my Carb intake and avoid all sugars and High Glycemic Carbs.

With that said, How the heck do I know if I am Insulin Resistant or Sensitive?

I am 6'4" 230lbs. About 12-15% Body fat (2007 goal is to get below 10 percent)
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Old 12-19-2006, 12:57 PM   #6
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If you are "sensitive", you will gain fat (esp abdominal) easily from carbs.
If you are "resistant", your blood sugar/insulin levels will stay elevated and increase your risk of diabetes.

One you can test on your own...the other would have to be a blood test.
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Old 12-19-2006, 01:05 PM   #7
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You can probably do some simple monitoring with a blood glucose meter like diabetics use if you are really interested.

You'd track your blood sugar levels after eating a standardized carbohydrate meal. If you see a rise, then drop, it could indicate a sensitivity. If you see a rise, and no drop, or a slow drop, it could indicate a resistance.

Just an idea...I don't know how workable it is, those blood glucose meters aren't exceptionally precise tools, IIRC.
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Old 12-21-2006, 07:49 AM   #8
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Interesting stuff. One point I'd nit-pick is that getting a little fat makes it easier to get MORE fat. There is no braking mechanism for weight gain when it is in the form of hyperinsulinemic fat gain. I think I wrote something about this in another thread: We have a myostatin gene which limits muscular gain. We have no lipostatin gene. I think Art Devany's perspective on this is more accurate than Lyle's. The body is trying to protect itself from elevated blood glucose levels and thus grows the fat base as a dumping ground. The fat then secretes hormones that help to propagate itself. This all happens after the muscles have become insulin resistant.
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Old 12-21-2006, 11:02 AM   #9
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So I'm confused...if hypoglycemia and diabetes are opposite ends of the same spectrum, why does hypoglycemia predispose one to diabetes? Isn't hypoglycemia a precursor to diabetes if not checked?
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Old 01-04-2007, 12:52 PM   #10
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I read Baggett's No Bull book. The point he makes there about hypersensitivity is that it can occur when your body fat declines below around 6% (or was it 8%). I've bulked up a bit more recently from around that level and find that I manage my energy levels much more easily. At 6% I reallly had to have an energy drink around when I exercised hard. Someone at CF posted that it was insulin resistance but in fact it seems to have been the opposite.

That doesn't mean that it's a permanent condition. If you're very lean because you're very active and not eating that much, then it would make sense that your glycogen stores will be depleted. Exercise will then force you to use external sources. It is true that when I get hypoglaecemic, I feel like I need to eat something sugary and that there is a delay before it hits the system.

My solution is to go for a bit more body fat than I perhaps would like otherwise in return for a better energy state.
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