Category Archives: diabetes

As if we needed another study about breakfast. Or 4.

Exhibit A. Participants were given ~30 grams of whey, casein, or carbs 30 minutes before bed (Kinsey et al., 2014). [side note: the closer it is to bedtime, the less food is needed to mess up your rhythms. Worded another way, if you’re gonna have a big dinner, the earlier the better]. The following morning, you guessed it, they weren’t hungry for breakfast. And they had higher insulin levels. FFS. Worded another way, light early dinner -> lower insulin and more hungry for breakfast, in the morning.

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Dopamine and breakfast.

Light and food in the morning.

Metabolism is gimped at night.

Exhibit B1. Expecting mothers: “Across the whole cohort, night-time, but not day-time, carbohydrate intake was positively associated with glucose concentrations after the glucose load and inversely associated with early phase insulin secretion (P < 0.05)” (Chandler-Laney et al., 2016).

 

 

Evening is not the best time to carb… but it’s not just carbs… and it affects infants, too.

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Sunlight, Meal Timing, and Circadian Rhythms.

we’re talking some serious epigenetics

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Funded by Big ‘Shrooma

Reishi, the mushroom of longevity.

“The goal is to maintain or improve brain function and physical performance. And not get cancer.”

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‘Shrooms-every-day is part of my long-term anti-cancer plan. It’s not always a lot per serving, but I try to do the whole variety thing as much as possible, whatever’s available.

Maybe it’s one of those ice-age fairy tales fallacies, but cultures around the world have attributed a large number of health benefits to ‘shrooms for literally, thousands of years:

Ganoderma [reishi] has a very long history in East Asia as a medicinal mushroom dating back to the Chinese materia medica ‘Shen Nung Ben Cao Jing,’ written between 206 BC and 8 AD. It was considered a superior tonic for prolonging life, preventing aging, and boosting qi.”

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The importance of entraining skeletal muscle’s circadian clock (and how)

“Literally, every single model of skeletal muscle circadian arrhythmia mimics aging sedentary people who skip breakfast, stay up late, and get sick.”

But first, the human studies that confirm these newer findings aren’t restricted to preclinical models: 1) a randomized CROSSOVER study; two weeks of modest caloric restriction. Same diet; either 5.5 or 8.5 hours of sleep.

In other words, circadian rhythms broke or woke (Nedeltcheva et al., 2010):

 

 

Same diet & energy expenditure + circadian arrhythmia = lose less fat and more muscle. This is basically the opposite of optimal. Large error bars because it was a CROSSOVER study, although it still managed to reach statistical significance.

And this happened despite lower 24-hour insulin AUC (Nedeltcheva et al., 2012). GRAVITAS.

 

 

And in an ad lib setting, “Laboratory studies in healthy young volunteers have shown that experimental sleep restriction is associated with a dysregulation of the neuroendocrine control of appetite consistent with increased hunger and with alterations in parameters of glucose tolerance suggestive of an increased risk of diabetes” (Van Cauter et al., 2007).

 

 

Part 2. THE BETTER PART: The muscle clock, how it works, and how to fix it.

 

 

 

Similar to other peripheral circadian clocks (eg, liver, adipose, lung, etc.), the muscle clock is entrained by LIGHT via the central pacemaker located in the SCN and feeding (via an as of yet unclear mechanism), but also scheduled exercise.

Interestingly, mice who had been subjected to a 6-hour phase advance adapted faster if they exercised early in the active phase (would be morning for humans).

 

 

Much of these data are summarized in a review in Frontiers in Neuroscience (Aoyama and Shibata, 2017).

The muscle clock is entrained by timed exercise but also feeding. This was demonstrated by showing the circadian rhythms in a subset of muscle-specific genes in fed mice were absent in fasted mice.

It is thought that the muscle clock’s function is to prepare us for the transition from the resting/fasting phase (night) to the active/fed phase (day)… and although I like that phrasing, this seems somewhat subjective (and really hard  to test/prove even on a hypothetical level).

 

 

Part 3. The BEST part: impact of various muscle clock disruptions.

Hint: THEY’RE ALL BAD.

 

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Allu-lujah: the new Quest Hero bars

On that sweetener in the new Quest Hero bars: allulose (formerly known as D-Psicose).

1. I’m sure they were quick to adopt the alternate nomenclature because it’s hard not so say Piss-cose lol

2. Nutrition-wise, Hero bars are basically Quest Lite. A bit less fibre. But I really think they’re getting much better at texture.

3. On to allulose. It’s not really like sugar – even though the FDA says it must be labeled as such – because it carries virtually no calories and actually blunts the blood glucose spike from a meal.

 

Exhibit A. n=20 healthy peole: 7.5 g D-psicose alone, 75 g maltodextrin alone, 75 g maltodextrin + 2.5, 5, or 7.5 g D-psicose (Iida et al., 2008)

amazeballs

 

 

 

 

 

Exhibit B. n=26, zero or 5g psicose with a standardized meal (Hayashi et al., 2010). Note: there are ~12 grams of allulose in a Hero bar.

It works better in diabetics.

 

 

They did a 12-week study where psicose was dosed 3 times a day, 5 grams each time, and showed it was perfectly healthy. Some markers even improved.

 

Exhibit C. Psicose metabolism (Iida et al., 2010)

In doses ranging from 5 to 30 grams, up to 70% is excreted intact and the rest does not go to farts.

It’s virtually calorie-free:

 

 

and is barely fermentable (compared to FOS):

 

 

compare to other low carb protein bars here, get the new Quest bars here, or just buy some straight allulose and experiment with it!

Mechanisms? 1) it’s not sugar, but it still enhances glucose disposal; and 2) some animal studies show it enhances liver glucose uptake. Idk.

If you like what I do and want to support it, head over to Patreon! Three bucks a month for access to all articles and there are many other options. Don’t hesitate, there are only a limited number of spaces left at the $3 level. It’s ad-free and you can cancel at any time 🙂

Discounts: still looking for a pair of hot blue blockers? Carbonshade and Spectra479 are offering 15% off with the coupon code LAGAKOS. And for some delish broths/stocks, Kettle & Fire is 20% off HERE.

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The alkaline diet is bullshit. Proof: vinegar is the bomb

1. Whether it’s Balsamic, sherry, red wine, apple cider, or even plain distilled white, vinegar is a great condiment (P<0.05). Try cutting your favorite with a more concentrated one for more fun (be careful, it can burn you; I’d start with 1:20 or 5%).

2. It reduces the glucose and insulin response to a meal.

World’s coolest fatty acid?

 

 

Exhibit A: 20 g apple cider vinegar, 40 g water, and 1 tsp saccharine two minutes prior to “a white bagel, butter, and orange juice (87 g total carbohydrates)” (Johnston et al., 2004)

 

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High protein magic

Remission of pre-diabetes to normal glucose tolerance in obese adults with high protein versus high carbohydrate diet: randomized control trial (Stentz et al., 2016)

n=12/group

Duration = 6 months

Diet: all food provided.  Mucho gusto!

 

Critique #1: if my calculations are correct, we’re comparing low protein (0.675 g/kg) to adequate (1.35 g/kg) (not “high”).

The diets were decent:

 

 

Results:

 

 

Author’s conclusion was that this was due to high protein alone, but I’d say it was at least partially due to weight loss.  BOTH groups lost weight and improved insulin sensitivity.  Statistically significant in both groups.

 




 

Glucose (A) and insulin (B) in response to a 75g OGTT (red is high protein, blue high carb):

 

 

I still say weight loss was the primary driver, but must concede, however, that protein did have a little magical effect: high carb group actually lost slightly more weight, but insulin sensitivity improved more in the high protein group.  The high protein magic: reduced insulin secretion yet still greater reduction in glycemia.

 




 

Well, maybe not magic…

 

 

Despite having more insulin, high carbers lost slightly more fat mass but way more muscle.  THAT’s high protein magic lol

 

However, the meal tolerance tests show a slightly different trend:

 

 

We expect glucose and insulin excursions to be greater in HC (blue), because they had a high carb meal whereas the HP group had a high protein meal.  From this perspective, if we graphed the results as “change from time zero,” I think the reduction in glycemia from baseline to 6 months would be similar in both groups suggesting weight loss as bigger factor.  We’d still give some props to high protein because it lowered glucose just as much despite having less insulin.  High protein magic.

 

Note to self: gotta stop saying this was “high protein.”  1.35 g/kg is not “high,” seriously.  But still, High protein magic haha

 

Oh and one other thing, high protein usually induces greater weight loss:

Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity (Skov et al., 1999)

High protein vs high carbohydrate hypoenergetic diet for the treatment of obese hyperinsulinemic subjects (Baba et al., 1999) (not ad lib)

Comparison of high-fat and high-proein diets with a high-carbohydrate diet in insulin-resistant obese women (McAuley et al., 2005)

The effect of a low-fat, high-protein or high-carbohydrate ad libitum diiet on weight loss maintenance and metabolic risk factors (Claessens et al., 2009)

 

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The BROAD Study or Meat

Is eating meat necessary?  Optimal?

THE ANSWER MAY SURPRISE YOU

Hint: it’s more important to not eat processed refined junk foods.

 

Exhibit A. The BROAD study: a randomized controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease, or diabetes (Wright et al., 2017)

Tl;dr: it worked.

 

 

The longer version: it was a low-fat vegan diet supplemented with 50 ug B12 (methylcobalamin) daily.

 

Participants were advised to eat until satiation.

We placed no restriction on total energy intake.

Participants were asked to not count calories.”

 

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GLP-101

Insulin secretion happens pretty quickly after a meal, in part, due to nutrients and gut-derived incretins like GLP-1.  GLP-1 secretion only happens with a meal, so the insulinemic response to oral glucose is greater than that to i.v. glucose:

 

 

Part 2. The liver sees WAY more insulin than peripheral tissues when this happens.  And it’s probably that way for a reason; ie, perhaps you need more insulin to shut down hepatic glucose output than to stimulate muscle glucose uptake and shut down lipolysis, etc.

 

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The Hunger-Free Diet(s)

It started out as “lose weight without hunger on LCHF” and went all the way to “effortless fasting on keto.”  Works for some and it might be true, but the same can be said for low fat diets!  The key, I think, in both contexts, is simple: fewer processed & refined foods… something the Paleo movement got right, imo (although I still think many low-calorie sweeteners are way less unhealthy than HFCS & sugar).

The logic:

1) add “good calories” like almonds to your diet and appetite spontaneously compensates by eating less other stuff: energy neutral

2) you don’t compensate for added “bad calories” like sugar-sweetened beverages: positive energy balance

3) remove bad calories from your diet and you don’t compensate by eating more other stuff: negative energy balance

 

Book: Good Calories, Bad Calories

 

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Keto myths & facts

:::begin rant:::

Trigger warning?  Maybe.

Disclaimer: I’m pro-LC (P<0.05), but not anti-LF because LF works better than LC for some people.  And with the exception of things like keto for neurological issues, I think macros take a back seat to many other factors.

Myths: carbs cause insulin resistance (IR), diabetes, and metabolic syndrome.  Carbs are intrinsically pathogenic.  If a healthy person eats carbs, eventually they’ll get sick.

And the only prescription is more keto.

cowbell

And of course all of this could’ve been prevented if they keto’d from the get-go.

Proponents of these myths are referring to regular food carbs, not limited to things like Oreo Coolattas (which would be more acceptable, imo).  Taubes, Lustig, Attia, and many others have backed away from their anti-carb positions, yet the new brigade proceeds and has even upped the ante to include starvation.  Because “LC = effortless fasting?”

Does this sound sane?

“No carbs ever,
no food often…
otherwise diabetes.”

oreo-coolatta

no one in their right mind would say lentils & beans cause diabetes

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