Is too much insulin the cause of common obesity? Yes, most likely.
Here’s another embarrassing high-profile study for all insulin deniers out there: Rats genetically modified to secrete less insulin from their pancreas stay slim even on a diet that makes other rats fat. Apart from the pancreatic insulin there was no difference between the slim (low insulin) and the fat (high insulin) rats.
The researchers, publishing the study in the high-impact journal Cell Metabolism, conclude that too much fat-storing insulin is a necessary cause of common diet-induced obesity (press release).
In humans the main cause of elevated insulin is eating too much junk carbohydrates. So it’s no coincidence that low carb diets consistently outperform other diets for weight loss.
It’s the insulin, stupid.
Earlier: The #1 Cause of Obesity: Insulin
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149 Comments
"The problem with obese people is that they are taking in more energy than they are burning"
Try overeating on butter and see how well that works for you. And remember that fat is much more energy dense than carbohydrate. I'm mighty sick of this closed-minded attitude that has to make it all about "behaviour". You just don't get it Ben and maybe you never will.
The populations you describe are NOT eating diets high in sugars and refined starches AKA the "Western" or "SAD" diet.
A) Human bodies are designed to process a wide range of fuel sources
B) Human bodies are capable of attaining energy balance with a wide variety of fuel sources (high fat, high protein, etc)
C) Human bodies ordinarily gain weight when they eat outside of energy balance needs
The fact that people can exist in perfectly happy energy balance yet have a high carb diet (meaning most of their fuel is burned under the direction of insulin), is good evidence that insulin cannot be the culprit behind obesity. Mark Sisson makes the point that metabolically speaking, a bowl of cereal is metabolically equivalent to a bowl of skittles. If it were the insulin, then one would not expect people who burn most of their fuel under the effects of insulin to exist - yet they do. This is primarily why I find the carb-insulin hypothesis so uncompelling.
Now, you bring up the SAD. Yes, that includes more refined sugar and carbohydrate - there is no dispute over that. But it also includes... a higher calorie count.. 22% higher for women and 6% higher for men from 1970 to 2000, according to a 2004 NYT article. According to point B above, a person can, if they were determined enough, lose weight on the twinkie diet. But as it turns out, people who eat a lot of twinkies tend to overconsume calories in general.
There is where Guyenet becomes compelling. A rat, exposed to standard chow, does not spontaneously get fat. A rat, exposed to junk food, spontaneously overconsumes and gets fat. I find that fact alone quite fascinating. Americans are, by and large (no pun intended), like the rat in the cage with an unlimited supply of junk food. Of course they are going to overindulge.
All that to say, food environment matters. LC works for a lot of people because they fundamentally change their food environment. Sisson advocates purging your kitchen of the bad stuff, which is great advice. But at the end of the day, I believe that the bad stuff is bad not because it spikes your insulin, but because it leads to binge eating and overconsumption.
Trust me, I "get it" - I just go where the observational evidence leads, which is away from insulin as the proximate cause of obesity, and toward ordinary overconsumption of food
http://blog.cholesterol-and-health.com/2010/11/is-insulin-resistance-...
"Their insulin receptors are only knocked out in their liver. So if high insulin levels are what act on our adipose tissue to make us fat, these mice should be really, really, really fat. On the contrary, they are quite lean"
"Why aren't they fat? This study showed that they were just as sensitive to leptin, perhaps slightly more sensitive, than controls. Thus, while leptin resistance and insulin resistance often go together, it seems that leptin resistance is a much more important contributor to obesity.
These data should not be considered evidence that insulin resistance can never lead to leptin resistance in humans. In fact, human hepatic insulin resistance (insulin resistance of the liver) looks nothing like what happens in the hepatic insulin receptor knockout mice. The livers of these mice don't respond to insulin at all. In humans, this insulin resistance is "selective." The livers of "insulin resistant" humans continue to manufacture fat and send it out into the blood as triglycerides in response to insulin, but fail to suppress the production and export of glucose in response to insulin.
In humans, insulin resistance of the liver leads to increased triglycerides in the blood. One theory that has some experimental support, but is still questioned by some experts, is that increased blood triglycerides decrease the transport of leptin into the brain. For this and perhaps other reasons, insulin resistance as it occurs in humans could, perhaps, cause leptin resistance. However, if it does not cause leptin resistance, it is very unlikely to make people fat."
Perhaps Leptin is a key part of the puzzle BUT why discount the role that Insulin-Resistance has in leading to Leptin-Resistance?
Gary Taubes in GC,BC uses the analogy of striking yourself on the head with an hammer... now you might spend millions of research dollars on examining the down-stream biochemical pathways to determine how the pain is communicated to the brain (an interesting and enlightening exercise) BUT the obvious solution is to stop hitting yourself over the head with an hammer!
That is to say that I know how to alter what I eat so as to limit my requirement for insulin (and that has changed my life dramatically for the better)... can you say the same about leptin?
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@Ben: what is is about "junk food" that makes rats and humans keep coming back for more?
I have asked repeatedly for examples of so-called "high reward" foods that do NOT contain ANY sugar or refined starches. I can think of examples (soda is the primary one) that ONLY contain sugar or refined starches but none have been offered that ONLY contain fat.
Again remembering that fat has over twice the energy density of carbohydrate, or protein; so logically ought to be the prime candidate for over-consumption of energy?
What is is about "diluting" such a rich source of energy with sugar and refined starches that makes it that much harder to stop eating? Can you show that it is not the insulin leading to increased fat storage and cellular hunger?
Yes most breakfast cereals (sugars and refined starches) are akin to eating candy... is that what your traditional populations who get a high percentage of energy from carbs are eating? If so I will stand corrected.. otherwise look to the glycemic index and note that not all foods lead to a rapid spike in Blood Glucose and resulting insulin levels.
Ben -- I do not "trust you" nor do I think that you do "get it"... because when all else fails you fall back on the simplistic platitudes.. to paraphrase "fat people just eat too darn much".. I don't care how many weasel words you dress that up in to make it seem more palatable, you are still wrong.
That begs the question and overlooks the fact we are all exposed to junk food and most of us do not get obese. Guyenet has staked out a research niche and must defend it to sustain his funding. It is healthy to have different poles in the debate, to generate multiple interpretations of data (which is always intrinsically ambiguous). Nonetheless, I have no financial stake, no professional role in the cogs of science, just an interest in personal health. I simply don't find the behavioural hypothesis convincing in the least. It reminds me of psychoanalysts in the 1960s and their behavioural explanations for the causes of schizophrenia and bi-polar disorder. In any event, the causes of obesity rates within a general population are not what is interesting to me, Going low-carb has resulted in me losing 30 pounds about 6-8 years ago and body fat is no longer an issue for me. For me the important issue is health, and it seems that with every chronic disease I study, continual excess metabolism of glucose beyond a person's individual level of tolerance results in disease. Sure there is metabolic flexibility in the short term--cells, for example, can persist under hypoxia by using fermentation to produce ATP--but chronic hypoxia has deleterious effects. The fact the body is capable of short-term flexibility hardly demonstrates that no long-term fuel-consumption pattern is deleterious or that none is optimal.
I have been re-reading Thomas Seyfried's Cancer as a Metabolic Disease. He comes to carbohydrate reduction from an entirely different perspective, studying the effects of cumulative damage to mitochondria from excess ROS production (from excess glucose metabolism, among other things) and other insults and the reliance of cancer cells on glucose metabolism.
A recent Mayo clinic study found a very high correlation between increased carbohydrate consumption and cognitive decline. The highest carbohydrate eaters had a 360% (!!!) higher occurrence rate of decline, The highest fat eaters had a 42% lower occurrence rate of decline.
My experience with people who have developed type II diabetes is that the condition is entirely manageable without any drugs simply by reducing carbohydrate consumption.
Research in heart arrhythmia points to mitochondrial damage to heart muscles from excess metabolism of glucose as fuel as the likely cause. (The muscle cells with compromised mitochondria have less output and so multiply, thickening the heart muscle wall, enlargening the left ventricle and disturbing the pattern of electrical signal propagation, resulting in arrhythmia).
Clinical experience measuring coronary artery plaque indicates high carbohydrates, particularly with reduction of vitamin K2-rich fats and organ meats from grass-eating animals, worsens plaque and conversely, that virtual elimination of starch and sugar and adding K2 rich sources reduces artery plaque. And dental plaque. I have since stopped getting dental plaque. Three other people I have gotten on to vitamin K2 supplements (with vitamin D3) have also reported abrupt cessation of dental plaque formation. (Vitamin K2 is what Weston Price discovered and called Activator X.)
Then there is the systemic theory of dental cavities on how insulin suppresses the parotid hormone which otherwise activates remineralization of teeth. Starch and sugar are bad for the teeth from the inside. The acid theory of dental caries breaks down in the absence of high glycemic foods. In fact, as I have observed and have learned in discussions with nutrition oriented dentists, cavities heal themselves, so long as high-starch and sugar foods are avoided (likely the insulin effect) and a person follows a mineralization diet.
So many roads suggest the human body is not a sustainably all-fuel metabolism. It is flexible, to abide short term insults (such as bountiful fruit in late summer), but long-term consumption of starch and sugar beyond some threshold appears harmful. What is the threshold? It obviously varies. Phinney and Volek (Art and Science of Low Carbohydrate Living) have found liponeogenesis metabolites in some people even below 20% carbohydrates. Other people can go much higher without it. I would hope the sceintists start looking for that, rather than feeding rats junk food.
Targeting insulin inhibition as a metabolic therapy in advanced cancer
http://rdfeinman.wordpress.com/2012/10/15/targeting-insulin-inhibitio...
I agree that this is not just about managing excess fat mass but about overall health... my dentist too has (sadly for him) had no work to do on my teeth since I started eating LCHF
http://wholehealthsource.blogspot.ca/2012/06/new-study-demonstrates-t...
On the subject of why everyone doesn't eat junk food, its the same reason everybody doesn't do cocaine and heroin which are also highly addictive - we know what is bad for us. My kids love candy, and would eat it all day if given the chance. I also like candy, but have the self control to eat it rarely. We can do things like intentionally exercise to compensate for excess consumption.
There can certainly be other bad things about carb consumption, but that doesn't mean it is necessarily the bad guy with regard to obesity.
The fact that people are eating more calories now than they were 30 years ago is well established. The interesting question is why, and that is where food environment issues are important to the discussion. This isn't blaming obese people for being obese, it is searching for answers as to why these changes have happened in this time and place
If anything, the food reward / palatability hypothesis is more sympathetic to the obese, as it is realistic about the fact that there are strong internal psychological pressures to eat unhealthy foods. Sure, we are not rats who will always get fat when given the chance. But we still want to eat the yummy stuff, and must be on our guard at all times
I was lean into my mid-to-late twenties and then struggled with excess fat mass for 25 years. Do you seriously think that during all that time I did not consider changing my "food environment" or spend countless hours down at the gym?
Yet having done all that I read GC,BC and within 24 hours of starting an LCHF diet I was no longer constantly hungry (and have not been since) I lost 25 lbs in the first two months and have maintained an over 100 lb weight loss for over 5 years now.. that along with many other health benefits and ALL without starving myself or following the dictum of "just eat fewer calories".
What I eat today is incredibly tasty, varied, pleasurable and highly palatable, yet somehow I am able to maintain balance WITHOUT counting calories! Almost as if this was the way I was evolved to eat!
Once again I urge you to open your mind and look beyond the interpretations others offer you.. especially folks like Guyenet who clearly has an agenda. So genetically manipulated mice who couldn't taste sweetness didn't get fat... what about the studies looking into people getting fat after using artificial sweeteners? Is it a psychological effect or physiological? Any chance the taste of sweetness has a biochemical effect in the body related to how we digest the food? Critical thinking means being open to alternate interpretations and not just settling on the one that suits you.
I figure after my 25 years of struggle while accepting CICO and ELMM it has had a good run for its money.. its doesn't help.. in fact I think it is worse than useless to concentrate on how much we eat... instead look at the quality of the food and in my personal experience (and a growing number of others) the quantity naturally takes care of itself.
And, ultimately, this discussion has drifted away from the mechanics of weight gain or weight loss - because from a practical standpoint, we probably would agree with 95% of each others food choices when it comes to how to live healthy.
Now, I'm sorry you feel insulted by the notion that food and psychology are related, but common - really? Lots of people eat for non energy balance reasons. They find comfort in food, or just find it plain tasty and pleasurable. Saying the brain has no role in body fatness really just isn't realistic. Ignoring the addictive power of other foods (especially refined sugar) is downright dangerous.
It's great that you lost weight going low carb. I suspect that to lose that much weight, you probably cut out some foods you previously had greatly enjoyed. When people are overconsuming on carbohydrate, like the Standard American, a low carb diet can work wonders. I am probably about 70 pounds down myself from my peak. I am not however persuaded by Taubes' specific theory - there are too many gaps for my satisfaction.
For what it's worth, I got interested in these issues through Taubes. My "mind opening" happened when reading people critical of his hypothesis (e.g. Guyenet)
this doesn't disprove the carb hypothesis. what is overriding the normal brake our bodies are equipped with (a sense of satiety) to keep us from overeating?
the starchy, sugary SAD itself!
To the Palability teori.. if one do exchange palability with sugar.. then its right!
But if one eat real good tasting food one feel satisfyed for a long time.
I do reject that SG theory, some of his exampel is so low water marks so it looks like he is scramble anything to prove his theorys?
He have some god points and som bad.. the thing he is right about is that if junkfood tasted like shit.. we wouldnt eat it!
The bad point is that real good palatible and rewarding food, tastes better then junkfood, and you get another satisfying feeling!
Its boils down to that junkfood often is a lot of sugars and processed carbs.. one get an high blood sugar that rise ones dopamin.. you get addictet to that.. and of course you get sick in the long run, some of us does it anyway.
And some does get hyperinsulinemia.. and get obese of it.
by the way have you heard that according to studies, it was also established experimentally that the use of Testosterone at a dose of only 3-4 mg per kg of body weight per week raises the level of growth hormone in the blood by 22% and insulin-like growth factor (IGF) by 21%.
this is not the topic of this discussion but I had decided to change the lifestyle about two weeks ago, and now I am craving salt like crazy!!! does anyone has any suggestions.
thank you, guys.
Seriously I have heard others comment that when first starting LCHF it is a god idea to have extra salt, often chicken stock is suggested as an example.
Your kidneys start excreting more salt when starting a low carb diet. You should add salt to your food or drink broth to make sure you're not depleted of sodium (remember to get enough potassium and magnesium too).
Spare Ribs, Glaze on Ham = "sugar coated meat"
Dessert = "confection, eat a bowl of candy"
"It's Good" - NO - "It tastes good but it is NOT good for you"
I am 53, about a 6 years ago I looked at the mirror & said WTF. I dropped 100 poinds & have stayed stable at 195 for 4 years. Look up "the Physics Diet" & stop putting garbage in your mouth. The weight loss took about 8 months. If it did not grow, it is not food. I enjoy garbage infrequently. Sugar is not food. For all the toxic victim mentality that pervaids our society, I have no sympathy. You are the one in control of this hand to mouth action.
Insulin resistance and insulin secretion cancelling each other out? Really? So magically "insulin resistance" is a single biological variable, and not something that happens at different rates to different kinds of cells?
I'm not sure what world he's living in where he doesn't see that type 2 diabetics are almost universally all fat!
http://high-fat-nutrition.blogspot.ca/2012/12/more-yawns-on-insulin-a...
Oh and by the way... It's the Insulin, Stupid!
If Dr Eenfeldt had used the term 'High Fat Diet', some people would have jumped to the wrong conclusion that a proper high fat or paleo diet would lead to chronic hyperinsuliaemia and all the jolly downstream metabolic consequences. It could have stopped some readers to implement an intervention that has the well documented potential to make them healthier. You would not want that, would you?
For humans a high fat low carb diet is very much insulin-lowering. And as dozens of studies have shown it also tends to lead to rapid weight loss.
You could have kept the figure as is, and explained any objection that you have to it. Instead you silently altered what you didn't like. You seem like a born liar that can't be trusted.
http://en.wikipedia.org/wiki/Bracket#Square_brackets_.5B_.5D
If I wanted to "lie" or was a "born liar" I would not point out exactly where I modified the figure, now would I?
The original does not apply to humans. That's why I changed it so that it can be used for both rats and humans.
However, I do not agree with your explanation of the use of square brackets in a cited graphic without making it obvious what you intended. When square brackets are used it is normal to provide the original text so that the context of the "change" by the citing author can be seen. This is clearly outlined in the Wikipedia article you referenced.
Not everyone reading your blog knows about the differences between rodent and human diets and I think that you would have performed a better service to your readers by pointing out in your original post that you had changed the graphic and explained the quite valid reason for doing so.
On a related note: it seems to me that there are word associations which can be misleading in common usage... for example, in the UK "chocolate" often bears little resemblance to what I would think of as 70%, or higher, cocoa content... it is just as likely to mean a sweet candy bar (think mars or snickers) which is more about sugar and refined starches than it is about cocoa
In the same way I too often see "fattening" foods described as "fatty" or "fat" when in fact it is more likely to contain high amounts of sugar and/or refined starches...
guilty by association in other words.
I see nothing here to make me think that Dr Andreas was in any way deceitful and I'd like to see some of the knockers write their own blogs (in a second language, not their native tongue) while second-guessing every possibly interpretation of what they write, or don't write.
And how do you explain fit2fat2fit.com where a perfectly health personal trainer intentionally becomes obese and than reverses it as part of a self experiment? Is his insulin profile broken as well? I think not.
A key word in the statement that you quoted is "common"... as in "the majority of cases"
Asking questions is what science is all about. Being certain that you already have all the answers, is not.
Anyways where is the evidence that this rat study applies to "common diet-induced obesity"? How can one extrapolite that how something works in a genetically modified rat also applies to the majority of humans? Sounds ridiculous to me.
Nor has Gary Taubes claimed that CICO is nonsense.
What is presented (as with ALL science) is (in my opinion) the best working hypothesis that fits our current knowledge.
I don't "blame" insulin but I do recognise that by limiting my requirements for it (by changing what I eat) I have made dramatic changes to my own health.
Now if NuSi or any other future studies present convincing evidence to the contrary then I will be one of the first to acknowledge that.
Guyenet getting his panties in a knot over a perceived dressing-down by a "journalist" is no reason for me to accept his claims that the carbohydrate->insulin hypothesis is already dead and buried. I don't care what authority he claims... where is the substantial evidence that holds up to scrutiny?
Its about to manage. hyperinsulinemia, insulin resistance, metabolic syndrome and obesety !
And its about to contradict that a low fat, low calorie diet is the cure for almoste everything!
And this study that it seems that nobody have full access to is saying that hyperinsulinemia comes before obesety.. at least on mice.. at least on a perticaly diet, at least if they are geneticaly predisposed for that purpose!
Taubes says manipulating macro-nutrient ratios (low carb, high fat) while keeping calories constant in order to reduce insulin action will have an effect on fat-derived weight status, but it does no such thing. He says carb intake is what determines fat loss, not calorie intake, but all of the metabolic ward studies tell us that is far from true.
All low-carb diets that result in weight loss ARE also low-calorie diets in disguise. No serious researcher these days is going to favor LF diets, so don't even go there. Most would say to eat whole foods, and don't be afraid of animal products. Sometimes there is more than just the extreme cases (LC vs. LF), and that the middleground is right way to go.
Have you read all the other comments above? I'm not about to repeat myself regarding metabolic ward studies for your benefit.
You assert that "Taubes says manipulating macro-nutrient ratios (low carb, high fat) while keeping calories constant in order to reduce insulin action will have an effect on fat-derived weight status, but it does no such thing"
Where specifically does he says the piece about keeping calories constant?
...and on what basis do you say that macro-nutrient ratios do not impact fat storage? That concept certainly fits in perfectly with my own experience and apparently an increasingly large number of others are finding the same thing.
You're building a strawman grinch.. either consciously being obtuse, or because you have only read the headlines put about by others. Again, read my comments above regarding this so-called metabolic advantage.. there is no magic involved here that breaks physical laws.
The only extremes are the one you are arbitrarily relying on to vainly make your case. I'm following the example of another commenter over at Hyperlipid who suggests we drop the term "low carb" in favour of "normal carb".
I guess I'm in the minority when I say that it makes absolutely no difference what I eat with regards to what my calories demands are. I can both lose and gain weight on both VLC and the junk food diet. It makes no difference from that perspective. However when I eat whole foods and increase protein consumption, I can manage hunger better regardless of which of those are carbs or not.
http://www.sugaraholics com
http://highfatlowcarbrecipes.wordpress.com
Instead low-carb diets do a lot of coincidental things to improve one's health.
1) They increase protein intake which increases satiety
2) They remove "empty calories" such as soda and other nutrient-depleted processed foods
3) They remove grains, which are unnatural and often problematic for the body
4) They increase saturated fats, very healhy for the body
5) They decrease Omega-6 PUFAs (depending on which LC diet you're following), harmful to the body in excess
6) They increase consumption of leafy green vegetables
There are so many confounding ways low-carb diets are healthful independent of the carbohydrate effect on insulin.
I recall that Richard Nikoley (?) started eating potatoes AFTER he had already lost significant weight and jumped to the very questionable conclusion that he could have been doing so all along.... is that who you mean? I've no idea what he is doing now as I no longer read his blog.
You see it makes perfect sense to me that as someone becomes successful with a low-carb approach they can reduce insulin resistance, reduce the hyperinsulinemia and by doing so, INCREASE their tolerance for carbohydrates again.
I give up with you.. you're just building more strawmen and clinging onto them for dear life. Eat what works for you 'cos I damn well know EXACTLY what baked potatoes would do to my Blood Glucose, my need for insulin and my fat storage.
Who exactly has said that Insulin per se is what causes obesity?
Or that "all carbs make you fat"
Or that Gary Taubes says you can keep the "calories constant" but still lose weight?
Or that LCHF is a panacea?
etc... etc... blah blah blah... and for gawd's sake let's bring up the Kitavans again
To that casual observer -- perhaps someone who only reads the headlines... like just the title of this blog post -- those may seem like plausible premises for you to argue against but they are false and do not hold up to scrutiny.
Perhaps you should stick to the blogs where you find like minded people, the ones I no longer bother visiting, the ones with a rapidly declining IQ amongst the collective readership. I really have no idea why you comment so much as a contrarian on blogs such as this and at Gary Taubes'? Do you just like to argue on the internet? Do you think you are impressing anybody, or saving us poor idiots from our self-delusions?
Unfortunately, Gary does not help much with this with his wording sometimes, but it's clear where his views on calorie balance lie if you take more than a quick glance.
A quote of his from his blog:
"If you asked me this question — why did this restaurant get crowded? — and I said, well, the restaurant got crowded (it got overstuffed with energy) because more people entered the restaurant than left it, you’d probably think I was being a wise guy or an idiot. (If I worked for the World Health Organization, I’d tell you that “the fundamental cause of the crowded restaurant is an energy imbalance between people entering on one hand, and people exiting on the other hand.”) Of course, more people entered than left, you’d say. That’s obvious. But why? And, in fact, saying that a restaurant gets crowded because more people are entering than leaving it is redundant –saying the same thing in two different ways – and so meaningless."
* although I have serious doubts that he added the rider "even when calories are reduced"
" However there is no proof whatsoever that insulin levels in humans cause energy expenditure to decrease to allow this to happen. Its complete and utter nonsense until proven otherwise."
It is exactly your use of hyperbolic, absolute statements like these which convince me that you are not applying a scientific method to your interpretation of what you observe and read. There are no such absolutes in real science.
It's getting really tiresome to have you simply parroting the dictums of those who you seem to blindly accept as the "experts", without applying your own scrutiny to what they say... especially as they are clearly those who I have already indicated that I no longer trust as reliable and unbiased sources of information.
The biggest eye-opener for me in reading Gary Taube's GC,BC is that I no longer trust the word of ANY "expert" simply based on his credentials.. and yes, that INCLUDES Gary Taubes.
All you have to offer are un-referenced, wild claims that don't hold up to scrutiny, so guess how much credibility I give to you?
If one is eating more then one use, then one get obese.. its a fact.. not the explanation of why some do eating more then they expend!
I think you have some problems to understand the semantics?
GT have a hypotese that those.. or some of those get obese by diet induced hyperinsulinemia!
And you seems to think its all about glutony.. GTs hypotese dont exclude glutony!
Its more about if Hyperinsulinemia do comes before obesety or after.. in this study!
And one can make a firm conclusion from that many how transited to a low carb living seems to be able to manage that posibly glutony and restored theres morale backbone??
Do you have any thougts by your self, how those morale and psycological regulations are affected by diet??
You have a lot of thougts of things and persons beyond the topic, but I am curious if you have any hypotesis of your own?
Speak out to reveal your thoughts!