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Subject: Re: Insulin

> Regarding Dr. Rosedale's patients which he describes in the

> transcript, Hamish Ferguson wrote:

>

> <<Do these people get into this shape because of Syndrome X or

> Insulin Resistance or do they develop this because of their shocking

> lifestyle habits?>>

>

> * I don't think you can make a blanket statement as to the

> reasons that people become insulin resistant because sometimes this

> happens even when a person lives a decent lifestyle. They have a

> genetic marker for the condition. However, many people get into the

> condition Rosedale describes by poor lifestyle choices, i.e. poor

> diet, too much alchohol consumption, heavy smoking, not enough rest,

> i.e. trying to burn the candle at both ends for such a long time

> that the flame finally meets in the middle.

Pomeroy:

You are correct; there are a variety of reasons why

people are insulin resistant. There is even a link between insulin

resistance and depression. I work in the metablic syndrome capitol of

the world and while most of the individuals that I work with show the

classic characteristics, I have also worked with more than one person

who is under 25 y/o without any known characteristic.

> <<If it was intended for an audience of Medical and Nutritional

> professionals I would have thought it would have included full

> references for each point and have appeared in a peer review journal

> not on a web site intended to draw the punters in.>>

>

> *Much of the work on Syndrome X has appeared in peer reviewed

> journals, however this is simply a transcript of a presentation.

> Possibly Mercola attended. From the way this is written, it sounds

> like someone set up a tape recorder afterwhich some computer took it

> from there. Personally I feel it should have been edited for print

> before it was put up on the web site.

>

> As far as Brasco's article, one of the very reasons I liked it was

> *because* it was understandable to the lay individual. With the

> current state of medical care in the U.S., it pays for people to be

> " pro-active " (gosh, I detest that word, but it fits this situation)

> and keep up with some of these things.

>

> This is especially true when it comes to possible causes of Type II

> diabetes as it is becoming much too prevalent in our modern society.

> A great deal has been written about the causes of it lately.

> Interestingly, it is pretty much preventable and often reversible

> simply by making the necessary dietary changes. You can find quite

> a bit of referenced material by doing a Net search for " Syndrome X "

> where you will find information from Gerald Reaven, M.D., the

> Stanford University doctor who discovered the condition in the first

> place. Rosedale is more radical in his approach. Reaven has also

> changed his thinking over time as to the intake of certain types of

> carbohydrates.

Pomeroy:

Actually it is my experience that the dietary changes

are insufficient alone and a physical activity component is necessary as

well. I think that the literature tends to agree with my experience.

<some content snipped>

> <<How does one know [they might have insulin resistance]? Is there a

> medically accepted test?

>

> *Yes. Most doctors will give people the standard glucose

> tolerance test for diabetes. According to Rosedale, this doesn't

> really tell much. He recommends getting a fasting insulin test

> which shows how much insulin is actually in the blood. You can

> order one of these yourself through the Life Extension Foundation

> (http://www.lef.org). Again, I suggest you read my article on

> Syndrome X on Dolfzine at which can be found at

> http://www.dolfzine.com/page159.htm

> It provides an " Insulin Resistance Checklist " from the book " The

> Insulin-Resistance Diet, " (Hart, C.R., M.D. and Grossman, M.K.,

> Contemporary Books, 2001), which can be helpful to people in

> deciding whether they fit the profile. There are some things

> which, as I point out, are extremely subjective. However, there are

> others which are not. The recommendation is that if you think you

> fit the profile that you head to your doctor's office for some blood

> tests.

Pomeroy:

Glucose tolerance tests (both fasting and 2hr) can

tell a great deal. Elevated blood glucose has medical consequences

regardless of insulin levels. In my experience, I have seen individuals

with low, normal, and high insulin levels with blood glucose values >300

mg/dl.

Pomeroy

Outer Mongolia?

* Please sign all letters with full name and city if you wish them to be

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Eugene Sanik wrote...

>Your questions and scenarios seem to be ostensibly based on a

>superficial understanding of human metabolism.

No, I have a good understanding of human metabolism.

The problem is that I am offering up a simple heuristic while you are demanding

a perfect algorithm. Sorry I can't, too many factors involved.

To illustrate, say we take your example of 2 grams of protein per pound of

bodyweight.

I would say this is a heuristic. If I wanted to be pedantic and demand an

algorithm

I would question you like this...

How did you determine 2 gr / lb bodyweight?

Is it exactely 2 gr or is it 1.9gr?

Is this what you plan to eat or what you actually eat?

Can you be sure you get this exact amount?

And so on.

>How can you ask that question while disregarding macronutrient profiles?

Okay, let's change the question.

Most fat loss guidelines suggest eating 200-500 cals per day less than their

" hypothetical " number of calories burned for the day.

In terms of body fat loss does it matter whether they followed a diet low in

carbs or high in carbs as long as they hit that 200-500 less figure.

>Based only on that info, I would envision them gaining bodyfat. 2

>meals per day leaves 10 hours in between meals during which the body

>is in a mode of starvation and will catabolize muscle. This will

>reduce LBM and subsequently increase bodyfat.

Seeing this was a real life observation on your behalf I thought you would be

able to comment on whether they did or did not lose/gain/remain constant in

terms of body fat. BTW How do they perform?

But, hey I have no argument with eating several smaller meals over the day.

Hamish Ferguson

Christchurch, New Zealand

* Don't forget to sign all letters with full name and city of residence

if you wish them to be published!

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> Casler writes:

>

> This is not my area of expertise, but I am under the impression that

> Ascorbic Acid is synthesized in other animals in the liver " from "

> glucose. http://www.chem.ox.ac.uk/mom/vitamins/vitaminc.html

> > The largest " concentration " of vitamin C is in the liver, same as

> glycogen/glucose.

> > This could lead me to believe that the similarity to glucose might

be

> close. Not being a chemist or cellular uptake expert, I might not be

> able to know what may be untrue about this assertion....

>

> So, you are saying that the structures are not similar enough to offer

> " competition " ? Are you familiar with the " uptake mechanism " and why

> this statement is inaccurate?

>

> Could you explain in further detail?

>

Yes, the structures are very different from a biological point of view.

Most Biochem texts have these structures so check them out when you get

a chance.

The GLUT family of transporters are specific for glucose transport and

are driven by facilitated diffusion. Vitamin C (ascorbate) transporters

are a family of Na-dependent transporters specific for ascorbate. There

is no sharing of transport between the two molecules. I have no idea

where Dr. Rosedale came up with his statements.

> Casler writes:

>

> The exact quote from the article states:

>

> *****************************

> " What is one of magnesium's major roles?

>

> To relax muscles. Intracellular magnesium relaxes muscles. What

> happens

> when you can't store magnesium because the cell is resistant? You lose

> magnesium and your blood vessels constrict, what does that do? "

> *****************************

>

> I too wondered about this, since magnesium is crucial for ATP and thus

> actually muscle contraction.

There is no question that Mg is an important cofactor for any ATPase or

Kinase activity. It essentially stabilizes the phosphate molecules and

permits binding of ATP to the catalytic cleft of the enzyme. Without

this action all kinds of things fall apart. The bottom line is that Mg

does not directly cause muscle relaxation. It is indirectly involved in

the process in skeletal muscle, but in smooth muscle the mechanisms of

relaxation are very different.

>

> Casler writes:

>

> Are you suggesting however that one has to eat a " carbo rich " diet to

> train or compete anaerobically? How so and why?

>

Greg Haff did a review on this topic in the latest NSCA Strength and

Conditioning Journal. You may want to check out the references he cited

and form your own conclusions. Based on these sorts of studies, I feel

that an individual competing in an anaerobically intense sport would be

at an extreme disadvantage if not consuming carbohydrates.

> Although I agree the article is not scientifically referenced, the

> primary message becomes increasingly clear. Hyperinsulinization is

> many

> times the result of the over ingestion of high density foods,

> particularly some forms of carbohydrates. The resulting metabolic

> garbage and fallout are certainly damaging to ones health long term.

>

I felt that the message was that insulin at any level is bad and that

you would live to be 150 if you ablated your pancreatic B-cells. The

arguments for this were partially based on mistruths and unreferenced

leaps of logic. Again I restate that the concept of high carbs as a

culprit in disease is well founded, the rest is just self-promoting

hype.

Trevor Cottrell

Kingston, ON

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Hamish Ferguson wrote:

<<All second hand information. For someone so passionate about the

subject I would have expected convincing comments on the actual

studies that will support your claim.>>

****The references I provided all drew conclusions based on research

studies. All of them are referenced except for the reports on Dr.

Lardinois' talk (at a medical conference) and the transcription of

Dr. Rosedale's presentation. The others are written by medical

professionals.

I'm not a doctor or a research scientist, nor have I ever stated

such, so why would I have first hand information? I don't think you

need to work in a research lab to be " passionate " about this sort of

a subject. Since the end result of insulin resistance is often Type

II diabetes, which is becoming all to prevalent, it would bode well

if more people were concerned.

Part of my concern and interest is because as the Editor of

Dolfzine, I wish to get this information out to the lay public in a

manner they can understand. Like me, many individuals do not have

the scientific education to enable them to understand everything

that's in these studies. However, I do not feel like I'm headed in

the wrong direction to accept the conclusions of people such as Drs.

Reaven, Lardinois, Rosedale and the other authors of those books.

ly, I appreciate the fact that they took the time to present

this subject in a manner that the lay public can understand.

IF you have a problem with insulin insensitivity, it's not something

that you necessarily know about until the situation has already done

some damage. When I looked at the checklist provided in the book by

Dr. Hart, many of the items were very subjective, so much so that by

themselves they could pertain to anyone. However, other items were

not (such as history of hypertension, familial diabetes, race) and

if those pertained to you along with some of the others, then your

best bet would be to visit your doctor.

As for Lyle, I in no way approve of the manner in which he addressed

Mel or the members of this list. However, the book he wrote (which

I have in hard copy, not an e-book) was a referenced discussion on

the subject and provided some recommendations. They were not

totally different from those provided by Dr. di Pasquale or Dan

Duchaine.

What I am having a hard time understanding at this point is that

many people on this list insist on references on how someone formed

an opinion. They won't do anything or try anything on anectodal

evidence. Then, when references are presented they turn right

around and say, well, those aren't any good. What I have taken from

the list members is that someone can prove just about any theory in

a research study they wish if they are unscrupulous. So where does

that leave me and other members of the lay public in trying to

become informed? I wouldn't say it helps the medical community

either. Just because you can understand the scientific lingo, if

the study is skewed, what good does it do you?

That puts all of us in somewhat of a Catch 22 as to what to believe.

The reason I feel that the above doctors are correct is because I've

witnessed first hand one positive result and heard about several

others. I also know of people who do much better with more carbs.

As Joe Cole stated, there are no pat answers here and I have never

attempted to give any, simply to bring a condition to the forefront

which affects many people. Are you one of them? The only way you

will really know is if you have a fasting insulin test.

Unfortunately in the U.S., this test is not being given as it

should. It's much easier to perform than a glucose tolerance test.

I haven't the slightest idea what kind of care the medical community

provides in NZ. However, in the U.S., it's going from bad to worse.

Many people get little or no medical care at all. Many get very

inadequate care because the HMO's to which they belong are trying to

save money. I don't think this situation is any big secret. The

problem is that like many other things in the U.S., it's turned into

the usual political football infused with PAC's on one side and the

voting public on the other.

The care at the VA is problematic. Much of it depends on which VA

facility you go to. West LA has the advantage of being a UCLA

teaching hospital, but that doesn't mean all the care is good. The

system is overloaded and one of the satellite clinics (that had a

full patient load) was closed the end of August. Why? Probably

someone in Washington decided to cut the budget. This now puts even

more of a load on the already burdened District Hospital facilities.

My husband has had (and is receiving) some absolutely top notch care

both here in LA as well as in Dallas prior to that, but he's also

received (and still is) an equal amount of just the opposite.

In some ways the problems with the medical care in the U.S. is a

different subject, but in reality it's not because it all boils down

to whether people are being treated properly. Many don't think so

as evidenced by the burgeoning alternative health care industry and

the success of businesses such as the Life Extension Foundation.

Rosemary Vernon, Editor

Dolfzine On-Line Fitness, Inc.®

A Not-For-Profit Corporation

www.dolfzine.com

Marina del Rey, CA

IronRoses@...

http://www.chuckietechie.com

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> Joe Cole wrote...

>

> >Hamish, it is not as simple as that.

> >

> >The 'eat less than you need' is still true

>

Good ,then I can stop restating the cals in cals out question:-)

>

> >, but what you need (in terms of kilojoules a day) can dramatically

> >change between individuals of the same height, weight and sex.

>

Can anyone point out where in anything I have written that I don't believe

this?

>

>

> >Once again, if you do not understand the >biochemistry, its impossible to

get

> the diet right.

>

Hmmm, don't really buy that one.

>

> There are many other factors than just biochemistry.

>

This debate started when claims were made about insulin being evil and the

cause

of many of the ills of the World. I challenged this with the statement that

many of the problems with insulin only happen when one overeats.

There are numerous factors for overeating.

>

> >There is the capability for the body to burn excess energy as heat,

through

> what are known as futile cycles,

> >and also as heat through mitochondrial membrane decoupling. There is the

possibility

> of increasing your energy

> > expenditure through dietary intake of particularly monounsaturated and

polyunsaturated

> fatty acids, which

> >in certain individuals will work well.

>

Is this why Will Brink pushes flax seed oil so much?

>

> >Again, it is all individual, and it would take me weeks to put together a

comprehensive

> review of the area. This

> >will happen when I get time.

>

Knowing what I know and what I have read (first hand, second hand and

through psuedo-science sources)a review comprehensive review would take you

a few years.

>

>

>There is no such thing as a balanced diet, because what is balanced for one

>cannot be for another. We all have a

>different metabolism, that's the hardest part about it.

It is but it isn't. When training people we were always tinkering with

diet.

Small changes (for me along a lower fat, slight increase in protein, higher

carb, no junk) in diet played a big part in fat loss success. The big

results

came more from behavioural changes.

Some examples...

Changing the way a client drove home from a route with 16 takeaway outlets

to

one with none.

Leaving EFT-POS cards at home.

Filling in a food diary.

Me going food shopping with them.

Me educating them about food.

Planning trips away so they would eat well on business trips

The list is endless.

Hamish Ferguson

Christchurch, New Zealand

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Trevor - exactly!

Although thermodynamics stay the same, as it is just energy in - energy out, the

energy out is an amazingly

complex part. Yes, your macrontrient profile can change this, your genetics

change this, and even your environment

can change it. It is simple, but its not.

2000 kj of fat cannot be equal to 2000kj of carbohydrate in terms of metabolic

cost. Sure they have the same

kilojoule content, but they dont have the same effect on metabolism.

Its like saying the 20l of 91 octane petrol and 20l of 100 octane petrol do the

same thing in every car. An

oversimplification.

Some references:

Key words :

uncoupling protein AND PUFA

(pufa means polyunsaturated fatty acids)

UCP-1 (or 2 or 3), thermogenesis.

Here is a decent start:

Diabetes 2001 Apr;50(4):803-9

Uncoupling protein 2: a possible link between fatty acid excess and impaired

glucose-induced insulin secretion?

Lameloise N, Muzzin P, Prentki M, Assimacopoulos-Jeannet F.

KeyWords:

Futile cycles

Here is a start... pretty recent at that

Am J Physiol Endocrinol Metab 2002 Feb;282(2):E312-7

Accelerated substrate cycling: a new energy-wasting role for leptin in vivo.

Joe Cole

Dunedin, New Zealand

----- Original Message -----

From: Joe Cole

Hamish, it is not as simple as that.

The 'eat less than you need' is still true, but what you need (in terms of

kilojoules a day) can dramatically

change between individuals of the same height, weight and sex.

Once again, if you do not understand the biochemistry, its impossible to get

the diet right.

There is the capability for the body to burn excess energy as heat, through

what are known as futile cycles,

and also as heat through mitochondrial membrane decoupling. There is the

possibility of increasing your energy

expenditure through dietary intake of particularly monounsaturated and

polyunsaturated fatty acids, which

in certain individuals will work well.

Again, it is all individual, and it would take me weeks to put together a

comprehensive review of the area. This

will happen when I get time.

[i am sure that many members will appreciate that! Meanwhile, would you be

able to suggest a short list

of readily available abstracts from Medline and other online sources? Mel

Siff]

The dietary guidelines were established from the biochemical basis of: (to my

knowledge, I can't remember

the source)

" Since carbohydrates have less energy than fat, you can eat more carbohydrates

(grams) and have less energy intake " .

Sophisticated no?

There is no such thing as a balanced diet, because what is balanced for one

cannot be for another. We all have a

different metabolism, that's the hardest part about it.

Joe Cole,

Dunedin, New Zealand

-------------

From: Hamish Ferguson (Bikecoach Account)

> Guess what? The human body is most decidedly NOT a bomb calorimeter!

There > are far more complex processes at work here that we know very little

about.

Why does everyone evade the question? Cals in cals burnt. Eat more you gain,

eat less you lose, eat same you stay the same. Where does macronutrients

come into this equation???

In my many discussions with Lyle Mc the best he could come up with was

that a low carb diet was psychologically easier for him to lose body fat

on.

Hamish Ferguson

* Don't forget to sign all letters with full name and city of residence if you

wish them to be published!

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Trevor Cottrell writes...

> I felt that the message was that insulin at any level is bad and that

> you would live to be 150 if you ablated your pancreatic B-cells. The

> arguments for this were partially based on mistruths and unreferenced

> leaps of logic.

That's about where I am at.

>Again I restate that the concept of high carbs as a

> culprit in disease is well founded, the rest is just self-promoting

> hype.

Now that calories is a dirty word how do we determine what is high carbs or

overeating is? Do we just aim to eat a certain number of grams of protein,

carbs and fat per day.

Hamish Ferguson

Christchurch, New Zealand

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