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Post festive season, many people begin the year with a variety of methods to shed the excess pounds, some succeed and others do not. Insulin plays a big role in how successful your fat burning efforts are, as well as blood sugar stability and ‘sugar addiction’. Resistance to insulin is linked whole host of other health issues, including cardiovascular disease, cancer and memory problems. Many people have heard of diabetic people using insulin but aren’t sure how it relates to their daily life.
Brief introduction to insulin
Insulin Is a two stranded peptide hormone produced by the β-cells in the pancreas and its main job is to lower blood sugar by promoting the absorption of glucose, as well as amino acids from the blood into liver, skeletal muscle, fat and other cells. The liver and muscles store glucose as glycogen, which can be thought of as ‘animal starch’ as it is many many molecules of glucose all joined up together.
Insulin is important in how we metabolize carbohydrates, fats and protein and can be thought of as a storage and growth promoting hormone. When insulin is high the body is in storage mode so fat is not used as a fuel source, when insulin levels are low and glycogen is depleted the body will dip into stored body fat for fuel. Insulin decrease the breakdown of protein, which includes muscle.
Blood sugar needs to be tightly regulated and without insulin we would die. Lots of mood/mental wellness problems come from badly managed blood sugar.
Type 1 diabetes is an auto immune disease, where the insulin producing cells have been destroyed by the immune system and the body cannot make its own insulin anymore, so patients need to inject insulin each day. There is a debate on how or why this disease occurs, although there is a genetic element, there have been occasions with identical twins, where one twin develops type 1 diabetes and the other does not.
Type 2 diabetes is either not enough insulin production by the β-cells or insulin resistance (cells not responding to insulin) or both. There are genetic, lifestyle, diet, environmental, hormonal, drug and other factors which create type 2 diabetes, so it is more complicated than type 1. The symptoms of type 2 diabetes are usually managed with Metformin and related drugs, and sometimes insulin. This is not a cure.
Metabolic syndrome and poly cystic ovaries (POCS), certain types of dementia (type 3 diabetes) are related as most of these patients also have insulin resistance. Because there are so many ‘nurture factors’ involved in type 2 diabetes lots of people successfully reverse it by changing their lifestyles or catch it early and prevent it progressing. Type 2 diabetes and insulin resistance are accompanied with other health problems like high blood pressure, abdominal obesity, abnormal cholesterol/triglycerides in the blood, abnormal muscle and mitochondria structure.
The take home message here is that you don’t want to become insulin resistant as it is pretty much the start of a road to health hell. No other protein can do what insulin does, so it needs to be conserved and respected. Insulin does make you store fat under certain circumstances, but it is not the devil hormone.It is the combination of insulin and cortisol together which promote belly fat storage, along with eating a high fat high sugar meal.
There is lots of complicated and boring biochemistry surrounding the daily life of an insulin molecule, how the pancreas knows when to make insulin and how insulin talks to cells and how the cells reply and other hormones involved. For that reason it is better to discuss practical daily life situations, like getting a sugar craving and how insulin is involved.
Blood sugar crashes and sugar addiction
Most people know what happens when their blood sugar drops too low as they feel it. Symptoms include, fatigue, headache, blurry vision, brain fog, sugar cravings and bad moods. Women aren’t as good as men at regulating blood sugar and when women have a blood sugar crash it goes down it goes lower than a man’s, this is mainly due to hormonal differences.
When blood sugar goes too low, cortisol, adrenaline/noradrenaline and glucagon rise to pull glucose from somewhere in the body or from food. Cortisol and adrenaline are stress hormones, which is why the bad tempers and food craving can come out. The cortisol rise or spike is the main problem. Cortisol is not bad, in the correct amount it is anti-inflammatory, it is just doing its job. Cortisol is like a very enthusiastic scout leader who means well, whips the body into a frenzy to get glucose from somewhere, anywhere.
When blood sugar drops low the brain thinks you are starving as it still thinks we live in cave man time, so this doesn’t help in the situation.
Cortisol inhibits blood flow to the pre-frontal cortex in the brain which control reason, logic, inhibition (will power) and socially acceptable behavior. Cortisol also encourages blood flow to the emotional limbic center of the brain, which is where irrational survival based behavior originates. This combination of “logical part of brain off” and “emotional part on” is why people, (women more than men) get very cranky if blood sugar drops too low and why unstoppable cravings for sweet food suddenly appear.
When you have a sugar binge, this floods the brain with dopamine, making you feel great for a bit, until that crashes.
Back to the low blood sugar scenario, off we go and eat a bar of chocolate or cake, the blood sugar shoots up, dopamine floods out, insulin rushes out, blood sugar goes down (over shoots the mark) and crashes. Cortisol and other stress hormones rush out to try and raise the blood sugar by whatever method they can, a sugar craving is triggered in an environment where the brain is low in will power mode, being illogical and thinks you are starving, so ‘the craving wins’ and the cycle starts again.
The sugar and insulin roller-coaster and can and do go on all day, and is called fluctuating or unstable blood sugar levels. The brain gets off on the dopamine rushes, eventually causing sugar addiction. Luckily the body can be re-educated, insulin sensitivity can be restored (fixing insulin resistance) and sugar addictions can be overcome, but for now lets pretend it carries on.
What happens next?
Insulin resistance, is basically your body becomes resistant to absorbing glucose and other nutrients, so makes more insulin, which over works the B-cells. Insulin binds to receptors and the receptors set off signalling cascades, these stop working properly during insulin resistance. Now that the cells aren’t absorbing glucose properly, even though there is enough in the blood, they start complaining and think they are starving. When the body/brain thinks you are starving your the metabolic rate will drop to conserve energy, and hungar levels will go up. Some say that when the body is insulin resistant it burns about 250-300cal less per day.
High cortisol makes the body more insulin resistant and insulin resistance increases cortisol levels. Interestingly fat tissue makes cortisol, causing it to be amplified in the fat tissue, stimulating the growth of more fat tissue, which make more cortisol, therefore another kind of ‘Fat Trap’. This is different from cortisol made from the adrenals
High cortisol levels cause muscle to be broken down and muscle is important for weight and blood sugar management. Firstly muscle acts as a sink for glucose (the sugar in the blood has somewhere to go and be used) and muscle is metabolically active, so the more you have the more calories you need each day.
Adrenal fatigue in lay terms are over worked adrenal glands, but also a problem with the pituitary gland and hypothalamus, which tell the adrenal glands what to do. Symptoms include tiredness, insomnia, sugar/salt cravings, mood problems, depression and other hormones imbalances. Cortisol is meant for short term , in emergencies and first thing in the morning to help you wake up. If your adrenal glands are making cortisol all day long, firstly they aren’t going to be able to make other hormones which then means hormones like testosterone, estrogen and progesterone get out of balance (worse in post-menopausal women). Secondly, chronically high cortisol inhibits brain function, slows metabolism, breaks down muscle, and increases blood pressure.
Like panicking before a public speech or exam, and forgetting everything. That’s what a big surge in cortisol feels like.
Thin people can be insulin resistant or have type 2 diabetes, and obese people can have normal blood sugar metabolism.
Usually you become insulin resistant by chronically over-carbing, over-eating, or over-stressing. Over-stressing could mean to under-carbing, under-eating, over-exercising, not sleeping, worrying, exposure to toxins, among many other stressors).
In a way some obese people have this strange biochemical situation where they have plenty of fat, which they cant burn as there is too much insulin around or they are constantly craving and eating sugar or refined carbohydrates, trying to feed cells aren’t able to absorb sugar properly. Cortisol and insulin encourage fat to be stored in the abdomen around the organs (the bad fat), which causes a whole host of problems of its own. Fat cells can make cortisol, which makes more fat cells. Estrogen levels rise as body fat rises, so more estrogen is made, which makes more fat as estrogen can inhibit metabolism by disrupting the thyroid gland, so yet another angle to the ‘Fat Trap’. Trying to restrict calories under these circumstances will only encourage the body’s belief it is starving and make the situation worse. So this is what a ‘Fat Trap’ is. Lots of people get stuck in a fat trap. The diet industry thrives on these fat traps, by offering fad diets, milkshakes or methods to desperate people, only to make them fatter in the long run.
The dangers of high blood sugar.
Does it end there? No, it gets worse as now we have hyperglycaemia or chronically high blood sugar. When you have low blood sugar you know about it. Many people have high blood sugar or even type 2 diabetes for years and are blissfully unaware, as symptoms only appear if it gets over a certain level. The damage from high blood sugar all happens almost secretly.
First, when your blood sugar level is consistently high, it prevents nutrients and oxygen from getting used properly by your cells. Secondly, sugar creates free radicals and lots of them which damage cells and high blood glucose causes your body to responds by increasing inflammation everywhere. Third, your immune system cannot function properly when blood sugar is too high. Fourth, your blood sugar level is the main factor that affects how quickly your wounds will and it is the primary reason for concern with diabetes and wound care. When blood sugar is high wounds heal slowly and the risk of infection is high. Microorganisms like bacteria love sugar.
When blood sugar is chronically high then insulin levels will be high too (even though the cells are ignoring the signals from insulin), high levels of insulin are an ‘inflammatory marker’ so both high glucose and high insulin pose health issues.
Cancer and sugar
Last but not least many people ask ‘Does Sugar Promote Cancer Growth’?. In lay terms, when cells are stressed, inflamed and think they are starving they can become selfish and decide to behave more like a primitive cell, a yeast cell, which is easier. Yeast get energy by fermentation and it is not very efficient only 2 ATP per glucose compared to 38 if oxygen is used. The selfish cells are now only concerned about surviving, eating glucose and growing, not doing their job, and can become cancerous. Cancer cells have a hard time metabolizing fat and ketones. This is in essence The Warburg hypothesis, where cancer cells ferment glucose to get energy, even when there is plenty of oxygen around. The mitochondria are involved too as they are in charge of energy production, but it is known dysfunctional mitochondria play a role in cancer. Otto Heinrich Warburg won the Nobel Prize in Physiology or Medicine in 1931, in fact he was nominated for the award 47 times during his career. Cancer of course is multi faceted, with genetic and environmental factors too, but the role of sugar in cancer should not be overlooked by any means and is key player. There are several incidences of the sugar industry withholding data, like the tobacco industry did.
Part 2 of the blog will be coming in a few weeks as this blog is about ‘Blood Sugar Problems’ so blog will be Blood Sugar Solutions.