Understanding Joseph Kraft’s Diabetes In Situ- T2D 24

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Joseph Kraft is a medical doctor who measured over 14,000 oral glucose tolerance tests in his lifetime. This is a standard test to measure the blood glucose response to a standardized amount of glucose over 2 hours. The difference is that he measured over 5 hours and included blood insulin levels. A summary of his work is here and Prof Grant also reviews it nicely here. Ivor Cummins, The Fat Emperor, has also reviewed it nicely here

What Dr. Kraft had discovered is that you can make the diagnosis of type 2 diabetes much earlier than the standard OGTT by measuring insulin. The OGTT itself is meant diagnose T2D earlier than blood glucose by measuring the blood glucose response to a 75g load of ingested glucose.

But people with normal OGTT may still have an abnormal insulin response. Those people who respond with excessive secretion of insulin to 75g of glucose are at very high risk of eventually developing T2D as well. So the insulin response is even earlier, which means you can diagnose ‘diabetes in situ’, which means incipient diabetes.

Let’s think about this for a second. This makes a lot of sense. If you simply wait until blood glucose is elevated, then you have T2D, no question. But if you have normal blood sugars, then you may still be at risk of diabetes (pre-diabetes). So, we give a big load of glucose and see if the body is able to handle it. If this is negative as well, this does not yet mean everything is normal.

If the body responds by very high secretion of insulin, this will force the blood glucose into the cell and keep the blood glucose normal. But this is not normal. It’s like the trained athlete who can easily run 10K in 1 hour and the untrained athlete who must dig deep and use all his effort to do so. Those people who need to produce prodigious amounts of insulin to force the glucose back to normal are at high risk. This makes perfect physiologic sense. But there’s a much deeper implication to this:

HYPERINSULINEMIA PRECEDES HYPERGLYCEMIA

This is very important. Consider our two different paradigms of insulin resistance – the ‘internal starvation’ model and the ‘overflow’ model. In the standard ‘internal starvation’ model, some unknown thing (inflammation, oxidative stress etc.) causes IR, which blocks glucose from entering the cell. It looks like this.

IR –> hyperglycemia –> hyperinsulinemia

This is completely incorrect because this model assumes that the hyperglycemia PRECEDES the hyperinsulinemia, which Kraft showed to be untrue. According to the this theory, we still need to find the mysterious boogeyman that causes IR. There are those, for example that claim dietary fat causes IR, others say vegetable oil, inflammation, oxidative stress, genes etc. But it simply is not correct because the high insulin comes first. So therefore the high blood glucose cannot CAUSE the high insulin.

But according to the ‘overflow’ model, things look like this.

Too much sugar –> hyperinsulinemia –> fatty liver and IR –> hyperglycaemia

The implication of Krafts pioneering work is this – The ‘Internal Starvation’ paradigm is completely backwards. Think about this. If we think that T2D is the result of internal starvation, would we expect internal starvation to look like it does? (Large waist, obesity, fatty liver) What part of that looks like internal starvation of cells? This means that the high insulin causes the high blood glucose (symptom of the disease). Therefore, the proper treatment of T2D is to LOWER INSULIN. How? Drugs don’t do this, in general. It would require dietary changes – LCHF and Intermittent Fasting. What Kraft demonstrated was that the disease is NOT insulin resistance. The disease is HYPERINSULINEMIA.

This is ‘internal starvation’?

Overflow paradigm

Picture a subway train in the middle of rush hour. Each train stops at a station and upon getting the ‘all clear’ signal, opens its doors. Some passengers leave but most go into the train on their way to or from work. All the passengers go into the train without problems and the platform is empty as the train pulls out.

A cell works in an analogous method. When insulin gives the proper signal, the gates open and glucose enters the cell in an orderly fashion without much difficulty. The cell is like the subway train, and the passengers are like the glucose molecules.

When the cell is insulin resistant, insulin signals the cell to open the doors, but no glucose enters. Glucose accumulates in the blood, unable to get inside the cell. In our train analogy, the train pulls into the station, receives the signal to open the doors, but no passengers enter the train. As the train pulls out, many passengers are left on the platform, unable to enter the train.

Why does this happen? There are several possibilities. Under the ‘lock and key’ paradigm, the interaction of insulin with its receptor fails to fully open the gate. This leaves glucose outside in the blood while the cell experiences internal starvation. In the train analogy, the conductor’s signal fails to open the subway doors fully so passengers are unable to pass through. They are left outside on the platform, while the inside of the train is relatively empty.

But that’s not the sole possibility. What happens if the train is not empty, but already jam-packed full of passengers from the previous stop? Passengers are crowded and waiting on the platform. The conductor gives the signal to open the door, but passengers cannot enter. The train is already full, so passengers are left waiting on the platform. Not because the door failed to open, but because the train is already overflowing. From the outside, it appears that passengers are not able to enter the train when the door opens.

The same situation can happen in the cell, particularly the liver. If the cell is already jam-packed full of glucose, then more cannot enter despite the fact that insulin has opened the gate. From the outside, we can only say that the cell is ‘resistant’ to insulin’s urging to move glucose inside. But this is not a gummed up ‘lock and key’ mechanism. This is an overflow phenomenon.

In the train analogy, what can you do to pack more people into the train? One solution is simply to hire “subway pushers” to shove people into the trains. This was implemented in New York City in the 1920’s. While these practices died out in North America, they still exist in Japan, where they are called “passenger arrangement staff”.

Insulin is the body’s “subway pusher”, shoving glucose into the cell, no matter the consequences. As glucose is left outside the cell, in the blood, the body produces more insulin for reinforcement. This extra insulin helps push more glucose into the cell, but it becomes ever harder to put more and more glucose inside. In this case, insulin resistance causes compensatory hyperinsulinemia. But what was the initial cause? Hyperinsulinemia. It’s a vicious cycle. Hyperinsulinemia leads to insulin resistance, which leads back to more hyperinsulinemia.

Let’s think about the liver cell. At birth the liver is empty of glucose. When we eat, glucose enters the liver cell. When we don’t eat, or fast, glucose leaves. With persistently high insulin levels, glucose keeps entering the liver cell. Over decades, glucose slowly fills the cell until it is now overflowing like the congested subway train. When the gate opens for glucose to enter, it is unable to do so. The cell is now insulin resistant. Hyperinsulinemia creates the insulin resistance.

To compensate, insulin levels increase and like the Japanese Subway Pushers, tries to push more glucose into the cell by force. The insulin resistance creates hyperinsulinemia, the very thing that created it. This works, but only for a short while, because eventually there is no more room for the glucose. The vicious cycle goes round and round, worsening with each iteration.

The cell is not in a state of ‘internal starvation’, but rather, it is overflowing with glucose. As it spills out of the cell, blood glucose levels increase. Insulin’s action on glucose is being resisted. But what happens to insulin’s other major job to increase new fat production or DNL? If the cell is truly resistant to insulin, DNL should decrease.

But the cell is overfilled with glucose, not empty, so there is no reduction of DNL. Instead, the cell is producing as much new fat as possible to relieve the internal congestion. The action of insulin to increase DNL is not being resisted, but enhanced. This paradigm perfectly explains the central paradox.

On the one hand, the cell is resistant to insulin’s effect on glucose. On the other, insulin’s effect on DNL is enhanced. This happens in the liver cell, with the same level of insulin and the same insulin receptors. The paradox has been resolved by understanding this new paradigm of insulin resistance. The cell is not in a state of ‘internal starvation’, but rather a ‘glucose overload’ one.

As the liver ramps up DNL to deal with its internal congestion, more new fat is created than can be exported. Fat backs up in the liver, an organ not designed for fat storage. This disease of fatty liver is intimately related to the overflow problem of insulin resistance.

Understanding this new paradigm is critical. According to the old ‘lock and key’ paradigm, the treatment of T2D involved hiring more subway pushers to shove even more passengers into the crowded train. This is analogous to giving more insulin to patients, even though we already know that insulin is too high.

If we understand the ‘overflow’ paradigm, we see that the logical treatment of type 2 diabetes is to empty out the train. How? LCHF diets, intermittent fasting. In other words, type 2 diabetes is essentially just a disease of too much sugar in the body. The only logical treatments, therefore are to

  1. Stop putting sugar in (LCHF)
  2. Burn the sugar off (Intermittent Fasting).

That’s all you need to know to reverse type 2 diabetes.

2017-10-13T21:34:49+00:00 62 Comments

About the Author:

Dr. Fung is a Toronto based kidney specialist, having graduated from the University of Toronto and finishing his medical specialty at the University of California, Los Angeles in 2001. He is the author of the bestsellers ‘The Obesity Code’ and ‘The Complete Guide to Fasting’. He has pioneered the use of therapeutic fasting for weight loss and type 2 diabetes reversal in his IDM clinic.

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62 Comments on "Understanding Joseph Kraft’s Diabetes In Situ- T2D 24"

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David
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I was discussing medical problems with a doctor years ago, and he told me that “there’s no such thing as pre-diabates”.

Oh. I guess there is.

Billy
Guest

http://www.mayoclinic.org/diseases-conditions/prediabetes/home/ovc-20270022

Your doctor needs to get hit with a cluestick. It’s not controversial AT ALL.

ChrisW
Guest

Actually, he might have been right. “Pre-diabetes” might as well just be called Diabetes. Calling it “pre” makes people think the the pathology is sometime in the future, whereas it’s already upon them.

Roger Bird
Guest

In the 1960’s two separate doctors told me that exercise was bad for my health.

Stephen Reed
Guest
Not defending the doctor, but these terms, ‘diabetes’ and ‘pre-diabetes’ are nothing more than relatively arbitrary figures that are applied in response to demographic statistics. We’re all on the diabetes continuum to some point, either at the low end with good insulin sensitivity and energy partitioning capabilities or at the other end, with full blown diabetes and such damage to the beta cells in the pancreas that we can only ever manage the condition, not reverse it. The only reason you become ‘diabetic’ or ‘pre-diabetic’ is because someone decides what those numbers are. You obviously are not pre-diabetic if your… Read more »
CTY
Guest

Years ago I had a doctor say that pre-diabetes is like being almost pregnant. A woman can have a fertile body that enhances the chance of pregnancy–but fertility does not equate to pregnancy. He added if you want to avoid pregnancy take the necessary steps and if you want to avoid TD2 take the necessary steps. I am sorry to say that I never asked him what those steps are. But to my credit I know now– LCHF and IF.

JR62
Guest
Joseph Kraft have conclusion that much more people have diabetes disease than is known now. No one wanted to buy that. What if we say that the diabetes type 2 is not a disease att all? It could be said that it is bodys natural way to react to too many sugars like skin is reacting to too much scratching. Some people can stand up it longer and some not so. To say that diabetes 2 is not a disease moves responsibility back to people themselves and away from Big Pharma and their drug pushers. Doctors job would be consulting… Read more »
David
Guest

There’s plenty of responsibility with doctors — anytime they’ve given misguided advice to patients, or prescribed the wrong medicines.

Vadym Graifer
Guest

And to think, the common advice to newly-diagnosed diabetics is “eat frequently, eat carbs.” Mind-boggling.

George Thomas
Guest

Gotta sell those diabetes drugs!

Amy
Guest

The only thing I would add is to your very last sentence…
“That’s all you need to know to reverse AND PREVENT type 2 diabetes”
You hit another one out of the park, doc!!

Freeman Brown
Guest

“This is completely incorrect because the hyperglycaemia PRECEDES the hyperinsulinemia.” I think that you wrote this backwards.

Dr. Jason Fung: I’ve tried to clarify in the text. I meant that the ‘lock and key’ paradigm, which assumes hyperglycaemia precedes the hyperinsulinemia, is wrong.

sten bjorsell
Guest

The text above is fine: “This is completely incorrect because this model assumes that the hyperglycemia PRECEDES the hyperinsulinemia,…”

You got it backwards by not reading/including “this model assumes”:

Sue
Guest
Without a doubt we completely buy into LCHF + IF for completely reversing T2D. Which is why, on Feb 1st, 2016 we began this WOE. We did this for my husband only. Almost a year later, his T2D is completely reversed symptom wise. He had very bad gall bladder issues, and was going to have his gall bladder removed and this has been completely resolved. I had very bad indigestion and was taking Nexium constantly for it. That is completely gone. I had terrible, life debilitating Restless Leg Syndrome. This is 95% gone. A true miracle for me. We have… Read more »
BobM
Guest
Sue, I’ve been on low carb for three years and LCHF + IF for about a year and a half. I have lost about 55 pounds. I want to have this test done, but I can’t find a place that would give it. No one is familiar with this test. I will have some carbs at times. I plan on having chocolate pudding and some bread (home made, sourdough, using Einkorn wheat) on Christmas. But I get right back on track using IF. Also, three years of eating low carb except for infrequent splurges means that I don’t get as… Read more »
Sue
Guest
Hi BobM ~ I’ve read a lot of your responses over the last months and always find your advice good and honest! If you don’t mind refreshing memory, were you T2D? And I’m not surprised you can’t find someone to do this test. We can’t even find a doctor willing to do a fasting insulin test yet alone, do this test. I will say this, on the rare, rare occasion we having something high carb (had Asian about a month ago with rice noodles to celebrate the engagement of our son) and when we came home my husband and I… Read more »
BobM
Guest
Hi Sue, I was probably close to being type 2 but was never diagnosed. I ate very low fat for many years, thinking fat was horrible and would kill me. I used to count calories and would keep my fat intake under 10% by calories, thinking that was healthy. I couldn’t understand why I could eat a large bowl of rice and beans (or pasta) and be starving 30 minutes later. I had mood swings, which lead to depression. When I was young and in college and biking, walking, lifting weights a lot, it wasn’t too bad. But when I… Read more »
Vadym Graifer
Guest

Quite a story BobM. Thanks for sharing!

Sue
Guest
BobM! Thank you for your detailed reply. My husband was diagnosed with T2D, I’m just along for the ride but love the health benefits for sure! We have taken our blood sugar (I am the “control group” in more ways than one my husband would say….lol) at all kinds of different times. If we are trying a new processed low carb food (like LC bread) we will test every 1/2 to see if he reacts differently than me or if our BG goes up higher than we think it should, but we are not happy at all with the accuracy… Read more »
Shelly
Guest
Hi BobM, I want to thank you for your contributions to the comments section. I was diagnosed as pre-diabetic in June 2016 and started reading Dr. Fung’s book. But I was hungry for more information and actual stories on how people were incorporating this solution in real life – so I went through Dr. Fung’s blog and also read all the comments over time. This was very helpful – and your commentary was particularly helpful. Since June, I have lost 70 lbs doing LCHF and IF – it has been an incredible journey – my lipid profile has improved greatly,… Read more »
Shelly
Guest

And, of course, I also owe a HUGE THANK YOU to Dr. Fung as well!!!! Your book connected everything in a way that finally made sense to me!! Thanks for everything you do and all the time you put in to help us all!!

Shelly

Vadym Graifer
Guest
Sue, having lost 75 pounds and moved my A1C from 9.2 to under 6, I can honestly say this about OGTT: I don’t care 🙂 I know my body reacts to carbs much better than it used to. Even without taking measure I can feel it by absence of sleepiness after an occasional carb-rich meal. I make sure I apply protective measure when I do have those occasions, by taking protein with it, by scheduling physical activity around that time, taking resistant starch a few hours before, having some apple cider vinegar later that day. It all works, I stay… Read more »
Sue
Guest

And I agree to all of that. Like I said, we’re not interested enough to do the test and ingest all that sugar…. it really does matter not since we are not looking for an “out” to the LCHF, WOE. It would just be fun to know if we are really curing T2D or managing it. I believe this is a cure… might take a few months or a few years, but I do believe if you are vigilant, it is a cure. Happy New Year! Cheers!

Vadym Graifer
Guest
I know what you mean 🙂 I for myself settled on this answer: if my current lifestyle maintains healthy blood sugar level and I can maintain this lifestyle without being miserable, for all practical intents and purposes my diabetes is essentially reversed. Both of these are true: my BG stays steady, and my lifestyle is far from miserable, it’s in fact enjoyable. Some advance this argument: but if you start eating all that sugar and refined carbs again, and snack every 2-3 hours, and your diabetes return, then you are not cured. I don’t buy it. If I fixed broken… Read more »
ChrisW
Guest

Sue, you may not need another OGTT. Not sure if you’ve seen this video, but Dr. Ted Naiman basically echoes your misgivings about ingesting that much glucose. In his practice, he determines IR through other markers that don’t require an OGTT.

https://www.youtube.com/watch?v=193BP6aORwY

Sue
Guest

Great video ChrisW, thank you so much for sharing! Happy New Year to you and yours!

I will be sharing this video as well!

sten bjorsell
Guest

Sue and Bob, if you do a sugar challenge make sure you use glucose = dextrose which is free of the liver damaging fructose, half of standard sugar. Easier is to measure waist. Healthy target is half the body length. Then continue IF while above !

Linda Simpson
Guest

Dr.Fung!!
What an AMAZING article!! So, so simple and easy to understand.

I have a question….After eating…What is considered high glucose levels. What number am I to aim for in order to keep my insulin low?

Thank you!

jan
Guest

Standing O, Dr. Fung. Best and clearest explanation I have read!

Wenchypoo
Guest

If you simply wait until blood glucose is elevated, then you have T2D, no question.

Yep, and the AMA tells doctors to wait until the fasting blood sugar reaches 140 before stepping in with armloads of (bad) literature, a meter + test strips, and a vial of insulin. THEN comes the instructions of how to shoot yourself–they like to use an orange for patient practice.

Yeah–I’D like to stab an orange right about now…

oxapodo
Guest
It seems that insulin is truly the lynchpin of the whole T2D problem. I guess the big question that comes right up is: why do some people have a much higher insulin response than others when they ingest the same ratio of macronutrients? I.e., why do different patterns show up in Dr. Kraft’s diagram. If the answer is genetic programming (afaik nothing can be done about that so far), then for those unlucky people with a high insulin response, LCHF and IF is the path to take for life. Any consistent deviation from that one-way street, will only bring them… Read more »
Richard S Stone
Guest
Yes, but I think the point is that really, it’s kind of the other way around: maybe only a few can manage the SAD and NOT ultimately get diabetes. Otherwise we would be looking at an entirely different medical/public health situation. And it’s not just the “obesity” issue, because some people can have “diabetes” and still be reasonably shaped. What also seems to be the implication of Dr. Fung’s view on this is that when people are young their cells are not yet full of the fat pushed into them by insulin. So they eat what they want and stay… Read more »
Stevo74
Guest

Oxapodo,
If you are familiar with any of Dr. Robert Lustig’s work, there are likely other factors than genetics to blame for the insulin resistance. High amounts of sucrose (fructose + glucose) in the diet can be both addictive and have significant impact on subsequent insulin sensitivity.

IanA
Guest

An issue that I am trying to understand is – what happens next?
You follow an LCHF diet and, lose weight and blood glucose normalises.
But insulin does not.
Even after 18 months .
What do you do?

sten bjorsell
Guest

Without IF it is almost impossible to lose the belly = the insulin resistance. In my case it had to be water fasting minimum 24 hrs at a time.

Lynn
Guest

My parent has been overweight most of their life. They eat candy everyday all day long and yet their blood glucose is normal. I on the other hand who was not overweight until after age 40 and never ate anywhere near the coca cola and candy bars they ate have high blood sugars. Not fair

ChrisW
Guest

Not fair indeed. Hate to say it, but you may have “inherited” your carb intolerance because of your mother’s poor diet (assuming that’s who you mean when you say “parent”). If you were talking mother, there’s some research that suggests that it’s possible for the mother to give birth to an insulin resistant child simply by virtue of poor diet during pregnancy.

carolyn anne
Guest

Just read the letter to Health Canada-You are a true champion!!
I feel that the tipping point has arrived here-Am a Canadian living in London,Ont.-
and that the importance of nutrition and diet in good health will once again be primary.Thanks to my mother we were raised onLCHF food real,garden fresh and home preserved and prepared food!
The 200 health care providers that signed that with you should know there are thousands like me that support and follow you advice with gratitude.
Happy New Year

Birgit
Guest
Hi Carolyn Anne, would it be possible for you to provide a link to that letter to Health Canada? I am a lay person an have written many letters to my MP to Health Canada and the Ontario Ministry of Heaelth. I have received almost no response, except for one letter patting me on the head for “taking responsibility” for my “own health”, while otherwise ignoring the issue. To me, writing a letter to our politicians is like dropping something in a well so deep that you can’t even hear the splash when it hits the water. The I Colle… Read more »
Mike
Guest

Here is a link to the open letter.
http://www.foodmed.net/2016/canada.pdf

Birgit
Guest

Thanks, Mike

Doug Gardiner
Guest
Hi Jason Thank you for your continued sharing of your research and ideas on this subject. I have benefitted greatly from implementing your recommended LCHF and IF protocols If the overload theory is correct, why then, when the cells are emptied of sugar via LCHF and IF, does IR and type 2 diabetes remain? The bio markers for type 2 are corrected only while the LCHF and IF protocols are adhered to. Blood glucose is normalised only because none is ingested. The ability to cope with dietary sugar is still compromised after the full carriages are completely emptied. Why is… Read more »
Terry teh
Guest
Hi dough, Just to share my personal experience on lchf and if. I use to have metabolic syndrome and after 6 moths, my blood glucose is 5.1, my blood pressure is Std 110/70 my cholesterol is down to almost normal and Uris acid and fatty liver problem resolved. What 9 have done are experiments on my own using food as a medicine. I am following 2 Nobel prize wining ideas. Dr ignarto nitric oxide and auto-Nagy achieved thru fasting. This is my personal experiments as I understand doctors cannot claim or advise anyone without medical proof. I took it upon… Read more »
Mathieu Clément
Guest

You write that LCHF / IF will “reverse” T2D, so you mean it will “cure” it ?

And it means that these person can then go back to a normal diet ?

By “normal” I mean with carb intake according to their activity (probably medium-carb then), from good a natural source (no sugar) and no IF ? Which is a diet that doesn’t lead to T2D for healthy persons.

If not, then LCHF/IF is the natural (no drugs) treatment, but not a cure.

sten bjorsell
Guest

LCHF removes symptoms but wont cure metbolic syndrome. Combined with IF it is a cure when it reduces insulin resistance enough. LCHF alone did not do it for me. After normalised insulin levels (fasting insulin at least below 5), only revert to medium carb diet, not too high carb as it seems to be key cause of DB-2.

Terry teh
Guest
I am not saying that lchf and if or long term fast can cure diabetics. I am taking myself as an experiment to reverse metabolic syndrome. Thru autophagy, nitric oxide and thru upping my intake on potassium and magnesium. I also take vinegar and am very sensitive to the incretin effect i.e., stress. This I try to achieve thru meditation nad having. A let go attitude in life. According to researchers on the telomere length, so far the best answer is to accept what life brings you nad base on what is available studies at this point in time, this… Read more »
Richard S Stone
Guest
Mathieu: I wonder if your question/comment is more about definitions than results? Maybe before we talk about a cure, or the meaning of “cure,” we should discuss the nature of the disease? If we are talking about measles, as a disease, that is one thing. Time alone, and proper rest, will likely cure measles. Or are we talking about something like alcoholism (and whatever that term means), as a disease? Is diabetes contagious? Or is it a function of some pattern of behavior? I obviously would argue the latter. What Dr. Fung has proposed, as I understand from his various… Read more »
Sue
Guest
Richard S Stone!!! This was so very well written! I’ve never quite thought of it like that, but I have been AMAZED at the resistance from people to change their diet who are very, very sick with diabetes. I’ve met people grossly overweight, having trouble with their eyes, pain and numbness in their feet but suggest giving up bread and you’d think someone told them you were taking their first born. So when you frame it as an addition that makes so much sense! My husband was diagnosed with T2D last January so it has been a year now. We… Read more »
Barry
Guest
A year ago I was told that I was overweight, diabetic, poor kidney function and high blood pressure. Over the last year I have gone ketogenic and lost 15 kg (down to 80 kg at 6ft tall). My HbA1c is down to 5.6 , i.e. no longer diabetic. My HDL is 1.3. My kidney function is now normal. However my BP is still averaging 150/80, which doesn’t seem that bad for a 75 year old man, but my doctor wants to put me on medication. I am worried that the medication will adversely effect my weight and insulin levels and… Read more »
Stephen T
Guest
Barry, I wouldn’t touch blood pressure (BP) medication in your case. I think there has to be a clear benefit before even considering taking a drug. Last November I had an above average BP reading and was advised by my doctor to take medication. I was prepared for this and quoted evidence from Dr Malcolm Kendrick’s article on this subject (spacedoc.com). My doctor’s response was simply that I met NICE guidelines (in the UK) for BP medication. I told her the evidence seemed to be clear that I would not benefit from these drugs and that there was a 1… Read more »
Stevo74
Guest

Hi Stephen.

I agree with your general premise that medication should be a last resort. Having said that, there is now, however, a randomized trial showing benefit to controlling blood pressure below 140 (SPRINT trial). Here is a link to PubMed. https://www.ncbi.nlm.nih.gov/pubmed/26551272

Personally, I would only consider using medication if IF, LCHF, and high intensity interval training in combination have failed. While I’m not convinced of the benefits of HIIT to reduce weight, I have personal experience that it does a very nice job reducing systolic blood pressure.

Stephen T
Guest

Thank you, Stevo, but I remain highly sceptical. I’m afraid I’ve got to the point that I trust almost nothing a drug company has to say (and one of the authors has links to drug companies) because they will say anything to increase the pool of ‘patients’.

One of the responders to the paper referred to a “near tripling of the rate of acute kidney injury or acute renal failure in the intensive-treatment group”.

They haven’t go anywhere near passing my test before taking a drug. We all have to make our own decisions

Barry
Guest

That you for that Stephen. Problem is that my GP is putting a lot of pressure on me to take medication. I have already resisted statins but he is adamant that I should take BP medication or I will be at serious risk of stroke or heart attack.

Stephen T
Guest

Barry, we do all make our own decisions. There is no way I’m taking a drug to keep my doctor happy. I suppose it depends on whether you think artificially lowering a symptom (a BP number) with a drug actually does any good. I don’t think it does, so it gets nowhere near passing my ‘clear benefit’ test for taking a drug.

sten bjorsell
Guest
“Overflowing cells”. Cells may well be full of glucose for different reasons. Lack of materials for instance. One material from this abstract: https://www.ncbi.nlm.nih.gov/pubmed/15319146 “Magnesium is required for both proper glucose utilization and insulin signalling. Metabolic alterations in cellular magnesium, which may play the role of a second messenger for insulin action, contribute to insulin resistance.” It is well known that increased carbohydrate metabolism demands more magnesium “to work”. At the same time our food contains less magnesium due to less recycling in modern agriculture at the same time as magnesium is important to bind and excrete toxins, which increase in… Read more »
Ron Hunter
Guest

How come more doctors don’t measure insulin response along with glucose response? Is that historical? Is it still people on the lock and key paradigm?

David Magnus
Guest

This study makes your theory invalid
https://examine.com/nutrition/really-low-fat-vs-somewhat-lower-carb/
even though the insulin went down, low fat lost more fat.
Please answer.

Drifter
Guest
I didn’t read every word in the link but if this is the study I think it is, Dr. Fung has already addressed it by pointing out that the low carb folks maintained their metabolic rate and the low fat people didn’t. As the commentary in the link points out what works in the real world is not what appears to work in the lab when the end point is loss of fat, since in the real world loss of fat without hunger or meaningful deprivation or significant reduction in metabolic rate is what determines long-term success. Further, Dr. Fung… Read more »
Dr Marcus Chacos
Guest

This is a wonderful revelation, a fantastic protocol and I am very grateful to have found my way to this site and Dr Fung.

thebigpicture
Guest
I cannot emphasize enough that there is a social aspect to eating and to obesity. Quite simply, we eat what others eat, and we gain weight when others are doing so. During the holidays this is especially true. If you think about it, this must be true. If you are say, thin, active, or deny yourself certain foods or periods of eating in order to maintain your health, and then you find yourself among others who are enjoying all the food they can eat, your willpower may begin to break down. You may decide to heck with it, and to… Read more »
Stephen Reed
Guest
Hey ‘thebigpicture’ I do agree with your idea that we tend to be the sum of the people around us, but I think my agreement kinda stops there. Being around obese people doesn’t necessarily make you obese. Many obese people don’t eat huge amounts of food (perhaps they did once), they don’t all spend there time eating pies, cakes, drinking full fact Coke 🙂 and lying around all day of the sofa. We don’t all respond to food in the same way, either the hormonal or the psychological effects of it. Sure, if you spend your time around lean, fit,… Read more »
Colin
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I see the value of the “glucose overflow” analogy to explain hyperinsulinemia and its onset as a result of chronic overfeeding. However, “internal starvation” also seems to be going on in the sense that in the presence of heightened levels of insulin, the body is unable to access lipid stores (if anything, increasing them). Certainly something is going on systemically in terms of ongoing hunger in the obese that doesn’t square well with “overfull cells” — somehow the signal that cells are full is not translating into reduced eating on the part of the organism. I’m not so sure that… Read more »
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