Atkins Diet Misconceptions: Do ketogenic diets increase insulin resistance?



In a response to a message, I wanted to see if I could help others understand some of the research on ketogenic diets and insulin resistance. Vegans assert that the animals fats make insulin resistance worse, but the science is obviously not on their side. Most of my misconception videos, I try to detail the science, but for this topic, I made an analogy.

For this analogy, I used a cattle yard and the obnoxious smell as being analogous to the overwhelming refined carbs present in the Standard American Diet. Most people when assaulted by the smell immediately would have response to the smell. That response is the insulin release. Over time, the person eventually needs to be assaulted with new more horrible smells and might eventually not be bothered at all. It is at that point they become diabetic in the analogy.

Here’s the research:

“Do very-low-carbohydrate diets cause insulin resistance?
Despite concern that very-low-carbohydrate diets, especially if high in saturated fat, might lead to insulin resistance, the link between saturated fat and insulin resistance is tenuous. Further, data from three recent studies that used the insulin clamp technique indicate that very-low-carbohydrate diets do not have an adverse effect on glucose metabolism or insulin resistance.

Collectively, these studies indicate that very-low-carbohydrate diets alter the effects of insulin on oxidative and nonoxidative glucose disposal, favoring storage of glucose as glycogen in muscle. They also appear to prevent insulin-stimulated inhibition of lipid oxidation. Data from these studies do not support the notion that very-low-carbohydrate diets exacerbate the risk of type 2 diabetes and insulin resistance; rather, they actually show a potential favorable effect as evidenced by decreased basal endogenous glucose production and improved insulin-stimulated nonoxidative glucose disposal.”

From the NEJM:
A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity
Frederick F. Samaha, M.D., Nayyar Iqbal, M.D., Prakash Seshadri, M.D., Kathryn L. Chicano, C.R.N.P., Denise A. Daily, R.D., Joyce McGrory, C.R.N.P., Terrence Williams, B.S., Monica Williams, B.S., Edward J. Gracely, Ph.D., and Linda Stern, M.D.

From the conclusions of the study:
” Insulin sensitivity, measured only in subjects without diabetes, also improved more among subjects on the low-carbohydrate diet. The amount of weight lost and assignment to the low-carbohydrate diet were independent predictors of improvement in triglyceride levels and insulin sensitivity.”

Conclusions Severely obese subjects with a high prevalence of diabetes or the metabolic syndrome lost more weight during six months on a carbohydrate-restricted diet than on a calorie- and fat-restricted diet, with a relative improvement in insulin sensitivity and triglyceride levels, even after adjustment for the amount of weight lost.”

One more New England Journal of Medicine study:
A Randomized Trial of a Low-Carbohydrate Diet for Obesity

“The increase in high-density lipoprotein cholesterol concentrations and the decrease in triglyceride concentrations were greater among subjects on the low-carbohydrate diet than among those on the conventional diet throughout most of the study. Both diets significantly decreased diastolic blood pressure and the insulin response (increased insulin sensitivity) to an oral glucose load.”

Here are my first two diabetes video:
Atkins Diet Misconceptions: Low Carb and Diabetes (Part 1)

Atkins Diet Misconceptions: Low Carb and Diabetes (Part 2)

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