Excess Insulin: What Causes It
Disclaimer The instructions and advice presented on this site are in no way intended as medical advice or as a substitute for medical counseling. The information should be used in conjunction with the guidance and care of your physician. Consult your physician before beginning this program as you would any weight- loss or weight-maintenance program. Your physician should be aware of all medical conditions that you may have, as well as any medication and supplements you are taking. Those of you on diuretics or diabetes medication should proceed only under a doctors supervision. As with any plan, the weight-loss phases of this nutritional plan should not be used by patients on dialysis or by pregnant or nursing women. As with any weight loss plan we recommend that anyone under the age of 18 follows the program under the guidance of their physician.
Welcome! In this Quick Study we're going to explore the connection between insulin and blood sugar: what causes it, what health problems it can lead to, and how the Atkins Nutritional Approach™ (ANA™) can prevent or control many insulin-related health conditions.
The Insulin Connection
Protein, fat and carbohydrates are the main nutrients in food--all provide fuel for the body. But once these three substances leave the small intestine and enter the bloodstream, the body metabolizes them in different ways and for different reasons.
- Protein is essential for building and maintaining your muscles, bones, organs and other tissues and to keep your body functioning.
- Fat is important for vital body functions such as making hormones, building cell walls and storing energy.
- Carbohydrates provide the quickest form of energy--they are converted into glucose, or blood sugar, when they reach your bloodstream.
The Role of Insulin
The hormone insulin is the carrier that transports glucose to the cells. Once the glucose is delivered to the cells, three things can happen to it:
- It can be used for immediate energy.
- It can be converted into glycogen (a complex sugar manufactured and stored in the liver and muscles) for later use as a source of energy.
The more glucose that enters the bloodstream, the more insulin the body releases to sweep in and clear it away. Insulin's job is two-fold--in addition to carrying glucose to cells, it works to keep your blood sugar within normal range. So think of insulin as a hormone that can both transport glucose and remove it from the blood.
The Blood Sugar Roller Coaster
When you eat something high in carbohydrates, the effect on your blood sugar levels is immediate. That's because all carbohydrates, whether they start as sugars or starches, are converted into glucose, which enters your bloodstream quickly and gives a quick burst of energy. Soon afterward, though, your pancreas releases a spurt of insulin to rush in, clear out the glucose (moving it to your cells) and regulate your blood sugar level. This is how it should work. But if you are like many people. guess what happens? You overproduce insulin, blood sugar falls, your energy level plummets, you crave more carbs and the cycle starts all over again.
On the other hand, when you eat foods that are mostly protein or fat, your body produces far less insulin and you avoid these extremes in blood sugar. When you produce less insulin, your blood sugar level remains constant--and so does your energy level and mood. Hunger is more controlled and cravings often disappear Result: you stop riding the blood sugar roller coaster.
What Happens to Excess Insulin
As we mentioned above, once the glucose is delivered to the cells, three things can happen to it:
- It can be used for immediate energy.
- It can be converted into glycogen for later use as a source of energy.
Guess what happens more often than not? Insulin is a very efficient hormonal regulator, and the body can only store a limited amount of glycogen. Once your muscles and liver have stored as much glycogen as they can hold, your liver changes the rest of the glucose to body fat for long-term energy. That's why insulin is also known as the fat-storing hormone.
Since fat is much more efficient--and has much more capacity to store energy--than glucose, we can store a lot more fat in our bodies than glucose. Over time this leads to obesity, which will soon overtake smoking as the leading lifestyle-induced cause of death in the United States.
For years we've been inundated with the message that excessive consumption of fat causes obesity, and that if we eat less fat we will lose weight and live longer. We've also been told that all carbs are good for us. But despite eating less fat than they did 10 years ago, Americans are fatter and unhealthier today than ever--and insulin-related metabolic disorders constitute a national epidemic.
The Atkins Nutritional Approach will make you healthy because it is different from the typical American way of eating. Simply put, you avoid the negative consequences of too much carbohydrate input, all of which can be attributed to too much insulin release in your body. -- Robert C. Atkins, M.D.
Points to Remember
- When carbohydrates are available, the body transforms them into energy.
- Excess carbs are stored as body fat.
Let's take a look now at what happens to the body when the pancreas keeps flooding the body with too much insulin.
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Health Effects of Too Much Insulin
Blood sugar disorders related to high consumption of dietary carbohydrate are now viewed as a spectrum ranging from insulin resistance, hyperinsulinemia, or"prediabetes," to full-blown Type 2 diabetes. These conditions are closely associated with obesity. And a newly renamed cluster of medical problems, known as metabolic syndrome, includes high fasting blood sugar levels and obesity as two of five accurate predictors of both diabetes and coronary heart disease.
Glucose tolerance tests show that as people get heavier, they are more likely to have insulin-related problems. Excessive carbohydrate intake, especially of poor-quality carbs, leads to excess insulin production which, in turn, leads to an increasingly unstable blood sugar and more stored body fat. The excess fat hampers the body’s ability to respond to its own insulin (hence the term "insulin resistance"), and thus a vicious cycle begins. Weight loss becomes increasingly difficult and resorting to restrictive diets leads to repeated failures. This so-called yo-yo dieting results in even more insulin resistance, which can lead to Type 2 diabetes.
Type 2 Diabetes
Remember the Blood Sugar Roller Coaster diagram we saw earlier? After years on this cycle, the body’s insulin and blood sugar get out of sync, resulting in unstable blood sugar and symptoms such as shakiness, irritability and excessive hunger. Even with this extra insulin, over time many people become less able to transport energy-sustaining glucose to their muscles and more glucose stays in the blood -- this leads to abnormally high blood sugar levels and diabetes. The body's fat cells resist the action of insulin, so the blood sugar that comes from dietary carbohydrates can no longer be burned. This results in more and more sugar circulating in the bloodstream and more damage to the body. Ultimately, the pancreas will become overworked or “exhausted,” leading to low production of insulin, increase insulin resistance--and ultimately an insulin-dependent diabetic.
Type 1 diabetes typically occurs in childhood or early adulthood and is generally unrelated to dietary habits. Type 1 diabetics do not produce insulin, and only 5 percent to 10 percent of all diabetics are Type1. But researchers believe that Type 2 diabetes, which is reaching epidemic levels around the world, is caused by a genetic propensity for the disease combined with improper eating habits. Most people who have Type 2 diabetes actually produce more insulin than do those who don't have the illness. The reason the diabetics have elevated-blood sugar levels is not lack of insulin, but insulin resistance. Only in the later stages of Type 2 diabetes does a person's insulin output decline.
Obesity and Type 2 Diabetes
Obesity and Type 2 diabetes can be viewed as two aspects of a single illness, characterized by insulin resistance (insulin not doing its job in your body) and hyperinsulinism (excess production of insulin). The overlap between the two is impressive. More than 80 percent of Type 2 diabetics are obese. And a majority of obese people have the very same problems that lead to diabetes. The most convincing connection of all is that these twin epidemics escalated simultaneously, coinciding perfectly with dramatic changes in the American diet, when the intake of dietary fat fell from 40 percent to 33 percent of total calories consumed. Predictably, the intake of refined carbohydrates, including both sugar and highly refined flour, went up by an even greater amount.
The metabolic syndrome, also know as syndrome X, is a relatively new term. It defines a cluster of metabolic-related disorders that are major risk factors for both diabetes and coronary heart disease (CHD). A person with metabolic syndrome has at least three of the following five signs present:
- abdominal obesity
- elevated fasting blood triglycerides
- low levels of HDL or "good" cholesterol
- higher than normal fasting blood sugar (glucose)
- high blood pressure
The good news for people with these conditions is that ever more drastic diets are not necessary. By controlling blood sugar to moderate levels, the ANA can prevent, control and even reverse many of the conditions we just discussed.
The Atkins Primary Principle for Disease Prevention: "By following an individualized controlled-carbohydrate nutritional approach that lowers carbohydrate intake resulting in normalizing insulin production, people at high risk for or diagnosed with certain chronic illnesses, including cardiovascular diseases, diabetes and hypertension, can see improvement in clinical parameters."
Next let's take a look at two more aspects of carbohydrates that affect blood sugar: fiber and glycemic content.
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All Carbohydrates Are Not Created Equal
The body digests most carbohydrates and turns them into blood sugar. Other carbohydrates, however, behave differently. Some carbs are digested by your body but not turned into glucose. And some carbs--such as fiber--are not digested at all, and can pass through your body as waste imparting no, or almost no, calories per gram. In either of these last two cases there is no noted impact on blood sugar levels.
The Fiber Factor
Dietary fiber is the digestible and nondigestible part of plant cells. It has many health benefits related to digestion. And although it is a carbohydrate, fiber does not convert to glucose and thus does not raise blood sugar levels the way typical carbohydrates do.
In fact, fiber actually slows the entry of glucose into the bloodstream. This, in turn, reduces the blood-sugar spikes that cause insulin over production and encourage the body to produce and store body fat. And by slowing down food's transit time in the digestive tract, fiber helps people feel full longer, resulting in fewer food cravings.
Why fiber matters: Although it is a carbohydrate, fiber does not convert to glucose and thus does not raise blood sugar levels the way carbohydrates typically do.
Now that we have a better sense of why high blood sugar is bad for us, and how fiber intake helps even out blood sugar, we'll take a look at how the ANA helps people control their blood sugar levels. We'll see how gradually increasing Net Carbs and reaching your ACE stabilizes blood sugar through the four stages of the ANA, then take a look at two tools for adding carbs back into the eating plan: the Carbohydrate Ladder and the Power of Five.
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Counting Net Carbs to Normalize Blood Sugar
We've taken a look at some of the negative health consequences of excess insulin in the bloodstream. The good news is that controlling carbs evens out blood sugar--and high fiber, as we've discussed, is an important aspect of this process, since it's used to calculate Net Carbs.
You've probably heard of Net Carbs, or seen that term on a food label or ad lately. Now let's explore what Net Carbs are, and how counting them helps control blood glucose and fosters lifetime weight management on the ANA.
Net Carbs are the carbohydrates that significantly impact the blood-sugar level; they're the only carbs that count when following Atkins. The good news is that the grams of carbohydrate in fiber, glycerine, and sugar alcohols don’t break down and convert to blood sugar and need not be counted by people on the ANA. Example: 14 macadamia nuts contain 5 grams of carbs, but 3 of those grams are fiber. Since the nuts have only 2 net grams of digestible carbs--the other 3 grams are in digestible fiber--only 2 net grams have to be added to the daily carb tally. So Net Carbs represent the number of grams of total carbohydrate minus those that do not impact blood sugar.
Gradually Increasing Net Carbs Through the Four Phases
Net Carbs factor into all four ANA phases for weight loss--with more grams of Net Carbs allowed as you move from Induction through the three later stages. As you do so, you'll gradually move up the Carbohydrate Ladder (from foods lower in Net Carbs to foods higher in Net Carbs), using the Power of Five (weekly, incremental additions to Net Carb daily amounts). When doing Atkins, the idea is to reach your goal weight over time and then learn your own threshold for carbohydrate consumption, which is the number of grams of Net Carbs you can eat each day while neither gaining nor losing weight. We call that the Atkins Carbohydrate Equilibrium, or ACE for short. This will become clearer as you read through the phases below.
- Phase 1: Induction. Consume about 20 daily grams of Net Carbs for a minimum of two weeks.
- Phase 2: Ongoing Weight Loss (OWL). Every week, add another 5 daily grams of Net Carbs until weight loss ceases. When that happens, drop back 5 grams and weight loss should resume. For most people, that amount is somewhere between 40 and 60 grams of Net Carbs a day. Continue until you are within 5-10 pounds of your goal weight.
- Phase 3: Pre-Maintenance. Each week, add another 10 daily grams of Net Carbs to your program. When weight loss stops, cut back 5 or 10 grams until very gradual weight loss resumes. Continue until you reach your target weight and maintain it for at least a month. This way you will find your Atkins Carbohydrate Equilibrium (ACE)--the number of grams of Net Carbs you can eat each day without gaining or losing weight.
- Phase 4: Lifetime Maintenance: You now know how much and which carbohydrate foods you can eat. Continue to eat the way you have become accustomed to, staying at or just below your ACE, and you should be able to maintain your weight and enjoy all the health benefits that Atkins offers.
Important Points to Remember
- The key to Atkins is counting grams of Net Carbs to control blood sugar levels.
- Every person has a different tolerance level for grams of Net Carbs.
- The key to lifetime weight management is finding your ACE and staying there.
In this Quick Study we examined the link between dietary carbohydrates and blood sugar--a topic of great importance, since many people don't realize they have insulin-related metabolic disorders until it's too late. We learned about the relationship between high carbohydrate consumption levels, excess insulin production and various metabolic disorders. Hopefully, you have a better understanding of why controlling carbohydrates is important, how Net Carbs are calculated and how people on Atkins increase their intake of Net Carbs through the ANA's four phases to reach their Atkins Carbohydrate Equilibrium.