
An Insulin Index of Foods (1994) - micaeloliveira
https://fermatslibrary.com/s/an-insulin-index-of-foods-the-insulin-demand-generated-by-1000-kj-portions-of-common-foods#email-newsletter
======
keymone
> However, some proteinand fat-rich foods (eggs, beef, fish, lentils, cheese,
> cake, anddoughnuts) induced as much insulin secretion as did some
> carbohydrate-rich foods (eg, beef was equal to brown rice andfish was equal
> to grain bread).

what? that makes zero sense, at least in case with fat. anybody got quick
explanation for this?

Edit: found the TLDR explanation in another part of the paper

> postprandial insulin responses are not always proportional to blood glucose
> concentrations or to a meal's totalcarbohydrate content. Several
> insulinotropic factors are knownto potentiate the stimulatory effect of
> glucose and mediatepostprandial insulin secretion. These include fructose,
> certainamino acids and fatty acids, and gastrointestinal hormones suchas
> gastric inhibitory peptide, glucagon, and cholecystokiin(25, 26). Thus,
> protein- and fat-rich foods may induce substantial insulin secretion despite
> producing relatively small bloodglucose responses.

~~~
wdewind
This actually makes a ton of sense and is what people on the sidelines of the
insulin debate have been screaming since Gary Taubes starting publishing his
work about dietary sugar. Unfortunately it's given people a very non-nuanced
view of the science.

The problem is _not_ dietary sugar, it is blood sugar levels, which are
elevated by many things (including protein and fat), but more than anything by
excess calories. The problem is _not_ peak blood sugar levels, it is _average_
blood sugar levels.

Edit: to quickly reply to your TLDR edit:

> Thus, protein- and fat-rich foods may induce substantial insulin secretion
> despite producing relatively small bloodglucose responses.

This is only true if you completely ignore everything else going on in the
body. Gluconeogenesis is a thing, and just because dietary fat or protein
doesn't immediately increase blood sugar levels does not mean long term they
don't. This stuff can't just be looked at as "input/output" you have to take
into consideration the existing state of the person before the input. /edit

You can reason about this fairly easily: take a caloric intake of 2000
calories consumed all at once vs in 10 meals over the day. The all at once
crowd gets a huge insulin spike. Oh no! Fat storage, right? Sure, but what
happens the rest of the day when there is no dietary input? Fat burn! The 10
meals/day crowd probably never gets as high blood sugar levels, but also has
much higher throughout the day, and accesses fat stores less. But guess what?
Net the body is really pretty good at smoothing this stuff out, it's sort of
the entire point of fat storage.

Where this gets tricky is that high insulin can eventually lead to low blood
sugar dips. People without diabetes can simply wait this out, and the body
will start burning fat again and raise the blood sugar. But this also makes
many people _feel_ hungry, and so they eat more, which raises their average
blood sugar levels, and the cycle continues. Some people have a hard time with
this, others do not, but it's really important to understand that the insulin
is causing people to consume more calories which is causing damage, not the
insulin itself.

~~~
rocgf
Sorry for the dumb question, but given the total calories are the same, does
this mean that it is generally healthier to eat one big meal per day rather
than 10 small ones?

Given my current understanding from all the intermittent fasting hype lately,
it is indeed better to eat big meals rarely rather than small meals
frequently. For some reason, your post got me slightly confused because I lack
the necessary knowledge to have a proper model about nutrition in place.

~~~
wdewind
> Sorry for the dumb question, but given the total calories are the same, does
> this mean that it is generally healthier to eat one big meal per day rather
> than 10 small ones?

We can't answer this confidently, the way I would say it is: there isn't
strong evidence to support the idea that either is better.

> Given my current understanding from all the intermittent fasting hype
> lately, it is indeed better to eat big meals rarely rather than small meals
> frequently. For some reason, your post got me slightly confused because I
> lack the necessary knowledge to have a proper model about nutrition in
> place.

The IF people (along with the Keto people) use a variety of tricks to try and
prove their point. There is absolutely not a single paper showing calorically
balanced food intake has different clinically significant outcomes. Period,
full stop etc. There are tons of papers saying things like if you force people
to eat in constrained windows they eat fewer calories (or if you force people
to eat high fat diets they eat fewer calories etc.). Those are all useful
outcomes: they are "compliance hacks." But they idea that any of these are
significantly metabolically different is not at all supported by the science.

As for yourself: nutritional science is weak, and if the nutritional science
says do something, and you observe a bad outcome in yourself from doing it,
I'd take your own personal data over the nutritional science, frankly. For
instance: fiber is a great modulator. If you go to a GI specialist and say
"I'm having dietary issues," increasing fiber is usually the first thing they
recommend. But also, sometimes that doesn't work and then the next thing is
decreasing fiber (FODMAP diet). So it's really hard to make sweeping
recommendations because the body is so complex and nutrition involves so many
different cooperating systems that can all go slightly wrong.

~~~
enraged_camel
>>But they idea that any of these are significantly metabolically different is
not at all supported by the science.

This doesn't seem correct. IF has statistically significant benefits:

[https://www.health.harvard.edu/blog/intermittent-fasting-
sur...](https://www.health.harvard.edu/blog/intermittent-fasting-surprising-
update-2018062914156)

(Supporting papers linked at the end)

~~~
wdewind
I'm sorry to just repost my paragraph from above, but I believe I already
responded to this:

> The IF people (along with the Keto people) use a variety of tricks to try
> and prove their point. _There is absolutely not a single paper showing
> calorically balanced food intake has clinically significant outcomes._
> Period, full stop etc. There are tons of papers saying things like if you
> force people to eat in constrained windows they eat fewer calories (or if
> you force people to eat high fat diets they eat fewer calories etc.). Those
> are all useful outcomes: they are "compliance hacks." But they idea that any
> of these are significantly metabolically different is not at all supported
> by the science.

1\. These papers do not show different outcomes with calorically controlled
inputs, as I mentioned. One of the tricks used by the IF scientific community
is to _serve_ the same number of calories and so it looks like the same number
of calories were consumed in the abstract. They never are, because if this did
happen it would have _massive_ implications for our understanding of the human
body. It would require us to be wrong about a lot of things.

2\. There is a difference between statistical significance (which could be,
but has not been, shown in calorically controlled diets), and clinical
significance (which definitely has not been shown in calorically controlled
diets, and likely will not).

~~~
otabdeveloper2
> They never are, because if this did happen it would have massive
> implications for our understanding of the human body. It would require us to
> be wrong about a lot of things.

Yeah, welcome to medicine. If you've ever encountered these things in a non-
theoretic perspective (i.e., having some condition), you quickly see that
doctors don't know shit.

Perhaps not surprising, given that human experimentation is taboo.

Anyways, how does what you're saying mesh with the fact that extra glucose is
stored in your body's reserves while ketones are secreted with urine and
breath?

~~~
wdewind
> Yeah, welcome to medicine. If you've ever encountered these things in a non-
> theoretic perspective (i.e., having some condition), you quickly see that
> doctors don't know shit.

That is, unfortunately, exactly why I am so acquainted with this stuff, and
yeah, it is pretty frightening to have doctors tell you they just don't know.
But to be fair, I'm talking about being wrong about fundamental biology, not
medicine, in which massive shake ups like that are far rarer. It's also not
like this stuff hasn't been studied.

> Anyways, how does what you're saying mesh with the fact that extra glucose
> is stored in your body's reserves while ketones are secreted with urine and
> breath?

Not sure what you mean but fwiw glucose is also secreted in urine and breath.

------
IdontRememberIt
My wife had gestational diabetes. She had to mesure and log the values and her
food. She is from the north of europe and I am from the south europe.
Actually, her body gave permutated values between potatoes and pasta. In a
same condition (starting G level, same plate, same quantities, same level of
activity, same hour, etc), she could eat potatoes without issue, pasta (even
whole wheat) was systematically making her GI skyrocket. It was the opposite
for me. A tool to mesure your G level is very instructive.

~~~
ghostbrainalpha
So many people don't realize this. There is a lot more to it than just this
sandwich has 200 carbs.

Each person is processing things differently. I'm hoping someday for a startup
that makes it easy for me to track my insulin response for all my favorite
foods so I can make better choices.

After testing on my own I found that the "sugar free Worthers candy" I was
eating on my failing low carb diet, actually triggered the same change in my
blood sugar as the non "sugar free" version of the candy. I guess this is
because some artificial sweeteners act like REAL sugar for some people.

~~~
johnkpaul
I found the same with the amount of sugar that's in a Splenda packet. Some of
us are just very very sensitive to carbohydrates and live our whole lives
without realizing.

------
MrBuddyCasino
2015 study finds that the glycemic index varies widely depending on the
individual:

[https://www.washingtonpost.com/news/to-your-
health/wp/2015/1...](https://www.washingtonpost.com/news/to-your-
health/wp/2015/11/20/the-diet-study-that-upends-everything-we-thought-we-knew-
about-healthy-food/)

~~~
SilasX
I don't see where that link says that? All I find is a remark about how GI
isn't the be-all-end-all of weight loss.

Also, the GI would still be relevant even if it varies, because what you
really want to know is the _relative_ GI, and the _ordering_ should at least
be preserved across individuals, right? Like if watermelons have a much higher
GI than nuts in the table, you're probably not going to find someone whose
personal GI is higher for nuts than watermelon?

------
jwr
Link to the page with the article downloadable as a PDF:
[https://academic.oup.com/ajcn/article/66/5/1264/4655967](https://academic.oup.com/ajcn/article/66/5/1264/4655967)

(I _really_ _really_ hate web pages that take over a PDF, present a poorly-
implemented crappy PDF reader experience and do not offer an easily-accessible
"Download and read in a sane reader app" button)

~~~
miguelrochefort
Their PDF reader actually freezes Chrome on my phone. I was forced to kill it.

~~~
DavideNL
...and Firefox on macOS

------
joduplessis
By far the biggest contribution I've made to my health has been being aware of
insulin responses, so this is awesome. People don't realise how optional that
mid-afternoon slump is or how un-necessary erratic energy levels are.

~~~
gibsjose
I'd love to hear more about this. Could you expand on how you measure your
insulin response and as a result how you avoid erratic energy levels?

~~~
yaronhadad
There isn't an easy way to measure insulin levels today. For glucose one can
use CGMs

------
estsauver
The really crazy effect of insulin is how it interacts with aging. The link
between insulin and aging is super well understood.

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2906894/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2906894/)

If you're interested in the Ted talk version:

[https://www.ted.com/talks/cynthia_kenyon_experiments_that_hi...](https://www.ted.com/talks/cynthia_kenyon_experiments_that_hint_of_longer_lives?language=en)

She now works at Calico, Google's longevity play. If there was one area I was
going to do something besides agriculture this is what I would work on.

~~~
wdewind
> The link between insulin and aging is super well understood.

This is really overstated. The paper is a paper on round worms, which is
really one step above basic cellular science (which is important but only a
building block of the whole picture). We do not have large scale,
epidemiological studies about sugar, and the ones that we do don't point to
sugar behaving differently than other calories with regards to health
outcomes. The problem is _blood sugar_ not _dietary sugar,_ and it turns out
high blood sugar can come from many places that are not dietary sugar, and a
calorically controlled diet that is high in sugar does not result in high
average blood sugar levels.

~~~
estsauver
* Agreed on blood sugar vs. dietary sugar. * This paper launched a whole series of mouse studies.

~~~
wdewind
If you have any that disambiguate between average and peak blood glucose
levels I would be really interested in reading them! To my knowledge no one is
really studying this because it is hard and if you are successful proving that
knowledge we came up with in the 50s still holds isn't very attractive for
most research institutes :(

------
micaeloliveira
"Why should you read this paper? Glucose and insulin are two of the most
important elements of metabolism. In an oversimplified nutshell - when we
consume food our blood glucose usually increases. Consequently, the pancreas
secretes insulin which lowers the glucose levels back to normal. Insulin is a
hormone and is often considered to be the principal regulator of fat storage
in the body (this is a bit controversial, but is mostly considered correct.
Read the book "Why we get fat" by Gary Taubes for more info). Therefore
knowing how the foods we eat spike our insulin levels can be helpful in
determining what should be eaten for weight loss."

------
bad_user
The glicemic index is basically a hoax that has nothing to do with reality
simply because the glycemic response differs widely from person to person or
even from one day to the next. Even more problematic is that it’s getting used
on food packages as a marketing gimmick.

I don’t see how an insulin index could be very different.

If you care about the glycemic load, then stop eating refined carbs and sugar,
it’s that simple.

Note that fruits have insoluble fiber that delay digestion and feed your gut
bacteria so fruits in their raw form are very different from sweets or even
from fruit juice. So unless you’re metabolically deranged, you shouldn’t fear
fruits, but you should fear fruit juice.

~~~
sickrumbear
hmmm even if the response differs widely, wouldn't the index give an
indication of the relative impact something would have? I've been reducing
carbs and sugars, which aligns with lower GI foods, I don't really agree that
its a hoax, it's helped me sustain energy levels throughout the day better.

~~~
bad_user
No, it wouldn't be, because that relative impact also differs from person to
person.

And it is more useful to just look at the carbs, sugars and fiber content.

Do you know how the glycemic index came to be? They used just 10 healthy
people for the experiments. It's a hoax on the same level as homeopathy.

------
JonesWilly
From a physicians standpoint I am very impressed with the accuracy of the
comments on this article. There are a few sticking points/arguable conjectures
being made but overall an excellent discourse on a multifaceted topic such as
insulin/glucose metabolism....

------
EamonnMR
While we're recommending food books, check this one out:

Why Calories Count by Marion Nestle and Malden Nesheim

[https://www.amazon.com/Why-Calories-Count-Politics-
Californi...](https://www.amazon.com/Why-Calories-Count-Politics-
California/dp/0520280059)

------
INTPenis
I need to give this a good read.

My dad is diabetic and his doctor told him that cinnamon is good for blood
sugar levels. It's not in this study though.

He was also told to avoid rice and potatoes. He manages quite well and the
doctors are astonished at his low blood sugar measurements every day.

~~~
m0zg
>> cinnamon is good for blood sugar levels

Medical errors are the third most common cause of death in the US. Let's just
say this is strong evidence that not all doctors know how to do all that
doctor-related stuff. Some of them just charge you through the nose and hope
that you won't die.

------
riemannzeta
Fascinated to see that both white AND brown rice are more insulinogenic than
white pasta.

That's one for the Mediterranean diet.

------
sleepysysadmin
Carbs cause diabetes. [https://www.diabetes.co.uk/reversing-
diabetes.html](https://www.diabetes.co.uk/reversing-diabetes.html)

~~~
sodosopa
That's Type 2 diabetes, which is misnamed since it's a completely different
than Type 1 which honestly affects more people.

~~~
sleepysysadmin
[https://www.diabetes.co.uk/diet-for-
type1-diabetes.html](https://www.diabetes.co.uk/diet-for-type1-diabetes.html)

You cant reverse type1 but if you cut carbs from your diet with type1 your
diabetes stops being a problem.

Plus, type 1 is fairly rare. >90% of diabetes is type2.

~~~
sodosopa
> if you cut carbs from your diet with type1 your diabetes stops being a
> problem.

Look up "dawn syndrome". Your body sometimes works against this idea.

