
A theory on how insulin resistance, metabolic disease begin - mishkovski
http://medicalxpress.com/news/2016-09-theory-insulin-resistance-metabolic-disease.html
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Declanomous
My capstone project was actually about how sugar affects metabolism. There is
a lot of interesting research and unexpected interactions in this area.

One of the things that is most interesting is that they have found the same
proteins that form our taste buds in the walls of our small intestine. It
appears that the gut "tastes" food and "tells" the body what kind of food is
coming and how to prepare for it. One of these pathways ends up producing
insulin.

The interesting thing when it comes to sugar is that sweetness is not directly
correlated with caloric content (or glycemic index, which is the measure of
the sugar insulin actually works on). An obvious example are artificial
sugars, which taste incredibly sweet and have zero calories. Natural sugars
vary in sweetness as well though - using sucrose/table sugar as a baseline,
fructose is 1.73 times sweeter for its caloric content. Furthermore, fructose
a glycemic index of 19, compared to 55 for table sugar.

This is really interesting because body regulates hormone levels with feedback
loops. So, if the taste buds in your gut taste sweetness and initially trigger
a release of insulin that would be appropriate for table sugar, you could have
5 times more insulin floating around in your blood stream than your body was
expecting. This might trigger some of these sugar taste buds to stop sending
the signal to release insulin when they taste sweetness.

Worst case scenario is when someone drinks a diet pop on an empty stomach. All
of the sudden there is the HUGE burst of sweetness, with no sugar in the
bloodstream for the insulin to bind to.

This might seem very speculative, but there is some physical evidence that the
body actually behaves this way. When a gastric bypass is preformed, a length
of the small intestine closest to the stomach is removed. This section would
have the most deactivated "taste buds", since it would be receiving the full
load of unabsorbed sugars from the stomach. "Taste buds" further down the
small intestine would not be deactivated because they haven't been triggering
falsely.

Indeed, after the surgery, people appear to lose weight much faster than
expected based on their previous metabolic rate, and their diabetic symptoms
decrease far more than expected as well.

The question I get asked the most after talking about this is whether it's
better to drink diet pop or normal pop. Unfortunately, it appears the best
thing to do is to not drink pop at all. Limiting your sugar intake is a good
idea for a lot of reasons, and soda is just far too sweet and/or too sugary to
be healthy as a regular part of your diet.

~~~
e40
Interesting. What do you think about sugarless gum? I chew it because it helps
with my acid reflux. I'm wondering if it might cause a spike in insulin, like
diet soda would.

I guess one good thing is I usually chew it after a meal, but I do
occasionally chew on an empty stomach if I'm having trouble burping.

~~~
akiselev
The amount of artificial sweetener in a can of diet soda is going to weigh an
order of magnitude more than your one piece of gum (which is mostly made of an
undisgestible polymer anyway, with very little in the way of actual
flavorings). You might as well dissolve a packet of splenda in an eye dropper
and take a few drops.

~~~
credit_guy
I understand the GP's comment a bit differently. What matters is how much the
taste buds are stimulated, not the amount of artificial sweeteners. If that is
true, the sugarless chewing gum is many many times worse than the diet soda.
The drink passes through your mouth in a few seconds, the gum stays in contact
with your tong for half an hour (or more).

~~~
Declanomous
Ah, I see. I guess I've been unclear. The taste buds in your mouth don't cause
the insulin response. There are separate taste buds embedded in the wall of
your small intestine that activate the insulin response, and play a role in
insulin resistance.

On a somewhat related note, my non-expert opinion is that sugarless gum is
probably still better for you than gum with actual sugar in it for reasons
relating to oral heath.

~~~
e40
Thanks for the clarification. Much clearer now.

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slyrus
And here's the link to the paper itself:
[http://www.jci.org/articles/view/81993](http://www.jci.org/articles/view/81993)

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mishkovski
I think this is the most interesting point:

>The new findings suggest fatty liver disease may be a red herring, Herman
said. The likely cause of insulin resistance may not be the buildup of fat in
the liver, as commonly believed, but rather the processes activated by ChREBP,
which may then contribute to the development of both fatty liver and increased
glucose production.

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phkahler
>> If we can develop drugs to target this process, this may be a way to
prevent the process early in the development of the disease

Always gotta come up with a new drug. Why not just eat a diet with no added
sugar?

~~~
jamroom
There's no money in eating less sugar.

These pharmaceutical companies are interested in one thing - making money, and
therefore they need everyone to be a "customer" by taking one of their pills
every day. This means even if there are simple (i.e. non patent-able)
solutions to health problems, you won't see them pushing it - instead you'll
see them ACTIVELY work to prevent it.

A good example is the recent case where these companies have spent $880
million in the last 10 years working against marijuana legalization, even
though studies are showing that it can work as a good pain killer replacement
for the more deadly opioids that they are eager to hand out.

See:
[http://bigstory.ap.org/article/4d69f4b41cbc475ca42f424524003...](http://bigstory.ap.org/article/4d69f4b41cbc475ca42f424524003d21/drugmakers-
fought-state-opioid-limits-amid-crisis)

~~~
moosey
While I can agree that the blame for continued marijuana criminalization falls
to some extent with pharma companies, I don't think that I can 100% agree with
the sugar aspect.

If pharma develops a pill for this it's because people want to eat sugar. This
will be the same for pills that eliminate hangovers (should they exist), why
not just quit drinking?

Simple answer is that people want to do these things, and neither should be
criminalized, nor should marijuana be criminalized. Eliminating the side-
effects of these products will probably be dangerous (with even more side-
effects, but different ones), but I guarantee that there will still be a
market for them -- especially if people can eat and drink what they want and
avoid obesity, even at the cost of other aspects of their health.

I really dislike pharma for attempting to continue criminalizing things like
marijuana and kratom, but to apply the same logic to a pill that keeps people
from gaining weight or avoiding diabetes while eating what they want is an
entirely separate issue ethically and logically.

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__d__
What about people who eat high fruit and blame diabetes on fat intake? Can
someone elaborate? These two individuals are crushing more than 30 fruits a
day with high glycemic loads

[http://www.mangomannutrition.com/](http://www.mangomannutrition.com/)

[http://mindfuldiabetic.com/coaching/](http://mindfuldiabetic.com/coaching/)

~~~
pixl97
They are probably wrong about the fat causing problems...

That said, if they are eating raw, whole, fruits with most of their fiber
intact (and from the look of their site, they are) they are reducing the
glycemic index of the foods they eat.

Many processed foods are bad, not simply because they are processed, but that
a massive amount of the fiber in the original food is removed. Fiber is a
glycemic moderator, foods with high fibers have lower glycemic indexes. For
example if you juice an orange, you've pretty much made kool-aid, it's junk
food now. If you instead try to eat as many oranges in a glass of orange juice
you would feel full before you finished and consumed a lower amount of
calories because of that.

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anu7df
Does this mean insulin resistance can be partially mitigated by switching to
glucose and avoiding fructose completely?

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0xcde4c3db
tl; dr: A mouse study (corroborated by _in vitro_ experiments with human liver
tissue) found that a liver signaling protein, ChREBP, is activated by fructose
consumption and causes the liver to produce glucose in a way that isn't shut
down by high insulin levels. IMO this is not so much a "new theory" as an
insight into the behavior of a particular pathway that would be part of a
theory.

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debacle
The only misleading word here is "new."

Edit: Thanks admins for fixing.

~~~
echelon
I haven't heard of ChREBP before. Is it something that has been well known in
the research community for awhile? Has there been consensus as to its role in
the disease pathway, or is it recent?

(I took two semesters of immunology in my biochem undergrad--courses that I
would have expected to cover this. I was never exposed to literature or
material on this protein. I also haven't heard of it in the primary literature
I do occasionally still read.)

~~~
debacle
The most major finding, which appears to be this:

> The study found that fructose initiates a process that causes the liver to
> keep making glucose and raising blood glucose levels, even as insulin tries
> to keep glucose production in check.

Is not ground-breaking. It's how the liver metabolizes fructose. The liver
can't respond to insulin because it _needs_ to metabolize the fructose.

~~~
echelon
I don't think that's fair. This is just a press publication; we'd need the
actual paper to see what its specific claims are. Besides, very little in
science is "ground-breaking" at first. Scientific progress happens most often
through an accumulation of evidence over time.

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dogdutyascetic
The connection to the consumption of animal products to diabetes is rarely the
focus but we know there is a big connection. Consider Kempner's Rice Diet
which used sugar to successfully treat diabetes! So I doubt sugar is a
sufficient condition. This is politics not science.

~~~
oldmanjay
I've never heard of a connection between consuming animal products and
diabetes. Perhaps you can expand on this.

~~~
kefka
I recognize the text pattern from before. Pretty sure I've dealt with this
user before, on articles about Diabetes.

In the end, it's a whole lot of breathlessness about veganism will "fix
diabetes". Of course, no citations, or cited articles that are completely
180deg out of phase.

I know what worked for me, was a form of Atkins diet (extremely low
carbohydrate diet) backed up with my glucometer. I plot trends of foods, and
how they respond to me. My limit is 140mG/dL, where we know neurons in agar
petri dish die.

Yes, my diet consists of a lot more meats, veggies, cheese, some nuts, some
'dryer' fruits. But no bread, rice, sugar, or things that cause my body to
rise.

~~~
debacle
What fruits do you allow yourself to eat? I've cut out fruits entirely and
miss them greatly.

~~~
kefka
My experience is, I can still have: blueberries, raspberries, blackberries,
strawberries (well, some), a little bit of apple (we're talking about
splitting a tart apple half with wife), and some grapes.

It's not 100% true, but the more tart, the better in terms of sugars. More
fiber also helps slow down absorption... But 10g fructose = 10g fructose, no
matter what else you put with it.

EDIT: I figured these out the hard way. Go get a cheap glucometer. ReliOn
brand is good at Wal-Mart. $25 meter, 9$/50 strips. And eat foods you like.
Test before you eat, and 1/2 hour increments afterwards for 2 hours. Wash-
rinse-repeat :) Make your own decisions based on your own health data.

