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e
Insulin Index –
Hormonal
e Obesity XXIII
By The Fasting Method

Insulin levels had always been assumed to go up or down with the blood glucose levels which led to the
glycemic index which had always been assumed to be a surrogate measure of insulin levels. The
glycemic index did not turn out to be as successful in weight control because glucose does not drive
obesity. Insulin drives obesity. With the insulin index, it was realized that only 23% of the variability of
insulin response depends on the glucose. In other words, how much the glucose increases only
o accounts for 23% of the insulin response. Even taking into account the other macronutrients fat and
protein, this only accounted for another 10% of the insulin response. The vast majority of the insulin
response is still unknown. Some of the factors that are suspected or shown to affect the insulin secretion
e include presence of dietary fibre, an elevated amylose/amylopectin ratio of the starch, preserved
botanical integrity (whole foods), presence of organic acids (fermentation), addition of vinegar (acetic
acid), and addition of chili peppers (capsaicin). We will explore some of these factors in future posts.
e Nevertheless, the main point here is that there are many factors in the co-ingestion of foods that affect
insulin. Things are about to become very complicated.

The simplistic “Carbs make you fat!”, or “Calories make you fat!” or “Red meat makes you fat!” or “Sugar

e makes you fat!” sort of arguments simply are not able to capture the complexity of the human
condition of weight gain. Among breakfast cereals, there is wide variation in the insulin response. All-
Bran, with its high fibre and promise of colonic regularity, seems be stimulate insulin much less than
cornflakes for instance.

e Protein containing foods turn out to be surprisingly potent at stimulating insulin. Beef and fish, for
instance, have virtually no effect on the blood glucose levels. Yet they stimulate insulin almost as much
Help
as most cereals. Nevertheless, we are able to discern some general patterns here. If we look at
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carbohydrates, there is a noticeable trend here. As the total grams of carbs goes up, the insulin level
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tends to go up. This is what we expect. This isContact Us (https://thefastingmethod.com/contact/)
the basis of many low carbohydrate diets from Search
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original Banting dietOur

of the 1850s to the modern day Atkins diet and its many imitators. It has been The Science
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(https://thefastingmethod.com/coaching/) (https://thefastingmetho
recognized for well over a century that the amount of carbohydrates
intermittent-fasting-program/) consumed plays a role in thescience-of-intermittent-
(/)
development of obesity. However, this study indicates that the correlation is far from perfect.

The correlation between carbohydrate content and insulin is relatively low (23%). Dietary fat, on the

e other hand tends to have a lowering effect on insulin scores. As the amount of fat increases, the insulin
score tends to decrease. Fat also tends to have minimal effect on blood glucose, so this is pretty much
as we expected as well. Carbohydrates tend to raise glucose and insulin. Dietary fat tends not to raise
glucose and tends not to raise insulin as well. So far, so good.

The surprise here is dietary protein. Looking at the protein, there seems to be a slight trend here as
drawn by the line. As protein goes up, the insulin score tends to go down. But you can see that this

e relationship is mostly driven by 2 main outliers at the extremely high protein intake levels (40 and 60
grams). If we remove these outliers, then it seems that there really is not much relationship between the
amount of protein and the rise in insulin. Some proteins raise insulin a lot and some proteins raise it

e
only a little. Dairy protein especially whey, seems to be the biggest culprit here. The implication is that
some protein containing foods can lead to obesity while other protein containing foods are not likely to
do so. Here the data become extremely murkily and there are numerous inconsistencies in the
literature.

In the study “The acute effects of four protein meals on insulin, glucose, appetite and energy intake in
lean men” published in the British Journal of Nutrition in 2010, insulin levels were measure in 30 men after
a test meal. Four different proteins were tested – eggs, turkey, fish and whey protein. Whey protein is
e one of the proteins found in dairy. Cow’s milk protein is composed of 80% caseins and only 20% whey.
Casein is mostly responsible for milk allergies. Whey is well known as the byproduct left over in cheese
making. Milk is separated into curds and whey. Whey protein is often used by bodybuilders as it is high
in Branched Chain Amino Acids (BCAA) that are felt to be important in muscle formation. Compared to
the other proteins, whey resulted in the highest insulin levels. This is despite the fact that none of the
proteins had a very large effect on blood glucose. In this study, after the test meal, participants were
given a buffet lunch 4 hours afterwards so that effects of protein on satiety could be measured. The
whey protein suppressed appetite to the largest degree. It is certainly possible that whey protein may
have two different effects on weight gain. The increase in insulin may promote weight gain, but the

o decrease in appetite may suppress it. Again, I will stress that I do not have all the answers here. The
field of study is new and ever evolving at this point. The propensity for dairy to cause insulin to increase
was confirmed in the paper “Glycemia and insulinemia in healthy subjects after lactose equivalent

e meals of milk and other food proteins” published in 2004 in the AJCN. Here the effects of milk and
particularly whey are seen clearly. In fact, the increase in insulin far exceeded even that of whole
wheat bread. The effect on glucose is negligible but the incretin effects of the stomach (release

e
of Glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1)) are felt to
be responsible for the increase in insulin. We discussed the incretin effect in a previous post
(https://thefastingmethod.com/incretin-effect/). The insulin stimulating effect of whey may also be
seen when taken with foods. A recent study in Israel
(http://www.sciencedaily.com/releases/2014/07/140707212746.htm) gave whey protein to type 2

e diabetics after a breakfast of white bread and jelly – a breakfast designed to increase sugars
significantly. Whey protein supplementation reduced blood sugar levels by 28%. The incretin hormones
total and intact GLP-1 increased 141% and 298% suggesting that the increased insulin is largely the
incretin effect. Here’s the problem, though. Blood glucose does not drive weight gain and diabetes.
Increased insulin does. What happens to that blood sugar? It is not removed from the body? It is

e merely shuttled to the liver where it is turned into fat. So, in effect we have removed sugar from the
blood where we can see it, and put it in the liver, where we cannot. Is that good? Hardly The high insulin

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This can Search
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intakes of milk, but not

Ourmeat, increase s-insulin and insulin resistance in 8-year-old boys
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(http://www.nature.com/ejcn/journal/v59/n3/full/1602086a.html)”
intermittent-fasting-program/) published in the European Journal of
science-of-intermittent-
(/)
Clinical Nutrition in 2005.Here they studied eight year old children. Given a test meal of meat or dairy,
the insulin levels were measured. Not surprisingly, the insulin response was higher to the milk. After
seven days of milk versus meat, the milk group started to develop insulin resistance. This is, of course,

e the first step towards the development of type 2 diabetes and a key player in the time dependent
effects of obesity (https://thefastingmethod.com/time-dependence-obesity-hormonal-obesity-xiv/).
The fact that this develops after only 7 days of milk overfeeding is downright scary. This data would
seem to indicate that dairy consumption may lead to weight gain. Is this actually true? The truth, as
usual, is far more nuanced.

Continue here for Hormonal Obesity XXIV – Is Dairy Fattening? (https://thefastingmethod.com/is-dairy-

e fattening/)

Start here with Calories Part I – How Do We Gain Weight? (https://thefastingmethod.com/how-do-we-

e
gain-weight-calories-part-1/)

See the entire lecture – The Aetiology of Obesity 3/6 – Trial by Diet (http://youtu.be/ZbnshVO4PRM)

By The Fasting Method

For many health reasons, losing weight is important. It can improve
your blood sugars, blood pressure and metabolic health, lowering your
risk of heart disease, stroke and cancer. But it’s not easy. That’s where
we can help.

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