Comment by acconrad | Hacker News Reader

Comment by acconrad | Hacker News Reader

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This is at best incomplete, armchair science, and at worst dangerous. The founders are all entrepreneurs / engineers, which is to say they don't have a medical degree or any expertise in biochemistry, so their argument is on the whole just skewed to deliver the argument that suits them - which is, "can I stuff enough kale in my mouth to slow down the release of insulin, and therefore reduce blood glucose".

Here's a few other things that reducing insulin does:

1. Decreases amino acid uptake

2. Decreases potassium uptake

3. Reduces brain insulin signaling, reducing control of energy homeostatis.

Insulin, in isolation, isn't bad. It helps increase muscle and improves cognition. What is bad is the way it fluctuates in the body and the ability for the body to regulate glucose and insulin efficiently. It's perfectly normal for a healthy individual to have a blood glucose reading of 140-150 after a carb-heavy meal. The key is how long does it take for their glucose to reduce back down to healthy levels (70-100). If it's 2 hours or less, you're fine. If it's longer than that, now you've got issues. Even then, acute blood glucose levels can vary wildly from individual to individual, particularly if they're on a ketogenic diet low in carbs, and that may report actually higher than normal (because you're constantly looking to the body to make glucose instead of food, so basal levels must remain higher).

Fear not glucose and insulin. Fear insulin resistance and glucose intolerance.

So getting back to the title of the article, the more practical way of making Five Guys less fattening is not to surround a burger in a basket of kale in your stomach, but to either (A) not eat the burger in the first place or (B) improve your insulin resistance/glucose tolerance. All that the article's experiment would do (in reality) is reduce your desire to eat a burger because your stomach is filled with kale - slow or fast, your body still had to break down and consume that burger. But if you exercise, eat right most of the time, and keep your vices in moderation, your improved lipid profile, fasting insulin, fasting glucose (and A1C), and insulin resistance/glucose tolerance will allow you to more efficiently process that burger so it is not as taxing on your body as it would be if you were not as healthy.

Thanks for your comment, Aaron. I will address your points in order.

You start by questioning the background and motives of my colleagues. While I have thoughts on how to respond to this, I choose to stick to discussing the facts.

Then you represent the goal of my experiment in the following way: “can I stuff enough kale in my mouth to slow down the release of insulin, and therefore reduce glucose.” This is not accurate. My goal was to see if I could influence my digestive system to release glucose into the blood more gradually so as to minimize insulin signaling to fat cells. More explicitly, the amount of glucose is about the same in the two meals; it was the amount of insulin signaling by my body that changed.

I will add additional detail that I do not mention in my blog post. Cells that have high need for glucose do not need much insulin signaling. In response to their need, they already have placed more glucose transporters on their cell membrane. Gratuitous insulin signaling causes fat cells to absorb glucose that could have been absorbed by a high-need muscle cell.

Then you say, “Here’s a few other things that reducing insulin does....” From your wording, particularly in your use of “other,” you seem to agree that less insulin signaling means less fat cell growth and that your concern is primarily with its “side effects.” I will address amino acids and potassium in a later post. For now, I will address your point about brain signaling.

Actually, too much insulin signaling interferes with leptin signaling, making you respond less to leptin signaling. Leptin is the satiety hormone that is released by your fat cells. The neurons in your hypothalamus that have receptors for insulin also have receptors for leptin, and unfortunately for us, they have commonalities in their signal transduction pathways. So a lot of insulin signaling interferes with leptin signaling. This makes leptin signaling less effective and makes you want to eat more in spite of having enough body fat. (See the paper, “The First Law of Thermodynamics Revisited” by Robert Lustig of UCSF.)

You state firmly, “Fear not glucose and insulin. Fear insulin resistance and glucose intolerance.” You do not state however how you would advise someone to avoid insulin resistance and glucose intolerance. My view is that slowing down the digestion rate of your meals, such as I have done here, is part of the strategy for doing so.

Unfortunately, I have to run now, but I will address your remaining points later. I am also happy to write another blog post with ample references to primary research literature.

Re: your comment on HbA1c, I will just leave this paper here and comment later.

"A Simple Meal Plan of 'Eating Vegetable Before Carbohydrate' Was More Effective For Achieving Glycemic Control than an Exchange-based Meal Plan in Japanese Patients with Type 2 Diabetes"

http://search.informit.com.au/documentSummary;dn=12049472055...

Statement: “... slow or fast, your body still had to break down and consume that burger.”

Response: You are saying that the digestion rate of the burger doesn’t matter, because the entire burger is still processed by the body. But the way your body processes the burger is different depending on the digestion rate.

A couple of things can happen after a given amount of glucose enters the digestive system.

Consider when the digestive system releases the glucose into the blood rapidly, much more rapidly than cells are able to absorb it. The pancreas releases a lot of insulin. Muscle and fat cells both significantly increase their blood glucose absorption rate.

Alternatively, consider when the digestive system releases the glucose into the blood gradually. Cells are able to absorb more of the blood glucose as it is coming in, so blood glucose levels do not rise as much. There is some insulin signaling, but there is less of it. High-need muscle cells already have increased their blood glucose absorption rate due to increased energy requirements, while insulin signaling to fat cells is minimized.

In the alternate scenario, high-need cells muscle cells, while fat cell growth is limited.

Statement: "not eat the burger in the first place."

Cutting out something I like is not a sustainable way to eat healthily. Food intake is not just regulated by energy homeostasis; the reward system, e.g. the mesolimbic pathway, is also potent.

Statement: "improve your insulin resistance/glucose tolerance"

Agreed.

There are two ways to avoid excessive insulin signaling. One, you can decrease the rate at which glucose enters the blood. Two, you can increase the rate at which glucose leaves the blood. My article talks about one, and you seem to be an advocate for increasing insulin sensitivity, which is advocating for two. I think most people should do both.

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