Wednesday, January 25, 2012

Blog: War On Insulin

While I appreciate the author's perspective, I would have named the blog differently.  Insulin saves us from neurological damage when blood sugars go too high, and those with no insulin die a cruel wasting death, as insulin is necessary to get vital materials into cells in order to sustain life.  BUT - the fact that the science of the last thirty years has focused so much on fat intake (and dislipidemia) as the cause of disease, and by extension accumulated body fat as the cause of disease, while almost ignoring how necessary insulin is in the accumulation and maintenance of excess body fat, has resulted in a generation of weird science (much of which you and I funded via the NIH). 

So, as blog author Petter Attia says: 
My mission is to demonstrate that insulin — not calories — is at the heart of the most pervasive chronic diseases: obesity, heart disease, and even cancer. Suppressing the secretion of insulin is the key to running your body on your own fat, which leads not only to weight loss, but also to what I call “chronic health” and peak performance.

I think I would pick a minor nit and say it's the excess carb intake - that makes hyperinsulinemia a short term necessity, and a long term death sentence - that's killing us.  You could eliminate the body's ability to generate high insulin output, but if you still ate a high carb "heart healthy whole grain" low fat diet, you'd still be dead from excess blood sugars, and sooner rather than later.

Attia addresses Tara Parker Pope's "The Fat Trap":
I fully agree with Ms. Parker-Pope’s assertion that obesity is categorically not an issue of weak will, and I’m encouraged that she feels a sense of renewed optimism in her own journey.
There were two aspects of this article, however, that disappointed me. First, it focused a great deal on hormones that almost certainly play some role in obesity – leptin, peptide YY, ghrelin – but not once in over 5,000 words was the hormone insulin mentioned.  The reason this disappoints me is not because I fixate on insulin, and therefore assume others should.  It’s because I’m reminded of how confused mainstream nutrition and obesity research is.  All of these other hormones – leptin, peptide YY, ghrelin – are reported to play a role in appetite.  The notion that “the answer” to treating obesity lies in manipulating these hormones suggests folks still think obesity is a disease of over-eating rather than a disorder of abnormal fat accumulation.  This distinction is not subtle, as I try to point out in the posts The great medical disconnect and Revisit the causality of obesityIf you believe obesity is caused by overeating then it makes sense to study hormones that govern hunger.  Certainly hunger matters, and a person who is constantly hungry is likely to overeat, but the fact that this article doesn’t even suggest a role for elevated insulin levels strikes me as missing something.

It's more than missing something, the author is trying to be polite.  It's an astonishing oversight.  It's proof that the scientists Mr. Pope counts on in her reporting are off the reservation.  It's an indictment of a generation of scientists who assumed they could reduce human metabolism to the simplicity of a bomb calorimeter and now are completely at a loss for what to try next (except pharmaceutical intervention) - but still have not confronted the reality that they have taken a dead end street. 

Those same scientists who's work is rejected by their failure to either understand or treat obesity are the ones who control much of the funding for research into diet, obesity and health.  Strangely, they don't want to spend much money trying to prove they have been wrong all these years.  Gee, I wonder what to make of that.

If it is sad that someone like Tara Parker-Pope, who has such a potentially potent stage, is still trailing through the scientific boonies with the lost generation of science, the awesome thing is so many people like Peter Attia are on to the "alternative hypothesis".  These folks are treating their patients, and spreading the word, and empowered recipients are recovering their health and their futures.   Their scientific results can be measured in smaller waists, eliminated medines, and by the fact that they look, feel and perform better.  This is science you can do.  Eat meat, vegetables, nuts and seeds, little fruit or starch, no sugar/no wheat.

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