Even if you consume zero glucose, you will still have a blood glucose level (so you’ll have some level of glucose in your blood) – your body makes it
The body can make it from amino acids (i.e. from protein)
Note from Podcast Notes – This is why you can’t eat high levels of protein and stay in ketosis (the state in which your body runs on fat). If you eat protein, it will be converted to glucose, which the body would then use for fuel.
Or from fatty acids (it’s a side effect of ketone production)
Note from Podcast Notes – This is talked about more in this blog post from Peter. Check out the graph. Even after someone has been fasting for 40 days, they still have a blood glucose level.
Biochemistry: 6-membered ring
When you eat glucose, ghrelin levels (the hunger hormone) drop
This enzyme works to keep blood pressure down by dilating blood vessels (makes them larger – called vasodilation)
Rob’s group has found that with every 10% increase in fructose consumption, your blood pressure will rise by 2 millimeters of mercury consistently – this also increases your risk of stroke by 10 percent
Summary – as fructose consumption ^, uric acid levels ^, blood pressure ^, risk of stroke ^
ALT goes up when your liver stores fat – it’s a biomarker for the degree of liver fat
Rob likes to see results for his patients below 25, Peter wants ALT in his patients below 20
Is there something that fructose does better than glucose?
It replenishes liver glycogen (glycogen is stored sugar) (note – not muscle glycogen) stores quicker
This is useful if you’re a high level endurance athlete in a race – that’s why they drink something like Gatorade (it’s filled with sugar/fructose)
But Peter has a good argument – “The limit to performance is not liver glycogen, it’s muscle glycogen”
Drinking a sports drink does not replenish muscle glycogen faster
Epigenetics, Nutrition, and Neurotransmitters
It’s known that animals that are stressed, or animals that consume large amounts of sugar during pregnancy, end up with offspring that will manifest various aspects of metabolic syndrome later on in life
“Metabolic syndrome is a cluster of conditions — increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels — that occur together, increasing your risk of heart disease, stroke and diabetes.” from here
So ….maternal hyperglycemia (high blood sugar – caused by eating a diet high in sugar) will have an effect on offspring genes (in a negative way)
de novo lipogenesis (DNL) – the process of turning the sugar you eat into stored body fat
This has risen steadily on average for many people over the last few years, as sugar makes up a larger and larger % of the human diet
This is the driver for the development of NAFLD
There are 2 ways to clear the liver fat
Fatty acid oxidation
Export – a VLDL particle carries it out of the liver
The one aspect of metabolic syndrome that everyone agrees upon is insulin resistance
Where does the insulin resistance come from?
One way – You get fat, your fat cells make cytokines (inflammatory molecules), which then go to the liver and cause it to be dysfunctional, hepatic glucose output (HGO) is increased – this causes beta cells to overproduce insulin, which results in insulin resistance
So the cause is cytokines from subcutaneous fat (fat under the skin)
HGO is when the liver shuttles stored glucose out into the blood stream. This is useful during exercise, for example, so you have energy. But the stored glucose isn’t needed, it’s problematic.
Another way – Chronic stress increases cortisol (the stress hormone), which increases visceral fat (fat around your organs)
So the cause is cytokines from visceral fat
Cortisol drives visceral fat accumulation
The last way – sugar consumption
Our body produces cytokines when we consume sugar
Some side notes…
Muscle’s don’t need insulin to import glucose
Insulin works to import amino acids into muscles though – to aid in muscle growth
What are the actual mechanisms that links metabolic syndrome, insulin resistance, fatty liver, and type 2 diabetes?
Once you have metabolic syndrome from one of the 3 causes above…
You’ll be insulin resistant from either the cytokines (from the subcutaneous or visceral fat, or sugar)
You’ll have increased hepatic glucose output (HGO) – so your serum glucose is increased
Your beta cells has to make extra insulin (to shuttle that glucose into cells) causing you to be further insulin resistant
So there’s really no off switch for the insulin production…and insulin levels are always high
Some other effects of prolonged high insulin levels