Thursday, September 22, 2005

Insulin: Fat Storage - Fat Use for Energy

Researchers at the University of California, San Diego (UCSD) School of Medicine have reported in RxPG News that chronically high levels of insulin, as is found in many people with obesity and Type II diabetes, may block specific hormones that trigger energy release into the body. In other words, high insulin levels inhibit the use of body fat for energy in the body.

The researchers found in their studies that high levels of insulin can block stress hormones known as catecholamines, which normally cause the release of cellular energy. Adrenaline is the best known example of a catecholamine. For normal metabolism to occur, the body needs a balanced input of insulin and catecholamines. One of the actions of insulin --, the main energy storage hormone, is to block activation of the protein kinase A (PKA) enzyme. After a meal, insulin levels go up, and the body stores energy primarily as triglycerides, or fat, in adipose tissue to be used later. When energy is needed, catecholamine triggers activation of PKA, and energy is released. But in people with Type II diabetes, the hormonal balance has been thrown off, because the body continues to produce and store more triglyceride instead of breaking down the fat as released energy.

The findings provide additional understanding to the cause and effect occurring when insulin levels are chronically too high. We know that as insulin levels go up and the body loses the ability to effectively use it, so it makes more, bringing insulin levels even higher as the body struggles with what is called insulin resistence. Insulin resistence is a pre-cursor to Type II diabetes.

Overweight and obesity is seen in the vast majority of those with insulin resistence and Type II diabetes due to the chronic storage of fat in the body.

“If insulin levels get too high for too long a time – which happens in many patients with type II diabetes –the normal catecholamine signal that triggers fat breakdown and energy release can be drowned out. This can lead to excessive energy storage in the adipocyte,” said Hupfeld, assistant professor of Medicine in the UCSD Division of Endocrinology and Metabolism and a co-author of the paper. “This may be one reason why chronic obesity and Type II diabetes are often seen together.”

In lay terms, one gets fatter as their ability to effectively use insulin diminishes and their body makes more insulin, thus storing more energy as fat, in an effort to compensate for the insulin resistence. It really is a vicious cycle.

Now while the article continues to say that this data underscores the goal to bring down insulin levels - which I agree with - it fails to fully explore options other than using medications known as insulin sensitizers.

Too often, the medical community is dependent on the thinking that "managing" the problem with drugs is the short and long-term solution. While such an approach may be an effective short-term aid to bring things under control, it fails to address the need to reverse and eliminate the underlying cause of the chronic high insulin - poor diet.

We know from dozens of research studies that reducing carbohydrate, especially refined carbohydrates and sugars, stabilizes insulin levels and reduces the effects of insulin resistence. This is due, in part, to the lower levels of insulin required with less carbohydrate being metabolized to glucose, which in turn stimulates insulin, which in turn (especially when insulin resistence is present) leads to energy storage as fat. So, reducing carbohydrate intake is one effective dietary approach that can improve insulin sensitivity.

There are a number of controlled carbohydrate approaches available - everything from very low carbohydrate diets (Atkins) to moderate controlled carbohydrate diets (Zone) with a number of plans between the two ends of the spectrum of carbohydrate restriction (South Beach). No matter what approach you choose, one thing is important - this is not a short-term, temporary fix. It is something that you will need to follow for the long-term so choosing a plan you can live with for the long-term is key.


  1. Anonymous2:57 PM

    Good, informative post, Regina. Can you imagine for one second if the many powers that be in the food/restaurant industry understood and accepted this notion? And can you imagine if they just made a slight effort to use better ingredients (unrefined products, natural fats) instead of what is currently being injected into what we eat, how close we'd come to possibly fixing this 'diabesity' problem?
    And it would take so little, too.

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  3. I really like your name "controlled carbohydrate" as a way to point out that there are different way to limit carbs for weight loss and nutrition. On my blog I started referring to my own way of eating as "lower carb" because it didn't really fit into what most people would call "low carb".

  4. A few years ago BBC2 showed a series of programmes called “The Truth About Food” and I learnt about some Danish research which throws light on fat retention. – See where you will read: "a high calcium intake increases the excretion of fat in the faeces". – The researchers found that twice as much fat was excreted on a high calcium intake as on a low calcium intake – and this was independent of calorie intake. – They also found that dairy calcium (they suggest low fat yoghurt) is a particularly good source for this extra calcium.

    On one of the links - - from the BBC The Truth About Food site, it says: "Calcium is the mineral most likely to be deficient in the average diet. Let me repeat that. Calcium is the mineral most likely to be deficient in the average diet. Calcium deficiency is a condition in which we fail to receive or to metabolize an adequate supply of Calcium," and also: "Calcium helps keep the weight off. Research suggests that if you don't get enough calcium in your diet, you're likely to be overweight."

    There are a number of reasons that overweight people in particular tend to be deficient in calcium. The main reason is that sodium retention/salt sensitivity/fluid retention depletes the body of calcium.

    Here are two other very simple reasons:

    1. Most fat people are ‘dieting’ most of the time – i.e. they are eating insufficient food for their body’s needs.

    2. Fat people are routinely advised to limit their intake of dairy food like milk because their advisors (wrongly) believe that milk is ‘fattening’.

    So to reduce fat retention, if it is present, the most important thing is to alter the diet to reduce the fluid retention which is the initiating cause of excess weight and the primary reason for fat people being short of calcium and for fat people ‘dieting’. That means reducing sodium intake and ensuring plenty of fruit and vegetables in the diet (because their high potassium content helps to displace sodium from the body).

    And specifically it also means having a higher intake of calcium, especially, if possible, from a dairy source like low fat yoghurt. – It is also necessary to ensure sufficient vitamin D intake, as this is needed to metabolise the calcium. Insufficiency of vitamin D is quite common, as is widely reported, e.g. here -