Richardson S, Hirsch JS, Narasimhan M, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020;323(20):2052–2059. doi:10.1001/jama.2020.6775
10:52 Insulin resistance is the single most common health disorder in the country. The US does not lead the world in insulin resistance.
11:30 Insulin is a hormone that elicits actions in every cell of your body. Every cell has an insulin receptor.
12:12 Fat cells will divide, rather than become insulin resistant. Muscle becomes insulin resistant. Liver cells have selective insulin resistance.
13:15 Chronic insulin resistance is not solely based upon insulin. A cell constantly inundated with insulin will become resistant to the insulin.
15:30 88% of Americans have at least one aspect of metabolic syndrome. About 12 percent of Americans are metabolically healthy. Middle Eastern and North African countries have higher rates.
16:30 The 5 aspects of metabolic syndrome/insulin resistance syndrome: high glucose, high waist circumference, high blood pressure, low HDL, and high triglycerides.
18:21. A skinny person could have a build up of lipids around their organs. Some people can be healthy on a high unrefined carb diet
19:30 If your HDL to Triglyceride ratio is 1.5 or greater, you are insulin resistant, even if you feel and look lean
23:25 Low glucose does not mean low insulin. Glucose and insulin measures are not the same thing and are not always coupled. Diabetes is an insulin disease, not a glucose disease.
24:21 Bumping up insulin with drugs (insulin therapy) lowers glucose, but forces beta cells to make more insulin. In diabetics, this means they are twice as likely to die from cancer, 3 times more likely to die from heart disease and twice as likely to die of Alzheimer’s. It is never better to lower glucose by making insulin higher.
26:08 You only need supplementary insulin if you are a true tested type 1 diabetic. Insulin is still prescribed for type 2 diabetics.
26:35 Metformin is a GLP1 agonist. GLP1 is an insulin secretagogue, inducing insulin release. Metformin also mimics glucagon, stimulating brown fat activation, which may offset some of the effects of bumping insulin higher. Side effects are minimal and it does increase insulin sensitivity without increasing insulin.
28:14 Insulin deficiency is uncommon in type 2 diabetics.
31:45 Studies fail to acknowledge the complexity of the whole organism.
33:51 Ceramides, a type of fat, directly antagonize insulin signaling. Ceramides block a cells response to insulin.
34:30 Ceramides are made from palmitate, an abundant saturated fat. Palmitate is made by the liver when insulin is high.
34:55 An inflammation cascade is necessary to take palmitate and place it in the pathway of ceramide biosynthesis.
35:25 Insulin lowers more on a low carb diet than any other intervention.
36:59 EPA and DHA levels indicate nutritional status. Some seeds, like chia and flax, contain alpha linolenic acid (ALA), which has little ability to convert to biologically relevant forms of EPA and DHA.
37:55 ALA/ alpha linolenic acid is the most oxidized and thus the most ketogenic of all the long chain fats, rapidly converting to ketones to be used in the brain as fuel. The shorter the fat chain gets, the more readily it is burned. MCT probably burns faster than ALA.
39:24 Flax and chia seeds, not the oil, has a place in the diet, especially for children. They need ketones for brain development.
41:18 Iodine is added to conventional table salt in larger amounts than is found in more gourmet salts. Thyroid hormone is needed for ample brain function. Inadequate thyroid hormone in a fetus or child causes catastrophic mental consequences that cannot be repaired.
43:12 One meal a day fasting can lead to over eating, keeping heartrate and breathing higher. Chronically elevated insulin induces insulin resistance. One insulin spike in a day may not lead to this.
47:14 Hormones dictate energy use in the body.
50:10 Metabolic rate is the sum of every chemical reaction that happens in the body. Insulin slows metabolic rate and ketones, influenced by hormones, speed metabolic rate.
54:55 Insulin inhibits aromatase in the ovaries. Aromatase converts androgens like testosterone into the family of estrogens. Men use less estrogen than women.
55:31 Insulin is at the root of PCOS. Insulin blocks the estrogen/estradiol spike needed to facilitate the ovulation of an egg from an ovary. When ovulation does not happen, the eggs build up. They are cysts, fluid filled little sacks, that can cause the swelling of ovaries.
58:27 The male erection requires vasodilation; capillaries must expand and increase blood flow. Insulin facilitates vasodilation through nitric oxide. In ED, capillaries have become insulin resistant and insulin cannot make as much nitric oxide to induce dilation.
59:48 You cannot have insulin resistance without hyperinsulinemia.
01:02:36 Decades before Alzheimer’s is detected clinically, there is a detectible brain/glucose hypometabolism. It is an energy deficiency in the brain. This is also true of migraines and epilepsy.
01:04:10 In Dr. Bikman’s study of healthy vs Alzheimer post mortem brains, every gene in the demented brain of glucose uptake and glycolysis was significantly lower than the healthy brain.
01:09:00 Studies are showing that the failing heart uses more ketones for fuel. Ketones induce a more forceful contraction of the heart.
01:19:20 Fat cells are among the highest expressors of ACE2. It is suspected that the ACE2 protein facilitates the COVID19 virus infection of cells.
01:21:11 Adipocytes make more of this PIA than any other cell in the body. Plasminogen activator inhibitor (PAI) is an implicated protein in a cytokine storm. It blocks blood clot breakdown. Blood clots are thought to be one of the leading causes of mortality with COVID19 infections.
01:27:10 3 Pillars to Reverse/Slow Insulin Resistance: Control carbohydrates, prioritize (animal) protein, and fuel with fat. Include fasting.
01:29:23 Adding fat to protein, helps protein work better.