Tuesday, July 21, 2009

How Can Eating Excess Protein Raise Blood Glucose?

It is almost an article of faith among low-carbers that the low-carb lifestyle is able to lower blood glucose values in diabetics and pre-diabetics. It would be logical to assume that the lower the carbohydrate intake, the lower the corresponding blood glucose. But recent observations in a limited sample of people who were doing something very close to zero-carbing suggest that this is not necessarily the case.

Donald K. Layman has done some interesting work on the effect of dietary protein on glycemic control that may help explain this phenomenon. In an article in The Journal of Nutrition, he presents a diagram of the glucose-alanine cycle, which appears in modified form above.

For those who are not familiar with this type of diagram, here is a brief explanation. Ingested protein enters the gut and is digested into amino acids. The amino acids are taken up in the blood and proceed to the liver, where many of them are metabolized. However the branched-chain amino acids leucine, isoleucine and valine are unique. Although they constitute 15-25% of protein intake, they experience very little metabolism in the liver. Most of the branched-chain amino acids, abbreviated BCAA, continue to move through the circulation and are eventually absorbed by muscle cells.

In muscle cells the branched-chain amino acids have two possible fates. First, when branched-chain amino acids enter a muscle cell, they promote protein synthesis. Our muscle tissue is continually undergoing repair, and because of this each of us has an individual daily protein need. If sufficient high-quality protein is consumed, this repair is able to take place without loss of lean muscle tissue.

Second, if there is an excess of amino acids in the muscle cells, the surplus branched-chain amino acids enter the pathway of energy production. In order to do this, they must have their amino group (NH3)removed in a process called transamination. The amino group from a BCAA is transferred to a molecule called alpha-keto-glutarate to form the amino acid glutamate. Next, another transamination transfers the amino group from the glutamate to pyruvate, transforming the pyruvate into the amino acid alanine. The alanine leaves the muscle cell and travels to the liver, where it is turned into pyruvate by removal of the amino group, and then the pyruvate is turned into glucose by gluconeogenesis. The liver sends the newly-synthesized glucose into the blood, where it can be taken up by muscle cells and broken down once again into pyruvate. Each pyruvate is ready to accept another amino group from one of the branched-chain amino acids, and the cycle repeats itself until the branched-chain amino acids have been used up.

The glucose-alanine cycle explains why it is possible to have an elevated blood glucose while eating essentially only meat and fat. Normally, leucine signals the muscle cells to synthesize protein and maintain lean body mass. When an excess of branched-chain amino acids is available, leucine serves as a metabolic signal to muscle cells telling them to upregulate their use of BCAA as a fuel, while simultaneously downregulating their use of glucose as a fuel. Any glucose that appears in the cell is preferentially broken down into pyruvate, which is used to accept excess amino acid nitrogen (NH3 groups) and allow them to be removed them from the cell in the form of alanine. In the liver, the alanine is recycled into glucose, and the glucose is returned to the blood until it is no longer needed to mop up excess NH3 groups in peripheral tissues.

If this pathway is correct, it shows that excess amino acids not only provide the raw materials for glucose synthesis in the liver, but they also require additional glucose synthesis in the liver in order to allow branched-chain amino acids to be converted into energy.

Metabolic regulation is a huge topic, and this post presents only a small piece of it. Once again, please do not modify your lifestyle in accordance with what you read here. In the overall context of a human organism, it may be incomplete or even incorrect. However the glucose-alanine cycle does provide a possible explanation for what some people have seen with regard to a higher-than-normal blood sugar while eating essentially zero carbohydrates.


jimpurdy1943@yahoo.com said...

So, in practical terms, what does this mean for a Type 2 diabetic like me?

I already try to eat a low-carb diet. If I also limit proteins, what does that leave?

A high-fat diet? Avocados drenched in olive oil?

Actually, I'm not being entirely facetious. I sometimes do eat avocados with a little olive oil, and it does seem to help my blood glucose.

Stargazey said...

Hi, Jim! As you noticed, I mentioned that it is important to consume enough high-quality protein to be able to support your daily protein need. Otherwise you will experience gradual muscle wasting.

People who are low-carbing also have to consume enough protein to be able to maintain blood glucose. A person who is fully low-carb-adapted will need about 40 carbs a day to maintain blood glucose. If he eats fewer than that, he will need to subtract that number from 40 and multiply the difference by about 1.7 to get the grams of extra protein he should eat. For instance, if he eats 10 grams of carbs a day, he will need about 30 x 1.7 = 51 extra grams of protein a day. (The exact numbers will vary between a 95 pound model and a 280 pound linebacker, but you get the idea.)

That said, the articles by Donald K. Layman seem to indicate that if a low-carber consumes a large excess of protein, the muscle cells will take any branched-chain amino acids that aren't needed for the two functions mentioned above, and use them for energy. To support this process, the liver will have to perform gluconeogenesis to provide glucose (i.e., pyruvate) to take up the amino groups produced.

In other words, if these ideas are correct, we should be careful to eat enough protein, but not go overboard. And yes, the extra calories would need to come from healthy fat.

Sue said...

Maybe with zero carb you get a higher than normal blood sugar level but that this is normal. Nothing to be concerned about?

Stargazey said...

I can't say for sure, Sue. I do know that high blood glucose can convert proteins in the body to Advanced Glycation Endproducts (AGEs), that accumulate in our eyes, kidneys, arteries, nerve endings, joints and skin, causing stiffening and the physical degeneration of old age. I don't know the level of blood glucose at which these changes start to take place.

Something to consider is that the accumulation of AGEs may be the reason that the explorer Vilhjalmur Stefansson noted in 1936 that Eskimo women who had lived on a zero-carb diet all their lives, "usually seem as old at sixty as our women do at eighty."

Anne H said...

You are so factual and interesting. I just love to learn from your posts. Thank you for taking the time to research, write, and answer posts, Stargazey.

Stargazey said...

Thanks, Anne H. It takes more work than I expected (most of the background reading I do never makes it onto the post), but it's motivating to know that people appreciate it!

Sue, I felt it necessary to delete your comment. We have already had the discussion at ZIOH of what caused the premature aging of the Inuit women. Although Stefansson believed that it had something to do with their all-meat diet, not one of the ZIOH discussants even considered that as a possibility.

If you wish to bring scientific references to document the levels of blood glucose that engender AGE formation, I will consider them. Scientific references that document the levels of blood glucose that permit the growth of cancer (say, throat cancer) will also be considered.

Stargazey said...

Sue, I have rejected a second comment. If you wish to find the ZIOH discussion of premature aging in Inuit women in the early 20th century, I'm sure the Search function at ZIOH will help you.

I have no way of proving or disproving that the Inuit women experienced early aging because of AGE-related causes. A discussion of life in the Arctic in the early 20th century would only contribute speculation, not proof. Instead I would like to encourage my readers to search the scientific literature for indications that a lifetime of slightly-elevated blood sugar will (or will not) produce symptoms of accelerated aging.

mariasol said...

I wouldn't base anything on Stefansson's subjective observation that Inuit women looked older than their age. What did he compare with? Rich women of that time that stayed out of the sun and were dressed fashionably? Or, someone that worked on a farm and had 10 kids?

Btw, did you receive my email with my BG readings? I don't think they are of any use for your data collection but I'd like to know if you received them.

Stargazey said...

Agreed, Mariasol. Stefansson's observations are only subjective observations, not conclusive fact.

As far as the e-mail, no I didn't get it. My Yahoo account is strange about who it accepts and who it doesn't. I've noticed that I can't e-mail myself, for instance.

You could send me the numbers here with a DO NOT PUBLISH note at the top. Or if the Yuku site is still up, you could try a PM through them.

mariasol said...

I'll resend the BG readings tonight. They are on my home computer.
I'll get them to you somehow.

If you want a friendly place to discuss, you and your commenters are welcome to join http://tippingthescalestohealth.com where some of the yuku members went. The forum is "semi-private." Requires registration to read as we don't want our posts to show up in google.

Anne H said...

By the way, my blood sugar always goes up and stay up after I eat 75 to 100 g of protein a day. I feel heavier, too.
I don't test every 15 minutes, but I test before, and 20 minutes after meals, looking for a spike.

Diet drinks never spiked me! Even when they were all I had.

I would love to see your take on MCT's!

dr. m.c. said...

so this is probably way obvious to y'all, but generally speaking, excess protein only gets used as fuel unless there's nothing else available for fuel. it gets stored as fat.

Our bodies will make glycolic fuel out of anything - lactate,fat, protein - on an as-needed basis.

so, i mention this lest folks think oh good if i overeat calories and they're protein i won't gain fat because they get used as fuel first.

And even if there are bcaa's as fuel in the bloodstream, if there isn't an energy requirement for them, they will also get converted into adipose tissue.

Stargazey said...

MC, I agree and disagree with what you've said. Some of it is nitpicking, so here goes.

excess protein only gets used as fuel unless there's nothing else available for fuel.

It appears that excess protein may be used before fat. It is probably not an either/or proposition, but if insulin is elevated at all, the body will be in storage mode and fat will not be mobilized. The fat that has been eaten will also be sent into storage. Once the excess of amino acids has been dealt with (possibly even by conversion of some of it to fat and storage in that form), insulin will fall and the body will be able to call on fat stores for energy.

Other than that, I agree with what you've said. We are used to thinking that we can eat as much as we want to of zero carb foods without gaining weight. It's not necessarily so.

To my readers, please remember that we're talking about an EXCESS of protein intake. A person's daily protein requirement will be used for maintenance and repair of lean muscle and will not be used for energy or to make fat. We're only talking about what the body does when it is presented with significantly more protein than it needs.

Sue said...

You know what Stargazey I'm not looking to your for confirmation I was just discussing.
I know what high BS can do.
You don't need to encourage me to read the scientific literature I already am.
You rejecting my comments doesn't make sense as they were not inflammatory at all.
I am not pro or anti zero carb if that makes any difference.

Stargazey said...

I agree that your comments were not inflammatory at all, Sue. However, if comments are liable to turn the discussion to a direction I would rather avoid, I will delete them. Except for spam comments, I will always tell commenters when I have done so.

Sue said...

Well, why didn't you just say that rather than letting me wonder why you deleted my comments.

rafonly said...

hello stargazey,
you wrote after sue's comment: " if comments are liable to turn the discussion to a direction I would rather avoid, I will delete them. Except for spam comments, I will always tell commenters when I have done so."

i wonder if my 2nd comment on leptin resistance, after i read & appreciated your 2 earlier posts on leptin, in which i asked for more details, was leading your blog in the wrong direction or sounded like spam -- since it never got posted or referred to

thanks & be well

Stargazey said...

I didn't get the second comment on leptin, Rafonly. It may be a glitch in Blogger. One time I commented twice on Jimmy Moore's menu blog and neither comment ever appeared. I made a third, snarkier, comment and that one was accepted, so I assume JM never got the first two.

I'll let everybody know if I'm deleting a comment. If you comment and it doesn't appear in six hours or so (hopefully sooner), try sending it again.

So, if you remember what you wrote, Rafonly, would you send it again and maybe this time Blogger will cooperate.

Stargazey said...

Rafonly, I found one of your posts on the Raw Paleo Forum.

further stargazey's blog mentions those 3 cases of overlyness i mentioned before, albeit relating only 1 of them, namely (current or previous) overweight, to leptin resistance -- but instead of elaborating on it she goes on to talk about too frequent meals as a cause of leptin resistance, which is also a point worth of attention, of course; she recommends to eat slowly to enhance 1's leptin sensitivity (allowing leptin the time it needs to kick in & do its job)

so i asked stargazey about leptin resistance in the case of persons who are over 50 or supertasters; hopefully she'll eventually come up w/ a post on this issue

I'm afraid I don't know any specifics about leptin resistance in people over 50 or supertasters. From the leptin posts I made, there are two likely reasons for leptin resistance:

1. You are eating too many carbs, which have raised your serum triglycerides, which renders your hypothalamus unable to "see" any leptin you may release.

2. You have lost weight and have less body fat available to secrete leptin. In that case you need to give the leptin response system time to reset itself between meals so that it can maximally respond to the leptin you do produce. Five to six hours should be enough time for the reset, but if you are eating more than a moderate amount of protein, defined here, your insulin may stay elevated longer and increase the time it takes for the leptin response system to reset itself.

Amber said...

I used the protein calculator when you posted it elsewhere. When I did I got a massive number off 200g+! This seems very high! Is that what others are getting?

Stargazey said...

Mine was 115, Amber, and that's a little high, but not much.

1. Take your weight in pounds and divide by 2.2. (If you're quite sedentary, divide your weight by 2.75.)

2. Take the number of carbs you eat per day and subtract it from 40. Multiply that number by 1.7. (If it's a negative number, just use zero.)

Add #1 and #2 and you should get a ballpark number for your daily protein need.

Amber said...

If I use the calculator posted and say I have been on the diet/plan for less then 3 weeks it says I need 226g of protein. I think this is where I went wrong. Thanks for the help!

Stargazey said...

You're welcome! Another thing that's important, if you're also looking at the suggested calories, is Sedentary with Metabolic Advantage versus Sedentary. According to Jenny, when you've been on low-carb a long time, the metabolic advantage goes away because your body becomes super-efficient at doing low-carb. That has been my experience, too, (but I don't have any scientific studies to back that up).

Amber said...

bummer ;-(

Vickie Ewell said...

I suppose the normalness or danger of continuous higher glucose levels (baseline and/or fasting levels) would depend upon just how high those glucose levels are. And whether or not one is personally suffering physical damage as a result.

Under the research studies regarding organ damage section of the Bloodsugar101.com website, studies show that in normal folks (not diabetic or even pre-diabetics) beta cell dysfunction can begin at levels just above 100 mg/dl. And that risk of death from stroke jumps from 0 at 83 mg/dl to 27% at 101 mg/dl -- 2 hrs post-meal.

Since a lot of pre-diabetes and diabetes goes undiagnosed due to current day definitions, and since diabetic complications often begin before diagnosis, in my own opinion, glucose elevation above 100 mg/dl at 2 hrs post-meal "is" something to be concerned about.

Stargazey said...

Well put, Vickie. I have been reading at Bloodsugar101 and reading Dr. Bernstein's Diabetes Solution as well. It may be similar to Bear's example of cigarette smoking. Smoke a little (slightly elevated blood sugar) or smoke a lot (blood sugar in the 300's and 400's), the consequences are probably coming somewhere down the road. Some people will escape them altogether, like the smoker who just died at 113, but depending on the person, the possibility of peripheral neuropathy, kidney damage and retinal damage are side effects to consider carefully.

Unknown said...

so, in terms of raising blood glucose level there is no difference between carbs and protein? or the difference is rather qualitative that quantitative? let's say, there is a meal of carbs and a meal of protein worth 2000 calories, and I can't help eating it at once - to choose the lesser evil should I go with a carb or with a protein one?

Stargazey said...

Hi, GN! There is quite a bit of difference between carbs and protein in terms of raising blood glucose level.

Dr. Richard Bernstein is a type 1 diabetic, so he makes no insulin at all. He must measure out his injected insulin very carefully depending on what he eats. For Dr. Bernstein:
--1 gram of carbs produces a 2 mg/dl increase in blood glucose.
--7 grams of lean protein produces a 2 mg/dl increase in blood glucose.

But Dr. Bernstein eats only small amounts of carbs and moderate amounts of protein.

If you ate 2000 calories of lean protein (about 20 powdered protein shakes), that would be 500 grams of protein, or about 3-6 times what a normal low-carber would need in a day. It might take all day, but your liver is theoretically capable of turning about 1200 of those calories into glucose. Any remaining excess could be turned into ketones and used for energy.

If you ate 2000 calories of carbs your blood glucose would go up, come back down and you'd be hungry for more carbs.

So neither is a particularly good choice.

Unknown said...

Stargazey, thanks for a reply.
On some days,like today, I eat no carbs (plants) whatsoever but I'm worrying that I consume more food than I need to. Like this morning I ate almost 1 kg. of chicken liver (with red pepper), and in the evening (I eat only twice a day) I plan to eat 500 gr. of salmon - is it way too much for a 5'7'' male?

Stargazey said...

GN, would you consider measuring your blood glucose just before you eat, an hour after you started eating and two hours after you started eating? If your body can deal with all that protein without turning it into glucose, well and good. But if it is elevating your blood sugars, you know that adjustments need to be made.

When we first start low-carbing the thought of eating lots of fish, chicken and beef is often somewhat repulsive. But after we get used to the idea of eating just a few carbs (or even no carbs) with moderate protein and healthy fat, it may be that our "satisfactometers" don't tell us we are full until after we have eaten too much.

Unknown said...

thanks for enlighting the subject of intrrchangabilty betweem carb and protein and creating high suger content in the blood without consuming carbs. its easy to see that the basic skeleton of some AA' ARE SIMILAR TO HALF MOLECULE OF GLUCOSE.


miki arbel

Cosmo's human said...

I am a Type II on Lantus (45u qhs), Humalog (sliding scale usually 0-2u) and SymlinPen (120mcg). I am on a high protein low carb diet. I drink 3-5 Nectar brand shakes, have a 6 egg white/1 yolk omlette and applesauce or other small fruit for breakfast. Dinner is: fish or chicken plus veggies and a small fruit for dinner. I am lowering my A1C and losing lots of weight. I have 50# more to go. The shakes have 23g protein, no carbs or sugar. I try real hard to stay less than 40-50 carbs a day. I know I can't do this the rest of my life, but am trying real hard to get healthy. Am I killing myself???

Stargazey said...

Cosmo's human--thanks for your comment! I am not a physician (just a biochemist), so I can't make an intelligent evaluation to know if you're killing yourself or not. :-)

Does your doctor know you're doing low-carb? He/she might be able to give you some guidance. If you haven't already read Dr. Bernstein's Diabetes Solution, that might also give you some insight. Usually low-carb is high-fat and moderate-protein, but if your blood glucose and A1c are good, the low-fat/high-protein version might work for you. Unfortunately my training is in research, not clinical work, so I can't do much except make suggestions.

Danny Roddy said...

I love your blog Stargazey!

Diana said...

"--1 gram of carbs produces a 2 mg/dl increase in blood glucose.
--7 grams of lean protein produces a 2 mg/dl increase in blood glucose."

Didn't Dr. Berstein say that 1 gram of carbs produces 5 mg/dL increase is blood glucose?

Stargazey said...

Good observation, Diana! On page 291 of Diabetes Solution it does say that 1 gram of carbohydrate raises blood sugar 5 mg/dl.

I think that at the time I wrote the material you quoted, I belonged to Dr. Bernstein's website and found that information there. I assumed (perhaps incorrectly) that it was more correct than the figure in the book. Unfortunately I didn't write down the citation and I can't find it on Google, so please go with whichever figure works best for you.

Diana said...

I did some further reading and found that the increase in blood glucose in response to carbs varies with the weight of the person consuming them.

Raquel said...

Hello, thanks very much for this blog, I have only just come across it half way through writing some coursework (nutrition course)and would value some input regarding excess protein/amino acids being a waste of metabolic energy. My course teaches me that because of the body having to get rid of the excess nitrogen by converting it to ammonia, and then excreting it through urea, consuming more than you need just gives your body more work. Do you agree with that? If you would rather not publish this as it goes off-topic slightly I would appreciate an email if that is possible. Rach (sorry if you get this twice, I'm not sure it went the first time)

Stargazey said...

Hi, Raquel. I did get your first comment but am not publishing it because it contains your e-mail address. (Blogger doesn't let me edit comments--I can only accept or reject them as-is.)

Anyway, and this is only my personal opinion, eating excess protein is not really a problem except for the few people who have kidney damage. For everybody else, the body is well able to metabolize excess protein into carbohydrate, fat or ketone bodies. If you think about it, it would have been maladaptive if our hunter-gatherer ancestors had needed to be careful about eating excess protein. If they happened to kill an elk or bison, limits on protein would have meant that they would have needed to leave valuable food uneaten. Under non-starvation conditions a healthy body doesn't really concern itself with more work or less work because metabolic pathways are incredibly flexible.

The body "wastes" energy all the time. (Look up "futile cycle" for an example.) There are lots of things to worry about in this world, but wasting energy by eating too much protein is really not one of them.

diff said...

Stargazey, I have just found your blog and am impressed and appreciative.

I am a type 1 diabetic (39 y.o., diagnosed at 17 years).

I have recently started a low-carb diet, more by deductive-reasoning than anything else, but since starting have found Dr. Bernstein's blog and ordered both his books (haven't recieved them yet).

When I started eating much less carbs (first cut out the sandwiches, then lots of other carbs, now eat about 50g a day, also very physically active), I was taking just the insulin needed to cover the carbs, which was working fine, after a week or so, blood sugar was getting higher.

Then I read this blog about protein affecting sugar, and things made sense again. Information has helped a great deal.

Question; how do protein shakes affect sugar level do you think? As in, I imagine the protein will be absorbed faster, and so will affect sugar level faster. How long does this glucose-alanine cycle take, rougly? Also, if I have had a day of high physical activity (I am a brick-paver, and practise Bikram Yoga) how much protein will be utilised in muscle repair before the remainder is converted to energy? I know each individual would be different, and there are many variables (energy expended/body size/metabolism etc.), but I would appreciate your considered opinion.

Stargazey said...

Hi, diff! I'm glad to hear that you have found your way to the low-carb lifestyle.

I don't have any specific answers for you, unfortunately. There is some anecdotal evidence that whey shakes can raise blood sugar here. When the Drs. Eades came out with "The 6 Week Cure for the Middle-Aged Middle," it called for drinking lots of low-carb protein shakes. And some people found that these shakes raised their blood sugar. If you're a type 1 diabetic, you have the equipment and experience to check your blood sugar before and at half hour intervals after you consume a particular kind of protein shake. That should give you the answer that works for you.

I don't know how long it takes for the glucose-alanine cycle. Once ingested protein is broken down into amino acids (less time for whey protein, more time for meat), I would assume the cycle goes on as long as there is substrate, or until all the excess amino acids are cleared from the blood.

As far as estimating when you will be overshooting your protein requirement, all I can offer is the link to Jenny's site here. Dr. Bernstein has a webcast at 7:00 PM Central Time on the last Wednesday of every month. You might send him a question and see what he says.

diff said...

Thanks for the reply, Stargazey.

Another question: do you know why the body performs gluconeogenisis when insulin levels are low? Is it because the body is expecting production of insulin to compensate for the rising sugar levels?

Stargazey said...

That's a good explanation, diff. When the body sees a need for glucose, it creates it, and expects the pancreas to be able to compensate if too much glucose is produced.

Unknown said...

Hi my name is Randy, going to be getting gastri bi pass. I started on a protein shake and solids protein mostly with some greens, but my blood glucose has gone way hi from 140-220. to 400 -500 ..on no carbs to speak of other than from the. shakes and. bars I forgot to mention any advise... I am doing this early cause my blood pressure is high also . Any suggestions are appreciated thank you. ...ps been. diabetic since 95 I'm 43

Stargazey said...

Hi, Randy. I'm not a physician, just a biochemist, so please take anything I say with a grain of salt.

If you need gastric bypass, I'm assuming you are a large person and are probably eating quite a few of the low-carb bars. If you'll look at the Nutrition Facts on the wrapper, you'll see that the carbs in a bar are something like 25. The one I'm looking at says it has 2 net carbs, but the Nutrition Facts on the back says there are 23 grams of total carbs in it. What that means is that the glycemic index of the carbs in the bar is very low, but they are still carbs and your pancreas still has to slowly produce insulin to cover them. If you eat too many of them, you run out of capacity to produce enough insulin and your blood sugar skyrockets.

There may be other explanations as well, such as the fact that a large amount of protein may also overstress the capacity of your pancreas to deal with it. In which case, your liver will happily turn many of the amino acids into glucose and your blood sugar will go high. Your best bet is to try discussing it with the doctor who treats your diabetes and see what he or she has to say about it.

Unknown said...

Thanks. for your input..this week on my diet I mentioned I have lost 9-110 pounds so far I am only eatting one bar at break fast. and about 3-4 shakes. at 40 grams each of protein . at dinner about that with fish. with a stuffing of three stalks of celery and 1 egg with 2 table spoons of bread crumbs all day. that's it thinking about 1000 or so calories

Stargazey said...

You're more than welcome, Randy. Unless you weigh quite a bit, you might want to go lower on the protein and higher on the fat. My fat of choice is coconut oil. It's also great if you have mitochondria that don't work as well as they used to. If you can handle the biochemistry, look here and here. If not, just read the Conclusion in the second one. If you decide to try coconut oil, increase your daily intake very slowly because your intestines will give you negative side effects until they get used to it.

Unknown said...

Hi Stargazey, Thanks for such an abundance of information. I am on a very low carb/high fat/adequate protein diet. During the first two weeks of this diet my fasting glucose was down from 105 to 72. Now my fasting glucose has increased to 95. As I eat only 30-40 fibrous carbs found in vegetables...no other carbs...I am assuming my body is converting protein to glucose. Frustrating, as I am trying to improve insulin resistance and lower leptin levels. Please clarify for me...are you saying that typically protein will be used first for repair and only then use excess protein for glucose production? And if so, would that mean that moderate exercise would increase the need for use of protein for muscle repair and in theory reduce the amount of protein available for glucose production?

Stargazey said...

Hi, Jasmyn! If you're only in the first few weeks of doing low-carb, your body is making all sorts of adjustments. It takes a couple of months for it to get used to operating on a low-carb basis, and lab values are not as dependable as they will be later on.

If you are losing large amounts of weight, your body is in flux for that reason as well. Jenny Ruhl has a good caclulator for optimal intake of macronutrients here Calculate Your Ideal Nutrient Intake for Weight Loss or Maintenance.

If you are in ketosis, some protein has to be used for gluconeogenesis in order to feed the glucose-requiring parts of your brain. Some protein will simultaneously be used for repair. Excess protein will be turned into energy, but you don't have to get all precise about how much you eat. Just don't overdo it and you should be fine.

Unknown said...

Hi, I am glad you had this posted. I am a type 1 diabetic and just started a very low carb, high fat/protein diet. My blood sugars have stayed steady in the low 200's since I started this. My endocrinologist is aware of my new eating (just started) so will be sending him my blood sugars. I had no idea why this was happening, thought maybe the nutrition information was skewed (said 0 carbs for that serving, but if I was eating more than one serving, there were carbs) but couldn't figure out the high blood sugars. I want to lose weight, but want to be in control too. I hope he can figure out a way to help me regulate!!

Unknown said...

Hello Stargazey, Why is there no distinction between slow burning and fast burning carbs in any of your articles. It is my impression that the slower the carb (under 50 in the glycemic index) the less insulin released and the slower the assimilation to glucose. My goal was to reduce the amount of insulin in my body as mentioned by Barry Sears Phd in his Zone diet approach and thus minimize the risk of major degenerative disease and some cancers. It was with this in mind that I aadopted a diet of high protein moderate amounts of slow burning carbs and just essential fats with fish oil supplements. Now in my mid-60s, I have been surprised to find my fasting glucose touching 100mg/dl, and have been looking for an answer. Since I equate high insulin levels with rapid absorption of carbs, raising my base line inflammatory rate, I have been concerned with this fasting glucose increase and am looking for suggestions.

Stargazey said...

Hi, Edward. I don't have a science article to cite, but just personal experience. Carbs are carbs. Whether they are burned slowly or quickly, insulin must be used to store them. Insulin also has to be used to store protein, which means that too much protein acts like slow burning carbs.

The secret of the low-carb diet is that you have to use fat (yes, fat) for energy. Fat has minimal insulinogenic properties. Eat healthy fat, like coconut oil and butter, for your energy. Eat enough complete protein to maintain your body's muscles, organs and enzymes. Eat some carbs for variety, but that's all. If you need fiber, eat a type of fiber that does not get digested, like psyllium husks. Fiber that gets digested will turn into carbs, and carbs require insulin for storage.

That's it in a nutshell. I hope you find it useful.

Unknown said...

I am a strength athlete and would like to experiment with Low carb diet. I plan to have 2.5 g of protein per kg and equal amount of fat which will constitute 60% fat and 35% protein in terms of calories.
Will this much of protein trigger gluconeogenisis and kick me out of ketosis?

Stargazey said...

Hi, hacker hacker! I would expect that that much protein would kick you out of ketosis, but the only way to know for sure is to buy some ketosis test strips (very cheap, so not a big deal) and check your urine at various times during the day. The good news is that you don't have to be in ketosis for low-carb to work. I would recommend that you give your plan a try and see if it works for you. If it doesn't, it should be easy enough to make modifications and arrive at a regimen that suits your body's needs.

David said...

Hi Stargazey

Your post is important because there are clearly a lot of people who, like me, have adopted a low carbohydrate diet in order to lower blood glucose only to find it increases it - and don't know what to do about it! I started with fasting level of 4.9 mmol/L and within a week on 20gms of carbohydrate + 75gms protein + fat to energy requirement it had risen to 6.3 mmol/L. This is where it has remained for several weeks. This is a worry because although the fasting numbers are still not in the diabetic range, I have peripheral neuropathy probably caused by AGEs (which you mentioned in a reply to Sue)

A recent explanation given by Dr Barry Sears and others is that the body interprets low carbohydrate as a threat to survival and the cortisol produced to initiate gluconeogenesis is in excess of what is needed. If that's right, it would be good to know if it's possible to do something that counters this response or if it's simple a matter of waiting for the body to adjust. The experience of Peter Dobromylskyj on his Hyperlipid website suggests that it doesn't!!

It seems that not only excess protein can raise blood sugar but also very low carbohydrate

I wonder if you have any further thoughts on the subject.

Many thanks


Stargazey said...

That's an excellent question, David. Unfortunately, I do not have any additional science-based thoughts on this problem. Anecdotally, I have found that 1500 mg of cinnamon per day has improved my blood glucose when I am eating very low-carb. (Cinnamon and Blood Glucose)

You might want to send your question to Dr. Bernstein. He has a teleseminar on the last Wednesday of every month at 8:00 PM Eastern to answer patients' questions. He has lots of practical experience with blood glucose and low-carb diets and may be able to give you some helpful insights.