Cracking the Code: Keto Basics to Reverse Insulin Resistance

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Keto Basics by Roxana Soetebeer

Introduction to Reversing Insulin Resistance

Any information in this blog is based on what we have learned from reputable sources and scientific research. Some information may be controversial. Special health conditions require special consideration. Nothing in this blog should be considered as medical advice. Humans are far too complex to find a one-size-fits-all solution. Before embarking on this new approach to health, it is important to consult a medical provider who is familiar with the benefits of this way of eating (WOE).

What is Insulin Resistance?

Insulin resistance is present when cells in the muscles, fat, and liver have trouble responding to insulin. They require extra insulin to take up glucose for energy. Eventually, the pancreas becomes overwhelmed and can no longer keep up with the insulin demands, leading to elevated glucose levels in the blood. Many metabolic disorders develop in response to high insulin levels, including type 2 diabetes, kidney disease, liver disease, hypertension, PCOS, obesity, dyslipidemia, dementia, and others. The conventional treatment involves adding more and more insulin, tricking the body into making more insulin, or tricking the cells into accepting glucose despite insulin resistance. However, these approaches only worsen insulin resistance. So, how do we reverse it? With lifestyle changes such as diet, intermittent fasting, and exercise.

Watch Dr. Benjamin Bikman's talk on insulin resistance:

Only 7% of US adults are metabolically fit, meaning only 7% have a good waist circumference and blood pressure, as well as healthy levels of glucose, triglycerides, and HDL. These are also markers for metabolic syndrome, which was initially referred to as the insulin resistance syndrome.

One interesting tidbit: insulin significantly slows the metabolic rate.

How Insulin Resistant Am I?

Please use these calculators. You can input your numbers for fasting insulin and fasting glucose into one calculator, while the other calculator uses the triglyceride to HDL ratio. The interpretation of the scores is explained above the calculators.

Why Keto?

The easiest way to lower insulin resistance is to restrict carbohydrates, giving the pancreas a break. In addition to consuming fewer carbs, we can also extend the time between meals. Having less frequent meals and avoiding snacking allows insulin levels to drop and decreases insulin resistance over time. The best argument for keto, however, is that it aligns with our ancestral diet. Humans evolved on a diet without grains, abundant sugar, or fruit. Scientific evidence suggests that we were not only carnivores but super carnivores, consuming both prey and predators.

Watch Dr. Michael Eades' lecture on the proper human diet:

Meat has always been a part of our diet. The low-fat and plant-based diet movement completely dismisses this fact. We thrive on the diet that we evolved to eat. Early humans, Neanderthals, and other humanoid species were not only carnivores but also super carnivores, meaning they consumed herbivores and carnivores. This is what we evolved to eat.

Interestingly, when comparing early hunter/gatherer and farmer populations, the farmers were the ones with sick and brittle bones and teeth, showing severe nutritional deficiencies.

Links to studies and more information can be found here.

Gary Taubes in "The Case Against Sugar":

Gary Taubes explains why sugar is detrimental to metabolic health and why it cannot be part of a healthy diet, not even in moderation.

Why intermittent fasting:

It is a good idea to restrict carbohydrates and lower insulin with time-restricted eating. Most of the fasting happens while we sleep, so achieving a 16-hour fast is easy by skipping breakfast.

It's recommended to focus on food first and add intermittent fasting once you are fat-adapted. This also helps with any hunger issues during daily fasts.

Dr. Jason Fung explains the advantages of fasting in this lecture on "The Aetiology of Obesity":

Dr. Jason Fung - 'The Aetiology of Obesity' The Aetiology of Obesity - What causes obesity. Dr. Jason Fung says, if we get the cause wrong, we cannot get the treatment right. Obesity is not a caloric problem; it is a problem of too much insulin. The ultimate solution to treat obesity is to lower insulin.

Easy keto start:

When starting this journey, keep it simple. This easy guide removes the guesswork, and you can modify the plan as your body adjusts.

Easy keto, first steps:

1. What to eat:
   * Meat
   * Fish (sockeye salmon, tuna, sardines, anchovies)
   * Eggs
   * Fat (lard, butter, beef tallow)
   
2. What to drink (unsweetened):
   * Water
   * Tea
   * Coffee
3. Add-ons:
   * Organic cream or half and half
   * TrueLemon or lemon juice (2 TBS max)
   * Sweetener: Monkfruit, Allulose, Stevia
4. Supplements:
   * Vitamin D3+K2
   * Omega 3 (optional)
   * Electrolytes to avoid keto flu (LMNT or Keto Chow Electrolytes)
   * Salt (Redmond Real Salt or Himalayan)

Allowed foods:

In addition to the easy keto start, you can find more foods here. Please note that it's not a complete list.

Off-limit foods:

Sugar, starches, grains, starchy or high-carb veggies, high-carb nuts, fruit (with few exceptions), milk, and seed oils. Eventually, try eliminating processed foods and anything labeled as "keto" on the box, with few exceptions. Approved keto products.

Why not fruit?

Some berries are okay in very small quantities, but most fruit is too high in sugar (glucose and fructose). While glucose is problematic for people with insulin resistance, fructose does not raise glucose levels. It is exclusively metabolized in the liver and converted into triglycerides. Fructose is a major factor in increasing insulin resistance. Modern fruit is bred to be super sweet and high in sugar for better taste and shelf stability.

Dr. Gary Fettke discusses this in the following video:

Is modern fruit actually processed food? Dr. Gary Fettke poses this intriguing question. After his search for local fruit, the only abundant supply he could find was in the supermarket, advertised as local fruit. Modern fruit is selectively bred to be exceptionally sweet and high in sugar, which also extends its shelf life.

The intention of fruit consumption is supposedly to promote obesity, to prepare us for winter. In 1992, the recommendation was to consume 5 to 9 servings of fruit and vegetables every day, without any scientific evidence to support this. Previously, only seasonal fruit was recommended.

According to Dr. Fettke, the metabolism of fructose has numerous effects on health. Some fructose is stored as glycogen, but any excess is stored as fat. The breakdown of fructose produces uric acid, a waste product associated with gout, which affects nitric oxide levels, leading to decreased blood supply to the brain, increased blood pressure, and a weakened immune system. It also inhibits leptin, causing increased hunger. Fructose contributes to insulin resistance in the muscles and liver, as well as the development of non-alcoholic fatty liver due to excess fat storage.

My brain requires carbohydrates:

No, the brain requires glucose, but not in large quantities. On an ultra-low-carb diet, the liver can produce the necessary glucose for the brain through a process called gluconeogenesis, using protein as a source. This requires adequate liver function and protein intake. The process is demand-driven. The brain primarily thrives on ketones, which do not rely on insulin for energy delivery to brain cells. Individuals with dementia show improvement when given ketones.

Protein and fat are essential nutrients, meaning we must consume them to maintain good health. Carbohydrates, on the other hand, are not essential macronutrients. Humans do not need to consume carbohydrates to survive or remain healthy. While carbs provide energy, they do not offer much else. Protein and fat, however, are crucial for tissue building, repair, various bodily processes, and energy provision. Unless for rare medical conditions, humans do not require carbohydrates in their diet.

Why avoid seed oils:

Seed oils, also known as vegetable oils, are often promoted for their ability to lower LDL cholesterol, which is one of the least important predictors of cardiovascular disease. Unfortunately, seed oils are high in Omega-6 fatty acids, which are inflammatory and contribute to insulin resistance. Moreover, the production process for these oils involves high heat and the use of harmful chemicals. Consequently, studies have shown that seed oils result in higher all-cause mortality.

In his presentation titled 'Diseases of Civilization: Are Seed Oil Excesses the Unifying Mechanism?' Dr. Chris Knobbe proposes the hypothesis that seed oils and processed foods are the primary cause of various diseases, including heart disease, hypertension, stroke, cancer, type 2 diabetes, metabolic syndrome, obesity, and Alzheimer's disease. He questions whether these so-called heart-healthy vegetable oils could ironically be the main cause of heart disease and other civilization-related diseases. The oils to be particularly cautious of include those derived from soybean, corn, canola, cottonseed, rapeseed, grapeseed, sunflower, safflower, and rice bran.

"Could the seed oils be the primary cause of the diseases of civilization? Heart disease, hypertension, stroke, cancer, type 2 diabetes, metabolic syndrome, obesity, Alzheimer's disease … the list goes on and on … and could these so-called heart healthy vegetable oils actually and ironically be the primary cause of heart disease and the major cause of all these other diseases of civilization as well?"

Dr. Chris Knobbe presents his hypothesis that seed oils and processed foods made us all sick.

The truly bad oils are derived from soybean, corn, canola, cottonseed, rapeseed, grapeseed, sunflower, safflower, and rice bran.

Supplements:

Ideally, we should obtain our nutrients from food. Fortunately, animal products are rich in bioavailable nutrients. However, some supplements can be beneficial, such as Vitamin D3+K2, electrolytes, Omega-3, and salt.

Click here for more information on supplements.

Why salt:

Salt is essential for survival. Insufficient salt intake carries a higher mortality rate than consuming five times the recommended daily dose. We need to ensure adequate salt intake. We recommend high-quality salts like Redmond Real Salt or Himalayan salt. Ancient sea salts come with a good mineral profile and are free from microplastics.

Salt intake needs to be limited in individuals with end-stage kidney disease. Another consideration is hyperinsulinemia, as the kidneys tend to retain salt instead of flushing out any excess. Insulin levels significantly decrease on a ketogenic (keto) diet.

Sweeteners:

Dr. Sten Ekberg explains the benefits and drawbacks of sweeteners in this video:

In the video, Dr. Sten Ekberg discusses sweeteners. Caloric sweeteners are not considered food as they are highly processed and provide empty calories. They may elevate glucose levels and increase insulin production. Fructose is stressful to the liver and contributes to insulin resistance. Artificial sweeteners, despite being controversial, are likely some of the worst chemicals to ingest. Some sweeteners can cause digestive issues.

Dr. Sten Ekberg presents his list of the top 10 best and top 10 worst sweeteners based on factors such as blood sugar impact, calorie content, gut health, toxicity, and more. The sweeteners include sugar, low-carb sweeteners like Stevia, Monk Fruit, Xylitol, Erythritol, Agave Syrup, Honey, Coconut Sugar, Maple Syrup, High Fructose Corn Syrup, and others.

Updates on Erythritol

Is Erythritol still considered safe?

Check out our blog on Erythritol written by Dr. Adrian Soto-Mota MD PhD

What about the nutritional guidelines:

The guidelines promote a high-carb, low-fat diet and suggest substituting saturated fats with seed oils. It may be considered the worst diet for anyone, especially for individuals with metabolic issues. To reverse insulin resistance, it may be advisable to disregard the guidelines.

I recommend watching Dr. Sarah Hallberg's TEDx talk on this topic:

In her talk, "Reversing Type 2 diabetes starts with ignoring the guidelines," Dr. Sarah Hallberg explains that the goal is to reverse type 2 diabetes rather than simply treating it as a chronic disease with increasing insulin requirements. She emphasizes the importance of treating a dietary disease with food by restricting carbohydrates, rather than relying on medication.

The guidelines have proven ineffective and unfairly place blame for obesity solely on the patients. Type 2 diabetes is fundamentally a result of carbohydrate toxicity, and insulin resistance is a manifestation of carbohydrate intolerance. Obesity is a hormonal disease, not a reflection of personal character. Most obese individuals are resistant to insulin, facing difficulties in transporting glucose into cells, which prompts the body to produce more insulin. When the pancreas reaches its limit, blood glucose levels rise, leading to diabetes. Additionally, high insulin levels increase hunger and facilitate fat storage, compounding the issue.

What about cholesterol:

Cholesterol is vital for the body, to the extent that if we restrict cholesterol in our diet, the liver will increase its production. It's important to note that cholesterol is not a single number; lipids include HDL (considered beneficial when high), LDL (controversial), and triglycerides (should be low). LDL comes in two forms: large, fluffy particles, which pose no concern, and small, dense particles, which can be oxidized and problematic. A ketogenic (keto) diet does not increase small, dense LDL.

I suggest watching Dr. David Diamond's presentation on this topic:

For further information, you may also watch Dr. Maryanne Demasi's videos:

Dr. Maryanne Demasi is a former medical scientist who completed her PhD in Medicine at the University of Adelaide. Her research focused on the pathology of Rheumatoid arthritis and potential therapies. Her innovative research has been published in several internationally recognized medical journals. Transitioning from her scientific career, Maryanne took on a role as a political advisor and speechwriter for the South Australian Minister for Science and Information Technology portfolios. She provided guidance on issues related to intellectual property and research commercialization. In 2006, she was approached by ABC's Catalyst program and gained a reputation for reporting on relevant and occasionally controversial medical stories. Maryanne has received numerous accolades for her work and was awarded the National Press Club of Australia's prize for excellence in health journalism in 2008, 2009, and 2011.

In his talk, titled "An Assessment of Cardiovascular Risks of a Low Carbohydrate, High Fat Diet," Dr. David Diamond challenges the notion that high LDL cholesterol is detrimental and argues against lowering LDL under any circumstances. He exposes how scientists manipulated data to present an exaggerated risk, when in reality, the difference in survival rates between low and high LDL groups was a mere 1%. The question arises: why such deception? This level of manipulation is profoundly disturbing.

Saving just 1% becomes significant when considering hundreds of millions of people. However, the numerous side effects associated with cholesterol-lowering medications offset any potential benefits, including erectile dysfunction, lower testosterone levels, kidney disease, muscle atrophy, type 2 diabetes, elevated liver enzymes, and an increased risk of cancer, among others.

If LDL cholesterol is not the primary factor elevating the risk of heart disease, Dr. Diamond highlights that clotting factors play a more substantial role. Obesity/metabolic syndrome and high serum glucose levels are identified as significant triggers for clot formation.

Everything in moderation:

For individuals who struggle with moderation, the advice to consume unhealthy foods in moderation can be detrimental. Similar to addictions like alcohol or hard drugs, it would not be considered appropriate to recommend moderation. Why do most nutritionists and doctors insist on moderation when it comes to unhealthy foods?

Dr. Ken Berry shares his thoughts on moderation in this video:

In his talk titled "All Things in Moderation" is TERRIBLE Advice (Sugar Addiction Help), Dr. Berry discusses the dangers of suggesting moderation to individuals who may be prone to sugar addiction. He argues that it is ignorant and dangerous advice, as some people are highly susceptible to becoming addicted to sugar, carbs, and junk food. He also highlights how large food companies exploit this addiction and manipulate their advertising and recipes to capitalize on it.

Exercise:

If you have an exercise routine, continue doing it. If not, focus on it later. And prioritize getting good sleep.

Exercise offers numerous health benefits, including improved fitness, cardiovascular health, mental well-being, muscle toning, and increased bone density, among others. However, weight loss is not necessarily one of its primary benefits. Studies comparing groups that exercise regularly to sedentary individuals over a span of 20 years found only a 1-pound difference in weight.

Medications:

Many medications used in people with insulin resistance primarily address the symptoms rather than the underlying cause. In some cases, these medications may even exacerbate the root cause. Adding insulin to individuals who already have high insulin levels can increase insulin resistance. For individuals with Type 2 diabetes, this can lead to a chronic progressive condition, necessitating more medications and higher doses of insulin, thereby increasing the risk of complications. While medications have their place in short-term or long-term treatment, our goal should be to address the root cause through dietary changes and fasting to truly improve metabolic health.

Caution: This information is not intended as health advice, and individual situations may vary. It is important to consult with a medical provider before discontinuing any medications.

What about the science?

Nutritional science has been plagued by flawed epidemiological studies that lack proper control or intervention and cannot establish causality. Nonetheless, these studies have been used to form guidelines that have had detrimental effects on the health of the entire population. Additionally, some studies have been sponsored by groups with vested interests.

Nina Teicholz discusses the shortcomings of evidence in her presentation:

In her talk titled "Science and Politics of Red Meat in 2021," she addresses why discussing the health benefits of red meat seems challenging and presents the current evidence on how red meat affects our health. Contrary to popular belief, red meat does not cause cancer, and saturated fats are not inherently dangerous. Nina also delves into the politics surrounding the topic and sheds light on why having a discussion about the health benefits of red meat seems to be difficult.

What if you need more help?

We have a dedicated Facebook group "Reversing Insulin Resistance" with many active and knowledgable members from around the globe. Help is available pretty much 24/7.

If you need intensive one-on-one help, check out our coaching services.

Final thought:

A little-known fact is that dietary cholesterol is no longer considered a nutrient of concern, leading to the quiet removal of the cap for its intake from the dietary guidelines.

Written by Roxana Soetebeer, MHP
Published May 27th, 2023

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