I've just started reading Paul Jaminet's book "Perfect Health Diet".........He is generally low carb (with "safe" starches), but the statement he made that really caught my attention (below)

"You might think that the answer is to consume very few carbs. But this would be naive! It turns out that on low-carb diets, much of the body becomes insulin resistant— meaning that it doesn’t respond to insulin signals and so doesn’t take in glucose after meals. This happens so that glucose will be directed to the liver, where it can be stored in glycogen and released later for use by the brain. This “physiological insulin resistance” is a protective response of the body that assures that the brain gets the benefit of a limited supply of glucose. But it has a paradoxical effect: because the rest of the body is refusing to take up glucose and the liver takes it up slowly, a meal of carbohydrates is followed by higher postprandial blood glucose levels in low-carb dieters than in high-carb dieters. In short, low-carb dieting can increase the risk of postprandial hyper -glycemia."

Jaminet, Paul; Jaminet, Shou-Ching (2012-12-11). Perfect Health Diet: Regain Health and Lose Weight by Eating the Way You Were Meant to Eat (Kindle Locations 1659-1666). Scribner. Kindle Edition.



Can somebody please explain this! I am keeping my carbs VERY low (under 10 grams a day)..........Is this possibly too low? Is there indeed a benefit to increasing them a bit? Can lowering them too much backfire?

I don't think that's really an accurate description. Depending on the composition of my LC diet, I've had very low BG's both when fasting and after eating.

Eating too much protein makes it higher, regulating my protein keeps it very low.

Also, people following LC tend to have pretty low fasting insulin, so I don't really think there's an issue.

Well, what he says is very much in line with what Jenny Ruhl writes about in her book about low carb diets, Diet 101. She goes into why you need to re-carb for several days before an insulin resistance test in order to not have a falsely high reading - and I see what Jaminet wrote as similar.

My interpretation is that while you are eating low carb if you have a "cheat" your risk of hyperglycemia is higher. According to Ruhl your body is back to normal after a couple days of higher carb eating. So I don't think you're doing yourself any permanent harm or anything. - and maybe keeping in mind how your low carb body will handle that cookie will help you say "no thanks"

Jaminet is not a low carb fan by any means from all I've read and heard from him. He's always rubbed me e wrong way because he seems convinced his way is "better" than anyone else's, and I get the impression he judges everyone and everything....

There was a looong discussion about PHD and insulin resistance , think on the paleo forum, but darn if I can find it. I wish we could do Advanced Search AND date range. As I remember, I tried PHD but cannot add starch (rice and sweet potatoes) without gaining weight. I had freaked when I got over 100 BG on a lab test for the first time (BG had been creeping up on LC) and net down of a few long emails, received reassurances from both Dr. Westman and Dr. Phinney this (PIR) is nothing to worry about in a long term LCer. I also had low thyroid type symptoms, but instead added iodine and that seem to fix those.

Though as Nancy mentioned about protein, I am doing some fasting right now (VHF, low protein, no carbs) , and my BG has dropped back to around 80, fasting and pre-meal. My ketones are also at 3.0 in matter of days. So who knows what that means? Do I normally eat too much protein? Is it the fasting part that has dropped my BG? So does physiological insulin resistance go away with both added carbs and lower carbs and protein? Do I really care? Especially since I know my Insulin level was 1.7 last test when the Range is 2.6-24.9!

Dr. Westman has many patients on 10-20g carbs per day for years and they are healthy, so I really don't worry about staying LC long term anymore, going on four years myself.

To read about it, check out this site (more than you could ever want to know): http://ketopia.com/physiological-insulin-resistance/

ParisMama, that's how I understand Jenny Ruhl too. One may become "physiologically resistant" but it is a totally reversible state and is very temporary. I can't remember how long she recommends to eat higher carb before a glucose tolerance test in order to get more typical results. I also feel like Phinney and Volek mention this in one of their "Art and Science..." books but can't find it right now.

I was diagnosed with insulin resistance 11 years ago. My doctor told me that he wanted to re-test me in a few months, made me an appointment with the diabetic clinic and I would probably be started on metformin.

I went on the Atkins by coincidence a few days later - I also had an appointment with the diabetic consultant - who did my blood sugars which we fine. I told him I'd started this atkins diet and he said "brilliant, I cant officially recommend it, but it'll sort your insulin issues out"

Like I say, that was 11 years aog. So I couldnt care less what so called "remedies" and ideas come and go. This works for me and I've got rid of my IBS, eczema, arthritis and lethargy - oh and 84lbs!!!!

Jo xxx

For non-diabetics, insulin resistance only matters if you're going to be eating appreciable levels of carbohydrate.

For diabetics, adding small amounts of "safe" starch to a ketogenic diet is disastrous--and physiological insulin resistance is a minor contributor to their blood glucose regulation problems, at any rate. To the extent that the competition of free fatty acids, or palmitic acid signalling, is the cause of physiological insulin resistance, adding starches probably wouldn't work anyways, since adding carbohydrate will often fail to reduce these appreciably in a person with diabetes or prediabetes. Elevated free fatty acids, and excess fatty acid synthesis from glucose (which starts with palmitate synthesis) are hallmarks of the disease.