DIABETES AND PUFA
Diabetes is a medical condition that affects the way your body processes blood sugar (glucose). Glucose is an essential source of energy for your body's cells and is primarily obtained from the food you eat.
Normally, your pancreas produces a hormone called insulin that helps glucose enter your body's cells and be used as energy. In people with diabetes, however, their pancreas either does not produce enough insulin or the body cannot effectively use the insulin that is produced.
This leads to high levels of glucose in the blood, which can damage organs, nerves, and blood vessels over time. There are two main types of diabetes:
Type 1 diabetes: This is an autoimmune condition in which the immune system attacks and destroys the cells in the pancreas that produce insulin. People with type 1 diabetes require daily insulin injections or an insulin pump to manage their blood sugar levels.
Type 2 diabetes: This is a condition in which the body becomes resistant to insulin or does not produce enough insulin to keep blood sugar levels within a normal range. Type 2 diabetes is often linked to obesity, lack of physical activity, and poor diet, and can often be managed with lifestyle changes such as diet and exercise, along with medication if necessary.
Other forms of diabetes include gestational diabetes, which occurs during pregnancy, and rare forms of diabetes caused by genetic mutations or other medical conditions.
It's important to manage diabetes carefully to prevent complications such as heart disease, nerve damage, kidney disease, and blindness. Treatment typically involves managing blood sugar levels through medication, diet, exercise, and monitoring blood sugar levels regularly.
This makes it seem as though glucose is the problem. How essential is glucose to a human? And how much do we use a day?
Glucose is essential to human life as it is the primary source of energy for our bodies. It is a type of sugar that is produced from the breakdown of carbohydrates in our diet, and it is used by our cells to produce ATP (adenosine triphosphate), which is the energy currency of the body.
The brain and nervous system are particularly reliant on glucose for energy, and in the absence of glucose, these systems can experience significant dysfunction. In fact, a severe lack of glucose can lead to unconsciousness and even death.
Glucose is of such importance that humans can produce glucose endogenously, meaning that they can produce glucose internally through various metabolic processes in the body.
The process by which glucose is synthesised from non-carbohydrate sources, such as amino acids, is called gluconeogenesis. This process mainly occurs in the liver and to a lesser extent in the kidneys and small intestine.
Gluconeogenesis is stimulated by low levels of blood glucose, high levels of glucagon (a hormone produced by the pancreas that raises blood sugar levels), and certain hormones like cortisol and growth hormone.
In situations where glucose is not obtained from the diet or glycogen stores in the liver are depleted, gluconeogenesis plays a crucial role in maintaining blood glucose levels to supply energy to the body's cells, particularly the brain and nervous system.
Where do these amino acids come from?
The amino acids used for gluconeogenesis can come from various sources in the body, such as:
Dietary protein: Amino acids derived from the digestion of protein in the diet can be used for gluconeogenesis if needed.
Body protein: Amino acids can also be obtained from the breakdown of body proteins, such as muscle protein, in situations where there is inadequate dietary protein intake.
Recycling: The body can also recycle amino acids from proteins that have been broken down during normal cell turnover and use them for gluconeogenesis.
Other non-carbohydrate sources: In addition to amino acids, other non-carbohydrate sources, such as lactate, glycerol, and certain fatty acids, can also be used for gluconeogenesis.
The amount of glucose that we use in a day can vary depending on a range of factors, including our age, weight, sex, activity level, and overall health. However, on average, the body requires about 160-180 grams of glucose per day to function properly. This glucose can come from a variety of sources, including carbohydrates in our diet and glycogen stores in our liver and muscles. When we consume carbohydrates, they are broken down into glucose, which is then transported to our cells and used for energy. If we consume more glucose than our body needs, the excess is stored in the liver and muscles as glycogen. When our body needs more glucose, it can break down the glycogen stores to release more glucose into the bloodstream.
Does the amount of glucose needed increase if human is more physically active?
Yes, the amount of glucose needed by the body can increase if a human is more active. When we engage in physical activity, our muscles require more energy to fuel the increased demand for movement. This increased demand for energy can be met by breaking down glycogen stores in the liver and muscles, and by utilizing glucose from the bloodstream.
In order to maintain optimal performance during physical activity, the body may need to release more glucose into the bloodstream to supply the increased energy demands of the muscles. This can be achieved through various mechanisms, including the release of stored glycogen and the breakdown of stored fat.
The exact amount of glucose needed by an individual during physical activity can vary depending on the intensity and duration of the activity, as well as the individual's overall health and fitness level. However, in general, more active individuals may require higher amounts of glucose to support their energy needs during physical activity.
Does the need for glucose increase due to mentally activity?
Yes, the need for glucose can increase due to psychological activity. The brain and nervous system rely heavily on glucose as their primary energy source, and any mental activity that requires cognitive effort, such as problem-solving, decision-making, and even stress, can increase the demand for glucose.
When we engage in mental tasks that require cognitive effort, the brain's glucose metabolism increases, and glucose uptake and utilisation by the brain also increase. This increased glucose utilisation can help support brain function and cognitive performance.
Studies have shown that individuals who perform mentally demanding tasks, such as those that require sustained attention or complex problem-solving, may experience a decline in blood glucose levels. This decline in glucose levels can lead to fatigue, decreased cognitive performance, and impaired decision-making. This should counter the argument about the sedentary individual, meetings, presenting, playing chess, worrying etc all have a large metabolic demand.
Therefore, it is important to maintain stable blood glucose levels throughout the day, especially during times of increased cognitive demands, by consuming a balanced diet that includes carbohydrates, protein, and healthy fats. This can help ensure that the body has a steady supply of glucose to support brain function and cognitive performance.
In my book Consistent Eating I wrote about the decline in brain function when aged subjects have limited glucose. As we age, the brain's ability to metabolise glucose is suggested to decrease, which can lead to a decline in cognitive function and an increased risk of age-related cognitive decline and neurodegenerative diseases such as Alzheimer's disease. This decline in glucose metabolism could be due to changes in the brain's insulin sensitivity, which can reduce the uptake and utilisation of glucose by brain cells.
In addition to age-related changes, other factors such as poor diet, sedentary lifestyle, and obesity can also lead to a decline in brain function by impairing glucose metabolism. For example, there is evidence to suggest that a high-fat diet can impair glucose metabolism and lead to cognitive decline in older adults. This relationship between fat intake and cognitive decline is complex and not widely studied in an industry keen to promote seed oils as health promoting and glucose as dangerous.
Some studies have found that a high-fat diet can lead to insulin resistance, which impairs the brain's ability to use glucose as a primary energy source. This can lead to a decline in cognitive function and an increased risk of age-related cognitive decline and neurodegenerative diseases. Other studies have suggested that a high-fat diet may impair cognitive function through mechanisms other than glucose metabolism, such as through inflammation, oxidative stress, and alterations in gut microbiota.
It is important to note that the ratio of glucose to fat intake in the diet may not be the only factor influencing cognitive decline in older adults. Other lifestyle factors, such as physical activity levels, sleep quality, and stress levels, may also play a role in cognitive function. Overall, the relationship between fat intake and cognitive decline in older adults is complex and requires further research to fully understand. However, it is clear that a healthy and balanced diet that includes a moderate intake of “healthy” natural fats, such as butter, coconut old etc may important for maintaining cognitive function and overall health in older adults, however, fats should be used in moderation to preferentially allow glucose usage to be optimal.
Explain how PUFA (veg oil) damages the islet cells in the pancreas
PUFA stands for polyunsaturated fatty acids, which are a type of fat that is commonly found in vegetable oils, nuts, seeds, and fish. While PUFA is suggested to be an important component of a healthy diet, even mainstream science admits that excessive intake of PUFA has been linked to various health problems, including diabetes.
Research suggests that PUFA can contribute to the development of diabetes by damaging the islet cells in the pancreas that produce insulin. Islet cells are clusters of cells in the pancreas that contain several types of cells, including beta cells, which produce insulin.
PUFA can cause oxidative stress in the body, which can damage cells and tissues. Studies have shown that excessive intake of PUFA can lead to the accumulation of free radicals, which can damage the beta cells in the islets of the pancreas. This damage can lead to decreased insulin production and secretion, which can contribute to the development of diabetes.
In addition to damaging the beta cells in the pancreas, PUFA may also contribute to insulin resistance, which is a key feature of type 2 diabetes. Insulin resistance occurs when the body's cells become less responsive to insulin, which can lead to high levels of glucose in the blood.
While more research is needed to fully understand the link between PUFA and diabetes, it is clear that excessive intake of PUFA can have negative effects on the health of the pancreas and insulin production. As with all dietary components, it is important to consume PUFA in moderation and as part of a balanced diet to maintain optimal health.
The Randle Cycle
The Randle Cycle, also known as the glucose-fatty acid cycle, is a metabolic pathway that regulates the use of glucose and fatty acids as fuel sources in the body. The cycle was first described by Dr. Randle in the 1960s and has since been the subject of numerous studies.
The Randle Cycle describes how the body switches between using glucose and fatty acids as its primary source of energy depending on the availability of each fuel source. When glucose levels in the blood are high, the body uses glucose as its primary fuel source and stores excess glucose in the liver and muscles as glycogen. At the same time, insulin is released from the pancreas, which helps to facilitate the uptake of glucose into cells for energy.
When glucose levels are low, the body shifts to using fatty acids as its primary fuel source. During times of high fatty acid availability, such as during a meal high in fat, the body preferentially oxidises fatty acids for energy and reduces glucose utilisation. In the context of a meal high in both fat and sugar, the effects of the Randle Cycle are less clear and may depend on several factors, including the composition and timing of the meal, as well as the individual's metabolic state and insulin sensitivity.
One possibility is that the high fat content of the meal could cause an increase in fatty acid oxidation, leading to a reduction in glucose utilisation and potentially impairing glucose metabolism. The Randle Cycle has important implications for the development of metabolic disorders such as diabetes and obesity. Insulin resistance, which is a “hallmark” of type 2 diabetes, can disrupt the Randle Cycle and lead to abnormalities in glucose and fatty acid metabolism. Additionally, a diet high in fat can disrupt the Randle Cycle and contribute to insulin resistance and metabolic dysfunction.
So reducing fat intake would help control diabetes? And also allow glucose to be consumed to fuel critical organs such as the brain?
Reducing fat intake can be beneficial for controlling diabetes, but it depends on the type of fat and the individual's overall diet and lifestyle habits.
PUFA’s, which are commonly found in processed foods, fried foods, seed oils etc increase the risk of type 2 diabetes and insulin resistance. These types of fats can interfere with the body's ability to regulate blood sugar and may contribute to inflammation and other metabolic abnormalities. While saturated fats are more healthy, excess consumption still has the potential to be problematic.
How essential are fats in our diet?
Humans can produce fatty acids endogenously through a process called lipogenesis, which is the synthesis of new fatty acids from non-fat sources in the body. This process mainly occurs in the liver, but other tissues such as adipose tissue and the mammary glands also have the ability to produce fatty acids.
Lipogenesis is stimulated by the hormone insulin, which promotes the uptake of glucose from the blood and its conversion into fatty acids in the liver. In addition, excess dietary carbohydrates can also be converted to fatty acids through a process called de novo lipogenesis.
However, and for those avoiding carbohydrates for fear of them causing obesity, the ability of the body to produce fatty acids endogenously is limited and varies depending on a person's metabolic state and nutritional status. In general, a diet that is deficient in both carbohydrates and fats may result in the body using protein as a source of energy and amino acids as substrates for gluconeogenesis rather than synthesising new fatty acids. To put it simply, the glucose is priority.
Human de novo lipogenesis, which is the synthesis of new fatty acids from non-fat sources in the body, is generally considered to be a relatively limited process compared to other metabolic pathways in the body. The capacity for de novo lipogenesis in humans is limited by several factors, including:
Regulation by insulin: De novo lipogenesis is regulated by the hormone insulin, which is secreted in response to elevated blood glucose levels. However, insulin also has a suppressive effect on lipolysis, the breakdown of stored fat, which can limit the availability of fatty acids for synthesis.
Limited substrate availability: The substrates used for de novo lipogenesis, such as glucose and amino acids, are limited in the body, and their availability can be influenced by factors such as diet and metabolic state.
Efficiency of the process: De novo lipogenesis is an energetically costly process and is considered to be relatively inefficient compared to other metabolic pathways in the body.
Overall, while humans have the ability to produce fatty acids endogenously through de novo lipogenesis, this process is generally considered to be a minor contributor to overall lipid metabolism in the body, and dietary intake of fats is the primary source of fatty acids for most people. Humans can produce omega-9 fatty acids endogenously from glucose. During fatty acid synthesis, acetyl-CoA, a molecule derived from glucose metabolism, is used as a substrate for the production of new fatty acids, including omega-9 fatty acids.
Omega-9 fatty acids can also be obtained from the diet, and dietary sources of these fatty acids may be particularly important for individuals who are unable to synthesise them endogenously due to certain medical conditions or dietary restrictions. However, for most healthy individuals, the body's endogenous production of omega-9 fatty acids from glucose is sufficient to meet the body's needs for these important nutrients.
Thus it would be my opinion that for those wishing to control diabetes, a better method that restricting glucose intake would be to record dietary macronutrient intake for a week and assess the percentages of fats and carbohydrates consumed daily. Typically in those I have consulted with, fat intake is generally high and can easily be reduced. If those fats are safe (butter etc) than gradually consider a reduction under the supervision of your medical consultant. If they are PUFA, try to eliminate and switch to a better source of fats.
