Dietary fat is insulinogenic. Sorry, guys - *The Scribble Pad*:

*The Scribble Pad*: Dietary fat is insulinogenic. Sorry, guys.

I'm always amazed when people ask me for "evidence" or references to validate that dietary fat is insulinogenic. Every time I hear this I am taken aback because this is really point zero of nutrition research. It's the foundation of stupid advice to eat low fat diets and count calories. The earliest and most fundamental diabetes/obesity research has focused on the problematic, insulinogenic, obesigenic nature of dietary fat. All of these studies finding met syndrome like issues with fat intakes are not wrong, they are only misguided/misinterpreted. While certainly fat worsens insulin signalling, carbohydrate does even more so ( in all but the lowest fat intakes.) 

So yea I'm always very surprised when people find it to be new information that dietary fat promotes greater insulin levels. Then I remember most people have been reading keto propaganda which states 100,000 calories of fat is entirely metabolically neutral and has zero impact on adipocyte growth dynamics, it's entirely a carb problem. The keto dogma really looks suspiciously a lot like veganism when we get to the extreme levels of it, sadly. In reality, it's rather uncontroversial fat is a HUGE factor influencing adipocyte growth dynamics i.e. insulin level. One need only chuck the phrase "dietary fat insulin" into google scholar to be showered in results of this truth.

Here's one study.

RESULTS Among the 544 individual women, a 20 g/day increase in total dietary fat was associated with a higher fasting insulin level (9% [P < 0.001] before and 6% [P < 0.01] after adjustment for the obesity variables). Higher intakes of saturated fat, oleic acid, and linoleic acid were each positively related to higher fasting insulin values. The relation of dietary fat with fasting insulin was significantly attenuated among physically active women compared with those who were sedentary (P = 0.04), even after adjustment for obesity.
CONCLUSIONS High intake of total dietary fat is positively related to relative fasting hyperinsulinemia in nondiabetic women, particularly those who are sedentary. 

Here's another.

RESULTS Seven patients with type 1 diabetes (age, 55 ± 12 years; A1C 7.2 ± 0.8%) successfully completed the protocol. HF dinner required more insulin than LF dinner (12.6 ± 1.9 units vs. 9.0 ± 1.3 units; P = 0.01) and, despite the additional insulin, caused more hyperglycemia (area under the curve >120 mg/dL = 16,967 ± 2,778 vs. 8,350 ± 1,907 mg/dL⋅min; P < 0001). Carbohydrate-to-insulin ratio for HF dinner was significantly lower (9 ± 2 vs. 13 ± 3 g/unit; P = 0.01). There were marked interindividual differences in the effect of dietary fat on insulin requirements (percent increase significantly correlated with daily insulin requirement
CONCLUSIONS This evidence that dietary fat increases glucose levels and insulin requirements highlights the limitations of the current carbohydrate-based approach to bolus dose calculation. These findings point to the need for alternative insulin dosing algorithms for higher-fat meals and suggest that dietary fat intake is an important nutritional consideration for glycemic control in individuals with type 1 diabetes. 

I know someone is reading this, chewing on a pepperoni log dipping it in sour cream, thinking to themselves "BLASPHEMY, THIS DOESN'T COUNT IF YOU KETO ADAPTED!". Sorry guys, no one wishes it was true more than wooo that the path to thinness lies in grinding up macadamia nuts and drinking it like water... but it's just not true.

The typical and expected response to increasing dietary fat, no matter what kind of diet you are on, is higher endogenous insulin, inhibited weight loss, if not frank weight gain. This is true on atkins, and its *definitely* true on a moderate carb or high carb diet. We never have 0 blood sugar. Even if you eat no carbs at all, you always have blood sugar. Consuming a lot of dietary fat will always disrupt glucose oxidation and increase basal insulin levels. The real world result of this is gaining body fat in people who are otherwise predisposed to, with a history of obesity.

You'll be good to notice most of the people on ketogenic diets who are tracking blood ketones will state their blood ketones are lower if they are sedentary, or if they are not fasting. They will also state ketone levels are better if they restrict fat calories. They are eating the exact same amount of protein and carb, but their ketones are lower (remember, ketones up = insulin down) if they are sedentary/eating more frequently/eating more calories of fat.

If fat is totally metabolically neutral and never *ever* affects insulin, why would exercise be necessary? Why would fasting be useful? Why would overt calorie restriction help, then? Technically the logical equivalent of an insulin free food should be continuous weight loss and calories never ever begin to count.
  • Insulin is the cause of lipid accumulation in adipocytes. 
  • Insulin is the cause of inhibited lipolysis. 
  • Insulin is the cause of lower ketone levels.  
  • If fat had no impact on insulin, ever, exercise/fasting/cal restriction would not be useful to hardcore keto dieters. But it always is, 100% of the time, stronger ketones via eating less fat/less often of fat/increasing metabolic needs for fat.

The reason keto dieters start fasting and exercising is because their extremely high intakes of dietary fat support a generous basal insulin that not only inhibits fasting ketones, but also stops weight loss if not causing frank weight gain. Exercise depletes blood glucose, increases fat oxidation, and profoundly lowers fasting insulin. Exercise helps weight loss not because it "burns calories"; it has a power insulin suppressive effect. It does not take much, I'm finding in the context of a diet that is so poor to facilitate insulin like the ketogenic diet, it only takes like running in place 15 minutes or a few pathetic girly pushups to promote a lot more fat loss/inhibited insulin level.

Relatedly, this is also why all diets work. Even on a diet of pure cheetos and garbage, if you eat less energy, your insulin levels decline. Just as it is true that fat raises insulin , it's also true that a calorie restricted high carb diet will lower insulin. People can lose on weight watchers, frutarian diets, or any stupid nonsense unscientific diet as long as their energy intake is profoundly less than it was before the diet. Weight loss on these diets are dramatically sub optimal (eating carbs to lose weight is kind of like trying to slightly reduce alcohol to quit alcoholism; why elect the most insulinogenic nutrient source to lower insulin? This is why these diets are miserable for most people to follow as every meal is an insulin assault with hunger/fatigue shortly after eating. The keto diet is far less insulinogenic and weight loss is almost effortless at least early on).

A lot of people out there live in gyms and eat total garbage, and are still slim and healthy. If you exercise a lot, especially weight bearing exercises (which are huge glucose sinks), your insulin levels are going to crash like a rock. You can then eat tons of food and not store it as fat, and insulin/ leptin sensitivity is much better. These people usually become HUGE if they stop exercising, however, as they just get used to eating like garbage and don't realize they can only get away with it because they are lifting weight and running or what have you. This is not mention the quasi-starvation like state of chronic over-exercise which enhances adipogenesis once "refeeding" begins, in which case stopping exercise and continuing the junk food diet is the neuroendocrine equivalent of carbsane going off her umpteenth diet/binge cycle.

Relatedly, it only goes to show the ignorance of people like Carbsane. This woman has been trying to discredit high fat diets for years, and not ONCE has she addressed the most crucial point which is that all food including dietary fat is insulinogenic. All food , whether a snickers bar or sour cream, is going to promote fat gain/stop fat loss after a certain point. She refuses to admit fat cell growth eventually boils down to insulin (it absolutely does, 100% of the time) so I guess this explains her stupidity. These magical "calories" cause weight gain, and somehow do so independently of neuroendocrine adipocyte controls. LOL.

As far as I'm concerned, "calories" is short hand for "adipocyte insulin stimulating agent". All things which are "calories" are only things that provoke insulin responses. Specific low carb diets, or ketogenic diets, merely choose those types of calories which do so as little as possible relative to their energy yield. This is the entire purpose of the low carb diet: to get maximum energy yield with minimum insulin requirement/release. It is illogical and unfounded to conclude that you might as well eat 10,000 cals of bacon fat as if it would have no impact. This fantasy just does not work out for anyone who has lost more than trivial body weight, who is anything but super resistant to fat gain.

Occam's Razor guys. A type 1 diabetic will be in a highly lipolytic state until ketoacidosis (BOHB >8 FTW). Without insulin, the default state of the fat cells is to HEMORRHAGE lipid and ketogenesis. This translates into emaciation.  Children born without functional insulin receptors cannot induct growth hormone, cannot induct adipogenesis. Not only are they incapable of gaining fat, they are more or less born without functional adipocytes because of the lack of insulin prevents proper development of adipose!

Conversely morbidly obese people have so uch insulin stimulation of fat organ that their adipocytes are 3+ times greater than normal in number, they develop hyperpigmentation of the skin from the insulin signalling, and are typically experiencing macrosomia at birth/are larger relative to others without hyperinsulinemia. Diet zealots point out how gluttonous and shameful americans are , our modern clothing is *so big* relative to our grandparents. Yea, well my grandma didn't develop in a womb with extreme insulin levels -> hyper induction of IGF1 either. Obese people have well developed pancreas with supersecretion of insulin, and hyperplasia of the entire adipose, and generalized macrosomia. These are ALL effects of chronic excessive insulin.

It does boil down to insulin, as complex as obesity is.

It would be great if bacon had zero impact on insulin. It would even be great if *butter* had no impact on insulin. Sadly, all food is insulinogenic, some are more so than others, and this is why as crude and stupid as CICO is, it does work. "Work" is relative, starving on rice "works", but it works nowhere *near* as well as what wooo is doing (see how much food I eat? See my recent pictures? I do no exercise other than basic activities very light work). CICO is another tool to reduce insulin and that's why it causes weight loss. Calories are just short hand for "something that increases lipid accumulation in fat tissue via insulin". Bacon calories are far less obesigenic than pizza calories for a lot of reasons, but ultimately if you are eating tons and tons of bacon , your insulin levels are going to be quite a bit higher and you are going to stall/plateau out.

Restricting cals is not always the answer. If you are cartoonishly sedentary moving around a bit may be a better idea. Fasting is a great idea or at least consolidating eating to more distinct periods (i.e. snack less).  Sadly, fat is not a free food, and most of us unless we are the most vegan-like of keto advocates will honestly admit this from hard earned personal experience.

This is why I generally offer the advice to base diets on protein. Protein is the least insulinogenic macronutrient. While protein promotes greater insulin than fat gram for gram, the actual real world effect is that most protein is used to support growth, repair, and powerfully suppresses appetite/eating behavior. Net insulin levels are lower on a high protein diet, relative to a high fat diet that is low in protein. There is a great deal of individual variation, but most of us find this so. If you are supersensitive to obesity even the insulin from protein and blood glucose increase may be too poorly tolerated. .. but like I said, this is more *rare* to experience.

For me personally, I follow ketogenic diet with limits on protein firstly for mood and second, because I tend to get escalating hunger from protein due to my crap body. But usually when I advocate for higher protein to a typical low carb dieter, the result for them is a lot less hunger and rapid weight loss. This is how most people with a moderate level of obesity sensitivity respond to protein based diets.

But yea, wooo sooooooooo wishes it was true that you could just sit around eat cream cheese and watch the fat melt off, just ain't true unless you are like super obesity resistant or already super fat / have not lost much weight / etc. Once you get wooo sized or anywhere near wooo sized, insulin sensitivity is sufficient that eating "insulin free foods" like butter = fatfatfat.