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Dr. Michael Eades - 'Incretins, Insulin, and Food Quality'
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О докладе

Dr. Michael R. Eades received his BSCE degree in Civil Engineering from California Polytechnic University (Cal Poly), Pamona, California and his MD from the University of Arkansas Medical Sciences (UAMS).

After completing training in General Surgery as UAMS, Dr. Eades (along with his wife) founded Medi-Stat Medical Clinics, a chain of general family medicine outpatient care centers in central Arkansas, where he practiced general family medicine for over a decade.

In 1996, Dr. Eades co-authored (with Mary Dan Eades, MD), their first joint book project 'Protein Power', which became a national and international bestseller, selling over 3 million copies and spending 63 weeks on the NY Times Best Seller List.

The Drs. Eades have appeared as guest experts on hundreds of radio and television shows across America. Their work has been featured regionally and nationally on NBC, ABC, CBS, FOX, CNN, MSNBC, and CNBC and seen in such publications as Newsweek, the NY Times, the LA Times, the Washington Post, and USA Today.

О спикере

Michael Eades
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Michael R. Eades, M.D.is the author/co-author of ten books including the NY Times bestselling Protein Power. A long-time advocate of nutritional strategies for the treatment of obesity and other diseases of civilization, Dr. Eades has used the low-carb/ketogenic approach in his practice since 1984. He has written a popular blog on nutrition since 2005.

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Okay. Well, I want to talk about something today. That's a little bit different and I think extremely important and I've watched either been here or what's time streaming? I think every talk I may have missed one or two and I've never heard anyone mention incretins and I think that's already extremely important thing to know if you're interested in low carb, if you're just interested in nutrition in general how many people even know what ingredients are in the see a show of hands? Okay, if you so let's get on with the disclosures. I have an affiliation of the companies

does a proprietary weight loss supplement. I'm the author Cawthra 10 books that are still generating income. I'm currently work with my co-author my lovely bride writing an update to protein power which will call protein power 2.0 and I get no funding from industry got something that's going to try out here. I put together a little packet of stuff. I'm kind of Piggybacking off of another company that I'm involved with which is the nutritional company, but if you want to get some references to this talk and another video and a couple of seminal articles, you can

text on your smartphone 44222 in the in the number part of the message part put LC thin 2019 and you'll get a message and it'll tell you what to do to get it. So what is Cassandra. I got it. I got to say that I got in trouble last year because I went over and Jeff was going nuts trying to give me the hook and he let me go a little long so he warned me this time not to do it. So this presentation maybe a little herky-jerky because when I ran through it, it was a little long so I went and jerked out all the transitional slides to shorten it down. So I

think I'll be on time. But anyway, this is the this is the first in the only scientific paper that I've been at co-author on and this was done back in 2000. Was it 2003 with Laura? Coeur d'Alene and in my wife and back then we mentioned glucose-dependent insulinotropic polypeptide which is the + in fredon and glucagon-like peptide-1 and how they stimulate pancreatic insulin and I was a little bit interested in it at the time and then I just got interested in other things and then I saw a great video about a year ago, but

I got in and got bored OC who's the Hungarian friend of mine who brought this whole thing back to the front of my mind and in this packet those of yous want to get it though. He's told me that I could give away his bibliography switch included in there along with his actual video, which is excellent. But anyway, what are and freedoms that one of them is called Gip which is glucose-dependent insulinotropic peptide. What it does is it it stimulates insulin secretion of the pancreas and also stimulates glucagon secretion, which wasn't in this

graphic that I dragged off the internet somewhere. It affects the brain that affects the bone which is really important and fix the adipose tissue apart from insulin. Then you got glp-1 glucagon-like peptide-1 and there is a ton of research going it on about this right now because drug companies discovered that they can manipulate them and actually decreased blood sugar and treat diabetics. So they're all over this one bit. It increases insulin secretion and decreases glucagon secretion and it affects some other organs as well. And we're

going to talk mainly about Gip because I think that's the most important one and terms of doing things yourself to solve health problems. Now I was looking for a good slide to show the GI tract to show release thinks we're in. This is the best I could come up with and I finally said screw it and I went to a I went to an actual dissection of the GI tract and you can see the esophagus coming down with stomach and deliver in the and then the intestine and large intestine and you see that the Gip is in the upper end of the small intestinal tract and those cells the case cells are

dentist there that released the Gip and glp-1 is a lower intestinal tract hormone. And once I got the slide completed, of course, I found the perfect graphic. So I'm going to show that too because if you know, they say learning scientist that you have to hear something three times to know we're going to be two-thirds the way of knowing what this is cuz you'll see it twice, but you can see that the proximal intestine puts out the grp that just puts out the GOP. One down the middle. You can see the little

the little dark blue cell that's actually a case L&L cell. They look the same. Some people actually think they are the same sales. What does the same and you can see the brush border on the on the right side for the food comes down and it senses it and then it puts out the g i p r the glp-1 into the bloodstream on the other side. Now what what do in Creedence do for these some things that are just insignificant deals and we're talking about little piddly things are they really important was take a look back at 19 that people have known there been something like this actually since the late 1800s

and somebody even posited it and In 1902, but it wasn't until 1964 and believe it or not right here in Denver, Colorado University of Colorado Medical Center. They did this study and what they did was they did a glucose tolerance test the standard oral glucose tolerance test which pretty standard curve and then they mimic that with IV glucose. Okay, so the curves are identical and then they said let's look and see what happens to insulin response in the insulin response to the IV glucose was like that not very high that people think insulin triggers the pancreas

to rid of that Sugar blood sugar triggers the pancreas to Produce insulin to deal with the blood sugar Bliss is how much the pancreas produces with IV glucose for the glucose in the blood and that's how much insulin at reger's now only see how much you treat her. So she goes to the digestive tract and trips these little increasing hormones. Huge difference and this difference in between is called in cretan effect. And since we since it's my theory anyway, I guess a lot of people see if you look at

the area under the insulin curve for your whole life. The smaller that is probably the longer you're going to live. Then you ought to pay attention to these and creams and what they do and we're going to talk about a little bit today and you can see how you can manage them. But that's a pretty major effect and you can see golden Cretin effects and you can see the upper right perfectly equal blood glucose curve usually different insulin curved because the food the glucose went through the intestinal tract and treat her the least of these side increase now, I'm a big believer. This is a guy

named theodosius dobzhansky who's a Russian geneticist and evolutionary biologists and he's made this famous statement. Nothing in biology makes sense except in the light of evolution and that's kind of how I look at things when I see something happening I ask myself. What's the evolutionary basis for this? And if you look at the incretins years, I guess you have seen it three times. So you'll know it now, but the money involved to maximize energy storage maximize energy storage Energy Efficiency,

so that people can store energy and not have to forage constantly and organisms that ended up developing the ability of this really flourished and prospered and spread throughout the world Swensons pretty important and evolutionary biologists think that back in the early days in evolutionary time where those little yellow dots are that the insulin-producing cells used to be on the inside of the GI tract. So is the food came down as stimulated those cells they put out the insulin to to deal with the blood sugar but it became problematic because

since they are exposed to the outside world does the inside of the GI tract Troy part of the outside world toxins could come down through there and damage the cells that produce insulin so over time these things migrated and ultimately became the pancreas but they're still needed to be some way to communicate with a pancreas instead of just through blood sugar. So that was through these blue things on the left these in producing cells and they could stimulate the pancreas because they can read when the food came through and that's called the Intero insular access.

Now if we go back to the slide on Gip that we showed earlier but it does it doesn't just go to the pancreas and tell him to put on insulin tells it to make insulin Phyllis to make glucagon and we'll see why in a minute but also affects the brain hit it actually stores fat tissue and adipose cells and increasing lipogenesis decreases lipolysis and it affects the bone and it affects the bone in an important way and it's not through insulin is directly through Gip. I don't know how many of you know, what tpn is Total parenteral Nutrition when you're getting food this nasty intralipid

usually which is kind of a bad fat that they give people IV. It's got fat. Calories got some good vitamins in it and people that stay on this long enough, even if they somehow can remain active tend to have bone loss because they're not getting anything through the intestines. They're not stimulating Gip which isn't stimulate a new bone formation. So it It's important besides just what it does to insulin now hear hear some people who have really maximize their efficiency. It's storing fat and you know it sits there the last

two tistics that are red or that people eat on an average of 1.1 hours a day and that doesn't mean you know, you sit down for an hour and a half to dinner at 9 and 30 minutes for breakfast in 45 minutes for lunch. That's a while longer than that. That's actually the amount of time from the latest statistics that I saw on 2012 at the average person actually spends stuffing his or her face 1.1 hours. This shows you how sufficient insulin is because you can go all day on that. You can't charge a Tesla for 1.1 hours and drive it all day. Okay. So it's it's a pretty efficient way to store

fat. And what's this is the sport fact that you see is that your battery and when you eat you recharge your battery and you got a lot of fat, okay, and in fact 70 kg mail isn't anyone. That's all that big is got enough stored fat to walk from Miami to New York without eating a lot of fat when he gets there, but it's got enough fat to do that. The guys in the previous like to probably walk to Anchorage in about half way back. All right. Now this is a this is going to be one of these transition. So let's get into what other

kind of clunky let's get into what these in Friedens really do. This is an interesting study using apples and pureed apples. I eat applesauce and apple juice and what they did is they took subjects and Anna meet a bunch of apples almost a pound of them took him out of 15 or 16 minutes to do that. Then they took it and they had them in these reports at different times using people as their own controls and they had them eat the apple puree the applesauce and they have a wolf it down on one stage 1 part of the study and the other part that had them actually

spread it out over the same length of time. It took them to eat the apple and it does the same thing with apple juice is in that's what the slow juice in the fast use this as they wanted to slow it down so they can mimic the amount of time that they spent eating the Apple. What's interesting about this? This is the glycemic index of Minneapolis 38th. And if apple juice is about 41 and many of you of red stuff I've written, you know, I'm not a big fan of the glycemic index and I've even got a more reason to not be a fan of it, but you got essentially the same glycemic index

and let's see what happens when when they measure the insulin response to this response for the first 60 minutes. We can hide it is that's the apple juice. This is the Apple then I hear same glycemic index markedly increased insulin response to the apple juice, even when it was spread out over the same time that it took to eat the apple. Now this is important because one of the things that these increased Kion is the structural stability of the structural Integrity of

plant Foods in the mall. Is disrupted the greater than free response that you're going to have which is kind of a bad thing for processed food. Let's look at another one hears particle size vs. Glucose and insulin response. Here's fine flour and corpse flower. They're going to have the same last name. You can fix your going to have cracked grains and you're going to have whole-grain. Okay, and the course in the fine flour have about the same glucose response to crack Grange the whole grains the same glucose response list with what happens with insulin. The final flowers got a huge

insulin response rolled it to the others and that's because the structural Integrity of the plant itself has been disrupted and if you look down here at the bottom, this is the increase in the fact that we've talked about it is insulin Ashley Under the Influence area under the curve get the whole grains to get low insulin out of the curve that fine flour. It's got about double the area under the insulin curve. This is another interesting study and there are a ton of these studies. I hear a kind of Cherry Picked these things but they all show the same thing that I wanted each one to show a

different thing that last one was particle size. This one is interesting because it's got wheat bread and it's got a whole kernel rye and it's got this beta-glucan. Rye and wholemeal pasta another bread. If you notice in the glucose curve, it's the only one that drops down below. The bassline was probably make it in a couple hours with trolling means these people are going to get hungry that had that now this whole kernel Rye is whole kernel rye bread in the beta-glucan why they remove some of the whole kernel rye and repair place to which is a soluble fiber

so they put more fiber back in and they took out and they wanted to see if this was an effect of the fiber or affected the actual particle size in the particle stability and structural stability in in the actual brain. So what they found look at the Gip, this is a Gip response and look at the top is the wheat bread. The second one is the beta glue. Even adding more fiber didn't do anything. If anything it made it worse cuz they're replaced structurally stable brain with fiber and then you get down at the bottom you get

the whole meal passes at the bottom and then the whole kernel Rye. And here again is a Gip kurvers a glp-1 prune. Here's the insolent Cur and wheat bread the greatest insulin stimulation followed by the beta glucan Ryan, which is much higher than the regular why so adding fiber back in doesn't really do anything. So it's not a fiber affect. It's a it's a structural Integrity effect of the brain and they actually said that it suggests the structure of compositional properties of fiber play more of a role than the amount of fiber and they also

said that it didn't really matter if it wasn't a function of this Greiner that grin because pasta made from wheat bread made from Rye had the same lower thing because they had in this particular pasta had greater structural stability of the cells. If you don't Jarrell Ravens group got into this back in the 1980 season of white beans. These are scanning electron micrographs and the one on the left is that is the the ranch You know the kind of thing that holds the starch granules is intact and then they managed to break those down and you can see the Little Star on the

on the right pictures a little starch molecules escaping and the same thing you can see not much difference in the plasma glucose at sensually no difference in the glycemic index to look at the huge difference in plasma insulin its enormous. I never ever ever ever thought I would be showing the slide to slide has been the bane of my existence since it came out in 2004 and it's totally inaccurate. I could spend my whole time bashing the slide, but I'm not going to because what it does is it basically tells you how bad should a little bit. I mean, it's it's a

food availability chart and back in the night's early nineteen-hundreds people ate everything. They could get their hands on there was very little food waste and now it's a huge problem and in an industry. And in fact, it's estimated that each individual waste about a thousand calories Cake House of Food a day because food so cheap stay back in 1909 on this thing started food was too expensive so big portion the family budget people than wasted. Now, it's next to nothing as a component of the family budget. So the car was really aren't as high as they were back then and back then

people work. It was it was it was a different world people mainly worked on farms. They worked in commercial. Sing that works in mining and they worked in factories. There are not a lot of white white collar workers. So these people wear out, you know, plowing the fields. They were digging in the mines. They were milking cows. They were wrangling horses. And today I Rangel tabs on my browser. So there's there's a huge difference in the work output today with what does shows is that fiber has definitely Fallen is a is a

percentage of food. And remember my timer doesn't really matter. But what fiber is as kind of a cigarette surrogate for the the amount of processing in the food and you can see that much more processed food. In fact, that's basically what American city is processed food. They processed grains and sugar and that's kind of the the basis of the true American food pyramid and you can see on this slide that in the whole green thing that back during the War years. El Puente the full unprocessed food because of rationing than the Roaring Twenties people were prosperous State process

more prosperous. What's the word I'm broken without processed food and then World War II in the depression the same thing they got rid of the process food. So we'd a lot of processed food and that's going to really increase the area under the curve based on what we've seen before. Now. Let's look at the in cretan sponge to live it now in Friedens respond to protein to but not very much. If you look at protein, there's not a lot there even if you grind it up, there's not a lot. It's about the same if you hydrolyze it which is basically you view predigested there a little bit of an anchor

response but not a lot but this is the increase in response to lipitz which is pretty interesting. If you look to the left this was done in 2011 was the same thing. They did back in 64, except they this time then they gave people lipids they gave them intralipid and they drank it and anyway, they created this curved. That's the with the black. And then they mimic that with IV lipid and you can see the Glucose stay the same with both of them free fatty acids. Take the same with both of them that you get in here. And you look at the g i p u c it got a pretty good response from

the lipid from the oral if it didn't do anything with intravenous because it didn't go past the cells and glp-1 did the same thing you look at the insulin. You got a little bit of Verizon insulin. Will you don't have any glucose is coming up? Why would you have a ryzen insulin? You have a ryzen insulin because you got to store this fat and you need insulin to store fan. So you got a little bump of insulin to store the fat and because you get that little bump and then sling you also get a little bumpy glucagon cuz if you didn't get the glucagon you would become hypoglycemic because you're

not getting any sugar with a fat that's coming and it's just fat and so if you raise that cause you to raise your insulin levels going to drop your blood sugar, so the Gip stimulates the production and release of glucagon. This is kind of a weird study. It's weird. But it's it's telling these four guys 6 obese males before and after 3 weeks of total caloric restriction. And I mean total caloric restriction. They fasted for 3 weeks have water only lost an average of 10.8 kilograms if she's a lot of weight and they

didn't when they did this test. They drink 150 cc's of a suspension of corn oil and and they they did this and you can see on the top. Is it before and after food restriction to go see the line across the top they can IV glucose and they wanted to have IV glucose to see what effect the glucose would have without it having the incretin effect. They give him IV glucose and what you can see is the top of the glucose corsey IV glucose has the highest in the Nexus the oral fast and then they are mean IV glucose supposed to oil fattening at the bottom is

oral fat witch. Shouldn't stimulate any glucose response the insulin response. The highest one now is the IV glucose an oral fat and this is what you find an increase in response. Is that when you mix fat and sugar You got a lot of insulin and it makes you think that maybe in olden times people didn't need a lot of mix meals. And if you try to think of a food that you can find a nature this time both fat and glucose sugar hard to find one. It's either one or the other but that runs it up and you can also see what it did with the g i p

and you can see on the right hand side after food restriction and they lost all this way everything. I moderated them in their got disrupted metabolism on the left side. So if you look again if what to think reading response to mix meals and I don't particularly like this study because it's a clamp study and I think that kind of screws things up, but it's interesting. Nonetheless is people a different times a sandwich and all the components of the sandwich seed butter. They drive me and the bread and sandwich and no meal and what they discovered is that if you the mix meal

had the the greatest response the greatest insulin response followed by the better for all of us to dry me like I said out of protein doesn't have a big infragen response. If you look over here, this is GPI one. It's kind of what you'd expect when you have the mix meals. It's really high and that means it's stimulating insulin which we saw on the other Charter and if you look at the increasing the fact which is what we looked at earlier, it's almost three times more for the next meal that it is to drive meet. Dallas this is one of

my favorite studies because these are even though it's a mouse studying. It's a c57bl mouse, which is kind of a broken Mouse metabolically anyway, but what this study shows is it if you put these my son Chau they don't have much of a away game there with 24% fat 57% carb. If you go to my high fat diet that he gained weight like crazy people on a western diet, which is kind of intermediate and fat and carbohydrate. They also gained a lot of weight. A lot of people would have stopped here and they would have just pronounced that well, this is obvious that the low-fat

high-carb diet is best because he's my eyes don't get any weight on it. These guys went the extra step and they decided to see what happened if they destroy the Integrity of the structure. So they they missed everything the ground assault the powder and they reset it to the mice and one ended up happening. Here's the basic channel guide. Here's a high-fat diet. And here's the Western diet exactly the same exactly the same. The only difference was this was powdered. And so you got to be careful when you read these studies and just in case you don't

believe me cuz I made the slide up. There's the actual slide from the from the journal. What's let's see what kind of an insulin response we get to the mattress and a macronutrient order of consumption. This is a Japanese a slide from Japan and they fed these people three different meals that could have been a lot C3 factor of 3 * 260 cat has six different combinations with a phantom 3 they start out with the carbs first and then a vegetable and then the meat then the vegetables in the car send them eat then the vegetables in the meat and the carbs and what they looked at was the

the glucose response and what you can see is you get the lowest glucose response. If you need the carbs last and you get the highest if you eat them first or even in the middle and if you look at the insulin response to Hisense for responses eating The Cars first Lois's last and the other intermediate and this is another quick study. That's that just was looking at greylyn which is a hunger hormone and it's looking at eating a sandwich bringing the car part of the Sandwich Fair. The carpet of the sandwich later and higher the grilling is the hired you're hungry as you noticed. If you

get the card first, you're going to get hungry in 3 hours. If you eat the carbs last you don't get hungry. So the moral of the story is life is short. Don't eat dessert first. Probably a good reason we eat dessert last now. These These are these incretins are glucose-dependent and the higher glucose is the greater the increase in the fact because glucose-dependent insulinotropic peptide. So there a function of what the underlined glucose level is this important

to keep the glucose low and this is a thing I got from a doctor friend of mine from a patient. This is a continuous glucose monitor. You can see this patient came in the second week in January of last year and look at the look at the flick of the glucose fluctuation. It's all over the place. Put the patient on a whole food low carb diet with a lot of meat and a very next week. Look at the decreased glucose movement. Decreased glucose exert Excursion so that if you narrow your glucose Excursion, you're going to have less of an increase in

effect. When you do something bad and everybody knows about how diabetes can be rapidly reverse with a gastric bypass surgery one type or another and here are three different examples and this is all the function of of GP l130 op1 and thus the first is gastric binding and if you think about it remember glp-1 is distal. It's at the lower end of the ballast. If you just wrench off the top of the stomach like they do in these gastric banding is still west of food through the food still hits the g i p at the top part of the thing as a gut hormones are really unchanged and

patience continue to feel hungry feel hungry and it's not really that good for reversing diabetes. You can see the stomach taken away. The little pouch right at the top of it is deferred it down to where it enters the jejunum, which is the lower part of the small intestine, the middle part of the small intestine the strength of the jejunum. The digestion is all distal you had this huge outpouring of GPL one and you have a reversal of blood sugar and enhanced insulin concentration. So these are the people to get well really quickly. And then if you do the sleeve gastrectomy you get rid of

the gastric Reservoir and you still got the soul sleeve coming down so it did it get some to the Athena in the upper part of the small bowel and it also elevates glp-1 levels and gives you enhance insulin concentration with the best one is the ruined why if you're doing it to reverse diabetes, so What are the take-home lessons from what you just learned about incretins? The first one is if you want to decrease the area under your insulin curve and you want to heal yourself and you want to do better don't eat if if if you if you're going to insist on

eating don't eat carbs. If you say I want to eat carbs will don't eat processed carbs in highly unprocessed carbs. Don't eat the carbs first eat them last and don't praise with these are some of the slides unlimited don't graze that you're better off any fewer larger meals because you have an overall lower in pretending response and Mainely Meat and that's it. Thank you very much for your attention.

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