Metabolic Syndrome 5 Part Deep Dive Part III

Part 3 – From metabolically healthy to metabolic syndrome – the mechanics continued

Recapping so far:

• We start with the physiological cause for insulin resistance in muscle, is that you can’t get glucose into glycogen in the muscle due to a block in the transport part of the process from build-up of fat in the muscle.
• Insulin levels increase to try and cram it in, which increases fat storing hormones and the production of glucose into fat.
• Muscle insulin resistance can lead to fat accumulation in the liver, atherogenic dyslipidaemia (increase in triglycerides, decrease in HDL-C) and fatty liver.
• Insulin resistance in muscle drives glucose to the liver, leading to fat accumulation

As for the liver in contrast to the muscle, insulin is not required to stimulate glucose uptake in the liver. (10)Similar to muscles though, the liver has insulin receptors.

Fat in the liver interferes with the signalling, which down regulates glycogen synthesis from the glucose trying to come in, and at the same time because of the liver not receiving the glucose it goes into a process of gluconeogenesis (making glucose from protein or fat).

So, now you have a fatty liver from the overflow of insulin resistance in the muscles and the peripheral and this leads to fatty liver and messes with the insulin mechanisms, so glucose can’t get in, so the liver produces more glucose thinking it’s in a starvation mode, increasing blood glucose even more.

“When you get both muscle and liver insulin resistance, and increased glucose production by the liver, then something happens to the beta cells (cells in the pancreas that produce insulin) and that’s when things really start to spiral where you have very profound hyperglycaemia (high blood sugar)- fasting and after a meal” Gerald Shulman

The next sugar we need to look at also is fructose, which I’m sure you might be aware comes from fruit. But also, normal sugar (Sucrose), the same sugar that is in most processed foods, like soft drinks and candy, is made up from 50% glucose and 50% fructose. It is different from normal carbohydrates which is mostly glucose, fructose is digested differently and is transported to the liver to be processed.

The problem here is your liver is the only thing that processes fructose, as where glucose almost every cell in your body can process it. if you take in too much fructose, only your liver can deal with it, and it will tend to make your more insulin resistant. It’s like a 1,2-punch combo.

There are also other factors that can contribute to insulin resistance, and they are:

• Genetic tendencies
• Low Sleep
• Low exercise
• Low sun exposure/vitamin D
• Sedentary behaviour
• Low omega 3
• High omega 6/vegetable oils
• Smoking

While insulin resistance is becoming more prevalent nowadays, there is actually an evolutionary explanation for insulin resistance and how it helped us survive starvation.

Important organs and systems need glucose to function, like our brain and our central nervous system. In the past, us homosapiens didn’t have a convenient store down the road, we had to hunt and gather for our food.
And at times the herd of buffalo might of moved on, or the fruit we’d normally get was out of season, whatever the reason, there were times when we could of gone some time without a real feed, and through evolution from humans all the way to fruit flies, insulin signalling is preserved. This tells us it’s been evolutionary important to spare glucose in times of starvation.

When we are in a starvation state, we get an increase of lipolysis (break down of fat) of white fat tissue, which leads to liver fat accumulation, and this fat accumulation is the same as insulin resistance mechanisms and mediates liver insulin resistance and decreases liver glycogen storage and gluconeogenesis (break down of fat and protein to be converted to glucose) increases in the liver. So now we have more glucose available for our central nervous system and our brain.

That’s a bit of a, hmm moment, right? So, when we are starving there is an evolutionary natural insulin resistance that occurs to save glucose for our brain and central nervous system. But now we have an overabundance of food available to us. And the western diet of processed and refined foods which makes things easier for us and saves us time, but all the extra calories and specifically refined carbs increase blood glucose. This raises insulin, and if you’re eating these foods all day your insulin levels don’t get a chance to go down. Our cells get jam packed, and insulin keeps trying to jam more in, until we get to the point of insulin resistance, and now our body thinks it’s starving. Yes, both starvation and this toxic environment of overabundance of the wrong foods use the same pathways in opposite directions- promoting disease by doing what they were at one time, was protective. And now they’re being called metabolic syndrome.

In the next article we will go through how this broken system can be fixed. Yes, even type 2 diabetes, which was once thought of as being irreversible, can be reversed and has been proven. Once we understand the root cause, we can make changes that really move the dial. This way rather than just getting your blood glucose levels under control we can reverse the process and achieve better markers; like your lipid profile, blood pressure, weight etc.