Monday, November 12, 2007

The South Beach Diet and insulin resistance

I'm reading the South Beach diet book and on page 41, met these sentences:

Once you've lasted through the 2 weeks of Phase 1 and rid yourself of your sugar addiction, you are ready to begin adding more carbohydrates to your diet. By this time, the insulin resistance syndrome has disappeared.

I find this comment quite remarkable for a number of reasons:

  1. He is implictly claiming that people who are overweight/obsese have insulin resistance.
  2. He is implictly claiming that insulin resistance is caused by eating carbs, which is not the orthodox idea.
  3. It is not known if there is a cure at all (which is implied by disappeared)
  4. It is not considered known (in standard medicine) that a low carb diet can lessen insulin resistance.
  5. There is no reason that I know of to think that even if low carb does cure insulin resistance that it would happen if 2 weeks.
Type 2 diabetes is basically a very bad case of insulin resistance. The converse isn't necessarly true, that is having insulin resistance means a person is at risk for type 2 diabetes, but it may not have occured.

He doesn't (at least, so far as I've read) explain or justify this claim, so I don't know what causes him to make it. I'm willing to accept points 1 and 2 as working hypotheses (unproven, but plausible) .

Point 3, that there is a cure, is more interesting. Insulin resistance means that the body cells don't respond normally to insulin, requiring higher levels to use the glucose in the blood stream. Withoug eating carbs, there is no glucose needing to be managed, no need for insulin, no need for insulin receptors to act. Insulin resistance doesn't matter, because insulin isn't used. In that sense, a low carb diet sidesteps insulin resistance and makes it irrelevant. It isn't a cure, but it doesn't manage the condition.

However, what the body does when it isn't challenged by hits of glucose and how that affects insulin production and the cells response is pretty much unknown, at least from anything I've read. Perhaps it resets itself, this is possible. If it does, it is also unknown how long it takes, but I would be willing to bet it is longer than 2 weeks.

So in summary: These statements to me are a mix of the probable (but unproven) -- that overweight comes from faulty insulin activity, that insulin resistance comes from eating carbs, that low carb can manage insulin resistance, the questionable -- that one can return to eating (good) carbs with impunity after 2 weeks and the unbelievable -- that 2 weeks of low carb cures insulin resistance.

To give him credit, he does say at some point that if one starts eating carbs and no longer gains weight, the thing to do is to back off on the carbs.