Fitter Food Radio #104 – The Role of Insulin

Keris and Matt review some of the latest research on the hormone insulin and its role in energy metabolism and disease processes including diabetes, cardiovascular disease, and cancer.

Listen below or head to iTunes or any podcast app for the full episode.

Please share this episode with anyone you think would benefit from the information and advice and if there are any topics you would like us to cover in future episodes please let us know and send an email over to [email protected].

Our discussion includes – 

  • Role of insulin in the body
  • Importance of healthy digestion and how you eat in supporting blood sugar regulation
  • Why and how insulin resistance occurs
  • The difference between Type 1 and Type 2 diabetes
  • Important nutrition habits to restore and support the role of insulin
  • One ESSENTIAL factor to implement with calories to restore insulin function

Access the full transcript here –

Matt: How we doing, guys? It’s Fitter Food Radio, episode 104. They are coming at you thick and fast. Now it’s me, and I’m here with Keris, of course, as always.

Keris: This feels like Groundhog Day, because we’ve just done this four times, and then one of us has fluffed up.

Matt: We fluffed up. Fluffed up.

Keris: So we end up … People don’t realise how many podcasts, we have mentioned this probably before, get recorded and don’t make it out.

Matt: If we just went proper organic with it, just put them out there, what we recorded, we’d be on what, about episode 5,000 by now? Geez.

Keris: We’ve done like 50. We’ve done over an hour and actually then bummed it, haven’t we?

Matt: Scrapped it.

Keris: It’s gone, I’m not even sure if there’s anything. Which is silly, because there probably was some value in it, but we definitely got off on tangents big time.

Matt: It’s just have fun though with podcasts, because you have some people that message and say, “Oh, I love your podcast, but I wish it was a little bit shorter, ’cause then I’d be able to fit it in in my dog walk, or my commute to work, or something like that.” Then you got other people saying, “Oh, you do some short ones. I miss your longer ones.”

Keris: Yeah. And then some of them say, “Cut the chit-chat, get to the point.” And some people say, “I really like the informal chit-chat.”

Matt: Yes. The reality is, and we know this.

Keris: Never gonna please anyone.

Matt: You can’t please everyone. But we like to keep it real, we like to keep it informal and organic, so to speak. And I actually quite enjoy listening to a bit of chit-chat, if it’s quite natural, and there’s a bit of banter there and stuff when I listen to podcasts.

Keris: Well, I listen to some that are educational, but I do just feel like I’m listening to a webinar, where you might be listening and some people come on, they go, “Now today, we’re gonna talk about this.” This is what happens with this … And that’s relevant to me. I teach, I need to do that kind of learning.

Matt: Of course.

Keris: But, then there’s a few that I’ve noticed has trends towards doing like, less than ten minutes. It’s driving me bonkers, because by the time I’ve set off on the dog walk, and got the poo bags at the ready, and you got the leads ordered, and you plug your headphones in, and … It’s a lot of faffing. And you get ready, and you plug in, and you start walking. Then it’s like, “and that’s the end of the podcast.” It’s, argh!

Keris: And I’m quite fussy about what I listen to. It’s got to be something I’m going to learn something new today, you know? Enough to troll back through. And I’m like, who’s decided that we only want five minute episodes now? They’re prolific! Everyone’s doing it.

Matt: Yes, very popular.

Keris: I’ve seen two minute ones. Which is just ridiculous. Like, [inaudible 00:02:24] who’s just gone home.

Matt: Morning!

Keris: Yeah. That’s it! Ha ha ha. Have a good day!

Matt: Love you, well!

Keris: It’s like thought for the day, and I’m like, yeah but the faffing around, and the trying to find … And then it runs into an episode that I didn’t really want to listen to necessarily.

Matt: That sounds a pill to me.

Keris: So, yeah.

Matt: Well it doesn’t appeal to me to do podcast like that. I doesn’t appeal to me to listen to podcasts like that, and truth to be told, I don’t get it anyway. Because I’m a bit like, what if the podcast, for example, was two hours long, not that ours ever are, some are. I’ve seen other people’s. IT’s like, well then, pause it, and listen to the rest later. Like what’s the …

Keris: Well I just want to …

Matt: Do you know what I mean?

Keris: Yeah, what’s …

Matt: Why’d you have to complete your whole episode in a particular amount of time? You know? It’s like reading a book, or listening to an audio book. You don’t do the full shebang in one go.

Keris: No, no. Well also, there’s that thing of always summarising everything at the beginning. Which I totally understand why you do that. For me, it ruins it. I’m like, “Ah! Don’t tell me, don’t tell me!” Like, I want hear it it play out. I want the conversation. I want the …

Matt: It’s interesting you say that, because sometimes I look at podcasts and I actually read the description, and the description doesn’t sell it to me. And I’m like, no, leave that. Whereas sometimes when I’m driving, of course, you know, can’t be on my phone and driving, and I’m not. Podcasts, I let them just play. And it’ll go into an episode, and I end up really enjoying it. But actually afterwards, when I was bit a like, “Oh well, what was the name of that guest again?” Or something like that. And I look at it and think, “Do you know what? If I had read that description, I wouldn’t have chosen to listen to this podcast.” Because that doesn’t sell it to me.

Keris: Yeah.

Matt: So it kind of just shows sometimes that kind of unknown and just see how it goes.

Keris: Yeah, yeah.

Matt: Is nice. And then you end up, you might enjoy it, you might not.

Keris: Yeah.

Matt: I suppose equally I’ve tuned into a podcast that I’ve thought, “Oh, that sounds amazing.” And it just …

Keris: Some of the ones I listen to …

Matt: Massively under delivers, and I’m like, “Oh God.”

Keris: It’s funny because that some that I listen to, I’ll be like, tidying the bedroom or something, and you’ll be like, “How can you listen to this? The voice is so monotone, and …”

Matt: So basically …. We just need you to consume more antioxidants through blueberries specifically.

Keris: Ha ha ha! It was one line that I’ve just got to repeat it back, and I was tidying up and this guy on a podcast went … He was interviewing a woman on Alzheimer’s saying, “Are you basically saying, when you say eat less sugar and eat more healthy fats, are you basically saying, don’t eat blueberries which have got sugar in, and eat more burgers and hotdogs because they’ve got fat in?” And I was just, like …

Matt: Face palm?

Keris: Yep, that’s exactly what’s she saying. The guy interviewing was really amazing and intelligent, was trying to draw her out to say the right thing, but you know it’s just painful!

Matt: Sometimes I kind of almost do a bit of, I suppose, try and get you to simplify something that you’ve just said, and it would almost be like, “Hey, just to clarify, here’s what you’re saying.”

Keris: Yeah.

Matt: But I just think our kind of podcast is just a little bit more conversational. It’s a bit more informal. You’re an expert, of course you are, you’re well clever. But what I’m saying is that for me, the podcast you was listening to wasn’t that casual, it was quite a bit of a geeky podcast. So I’m a bit like, a duh! Anyone that was tuning into that podcast was thinking …

Keris: Don’t eat blueberries, there’s so much sugar in blueberries!

Matt: Yeah, you know. I best cut fruit on the head.

Keris: To be fair, blueberries are getting very big though, I have to say. Don’t know what they’re doing to them in Mexico but they’re like …

Matt: Oh, as in the size of them?

Keris: They’re the size of grapes, aren’t they? But anyway.

Matt: I thought you meant, like, a bit of celeb at the minute.

Keris: No, no, no.

Matt: Just going right to them head.

Keris: There’s loads of …

Matt: Gone right to their heads, as they do.

Keris: There’s so much research to support berries, like as in every different kind of antioxidant, anti-inflammatory, loads of benefits, but when I look at them in the supermarket, I’m like, but the berries are the size of apples. And they’re like, brighter than they’ve ever been, and sweeter than they’ve ever been. And it’s like, well, we need to go back and pick them in Oakley, don’t we? Anyway.

Keris: We’re not talking about berries today. We are talking about …

Matt: Coincidentally as opposed to talking about berries and carbs and stuff like that, Keris was like, “I want to do a podcast on insulin!”

Keris: Ha ha.

Matt: I was like, “Right, then we will!”

Keris: Only because, again, there’s so many trends going on right now in the fitness industry and in the nutrition industry, and at the moment it’s really interesting because you’re more, I’d say, you’ve got one foot in the fitness industry, probably more than me, and I’ve got one foot in the nutritional therapy category.

Matt: Where’s the other foot then?

Keris: Tied to mine, we’re doing a three-legged race.

Matt: Ha ha ha!

Keris: Ha ha ha!

Matt: I thought you were going to say, “One foot in this, and one foot in the … Gelato shop!”

Keris: If only. Well, yeah, that’s probably true.

Matt: One foot in the nutrition industry, one foot in your ice cream parlour. Sounds like a [inaudible 00:06:50] lifestyle to me.

Keris: What I was about to say is, so we’re doing a bit of a three-legged race where we kind of come together, an I’m like, “Oh gosh, I’ve just read this, this, and this.” And it always go through bouts and phases, and at the moment there’s a lot of focus on, you know, low carb has always been there, but now ketogenic is kind of, I mean, it’s always … Ketogenic was kind of very big the last couple of years, and now I’m seeing it in the nutritional therapy world do a big surge again, and everyone is like, “Keto, keto” over various different things. So it was very big in sports performance side of things, and then if anything the science suggested it wasn’t really …

Matt: It was like endurance, kind of.

Keris: It was, wasn’t it? Yeah. And it’s not really, in terms of performance, there’s nothing to say that it’s going to be any better than other different nutrition interventions, very individual. I think, again, you can look at some studies on this. But just kind of looping round, in nutritional therapy now, and especially for cancer, ketogenic diets are having a lot of focus there. And I definitely think there’s something in that.

Matt: But it’s still very much in its infancy, isn’t it? In terms of …

Keris: Completely. Completely. And it’s for certain types of cancer, not all types of cancer. I think eventually what’s going to happen is there’s going to be, we’ve said this before, but different nutritional interventions for different types of cancer that across the board there’s about 10 to 20 things everyone should be doing that’s on to cancer. So before you go down the route of extremes, get them in place and then give your body the best chance.

Keris: Just to kind of move back to the hormone incident, one thing that’s kind of apparent to me, and you’ve seen this again in the nutrition education that you’ve done is: There’s a massive misunderstanding about what insulin does and the role of carbohydrates. The role of carbohydrates insulin in weight gain, and now because we have type 2 diabetes as well as type 1 diabetes, everyone is jumping to these conclusions.

Keris: So, if we get high amounts of insulin through carbohydrates it equals weigh gain. And insulin is the storage hormone. And actually, I have to give shout out here to two people who’ve really helped me understand insulin better. One is our favourite doc Sally Wood, and number two is Dr. Brian Walsh. Both of them have done loads of podcasts and courses and things on insulin and the science behind it, the new research behind it so that you understand it better.

Keris: So actually, [inaudible 00:09:00] for me, it’s nice because when I’ve looked at the new research on insulin, you can see how you can reverse so many of the disease processes that are driven by insulin which is things like type 2 diabetes, but also cancer, and heart disease even can be driven by insulin. You can reverse it by addressing the things that disregulate insulin or mean that insulin’s action isn’t how it should be within the body. It’s a lot of work we’re already doing, which is nice.

Keris: But now you understand the mechanisms that you’re supporting, and as a nutritional therapist I get to go deeper and geekier about the supplement or diet side if I need to to make sure that somebody … It’s hard to use the word reverse, but definitely halt the disease process.

Keris: I would definitely say with things like heart disease and type 2 diabetes the research now suggests you can reverse them.

Matt: Mm-hmm (affirmative).

Keris: Which most people don’t know. People email us and sometimes say, “I’ve been diagnosed type 2 diabetes, do you think there’s anything I can do with diet and lifestyle?” Sometimes I’m, like, jaw hits the floor. Like, I can’t believe that you don’t know this yet. Like, how does our industry know so much about this and yet your GP who’s diagnosed you with the condition never ever said to you there’s a lot you can do with nutrition and lifestyle and exercise with this condition.

Matt: Yeah.

Keris: Maybe even …

Matt: Well the thing is, you know, like, diabetes is … I think it’s changing right now but it’s often been referred to as purely a diet-related disease. Now …

Keris: Type 2.

Matt: Type 2. Type 2 diabetes, yeah. And, on the surface, it very much is because you make the link between foods that spike blood sugar, consuming too much too often, blah blah blah, leads to weight gain and all sorts of other things. And, you’re type 2 diabetic. However, we always try and look at the bigger picture and look at it as a lifestyle like we always say. Because what decides foods that you eat, you know, is it just that you make that decision to eat loads of sweets? To eat loads of processed foods, predominantly? Or, is there a reason behind that, you seeking comfort from food? Are you eating poorly because you can’t afford to eat better? Maybe there’s that economical aspect, et cetera.

Matt: It’s like, the second we start broadening our horizons a little bit, being a little bit more open-minded with how we could get on top of something, and just know it’s never just one thing, then …

Keris: I think there’s like, we’ve talked about this before, there are key barriers to somebody making some positive changes when it comes to their nutrition, and key barriers tend to be … It can be financial, it can be time-based, it could be knowledge-based, and it’s the latter I used to think was the main reason there wasn’t enough buy-in to a lot of these solutions. I used to think, even just looking at my own family, well if they’re not told this by GP or if this information is not available through mainstream medicine, they’re not being educated, they’re not going to believe in that process. And it doesn’t matter if they hear it on TV on a book; it’s not the same as being told it by the person that’s telling about medications to suppress your symptoms.

Matt: Yeah.

Keris: And so it was a real thing for me, was knowledge, but then having said that, I’ve worked so hard, as you have, in the last 10 years to increase knowledge, and there would always be what my dad calls “the wildebeests” that just ignore you and just walk off the edge of the cliff anyway. You have to just let some people go. They’re never going to make that change and there is for some people, even you said, “I don’t understand …”.

Keris: Like, I like cake and ice cream, you like cake and ice cream, but when it’s life or death, and it is, it just gets to that situation with some people, I have a lot of cases where I’m like, “You need to stop smoking, drinking, eating refined carbs.” Everything … This becomes life or death for that person, and I still see people go, “Well I want the alcohol, I want the cigarettes, I want the cake.”

Keris: It’s very sad, and that’s when …

Matt: It is, but like you said, you’ve got to be able to disconnect and be like, “Right.” Because at the end of the day we often talk about this, and we want to help as many people as possible but in the same way we know you can’t please everyone, you also can’t help everyone.

Keris: Yeah, yeah.

Matt: Because it’s like you’ve said, it is an inside job at the end of the day. Your dad said this the other day, in conversation, and it just, gosh, like, it’s so … I’ve already mentioned on previous episodes. Forgive me if I’m repeating myself, but he said, “My health is my responsibility.” And that’s not to say you can never seek help in any way. But it’s your responsibility to seek that help, first of all, instead of expecting help to just come to you. But it’s also your responsibility to then take action based on the help or the advice, the guidance, whatever, that you have received.

Matt: For us it’s like, there’s only so much you can do. You can take a horse to water and all that. There is only so much that you can do. But it’s for the individual to either play the victim, be like, “Oh, poor me. I’m diabetic or I’ve got all this going on, la la la la.” Or you can play the victor and actually be like, “Right. I’m in a powerful position here because I know what things I could potentially change to help me in the current situation that I’m in.”

Keris: Yeah.

Matt: You know, it’s like we said the other day, isn’t it? It’s like people moaning all the time about having no money, yet every time you see them they’ve got, like, a brand spanking jacket on, or their new car, or they’re going on another holiday. Like … Make your mind up. If you’ve got no money or …

Keris: Or you’re spending too much money.

Matt: There’s this thing with these people that they moan about their ailments until the bloody cows come home but then give you a million reasons why they can’t make any of the changes that you’ve suggested. It gets boring after a while!

Keris: Yeah.

Matt: You and I are quite different in that sense, aren’t we? About … I mean I call people up and I’m like, “Look.”

Keris: Yeah, I think for me …

Matt: You’re a bit nicer than me.

Keris: I think it’s that, and like … I’ve said this to you before: I don’t want my entire time that I spend with friends and family to be discussing ailments. But half of them are suffering with various different signs and symptoms of ill health and some of them are talking about, “I’m getting diagnosed with depression,” “I’m getting diagnosed with some kind of immune system problem,” “I’m getting diagnosed with maybe, osteoporosis, osteopenia.” And I’m like, when was the last time you ever looked whether you were eating bone nutrients? Like, never.

Keris: Then when I talk about bone broth or sardines or bones, they’re ugh! And you’re just like, “Oh.”

Matt: Like a kid.

Keris: Basically.

Matt: Ughhhh.

Keris: Ha ha ha. And then you’re like, “Yeah, this is why I’ve probably got no friends left.” But anyway, there’s only so long I can see you be unhappy and not well and not productive. You know, other practitioners have spoken about this on podcasts that we listen to where they’ve said: “There just becomes that divide eventually where it’s like, okay, keep doing this action and this is your outcome. You’re not very well, you don’t look to hot, you feel overweight, you’ve got poor body confidence or lack of confidence. You’re not fit. You can’t walk up a hill.” You know, like, it just goes on and on. We do have friends in that situation, and they do occasionally call upon us and say, “Can you help? Can you help? Can you help?” And we do help. We’ll always help.

Keris: But after a while I’ve stopped calling back and you’ve stopped calling back. We don’t necessarily want to get up every single day and repeat what we do. But we do it. Because also what we do really want is we want energy and we want happiness. We’re still not talking about insulin by the way.

Matt: But we will.

Keris: Okay. Anyway. That’s dial back round to insulin or else we’re never going to get through … This is going to be a complex one.

Matt: I was just going to say though, something, yeah. Forget about it.

Keris: Go on.

Matt: No it’s just I, you know. Just everything you were saying. I think … I’m always so conscious of ensuring that people know that it’s not a case of healthy unhealthy. It’s never one thing like we say. We don’t live a life of perfection that sometimes people think that we do.

Keris: No, no, no.

Matt: Well I say that. I’m always posting a photo of me eating ice cream and whatever else. We enjoy those things as part of a healthy lifestyle. The reason I’m saying it is we went to the pub, on our local pub after an evening of [inaudible 00:17:05] over the weekend, and we bumped into some of our neighbours who obviously know us, they know what we do. And he was like, “Oh, that’s a sparkling water and a slice of lime for you, isn’t it?” And I was like, “Well, having a pint.”

Keris: Yeah, yeah.

Matt: And he almost looked a little bit … He went, “Really?” Well, yeah! I looked at him saying, “Why do people get this in their heads?” Because I train. Because I’m a PT and I’m nutrition, I just don’t drink? Nothing, the slightest bit processed or sugary or whatever passes these lips? I think even in this day and age it’s the world we live in. People are like, “You’re either healthy or you’re not.” You know?

Matt: And it’s like, no. Stop it!

Keris: Ha ha ha. But equally that was their entire night, it was about the beer, basically, wasn’t it? Whereas we went for one which pretty much lasted two and a half hours, and we were actually in the pub talking about some big dreams that we’ve got, the bigger picture, doing some planning. Came home and had a roast chicken and some salad and some sweet potatoes and watched a film. It was nice.

Matt: Yeah. It was nice.

Keris: It was nice.

Matt: It was nice. Anyway. Insulin!

Keris: Ha ha ha. Right!

Matt: So, Keris.

Keris: Okay.

Matt: Keris wanted to geek out. We said we were going to start doing these more … We’re going call them Fit Food Radio Geek Out Sessions, and obviously Keris is the geek.

Keris: So you tell me …

Matt: I’m the jock.

Keris: You’re going to keep me on the straight and narrow with this one, so I don’t baffle everybody with insulin. I don’t really know what to start with. I’m just going to start off by talking about what insulin is. Yeah?

Matt: Mm-hmm (affirmative).

Keris: So some people call insulin the master hormone.

Matt: Yeah I used to do that because it sounded cool.

Keris: All right. In terms of … I’m debating this now, and this is thanks to again Dr. Brown raised this question in me, because I used to think that, like you, insulin’s main job was storage of nutrients. So, when we eat food. And most foods will insulin response but carbohydrates are known for biggest.

Matt: Be more like instagenic.

Keris: Instangenic. The proteins come as well and that’s why people take certain proteins and amino acids after work outs. So different foods have different insulin responses. By that I mean some can release a lot of insulin, stimulate relatively high amounts of insulin, some a bit less.

Keris: It was called the master hormone because it was thought it was involved in shuttling nutrients from the bloodstream into the cell, which is one of the roles this does. And then it has some opposing hormones that work to do the opposite. So the opposing hormones are when insulin is not up in the body, when insulin is not elevated we have other hormones that are released.

Keris: I’m just going to shuffle back a little bit and say what insulin’s main job is, really, along with another team of hormones, but they all work in opposition, is basically to keep blood sugar levels between a certain range. That’s what insulin is doing. When you look at the research, we seem to have this reference range where if blood sugar levels go … And I’m going to talk in international not U.S. units, that might be a bit confusing if you’re over in the states right now, but over here we use international units.

Keris: If blood sugar levels go below … When they start dropping down around like 3.5, we start to have this cascade of hormones released which is glucagon, glucose is gone, really easy to remember. Glucagon, cortisol, also everyone knows cortisol as your stress hormone, your weight-gain hormone as well. Adrenaline, which again most people known of adrenaline because that’s what we release when we going into some exercise. And then growth hormone. These ones are designed, growth hormone will block the uptake of glucose into a cell. So they’re all trying to keep glucose levels a little bit higher, they’re trying to raise glucose levels.

Keris: There’s one hormone when the glucose levels go high that will help to bring them down, which is …

Matt: Insulin.

Keris: Yeah. So we have one hormone if glucose levels go too high in the blood, and we have about four that we have if glucose levels go too low. What that really suggests is basically the body fights to keep glucose levels at a certain reference range.

Keris: One thing that we’ve been teaching for years across our plans and into our member is: You really don’t want glucose levels going to high. What you want to do … We can look at our response to foods, that’s one way of doing it with a blood blueprint you can have a look at what is your response to certain meals. And generally the kind of thinking is that it shouldn’t be going any higher than 7.8 after you’ve eaten. You can test it between one and three hours after you’ve eaten.

Keris: Another really useful marker that I use a lot with clients, especially when I’m doing blood chemistry, is fasted glucose. So what is their morning glucose? 4.8 is suggested to be a bit of a sweet spot when it comes to your morning glucose levels. But below 5, generally.

Keris: When that’s going really high, again, this doesn’t necessarily always mean it’s about food. There are loads of things that can mean that the body is not regulating glucose levels very well, and that’s what we’re going to try and explain in very simple terms today.

Matt: Yeah?

Keris: Which is going to be very complicated. Next up I’ll try and explain what insulin does, in terms of in the body to bring glucose levels down, is it’s essentially released by the pancreas, which is really important, because the pancreas is made of cells and cells can get damaged very easily. Glucagon is also released by the pancreas. So the two work really closely. The alpha and beta cells of the pancreas, one of is released in insulin to bring the blood sugar levels down, and one is released in glucagon to bring the blood sugar levels up. So you’ve got this really, kind of, tight team there.

Keris: And they oppose one another. So if one is being released than the other isn’t. There’s actually suggestion now that insulin’s main job is to shut off glucagon. And glucagon’s job is to basically run the body, or provide a source of energy in the fasted stage, so when you’re not eating. Glucose is gone, you’re not having anything, and glucagon goes around the body and it kick starts processing like lipolysis, for example, which is you breaking down your fat stores for energy. This is when people get really interested.

Keris: Whenever I lecture on this, by the way, people are like, “This is so fascinating, because this is fat burning.” Really, this is fat burning in action. I find it really interesting because it is … Basically energy metabolism is how are we running energy management in a fed or fasted state. How is the body fueling itself? It’s not about energy production, which is … We’re just either transferring food into energy, or we’re transferring stored body fat, or glycogen, into energy. So it’s always about energy cannot be created nor destroyed, it’s just transferred from one form into another. That’s what energy metabolism is.

Keris: I think it’s quite a sexy topic. Do you?

Matt: Oh yeah. Like super sexy.

Keris: But it is because it’s all about, firstly, it’s all about fat loss and it’s also about performance. If you want to be better, working in a fasted state or energy utilisation in terms of running on your glycogen stores on your fat stores. So that’s why I find it interesting.

Matt: I’m not belittling it at all. I’m just …

Keris: Bored. Ha ha ha.

Matt: No, no, no.

Keris: What if you said that?

Matt: I know, I’m just really bored. No, no, not at all, not at all. Then I think it’s one of those things that it is important to have an understanding of it, and I know we said this was kind of the geek out and what not, but I think it is a good … We always say the more you can understand something the better. You know? If you can get your head around something a little bit more … You don’t need to have a thorough understanding or a knowledge of something, but to have a general outline of what something’s all about. And I think insulin at the minute, it’s good to put some clarity on it because there is that notion at the minute that oh, carbs are bad because carbs ramp insulin and insulin is your storage hormone, and fat storage, carbs, insulin, ah, carbs are bad, don’t touch it. Go keto. Go low carb. Whatever. That for me is something that really bugs me, because that’s not the case at all.

Keris: Actually, when you look at the new stuff on insulin, I think it’s why I’m really glad I’m a nutritional therapist, because there are so many other things that affect insulin levels like inflammation, like infection, like … But, a big one, for most people, is going to be an energy excess. That has a huge impact on insulin, which is something that you and I have always debated whenever I’ve got a client case and I’m like, “I understand why this client is not progressing in any way from whatever mood to weight loss or whatever.” And you’re like, “You’ve always gone about the energy intake.” And I’m like, “No, no.”

Matt: I’m like, “She’s eating too much!”

Keris: No, no, no, or he.

Matt: I think you just said “she” that’s why I said “she.”

Keris: Yeah, sorry, yeah. And actually it definitely stacks up. What hormones do [inaudible 00:25:38] they go round the body and they’re kind of communicating what the environment is, what the body needs to do. So they’ve kind of got instructions, but they have actions so all of them will elicit some kind of effect. So, again, we know adrenaline will be like, okay, we’re going to get constriction of blood vessels, elevate your blood pressure, deliver oxygen nutrition around the body. We’re going to get raising of the heart rate, that kind of thing.

Keris: So we know all these different hormones can have a physical effect on the body to adapt or to respond to the environment. We’ve got these two hormones, we’ve got insulin and we’ve got glucagon. So one is being released when blood sugar levels are coming up and one is released when blood sugar levels are dipping. What insulin does … So let’s say that you are in, for now let’s say that you are … You have just eaten a meal. What happens is this is even more intricate than we ever realised, is as soon as you’ve eaten a meal the tongue has glucose receptors on which we’ve talked about before.

Matt: The tongue?

Keris: The tongue. Tongue has glucose receptors on. But also in the gut, in the small intestine there are hormones known as incretins which are released which basically signal the pancreas and say, “I’ve got some food coming here. Got some carbohydrates come in, you need to …”. The main one is called GLP-1, glucagon-like peptide-1, which signals the pancreas. And what we didn’t know is that the pancreas has actually been really efficient in the background and it’s pre-made some insulin. So it’s actually in advance. We thought insulin was …

Keris: Pre-made some insulin. So it’s actually in advance. We thought insulin was released when we were eating the food; it was kind of being made on demand. The pancreas was going, oh we’re eating, we need to release some insulin and get those blood sugar levels down, but actually pancreatic cells make insulin and they put it in little bags ready for when someone’s gonna eat a meal. And it’s the small intestine, and these hormones inside the small intestine which signal the pancreas, so the pancreas can actually start to get the insulin ready, which means that your response to a meal, there’s less of an insulin spike. Does that make sense?

Matt: Yeah.

Keris: Because the insulin’s already being released as the food’s being digested, which means by the time the food crosses through the gut wall, then what happens is all food basically ends up at the liver, so carbs, fats, and proteins end up at the liver, but we’ve already got insulin around the body ready to act on cells. The biggest deposition for food or for energy is generally things like muscle and fat cells. So all the cells are going to use a little bit of the energy for their needs. So a cell … even parasites in the gut might be like, I need a bit of these carbs for my own energy and to take some of this glucose, use it in a mitochondria, produce ATP to do my little bit of stuff.

Keris: What happens after a while is when all the energy needs are being met, there might be an excess that we start to store it as glycogen in the liver, or it can be, again, in muscles therefore in fat cells. So we start to store any excess. The small intestine is one of the first places which is integral in terms of making sure that you have a healthy insulin response to food. If that is knocked out, and there are various different ways where this can be knocked out. Just think of small intestinal health, gut issues, that kind of stuff. So maybe there’s some kind of problem with communicating from the gut to the pancreas, it means that you won’t do your pre-made insulin, and you won’t release it ready, and therefore you have a greater spike of insulin after eating, because the body’s suddenly like, “Whoa, there’s all this food here. I need to pump out some insulin.” We get a greater, higher release, or increased release of insulin after eating. Does that make sense? You still with me?

Matt: Yes. I’m with you.

Keris: Number one takeaway is basically, gut. But not just gut, the way that you eat your food. So chewing, rather than having liquid calories, can make a big difference to that first phase insulin response, as it’s called. The first phase insulin response is coming from the digestive system, and chewing the food … I think at the start it’s something ridiculous like 32 times … if you chew your food 32 times.

Matt: Wow. Blimey. But again that would –

Keris: You’ve got me thinking about … I have smoothies out of convenience, and I’m like, gosh I wonder what my … how that’s affecting your –

Matt: But wouldn’t that depend on the food as well? For example, a steak would require more chewing than some steamed vegetable.

Keris: Well, yeah. But what they’re saying is that generally if you think about it, we would have chewed prior to food processing, most of our food would be chewed, wouldn’t it? We would have eaten meat, eggs, vegetables, fruit, fish, bones. I think a caveman ancestral diet was like chew, chew, chew.

Matt: I don’t think even a caveman would have been eating eggs.

Keris: Well, no. But to be fair, maybe rocks. And if you think about even … go back 50-60 years, sandwiches, all those kind of things, it’s all chewing, isn’t it? Whereas now it’s a lot of things like smoothies and I have some kinds of the smoothies, soups, nut butters, those kind of things. We’re pureeing a lot of food for convenience more than anything, aren’t we? We’re like, “Let’s just puree everything and just get it down.”

Keris: So that’s interesting one. One of the first steps you might want to consider is to take out liquid calories for a start, and definitely think about drinks. That’s an easy, quick way right there. Removing any liquid calories in the form of fizzy drinks, lattes, milk, would possibly improve your response to food, and going back to more chewed foods.

Keris: With regards to the smoothie one, it’s a bit difficult. I think if you stack it with fibre there’s going to be a slower … it’s going to sit in the stomach for longer, but you are still missing the chewing side, so maybe start to eat a stick of celery, eat a carrot, and then eat your smoothie. That’s another option. That would get you chewing, wouldn’t it?

Matt: I tell you, I’m not feeling this. I can’t see this taking off.

Keris: What, eating a stick of celery before … to be fair, we eat our vegetable crudites most days.

Matt: Yeah, but with hummus and salsa.

Keris: Yeah, but we have them before lunch and dinner. Why not for breakfast? Or, start eating an apple before you eat your … an apple’s a good one, before you actually have your breakfast smoothie. Porridge is another example of a food that you don’t chew.

Matt: True. Chew. True. Chew.

Keris: We’re going to lose the ability to use our jaw soon. Because we talk less, we use our phones [crosstalk 00:31:46], we don’t chew our food. You’re gonna start to get seizure of the jaw.

Matt: We’ll evolve to have no jaw muscles. Your jaw will just be open all the time.

Keris: Like a pelican with a pouch, just to put the food in. I bet you it’s affecting speech in kids, actually. I bet you.

Matt: Why kids though? Kids aren’t really doing smoothies for breakfast, are they?

Keris: No, but parents … this is a big argument, and I don’t get involved in it. We don’t have kids, so we have no right to get involved in this argument.

Matt: That’s not true.

Keris: This is why you do the baby-led weaning, where the food is put in front of the kid and they use their hands and pick up the food and then chew it. So they use a lot of things like chopped fruit and vegetables. That process of using hand to mouth and then chewing, it’s all about development of jaw muscles, tongue, and therefore speech development. And now, parents are pureeing food because it’s cleaner, as in easier, and then spooning it into child’s mouth, and there’s a big debate between parents, where does that leave you. Some of my parent friends, step-parent friends, have said, “Until you’ve had food splattered up the wall, like spaghetti and all sorts, you can’t say anything.” And I get it, you know what I mean?

Matt: Oh yeah, I can totally –

Keris: I’ve got friends who are single parents and working and –

Matt: It’s almost like you need a feeding room. That’s wrapped with cling film –

Keris: Or like white clean boards all around it.

Matt: Everything’s a white, clean surface, so you just go in there, close the door, let them just throw the food around there like they do.

Keris: And then you could just put something like Peppa Pig on so their jaw just falls open like it always does with Peppa Pig and then you could just throw the food in.

Matt: When the jaws open. Got that down ’em.

Keris: How on earth did we get to this point from insulin? Anyway, so gut health, chewing your food, eating your food, avoiding liquid calories, is your first thing … just a couple of things that you could do to improve your insulin response to a meal. Next up, so once you’ve got … as I said, all food goes to the liver. A big factor that’s being discussed at the moment is whether the cells of the liver are … and when I say liver damage, people think it’s something really severe, like cirrhosis of the liver, where it’s from alcohol poisoning or drug toxicity or something like that. But liver cells are just like every other cell in the body, where they just need certain nutrients to run and do their thing, and they just need to be healthy.

Keris: You metabolism can be compromised by the fact that the cells of the liver just aren’t healthy and able to their thing. And one of the things they need to be able to do is listen to the hormones, [crosstalk 00:34:09], are we in the fasted state, are we in the fed state. Do I need to be … so one of the roles of the liver is to make new glucose when we’re in the fasted state. But how does the liver know if we’re in a fed or fasted state? So that’s one of the things that’s kind of being discussed. Because sometimes the cells will shut themselves off to the outside environment if they’re a bit metabolically damaged. I’m going off on a bit of a tangent here, but liver health is important.

Keris: So just to rewind a little bit, what happens next is, you’ve just eaten some food, insulin is released via the pancreatic [inaudible 00:34:41] cells, and what it does is it comes around, it’s a peptide hormone, which means in can’t get into the cell. It’s made of amino acids, so once it can get inside the cell, are made of cholesterol so they can pass through the cell membrane which is made of fats. Whereas what insulin does is it attaches to a little satellite dish outside the cell, which we call a hormone receptor or an insulin receptor. So it’s a bit of a lock and key, it’s designed to lock in to that little satellite dish. And then this cells knows, it says, “Right, insulin is here.” And what insulin does is kind of knocking on the door, and it’s saying to the cell, “There’s some glucose outside here and it needs to come in and you need to take it in.” And the cell makes a decision whether to listen, which is again slightly new thinking here.

Keris: What the cell does is, if it decides it wants to listen, and it wants to bring the glucose in because it’s healthy and it can do something with it, and this is a big factor. Sometimes the cells ignore insulin because they know better, they’re a bit like, “It’s too chaotic in here, I don’t want to have any more glucose coming in.”

Keris: One of the best comparisons I can make for this is imagine again if we’re doing a batch cooking session in the kitchen and you’ve seen me batch cook, and I make a tonne of mess in the kitchen. We’ve talked about this before, but this is my best comparison of cell function. I make a big mess in the kitchen, I’m doing my batch cooking, but that’s the equivalent, but that’s the equivalent to somebody consuming an energy excess all the time. It means that there is always this churning of nutrients coming into the cell, the cell’s constantly trying to metabolise them, fire their mitochondria, and turn them into ATP, which is the fuel source of the cell. And if it can’t, it starts to basically build triglycerides, which is stored energy or stored fat, or it starts to send it down a pathway to become glycogen, which is stored glucose. So it’ll use what it can, it’s got different pathways, different biochemical pathways to use glucose for function in the body, to make things. And then after a while, it starts to go, “Gosh, you know I’m getting a bit full of nutrients.”

Keris: So if we take it back to a kitchen, it’s a bit like you’re doing a batch cooking session, but at the same session I’m doing the batch cooking session and you’re doing some big supermarket shops, and you’re bringing in the supermarket shop all the time. You’re doing loads, you’re like, “We need to stock up, we need to stock up.” And there’s no break for me. So I’m trying to batch cook but then there’s more food coming in, you’ve got this big stack of recipes to cook, the kitchen’s getting really messy. The nucleus of the cell is the fit food recipe book, because it’s got all the recipes there that we need. And then it gets to a point where we’ve got so much food in the kitchen, so many shopping bags, we’re trying to shove it into the cupboards but we’re running out of space. The sink is blocked from all the waste products because I don’t rinse the plates, I just shove them in the sink and then it gets stuck with food. The sink is blocked, so we can’t even detox. The bin’s full; it’s overflowing.

Keris: This is what we call oxidative stress; when your antioxidant defence systems can’t deal with the amount of mess that’s going on in a cell. Because creating energy in a cell is messy; we get waste products from just processing food inside a cell. So this is what the kitchen is looking like now.

Matt: It’s funny, but I can actually feel myself getting stressed, just you talking about that. Because a messy kitchen does genuinely stress me out.

Keris: And your still bringing in more and more bags of shopping. At some point, I’m going to shut the kitchen door and go, “No. No more food. I can’t take any more food in here, there is just no room.” And that’s what a cell does, it goes, “No, I’m not going to listen to insulin.” And you’re insulin, and you’re knocking on the kitchen door going, “I’ve got bags of shopping, you need to open the door,” and I’m like, “No.”

Matt: I’ve got ice cream here that’s melting!

Keris: But then, do you know what might happen is, because I’ve shut the door I don’t really know what’s going on outside. I don’t know how much more food is coming in either. You could be bringing in more and more shopping but I’ve shut the kitchen door so it doesn’t matter. What ends up happening inside the cell here … you want to go into the topic of genetics in some ways and cell change, is I can’t find my fit food recipe book any more, the kitchen is such a mess. Do you know what I can find? It’s the takeaway menu, so I’m just going to ring for a takeaway.

Keris: And that’s how we get these genetic variations that take place, where a cell starts to make shortcuts to adapt to this kind of messy environment. One of them is the nucleus; it can’t run, it doesn’t have it’s original recipe book any more, it doesn’t use the original steps that should be … it’s starts to go, “Well that can’t happen.” It’s quick to do that. This would be quicker in this environment, and for me, one comparison would be you get the takeaway menu out and start ordering a takeaway; don’t even bother with the original recipe any more. That’s how we get the genetic changes.

Matt: Wow. You pulled that out one, didn’t you?

Keris: A little bit. Someone better than me is going to pick holes in that analogy. So what a cell does, and this could be any cell in the body, it could be a cell in the liver as we just mentioned, is suddenly shut the kitchen door and says, “Right, I’ve got to deal with this mess.” But the problem is, once you’ve got that messy kitchen what starts to happen is you’ve got glucose in there, you’ve got fats coming in there, because remember meals are all these different macronutrients, and what the cell will do is try and use them. It actually makes, do you know what hexosamines are?

Matt: Nope.

Keris: It’s things like glucosamine, for example, which are all the carbohydrate compounds that make up our joints, and the fluid around our joint, and mucuses and things that line all the eyes and nose and things like that. A lot of them are made of carbohydrate compounds and cell can make those. So the body will start trying to use all of these macronutrients that are coming in. It’ll make some hexosamines, it will make some stored fat, but eventually, when the kitchen is messy and full, all of these macros start to react with one another in a non-enzymatic way, almost because they’re reactive compounds. So we get what we call glucolipotoxicity inside the cell; it’s just a mess essentially. So this is why we get what we know as insulin resistant is actually more a cell defending itself and saying, “I have too much energy inside here.”

Keris: That’s why, going right back to your point, an energy excess, chronically implemented, is probably one of the biggest drivers of disease. Because that cell could be any cell, it could be a neuron, it could be a pancreatic cell. Remember the pancreas is there, busy making insulin; it’s kitchen is ruined if it becomes … And the thing about the pancreatic cell is to know is basically they just let glucose come in and out all the time, it’s not controlled, it doesn’t have anything … most cells like muscle and fat cells have glute-4 transporters, which when we know we need to bring glucose into the cell to bring the blood sugar levels down, they move to the edge of the cell. Remember I’ve called them sugar taxis, or carb taxis, or glucose taxis. They move to the edge of the cell, and they will then lock in to the cell membrane and they’ll pull the glucose in and they’ll take it into the cell and will use it for cell function, hopefully. Maybe store it as glycogen, maybe use it for certain processes inside the cell.

Keris: What happens with certain cells, like neurons for example, and like pancreatic cells, is they kind of need to know what the blood sugar levels are all the time, so they have these different two-way receptors where glucose can go in and out without control. So they’re most vulnerable to damage with high blood sugar levels. Does that make sense?

Matt: Yeah.

Keris: So what would happen normally, in a healthy cell, is insulin gets released, so this is you coming in with the shopping, knocking on the kitchen door, and saying, “I’ve been to Sainsbury’s, I’ve got all the shopping,” and I go, “Right, in a clean kitchen, empty all the cupboards, get ready, come in, the kitchen’s clean, come in. I’ve got loads of space because I’ve fasted 12 hours overnight, and I’ve done some exercise, and you can put the shopping away and it’s easy.”

Keris: In these cells where that’s not happening, because we’ve just mentioned one of them is because of this energy excess, but in a healthy cell insulin knocks on the door and basically what the cell does is lots of different signalling system that takes place below the cell membrane, so on the other side of the kitchen door. So this might be you knocking on the kitchen door, but basically there’s two of us in the kitchen and someone says, “[Cara 00:42:28], there’s food coming in,” and I open up the cupboards ready, and we all get ready if that makes sense … for the food to come in.

Keris: And the same thing happens in a cell, below the cell membrane surface. So insulin’s attached to the satellite receptor, and then there’s something called insulin receptor substrate one, which basically triggers lots of different … I was thinking it’s like a little domino cascade below the surface of the cell, and the cell gets ready to bring the glucose in. A couple of things it does is it increases an enzyme which is responsible for storing glucose as glycogen, so it activates that enzyme, so it gets ready to put it away as glycogen, that’s a good thing to do. Another it will do is stimulate the glute-4 receptors and send them to the edge of the cell ready to bring the glucose in. So this is about me being in the kitchen with some helpers and saying, “Get to the door, go and help Matt with the bags,” essentially. And they come to the door and they’re bringing the glucose in, bringing the shopping in.

Keris: So insulin has two roles when it attaches to the cell. One is glucose disposal, which I’ve just told you, so make it glycogen, send it into mitochondria for cell needs, whatever it might be, and bring it in via the glute-4 taxis. And the other role that insulin has is cell proliferation, so growth, essentially. And what they’re noticed, and this is a second pathway called [inaudible 00:43:42] pathway, what has been noted is when a cell is insulin resistant, so it’s not taking in the glucose, so I’ve shut the kitchen door on you, I’m like, “No more shopping.” But cell proliferation in the body continues, and that I think is one of the reasons why insulin resistance is then implicated in conditions like cancer for example: cell proliferation. Acne: cell proliferation.

Keris: Acne is when things like the cells that basically form the surface of our skin just begin multiplying and blocking pores. They’re stimulated to … think of like sebum, which is part of your defence of the skin, the oils of the skin essentially. Anti-microbial, that kind of thing, but they get over-stimulated. Insulin is being pumped out, cell proliferation, so you get [inaudible 00:44:31] where you get loads of sebum produced by the skin, and then also the cells that line the skin are proliferating so they’re blocking the pores. That’s how you get whiteheads. So that’s why insulin is involved in acne and other disease states.

Matt: It’s interesting because acne, you normally associate that with teenage years, and you know it’s like it’s hormones.

Keris: Which it is. So that’s just one example, but the more that we come to learn about how the hormones all affect one another, high insulin can drive our testosterone for example, and that’s why it’s also implicated in things like polycystic ovarian syndrome or antigen production generally. And conversion of testosterone into it’s more potent form, DHT, which again is associated with everything from acne to balding hair, to prostate problems, and enlargement of the prostate.

Keris: Insulin, what happens is, possibly because the cell is not listening, the cell is going, “I ain’t taking the glucose in,” insulin levels continue to rise. Because the body’s like glucose levels aren’t coming down, pump out more insulin. And insulin continues to act on this cell proliferation, this [inaudible 00:45:37] pathway on the cells, but the cells aren’t clearing the glucose. So can you see how that become a vicious cycle?

Matt: Yeah, of course.

Keris: So just going back to the number one thing to think about here is an energy excess, and I’d also add to that not just an energy excess because an energy excess is just going to mean you’ve just got this really messy kitchen where you can’t take the shopping bags in and put them away. But also, the frequency of your eating patterns, so the frequency also because eating more than every three hours is also going to affect small intestinal health because small intestines are kind of on this cleansing wave to get ready. They turn over bacteria ready for the next meal. Whereas if you’re eating really frequently, snacking, grazing, liquid calories as well coming in, it’s going to mean that firstly you’re always gonna be working insulin, elevating insulin, taking on a certain amount of calories may be an excess, and the small intestine isn’t getting time to run it’s cleansing wave and get ready for the next meal.

Keris: We’ve already talked about chewing food, eating in a certain way, but the meal frequency I think is really important, and trying to get into a habit of three to five hours between meals. And the reason I say that is some people feel better eating every three hours, some are more five-six, but you’re going to get a natural decrease in hopefully energy intake as well if you’re decreasing meal frequency.

Keris: So we often say to people stop snacking. Just simple, simple, and I mean liquid calories and –

Matt: For a lot of time though, we often talk about snacking being quite habit-based. People do it out of pure habit, out of boredom rather than genuine hunger. And also there is that belief that people do still buy into, that kind of eating often to boost metabolism, improve fat loss, blah, blah, blah, which we know is just rubbish. And the only time that we often would suggest maybe in smaller meals more often is if someone had a hype trophy goal, like if it was all about gaining muscle and putting on size. Because obviously there has been studies that suggest increases of muscle protein synthesis. And of course that’s a big deal if you’ve got a muscle gain goal. But other than that, for fat loss, it’s not necessary to eat little and often. Your energy intake across the day, whether it’s one, two, three, four, five, six, seven meals, is what matters the most.

Keris: And to be fair, across seven days because again, if you’re loading in a calorie excess, which is not unheard of in alcohol, between 1000-2000 calories from Thursday to Sunday, then this is again where this problem will occur. And another thing to note is to be able to put the shopping away in the cupboards and cook efficiently in the kitchen requires the micronutrients, so it’s a big reason why we’re always kind of emphasising nutrient density. It’s because of things like B vitamins, and iron, and [crosstalk 00:48:32], and all those kind of things are needed for the body to take those macronutrients and say, “Right, I’m going to use them for energy to fuel this cell, to fuel that cell, to be used for basic function in the body.”

Keris: But then also a lot of processes that we need to run in a fasted state, so the other side of it is to not need food all the time, to not need a constant drip feed of energy coming in, you have to be able to run some other processes. So first of all I mentioned when we’re not eating, and blood sugar levels go low, what happens next is the pancreas releases instead glucagon, and glucagon’s role is to start to bring blood sugar levels up by tapping into our energy stores.

Keris: So in a fasted state we actually go to the liver and glycogen is one of our stored energy states. And a lot of this switching between using our stored energy and using food requires some of the B vitamins, and magnesium, and zinc. They’re used for a lot of enzymes that are involved in these processes. So again, another reason to think about [inaudible 00:49:32], B6, and zinc … all the B vitamins, in fact. So the liver is basically fueling you quite a lot in the fasted state.

Keris: First of all we’ve got our liver glycogens that will break down stored glucose in the liver, and the liver will also run a process know as gluconeogenesis, which is basically, you make new glucose from something that isn’t glucose. So that’s not glycogen, because glycogen is stored glucose. Gluconeogenesis can be using things like fats, it can be using various different metabolic [inaudible 00:50:03] that are in the cell, things like pyruvates, lactate, things that are components of our macronutrients. Once they’ve come in, they’re being converted intra-cellularly and the liver’s very good as going, “Oh, I’ll take that and I’m going to make it into glucose.” And we always have to run gluconeogenesis to a certain extent because things like red blood cells and some of our neurons can only run on glucose. They don’t have the ability to run on fats, and they don’t have the ability to run on protein.

Matt: That makes sense.

Keris: So gluconeogenesis is running in the background, and again so this is one of the things that when insulin is released, it stops that straight away. Because it says, “Actually, I’ve got some glucose coming in. Don’t make new glucose.”

Matt: Because this is readily available. Have eats.

Keris: They think one of the problems is when we get hormone resistance, insulin resistance, the liver cells don’t know this and continue to make new glucose. Does that make sense? And drugs like diabetic drugs, one of their roles is to stop gluconeogenesis in the liver, and that’s how they act on that process.

Keris: A key component to diabetes generally, and this is type-2 we’re talking about, but with regards to type-1 it got me thinking … I’ll talk more about type-1 diabetes in a second, about how that may have come about just from damage to … So just to clarify, type-1 diabetes is when you’re not producing insulin any more, so the pancreatic [inaudible 00:51:27] cells have been basically kind of destroyed by the immune system, so there’s been some kind of autoimmune response so they can’t produce insulin and therefore that’s why you inject [inaudible 00:51:37] that you inject.

Matt: That’s type-1?

Keris: For the rest of your life. Yep. And then type-2 is more where we’re looking at everything we just talked about here. It’s more about insulin resistance, so insulin is being released but the cells are not responding and not taking the glucose up. Now one of the big questions that’s come about with the new research is a lot of what we do in functional medicine, nutritional therapy, and even conventional medicine is try and force glucose uptake into the cell with what we call insulin sensitizers, or things that help … they look like insulin or they act like insulin, and actually is that making the situation worse.

Keris: So essentially if we go back to the messy kitchen, it’s basically you get a bit more forceful at opening the door. You still come in with the shopping –

Matt: Kick the door down.

Keris: Basically, in the form of green tea [inaudible 00:52:24]. Things that are offered, alpha lipoic acid, those kinds of things. Now some of the things that we offer in nutritional therapy work in different ways, so alpha lipoic acid is also an anti-oxidant, so it’s actually got a bit of cleaning properties. [inaudible 00:52:38], so you can come in and start cleaning up, unblocking the sink, so it might help in that sense, as well as knocking the door down. But a lot the focus has been how to get glucose into the cell rather than saying, “Do you not think the cell has decided it’s a defence mechanism to not have it come in.”

Keris: So one of my big takeaways from all of this, and by the way it’s not just energy excess, but how beneficial things like fasting would be in this situation. And we’ve talked about somebody who is severely overweight, obese, fasting would be phenomenal for them. Because what they would then start to do … and one thing I haven’t really talked about is remember that I said to you about the deposition of energy in the body is going to be places like muscles and body fat cells [crosstalk 00:53:19] sites. What happens with muscles is inside muscle cells, we get such a build up of fat because basically it’s kind of like the kitchen’s full of shopping, we’re just shoving it anywhere now, any kind of place we can. And this fat oxidises, it becomes [inaudible 00:53:36], it’s kind of a toxic fat, and it can make the muscles insulin resistant. So we’re losing one of our best places to store energy and we’re losing the communication.

Keris: If you think about … we’ve gone from having 4G in a healthy person, in terms of communication, and mobile networks, and signalling, right down to no G. We’re going down to no G. Left hand doesn’t know what right hand’s doing. We don’t know if we’re fed, we don’t know if we’re fasted, we don’t know if we should be burning –

Keris: [inaudible 00:54:00] don’t know what right hands do, and we don’t know if we’re fed. We don’t know if we’re fasted. We don’t know if we should be burning fat or making new glucose and breaking down.

Keris: So the other thing that happens here is when the fat cells don’t really know if we’re fat, they become insulin resistant. They think you’re starving. They think you’re fasted, because there’s nothing coming in, because they’ve shut down essentially. And they start to break down triglycerides, which is stored body fat, and release them into the bloodstream. So they’re like, “Whoa, got no energy. I’m going to release some triglycerides to fuel the rest of the body.” And the liver’s going, “Yeah, I’m making new glucose.”

Keris: So we get this massive … shit storm is the best way I can put it … of high blood sugar levels and high triglycerides, which is what we’ve seen with things like diabetes, heart disease. And again, the big driver here has been being overweight, energy excess, but it’s also been a lack of hormone communication. And that’s why, again, it’s one of the first interventions that we should also be doing is restoring a little bit of hormone sensitivity with things like omega-3’s, for example, so hormonal communication. And the cell can understand what’s going on on the inside of internal and external environment.

Keris: But again, creating an energy deficit is going to be the quickest win.

Matt: I do think there’s … because obviously where your food comes from is very important. How energy [inaudible 00:55:21] your diet is a calories is also very important, right? This is the reason why, and this is the thing we often talk about, is that you actually see improvements in health markers in obese individuals who have lost weight through what would be deemed as unhealthy means.

Keris: Yeah. All these shake diets and things like that.

Matt: Shake diets or even a kind of

Keris: Flexible diets

Matt: … if fits your macros. It’s not as kind of nutrient dense as one might like a healthy diet to be, but it has meant that their body fat levels have come down. And therefore as a result of that, fasted blood sugar has improved, blood pressure … exactly.

Keris: Blood pressure, inflammation markers, yep.

Matt: Exactly. We often give the example of the Twinkies diet, and that diet that guy who followed the diet that was two-thirds from processed food such as Twinkies, Oreo cookies, diet soda. He took a more … he had a protein shake as well, keeps protein intake up. But over 10 weeks I believe he lost 27 pounds, and his health markers improved. Despite two-thirds of his diet being made up of processed foods. Sorry, I’ve missed an absolute [inaudible 00:56:42] here, he was in a calorie deficit. So he worked out his calorie requirements. He was in a calorie deficit, and he wanted to prove that calories are most important when it comes to fat loss. But he obviously yeah but he was a doctor himself. He obviously ran tests at the beginning and at the end, and health markers improved. Because he lost 27 pounds, but he was clearly overweight. And he openly said he doesn’t recommend it as a long-term diet, of course.

Keris: I’ve always literally just adding Twinkies to the docket list, going, “Can you get them in [inaudible 00:57:12].” Always a Twinkies.

Matt: Oh, Twinkies look horrible though. Have you seen them in those candy shops that do American candy…

Keris: Is that like a donut on a stick?

Matt: Well I suppose it’s like a sausage shaped donut. Going something like that, and it got a bit of cream in the middle I think.

Keris: Right yeah, on a stick.

Matt: To me, I don’t get it. If I’m gonna have something … I don’t get it. I don’t get the whole Twinkies thing. I never tried it, but even just to look at.

Keris: Each to their own. What I will say, on that point. Where that style of, and we’ll talk more about the things that go wrong, because a lot of people will be here saying, “I’ve tried that it didn’t work. I’ve tried calorie reduction. I tried to have a little bit of what I fancied.” Is if you aren’t eating the nutrient dense side of things and also looking after the gut bacteria with plenty of vegetables and fibre and root vegetables and healthy starch, and you’re not getting all the B’s in and all your iron and stuff, some other system will crash in the body.

Keris: So if it’s gonna be something like the nervous system, you’re gonna get so depressed and have no will power and suffer from cravings. If it’s musculoskeletal you’re just gonna get injured and you’re not be able to train and then [inaudible 00:58:13]. So some other system will crash without the nutrients and that for me is when, if you’re looking at sustainable fat loss, you need to factor in the hormone side of things, definitely. You need to factor in, as you took it right up stream and why you were so obsessed with ice cream in the first place. You need to factor in the calorie deficit and you need to also think about nutrient density.

Keris: Everything that we have factored into Fit 16 we weren’t big fans of tracking, but some people do Fit 16 and track, in terms of track their calorie intake, but what we did was say, “You’re gonna do elimination diet. Come off processed refined foods, and that’s gonna naturally create an energy deficit and also reset appetite, and so it shows you a little bit more and increase protein as well.”

Keris: So that’s how we kind of go about it, but we’ve personally found the tracking side turned out to be too much for a lot of people and overwhelmed and people have got over that that side of that after years of that. But yeah, it’s still important so …

Matt: Of course it is and it’s like you always say, you don’t have to track to get results, we often suggest maybe giving it a try, because a) it may well work for you, b) if might open your eyes a little bit to the way you have been eating and maybe you’ve been eating more than you think, which is often the case. A lot of people massive eat, underestimate … so I could always say they underestimate how many calories they eat, consume, and they overestimate how many calories they burn when they exercise or are in the gym or whatever.

Matt: But even if it’s just to get your head round just some basic numbers, know roughly how many calories are in a portion of the foods you eat on a regular basis. Roughly how much protein, fat and carbs are in the foods and the meals that you eat on a regular basis, cuz then you just start getting a bit of a ballpark figure, you start getting a rough idea, and you can be a little bit better at guesstimating and then adapt to your nutrition in accordance to your goal, how you’re feeding, the top trainer that you’ve done, etc. etc.

Keris: Yeah, my concern at the moment is as all this research is coming out, I think it’s really important. My big concern is that we’re gonna drive the nation back to calories in, calories out, and then food and health industry are gonna jump on that and everything is gonna be labelled …

Keris: Yes I think it’s relevant but I also feel like we are, we’re becoming a little bit robotic in a lot of ways, about a lot of things and health is one where I do want to keep an element of intuition about what is a good food, what is a bad food? It’s not just about the calories, and it also creates, I had a friend …

Matt: Yeah but it’s not really so much a case of good and bad foods, is it? Because it’s hard to say … sorry

Keris: Oh I just wanna say this story. I had a friend who was obsessed with calorie counting and she only ate out and in places, like food to go places, like you prep you eat some things like that, because she could then count her calories and stay under 1200 which is her goal. And there was nothing education, she didn’t give a toss about nutrients, or gut bacteria, or fibre, or anything that is also important, and so she relied heavily on processed food for that reason, and I see that a lot in the diet industry.

Matt: But I suppose that’s the key though isn’t it. Calories are talked about a lot at the moment because, well, they’re important, but there needs to be, you need be able to make that clear divide between when it comes to losing fat, or losing weight, we need to be in a calorie deficit. Calories are the most important thing in that respect, but from a health perspective, we can’t just ignore where those calories come from.

Matt: And anyone who does kind of … people push the calorie side of things a bit too much now, and rightly so, they’re important. We can’t ignore it. I’m not saying that for a second, but it’s almost like … yeah but it is not just about calories, because if you’re a 500 calorie a day deficit, and you got every single one of those calories through from jam on toast, chances are soon enough you’re gonna feel like shit, and you’re not gonna want to stick to that diet, and you’re gonna then just binge on a don or kebab or something like that that’s got fat and protein and whatever else.

Keris: But also think about things like … not that people do tend to go down the kind of low fat route, but fats over vitamins fundamental for fertility and reproduction, sex hormones production, and all of those do play a role in … all the hormones are always influencing one another, as I’ve just said.

Keris: So insulin and glucon are important, but sex hormone production is equally important and the cells that are responsible for making those, like hormone glands and testes, the ovaries, they also require antioxidants. They require vitamins and minerals to be able to … zinc and magnesium are well known for, if a man has testosterone issues, zinc, magnesium, CoQ10, because it’s the cells of the testes that are making those hormones, as well as signals from the pituitary gland and the brain.

Keris: So I just think it’s really important that that message is out there for sure, and so if you’re in the overweight/obese category, that’s your biggest, quickest win right there. Lose the weight and a lot of things are gonna happen. Same for joint issues, lose the weight, and lot of things are gonna kind of fall back in.

Keris: And if you’re type 2 diabetic, lose the weight, and do it ideally as we’ve just said in a way, do it with Fit 16 is your best bet. [crosstalk 01:03:28]

Keris: But do it in a way that’s going to support long term sustainable weight loss. Keeping it off because you’ve got energy, you’ve got health. You’re pain free. You’re managing the disease effectively because you’ve treated the cause.

Keris: And I suppose just to go back to another couple of things that, because lot of people might be sat here going, “Well I do a lot of this stuff and I’ve still got blood sugar issues. And I’ve still got, I’m definitely one of those people who gains weight much more easily.”

Keris: One thing I will say again is there are other hormones, like thyroid hormone which are also, kind of, require a lot of nutrition, require some fundamental lifestyle factors to be in place, and the immune system is always working away in the background, and a few things that will cause insulin resistance are infection, and high amounts of inflammation in the body. So they can add, but then equally being over weight we get an increase in inflammatory cytokines, which are the inflammatory chemicals that go around the body sicking the immune system.

Keris: So being overweight is a state of chronic inflammation and therefore that will cause insulin resistance, so the cells aren’t responding. So that’s another vicious cycle, but this is what, going all the way back to kind of type 1, it’s why with type 1 diabetes, there’s links with viral infections. For example, with most autoimmune conditions, but with type 1 diabetics, it can be that there was some kind of infection that was causing insulin resistance and then there was high amounts of insulin being produced. There’s loads of different mechanisms, but if you’ve ever had viruses or really severe illnesses, if you’re having your inflammation markers checked, good ones would be high sensitivity, c reactive protein, high cystine, ESR, which is, again, done standard by a doctor even looking at calprotectin [inaudible 01:05:07].

Keris: If you’ve got inflammation going on, there’s a chance that you are insulin resistant, or that the cells are not responding to … and again we might have, some people say glucose gets devoted towards the immune system as well in times of that defence. So blood sugar levels can be low, high, all over the place. So there are other factors that can … and lastly, this is the last point I’ll say, is also, do you remember we mentioned lipo polysaccharides a long time ago? A few podcasts ago.

Keris: And metabolic endotoxemia, which is when it’s kind of like the tail of gramme negative bacteria in the gut that breaks off and can pass into the body.

Keris: So if you’ve got disparitis too much bad bacteria, or kind of messed up gut, passes over into the body, especially with saturated fats and coconut oil in particular, and high amounts of lipopolysaccharides, it essentially means you’ve got some gut disfunction going on, are also associated with insulin resistance, so that’s how they become a driver of metabolic disease or metabolic endotoxemia, becomes a factor in this process.

Keris: But again it goes right back to when you’re looking at all of this, yes there may be some kind of infection and yes there may be low grade inflammation so it’s an anti inflammatory diet which we have always kind of discussed, maybe you need some kind of pharmaceutical intervention or supplement intervention, possibly to address it. Maybe you need antivirals, antibiotics to address the kind of infection be that in the gut or systemically to restore everything. But everything else still stands that we’ve talked about in terms of then you’ve gotta make sure body composition is healthy, nutrient status is good. Things like iron are just so important for this …

Matt: The thing is, for me, I just always think being fat is not healthy. Nothing about being overweight and carrying excess body fat …

Keris: [crosstalk 01:06:58] that’s the headline right here.

Matt: But it’s true. And we shouldn’t be carrying a huge amount of body fat. I’m not saying men should be absolute shredded, we shouldn’t be. In fact, a lot of men who do get absolutely shredded for bodybuilding competitions or fitness competitor competitions. There’s a reason they don’t allow that all the time, because it’s unsustainable for most, and not even from a sheer willpower point of view, but from a health point of view.

Matt: Men that diet down to those very very low body fat levels …

Keris: They often see testosterone, mood health …

Matt: Testosterone drops, mood health, they have energy to actually train and even function well, day to day. It goes down, hence the reason why they bring calories back up, they bring fats back up etc etc.

Matt: And the same with women. I’m not saying that women should be a size 6 or a size 8 or whatever it may be, and everyone comes in different shapes and sizes, but if you’re carrying a hefty chunk of body fat, you do not need to be a genius to work out it’s probably not good for you. And there’s a reason why a lot of people, that when they do reduce body fat for whichever mean they’ve chosen, feel better. Walking feels better. Going up a hill feels better. All of a sudden you can do a pull up, cuz there’s less of [inaudible 01:08:18] and that’s why when people say to me, “Man how can I do more pull ups?”

Matt: And I’m like, “Well lose weight for a start.” Cuz it’ll probably help ya. Give it a no brainer, right?

Keris: It’s hard because it became a topic for a long time that you couldn’t really talk about. Especially, you know as a woman, I think I kind of talked about in the past about just sort of eating, [inaudible 01:08:39] and those things were important. And I definitely had a fear for awhile of talking about fat loss, and I know for a fact I was judged by fellow nutritionists for being a bit kind of a trainer and you do before and afters and you talk about weight loss and that’s not healthy. We’ve got this kind of epidemic of disordered eating and orthorexia and eating disorders as well, and I completely agree but I see, like you, I just see both ends of the spectrum a lot.

Keris: And my job is to try and help everyone, so we do write a bit about eating disorders, body image, body confidence, orthorexia, but we’re also trying to say I’m not a huge fan of people who are in the overweight/obese category on social media saying, “It’s great to be this curvy.” I think curves are wonderful. I completely endorse a healthy amount of belly fat in a woman, but when it becomes to the point of, we just said, asthmatic disfunction, inflammation, then that’s no longer a role model to people, especially when we are in an obesogenic environment that tells us to eat all the time and makes that all possible yet the last thing we need is to be told is that this is a desirable, it’s desirable to be a plus size person essentially.

Keris: We just need to, there’s nice middle ground that we all need to go into.

Matt: Exactly. I mean, I think you kind of seem to have one extreme at the offer at the moment. You have the super lean, athletic, individuals, skinny individuals on Instagram, almost glamorised in very very low levels of body fat and kind of being a certain size all the time, whatever. Or you have the opposite head that’s … and I’ve never understood this whole plus size model thing. I think you’re either a model or not. I don’t care what size you are, if you’re a model, if someone’s paying you to wear a certain garment, you’re a model. Do you see what I’m saying?

Keris: But these women are gorgeous, and I just think that you can be gorgeous and you can be 2 to 3 dress sizes less so that you’re in a healthy reference range for body fat.

Matt: And that’s what I’m trying to say –

Keris: And it was a reference range –

Matt: All I’m saying is there, don’t glamorise being super skinny or super shredded all the time. Don’t glamorise being overweight because [crosstalk 01:10:50] either end is a bit of an extreme that is gonna impact your health, negatively.

Keris: My goal, body composition, for me, and for all my clients, is not to think about anymore, which means we’re implementing healthy energy management through lifestyle, happily, so through exercise if we like exercise, through lifestyle if we like lifestyle, through food because we enjoy those foods, and we’re not freaking thinking about it, and that’s was one of the reasons we develop Fitter 16 cuz we were saying, “Could we just start to eat a little bit more, in a balanced way that’s very natural. This is what 8-20 looks like. Sometimes you’re gonna need to be 9 and 10.”

Keris: And we do this, by the way, we sometimes slip. We’ve just had a whole host of family parties, engagements, and I was eating my brothers birthday cake and 2 o’clock in the morning, just slabs and slabs of icing, and after a few … and that’s been weeks and weeks of different celebrations. After a while I was like, “Okay my clothes are getting tighter.” And I said to you, “Okay, I’m just gonna go back to what I know. 9 and 10.”

Keris: And that simply means, coach you need to stop eating icing at 2 o’clock in the morning and probably a little bit less of the dark chocolate bowls that I keep making, and those kind of things, cuz it became a thing where I was also tired from all the travel and the socialising, so I was like, if anyone put anything in front of me I had no ability to say no, by the way, so there’s another key indicator.

Keris: But what I was about to say is rather than the big overwhelm and the big fuss. Just go back to a 9-10 template for a month and you should come back in. But there’s also to be saying that the longer you do this for, as in achieve a healthy body composition, the less a calorie excess every now and then makes a difference anyway. Once the body can find a nice body fat set point. Healthy body fat set point.

Matt: Exactly, and like I say, everyone comes in different shapes and sizes. I’ve given that example of, mate of mine, Bangee that I used to train with back in my teens, who was a black guy, and absolutely shredded. Ripped, yet he ate like chicken and chips, and drank fizzy drink, as did I. I was a teenager. It’s what we did. But he was always absolutely ripped, because genetically that was his body type. Mine, despite trying my hardest, it never happened. To this day – let me finish.

Matt: I think the point I’m trying to make is as well is don’t always make that association that because someone’s ripped, they’re healthy, because it might not be the case. Unless you are genetically very very lean. And I’ve trained guys who are like this as well, which was infuriating for me as well as a PT. I was like, “My client is absolutely ripped to pieces. Which I can’t take any credit for. It’s just genetic.”

Matt: And if anything, their dilemma was, “I can’t gain weight.” They couldn’t consume enough food. What a problem to have, right? But so unless you are like that genetically, to get that lean, a) like I said it’s unsustainable and it’s probably not gonna be very healthy for you at all, and going back some years, when I followed a low carbohydrate diet, before I had the knowledge and experience that I do now, and I followed it for about 9, 10 weeks, I was getting compliments left, right, and centre about how amazing I looked because I lost body fat, and I lost, body water was low as well due to the low carbohydrate. And of course to have lost body fat, I would have been in a calorie deficit as well.

Matt: And everyone was telling me how amazing I felt, how amazing I looked, and “What are you doing, what are you doing? Blah blah blah.” And if anything, it was these compliments that kept me going for as long as I did, and I felt like crap. I had no energy, my mood was like, and I know I’ve told this story before, but I kind of, the reason I’m telling it again, is cuz I’ve just … I wanna make it very very clear our message here is, “Oh you just shouldn’t be overweight.” But equally, you can look a certain way and be of a certain body composition that might, on paper, look healthy, but it isn’t.

Matt: And again, like you said, it goes back to that balance.

Keris: And to be fair, I have a lot of male clients. I suppose because we’re in the fitness industry I do blood testing on quite a lot of them, and many of them come back who don’t have a body composition issue at all. They’ve kind of come to me usually for gut or mood and the two kind of common or testosterone levels, and they all have high inflammation markers, or maybe iron, and low iron by the way can be the result of a gastrointestinal infection, or lots of things.

Keris: So they have nutrient insufficiencies, high inflammation markers, but to look at them, aspirational physiques for a lot of people if they were on Instagram. So yeah, you’re completely right in terms of behind the seems at a low level.

Keris: So it’s important to bring it all together at some point and I do think having a decent health MOT once a year, and same as a qualified professional, are these blood tests healthy, is my body composition healthy, should I be working in any way, any symptoms that you’ve got that have been on going, address those as well.

Keris: I was gonna say we’ve digress massively from insulin, so [crosstalk 01:15:50]

Matt: Well that’s cool though, because it all …

Keris: Well the next, I think we should do another episode, some things we can do in terms of supporting, because muscles are phenomenal I have to say, when it comes to insulin health. Muscles can be really supportive so we should do one just on that side of it and supporting muscle mass, and dietary interventions, certain foods specifically are [crosstalk 01:16:07]

Matt: But you know what’s good about this though, is we’ve spoken about insulin, we’ve dropped your knowledge bombs, you’ve have a little bit of a geek out.

Keris: I’ve flem bored ya.

Matt: But again, it’s like you always say, it often comes back to the same, thing, doesn’t it. In terms of eating a variety of nutrients, not banning a particular macro nutrient. Not eating too often, not eating too much, equally not eating too little, and just kind of finding that element of balance.

Keris: A big takeaway from me, looking at the latest research on this was how little carbohydrates do play a role in that side of it, in terms of the weight gain side of it. I’m still a big fan of low carbohydrate interventions, but mainly because you have change in the palatability of the food as well. So taking out flour, and secondly because there is some studies saying carbohydrate density, in terms of when it’s made into a flour, and then put into a bread or a cracker or crisp, it makes it more high palatable, so [inaudible 01:17:09] it doesn’t tend to feed the gut bacteria or create a nice diverse range of beneficial bacteria, which are involved in everything from insulin to digesting food making vitamins and minerals within the body.

Keris: So when you think of it on a more holistic level going back to the least amount of food processing in your diet as possible, there’s always gonna add that benefit, but as I’ve said, to you, for me the takeaway on all of this was, gosh, when I started out as a nutritional therapist, I was all about trying to shove glucose into the cell, I was all … chromium and [inaudible 01:17:39] acid and improve glucose uptake.

Matt: Do a HIIT session before every meal.

Keris: Yeah. And that’s really not the case and so again, we go kind of more holistically and think about what is the low hanging fruit, which for a lot of people is create that energy deficit, which we’ll do a podcast on energy deficit next, cuz I think that would be really cool to what could we do that’s very effortless and organic, and there’s some cool science on it that people may not realise that it’s a lot easier than you think.

Matt: Cool. Is that a wrap?

Keris: So, that’s a wrap. That was a long one.

Matt: That was a long one wasn’t it? But some good bits in there I think.

Keris: Hopefully.

Matt: That’s not very positive is it? I should hope so. We just invested an hour and a half of our time. You can’t get that back.

Keris: Yeah yeah.

Matt: Can’t get that time back, care is. It’s gone. Right guys, hope you enjoyed and any questions about today’s podcast or any questions at all, fire em’ our way at or catch us on social media and if you haven’t done so already, be so kind as to leave us a review on iTunes. It’d be very much appreciated, any feedback to watch is good feedback cuz it gives us the opportunity to either massage our ego or make some changes based on the feedback constructive of course that you’ve given us. Have a good one guys and we will see you in episode 105. See ya.

Keris: Bye!