Tuesday, March 11, 2008

Diabetes and cardiac apotosis

There is nothing wrong with eating carbohydrate per se. What is completely unacceptable is the development of hyperglycaemia. There may well be people who can live on a diet of yams and sweet potatoes without cardiovascular problems. I would suspect that the pre requisite is that insulin sensitivity must be such that they avoid hyperglycaemia. If they don't you end up back in to the realms of apoptosis, with your myocardial cells deciding they've had so much sugar they'd rather die than have more. They then vote with their "cytochrome c-activated caspase-3 pathway" (whatever that is: EDIT, okay I've read PSS now and have more of a clue!) and take this to its logical conclusion. Blood glucose levels of 22 mmol/l and 33 mmol/l are well within the reach of any diabetic taking the ADA dietary advice.

One of the best quotes I've ever heard was very second hand. It came from a poster on Dr Bernstein's forum who had tried to convert another type 2 diabetic to LC eating. The quote was from the LC refusenik:

"I'd rather die than eat bacon and eggs without hash browns"

So be it.



Anonymous said...

I wonder if people who say things like that really mean it, or if it's code for, "I don't think you're right."

Although ... I did have a family member who used to refuse to give up smoking and eating junk food, saying, "We're all gonna die, at least I'll die happy." Unfortunately, he didn't die happy. He died the day before his 55th birthday from an absolutely excruciating bout with lung cancer. Before he was diagnosed with cancer, he had diabetes, peripheral vascular disease, and I don't know what else. His last 10 to 20 years on earth were miserable.

The worst part for me was the suffering he inflicted on his lifelong partner and caretaker. I'm all for hospice, but when he opted to die at home rather than in the hospital, all I could think was, "Of course, he expects her to care for him just like he always did. Why should dying change that?"

People who say they'd rather die than take care of themselves never seem to think about the other people in their lives who ultimately be saddled with the expense, responsibility, and emotional suffering of caring for them!

Stephan Guyenet said...

cytochrome-c is a cofactor in oxidative metabolism that is released from mitochondria when they decide to kill the cell. This indirectly activates caspase-9, which is a (cysteine-aspartyl = "casp") protease that activates caspase-3 by cleaving off its prodomain.

Caspase-3 is an "effector caspase" that starts cutting up important proteins throughout the cell, perpetuating the cell death cascade. When caspase-3 gets activated, it's pretty much over. It's often used as a marker for apoptosis.

.^ said...

On the "trying to convert" thing: I struggle with this myself. I mean, I haven't really even proved to myself the full benefits of this lifestyle, but still I find myself wanting to persuade other people (i.e. based solely on the logic).

Worst is in the supermarket. Two examples: 1. Elderly woman behind me in line, with "healthy" breakfast cereal (Extra fibre!) and non-fat milk in her basket. I felt like saying, "You didn't reach your current age eating that shit, so why start now?"
2. Young Chinese woman with bad acne all over her face, including her forehead. She's negotiating something at the customer service counter. I'm too far to hear what shes saying, but I see her gesture at the bottle she's holding then at her face. I feel like accosting her and giving her a little talk about diet and acne.

I don't do either, of course, but I feel the urge.

Anonymous said...

Chainey - I almost never give in to that temptation, either, though I did impose myself on the guy ahead of me in the grocery store. He was buying two chickens (good) and a quart of premade chicken broth (bad). I told him he should make his own from the chicken trimmings or use plain water. Chicken broth is easy to make, and the commercial stuff always tastes like someone rinsed off a chicken in lukewarm water.

He muttered something non-committal, and to be fair, I would've done the same thing in his shoes. But I hope I got him thinking, even though I confess it was rude.

The guy behind me was buying some chicken and two quarts of pre-made broth. I decided it was an uphill battle and kept my mouth shut. :)

Peter said...

Thanks stephan, I'd sort of gathered (very roughly) it might be along those lines. But what really grabs me is normoglycaemia......


Peter said...


Is apoptosis always mitochondrial based? Fascinating if it is....


mess talker said...

I read this and laughed at the hashbrown quote. Then I thought that the optimal diet allows a great big breakfast with hashbrowns! Right? Just keep the other sugars/starches/etc out all day. Oh yeah, maybe fry the taters in lard instead of canola or whatever they use.
I know the thought reflects something deeper like biscuits, toast, pizza, soda, etc. But it's funny. I've been frying up potatoes and enjoying them with some tallow and sour creme. I used to avoid potatoes like the plague. But then I don't eat plate after plate and follow it up with a day of sugars. I wonder if it's spiking an insulin response? I prefer to eat them at night because if I eat the starch/sugars in the morning I find it harder to stay on the diet and that leads me to believe the insulin spike is making me crave more. HMmm. It's been fun to learn.
Thanks Peter.

Stephan Guyenet said...

Hi Peter,

I'm not sure if apoptosis always requires mitochondria, but I know it does in many cases. Canonical apoptosis involves signals flowing to and from the mitochondria.

In "Power, Sex, Suicide, Mitochondria and the Meaning of Life" (I know, it's a horrible title) Nick Lane claims mitochondria were what gave eukaryotes the ability to undergo apoptosis.

Stan Bleszynski said...

Fascinating, so a mitochondrium was the first parasite that turned us from some immortal yeast-like cells into humans but the price of developing brain and the Knowledge - is death!

Sorry, I couldn't resist posting it. Thanks Peter and Stephan for interesting discussion.

Stan (Heretic)

Peter said...

Another book on the pile then....


Peter said...


Yes, it makes you think about which organism does what and why and......


Anonymous said...

mess talker, hash browns aren't too high in carbs IMO. A cup of peeled, shredded potatoes has 14 g of carbs (excluding fiber). It's much better than refined sugars or grains, IMO. Low fiber, low PUFAs, low fructose. Everything I could hope for.

Maybe the problem now is the "mixed diet." Meaning, mixed starches with refined sugars and PUFAs and a boat load of calories. Maybe some liquor too. This way of eating seems a lot like suicide in many ways.

Food for thought. Thought for food.

.^ said...

I'm so glad you brought up the Hay diet (doesn't involve eating actual hay). I was a fan of food-combining in a previous life. It's kind of like half-LC in that there are meals with no carbs.

I distinctly remember part of the book I have (Food Combining for Health) that went, "The authors do not consider fats to be the villians in nutrition."

It actually worked well for me. Lost weight and felt good.

G said...

That's a very interesting mitochondrial reference (definitely the title is!)... I know I can grow my mitochondria... by intermittent sprinting and high intensity workouts. i wonder what the price for speed and energy? (hopefully not too much apoptosis!)

do you remember experiments in biology where we'd combine O2 and Hydrogen?? wasn't there a great HUGH 'poooowwwww!!'?

I think the mitochondria harness this 'pow' energy in our cells... there's a water layer surrounding them (did I read that here Peter long time ago? don't remember now -- you've got too much good stuff here) and involves all these redux enzymes, coupling-decoupling things, etc.

i guess sometimes mitochondria blow up too much? and need to be recycled?

that's why I take vit E for the extra peroxidations ;)

Stephan Guyenet said...


I wouldn't worry about mitochondrial damage due to exercise. It actually seems to keep them younger, with the possible exception of too much moderate cardio.

Anonymous said...

Mess Talker - I have the same experience you do - carbs in the morning, carb cravings all day. Carbs at dinner are much easier for me to limit and control.

Which is funny, because there was a bit of advice floating around a few years back that said if you were going to eat carbs, you should eat them in the morning when your insulin receptors are most sensitive after your overnight fast. This is so opposite my experience that I wonder if it's just one of those ideas that seemed like it should work, sort of like the reasonable but oh-so-wrong idea that, since fat has more calories than carb, fat is what makes us fat.

Peter said...

As I understood it insulin sensitivity is lowest in the morning due to peak free fatty acid release after the overnight fast and the surge in growth hormone (which triggers lipolysis and FFA release) which occurs in the early hours. I've got some refs on the "Dawn Phenomenon" somewhere. Apart from some chocolate I tend to eat most of my carbs with my evening meal. Saves on cooking rather than any specific plan.


G said...

Yes, you're right ... I think there's also a surge of cortisol (circadian pattern) also in the morning which contributes to a Dawn phenom. I've noticed that I can't handle carbs in the morning, not even oat bran...

it's hard though to miss my MILK and triple-quad shots in the AM --- so I'm not giving them up yet :) My coffee shop doesn't have non-pasteurized milk of course, but milk doesn't seem to affect me.

Anonymous said...

"...sort of like the reasonable but oh-so-wrong idea that, since fat has more calories than carb, fat is what makes us fat."

Maybe it's the combination of carbs and fat (esp refined carbs and high PUFA oils) that make you overweight and unhealthy. Many cultures do eat carbs in large amounts, but they do not eat lot of fat or they eat more saturated fat, like coconut.

It's very new in evolutionary terms to have "foods" like hamburgers and fries, pizza, doughnuts, ice cream, etc. In nature, you don't find many natural foods that are both high in fat and high in carbs.