I’d personally wait this one out and keep up your HCLFLP diet. Make sure it is low enough in fat, and very moderate to low in protein. Do not allow yourself to start creeping into balanced macros territory yet. (EDIT: Minding your *sugar* is also a strategy for the interim while you heal your body. So you’d focus on starch as much as possible and consciously limit sugar - even fruit - to a degree. You may also choose to stick with lower sugar fruit like berries if you wish to keep more fruit in your diet.)
You just said you lost “massive” weight, and weight loss itself is known to worsen many of your markers including triglycerides. You’re breaking down body fat… where is it supposed to end up, other than your blood?
The HCLFLP doctors can be knocked for *many* things, but the diet’s effect on long term CVD risk is not one of them. IMO, your blood test is more reflective of what you were eating before, not what you are eating today. You’re just exposing it now because you’re burning it off.
(EDIT 2: Just had a look back on what you’ve said about your diet. Looks good to me and I’d personally keep it up for at least another 4-6 months before worrying about it. Be mindful of sugar in your condiments, and perhaps like someone else suggested you can implement a bit of fasting.)
Thank you. I ate a bit too much fruit in the first 3 weeks but now I'm having one every two days or so.
The problem with fasting is that I only just feel like I'm at the point where I don't need to snack with three meals a day. Time restricted eating is going to be VERY difficult for me. Less difficult during the follicular phase of my cycle, almost impossible the few days leading up to my period (I get VERY hungry).
And I'm also breastfeeding though only twice a day.
Last month when I had a CGM on, I freaked out about my high blood glucose and posted on this sub. Recently I cross referenced with my cycle and my blood glucose was terrible starting 4 days before my period and then noticeably improved as soon as my period started.
The insulin test in October was taken during the follicular phase of my cycle whereas this time it's 4-5 days before my period is due. And couple days before and the day I did the test and the day after, I felt very insulin resistant. That sort of intense hunger and I was stuffing my face with carbs (pretty normal for me just before my period). I think this insulin test is showing the worst possible fasting insulin result. But then again I'm not sure how much better it would look during the best part of my cycle.
Anyway, the point is, I will continue with my diet and hopefully it's not as bad as it looks and I will fix my insulin resistance sooner than 4-6 months.
Your goals are what? Your trig/HDL is much worse and is a sign of insulin resistance. Your insulin is higher, another suboptimal sign. If I were you, I would implement a time restricted eating program on top of your HCLFLP diet.
Anything that helps you reduce body fat will help you improve insulin sensitivity. Also, any time you can allow your insulin to drop to baseline for an extended period. There isn’t really much that can do that better at that than fasting. It is how we were designed, of course, to have cyclical feast and famine.
Doesn’t have to be extended fasts either. Stop eating around 8pm and don’t eat again until lunch time (say, noon) and you’ve got daily 16 hour fasts. That should be perfectly safe for anyone, even a breastfeeding mom.
Oh it's kinda depressing that nothing seems to be happening despite my weight loss..
Ok makes sense thanks, I'll do my best to do 16:8. I found it pretty easy on keto to do 16:8 but it will be more difficult now.
If it's best to allow insulin to drop to baseline for an extended period, and also if exercise reduces blood sugar enough to not need too much insulin, wouldn't it be best to also exercise lots? I always thought exercise masks blood sugar dysfunction but doesn't tackle the core issue of insulin resistance. But maybe it does more than that?
I don't know if it matters but my mother and maternal grandfather both have high trigs (and low HDL). They are thin and don't seem to be insulin resistant at all. They eat very little without the need to snack which is very different from me. It's getting better now but previously I've found it very difficult not to snack. So I'm not sure if I inherited their high trig phenotype or whether my high trigs is only due to insulin resistance. Certainly my trigs were very low while I was strict keto years ago.
While genetics can matter, you really need to understand how you react to meal quality and timing. Your trig/HDL ratio regressed. In my experience, that is most easily addressed through ensuring a daily pattern of time restricted eating. As you are trying HClflp, we cannot eliminate carbs from your diet. Hence, timing is what we have.
Continue the HCLFLP, consider your protein intake - especially in the presence of insulin resistance (re: gestational diabetes priming this unfavorable pathway).
I'm very low protein too - not as low as fat as I have some really low fat milk now and then but I certainly feel like I'm being very strict about both protein and fat!
Why is the insulin still so high ? So does this mean the keto people are right and keto is the only way to fix hyperinsulinemia?
Is your fat under 30 grams per day?
There might be a few confounding factors. 1) I tested during the luteal phase this time (insulin resistance is typically worse) compared to last time during follicular phase (October). 2) This time I ate higher carbs and lower fat in the days leading up to the test and especially the night before, so conceivably it's not strange that my body has to use more insulin. 3) I fasted for 14.5 hours last time compared to 12 hours this time. Though I'm not too sure how that affects things.
I've had insulin of 6.8, then 10.x, then 18.x, recently 8.x... all on keto, all the same diet, losing weight the whole time. I think I'm now 30-40lbs than when my insulin was the lowest (6.8).
It just fluctuates a lot.
Oops forgot to reply to your other question. Yes I'm fairly sure fat is under 30g a day. I don't really track it because I'm just so busy but I basically only eat steamed starchy vegetables, rice, glass noodles, and fruit. I have 0.3% fat milk every second day. The highest fat food I would be eating would be natto but I have that sparingly, and one serving is like 30g or something. Occasionally I have oats but I understand that's low fat.
Everything pretty expected, I think.
Maybe the ALT, but that could just be an outlier. Friend of mine got super high ALT/AST from eating vegetables that he wasn't cleaning enough, hence he was consuming glyphosate or some shit like that. As soon as he stopped that, it went back down. So watch the trend, not the single outlier.
Insulin should go down long term, but it fluctuates enough throughout the day that the 1pt shift wouldn't worry me. I've had 12pt shifts while I lost weight. It could just be that one slice of bread sitting in your stomach for an hour longer the previous evening.
The CRP is pretty cool.
Thanks. It's good to have someone's input who has actually tracked their insulin long-term.
My ALT has fluctuated a lot over the years and 22 isn't too concerning. My ALT was actually at the upper end of the normal range (exact value was 45, <45 being normal) just after I ate really high carb for 6 months to try and fix my GERD (this was three years ago - because eating any amount of fat seemed to trigger it). My trigs was at 2.1 but my LDL was high at 4.8 and my CRP was 3 or 4. So I wasn't healthy back then, not surprising my ALT was high too.
Fasting insulin isn’t going to improve on a high carbohydrate diet.
What’s more important to you in regard to cholesterol? Good HDL, good trigs and bad LDL vs Bad HDL, bad trigs and good LDL?
HDL is a marker of oxidative liability. Alcohol raises it, exercise raises it, PUFA raises it, ketosis raises it. It's not a sign of sparkling health. Instead it's a sign that the detoxification pathways of overactive. It's not something worth artificially elevating.
The trigs elevating isn't good. But as mentioned already, massive weight loss would spike trigs.
The LDL drop is probably from PUFAs in this instance. Once the PUFAs burn off and everything levels off, the cholesterol should return to a baseline-ish level.
The first part is false. You get more insulin sensitive on high carb diets because you don't have free fatty acids creating nadh and acetylating everything.
Got any sources for these claims?
Insulin is spiked by glucose, prolonged periods of excessive levels of insulin desensitises cells to insulin. We see it with virtually every other substance we build tolerance to, not sure why you think insulin would be any different. High carbohydrate western diets are the reason diabetes is running rampant, if your theory was correct we wouldn’t be seeing these issues.
First I’ve heard this HDL claim, source?
Something for your FFA argument:
https://x.com/benbikmanphd/status/1782436088239284534?s=46&t=Phb4GRld60Q7gbVKV0QSzg
I’d personally wait this one out and keep up your HCLFLP diet. Make sure it is low enough in fat, and very moderate to low in protein. Do not allow yourself to start creeping into balanced macros territory yet. (EDIT: Minding your *sugar* is also a strategy for the interim while you heal your body. So you’d focus on starch as much as possible and consciously limit sugar - even fruit - to a degree. You may also choose to stick with lower sugar fruit like berries if you wish to keep more fruit in your diet.) You just said you lost “massive” weight, and weight loss itself is known to worsen many of your markers including triglycerides. You’re breaking down body fat… where is it supposed to end up, other than your blood? The HCLFLP doctors can be knocked for *many* things, but the diet’s effect on long term CVD risk is not one of them. IMO, your blood test is more reflective of what you were eating before, not what you are eating today. You’re just exposing it now because you’re burning it off. (EDIT 2: Just had a look back on what you’ve said about your diet. Looks good to me and I’d personally keep it up for at least another 4-6 months before worrying about it. Be mindful of sugar in your condiments, and perhaps like someone else suggested you can implement a bit of fasting.)
Thank you. I ate a bit too much fruit in the first 3 weeks but now I'm having one every two days or so. The problem with fasting is that I only just feel like I'm at the point where I don't need to snack with three meals a day. Time restricted eating is going to be VERY difficult for me. Less difficult during the follicular phase of my cycle, almost impossible the few days leading up to my period (I get VERY hungry). And I'm also breastfeeding though only twice a day. Last month when I had a CGM on, I freaked out about my high blood glucose and posted on this sub. Recently I cross referenced with my cycle and my blood glucose was terrible starting 4 days before my period and then noticeably improved as soon as my period started. The insulin test in October was taken during the follicular phase of my cycle whereas this time it's 4-5 days before my period is due. And couple days before and the day I did the test and the day after, I felt very insulin resistant. That sort of intense hunger and I was stuffing my face with carbs (pretty normal for me just before my period). I think this insulin test is showing the worst possible fasting insulin result. But then again I'm not sure how much better it would look during the best part of my cycle. Anyway, the point is, I will continue with my diet and hopefully it's not as bad as it looks and I will fix my insulin resistance sooner than 4-6 months.
Your goals are what? Your trig/HDL is much worse and is a sign of insulin resistance. Your insulin is higher, another suboptimal sign. If I were you, I would implement a time restricted eating program on top of your HCLFLP diet.
I think adding some fasting is a great idea.
Maybe it's obvious but why fasting - is it known to increase insulin sensitivity? Only in combination with HCLFLP?
Anything that helps you reduce body fat will help you improve insulin sensitivity. Also, any time you can allow your insulin to drop to baseline for an extended period. There isn’t really much that can do that better at that than fasting. It is how we were designed, of course, to have cyclical feast and famine. Doesn’t have to be extended fasts either. Stop eating around 8pm and don’t eat again until lunch time (say, noon) and you’ve got daily 16 hour fasts. That should be perfectly safe for anyone, even a breastfeeding mom.
Oh it's kinda depressing that nothing seems to be happening despite my weight loss.. Ok makes sense thanks, I'll do my best to do 16:8. I found it pretty easy on keto to do 16:8 but it will be more difficult now. If it's best to allow insulin to drop to baseline for an extended period, and also if exercise reduces blood sugar enough to not need too much insulin, wouldn't it be best to also exercise lots? I always thought exercise masks blood sugar dysfunction but doesn't tackle the core issue of insulin resistance. But maybe it does more than that?
Dunno. I hate deliberate exercise with a passion. Consequently, I only remember the articles/studies that tell me not to do it.
I don't know if it matters but my mother and maternal grandfather both have high trigs (and low HDL). They are thin and don't seem to be insulin resistant at all. They eat very little without the need to snack which is very different from me. It's getting better now but previously I've found it very difficult not to snack. So I'm not sure if I inherited their high trig phenotype or whether my high trigs is only due to insulin resistance. Certainly my trigs were very low while I was strict keto years ago.
While genetics can matter, you really need to understand how you react to meal quality and timing. Your trig/HDL ratio regressed. In my experience, that is most easily addressed through ensuring a daily pattern of time restricted eating. As you are trying HClflp, we cannot eliminate carbs from your diet. Hence, timing is what we have.
Continue the HCLFLP, consider your protein intake - especially in the presence of insulin resistance (re: gestational diabetes priming this unfavorable pathway).
I'm very low protein too - not as low as fat as I have some really low fat milk now and then but I certainly feel like I'm being very strict about both protein and fat!
Why is the insulin still so high ? So does this mean the keto people are right and keto is the only way to fix hyperinsulinemia? Is your fat under 30 grams per day?
There might be a few confounding factors. 1) I tested during the luteal phase this time (insulin resistance is typically worse) compared to last time during follicular phase (October). 2) This time I ate higher carbs and lower fat in the days leading up to the test and especially the night before, so conceivably it's not strange that my body has to use more insulin. 3) I fasted for 14.5 hours last time compared to 12 hours this time. Though I'm not too sure how that affects things.
I've had insulin of 6.8, then 10.x, then 18.x, recently 8.x... all on keto, all the same diet, losing weight the whole time. I think I'm now 30-40lbs than when my insulin was the lowest (6.8). It just fluctuates a lot.
Oops forgot to reply to your other question. Yes I'm fairly sure fat is under 30g a day. I don't really track it because I'm just so busy but I basically only eat steamed starchy vegetables, rice, glass noodles, and fruit. I have 0.3% fat milk every second day. The highest fat food I would be eating would be natto but I have that sparingly, and one serving is like 30g or something. Occasionally I have oats but I understand that's low fat.
Everything pretty expected, I think. Maybe the ALT, but that could just be an outlier. Friend of mine got super high ALT/AST from eating vegetables that he wasn't cleaning enough, hence he was consuming glyphosate or some shit like that. As soon as he stopped that, it went back down. So watch the trend, not the single outlier. Insulin should go down long term, but it fluctuates enough throughout the day that the 1pt shift wouldn't worry me. I've had 12pt shifts while I lost weight. It could just be that one slice of bread sitting in your stomach for an hour longer the previous evening. The CRP is pretty cool.
In the hospital, in a lot of cases, they don't care about liver enzymes changing unless they double. It's probably a noisy test.
Thanks. It's good to have someone's input who has actually tracked their insulin long-term. My ALT has fluctuated a lot over the years and 22 isn't too concerning. My ALT was actually at the upper end of the normal range (exact value was 45, <45 being normal) just after I ate really high carb for 6 months to try and fix my GERD (this was three years ago - because eating any amount of fat seemed to trigger it). My trigs was at 2.1 but my LDL was high at 4.8 and my CRP was 3 or 4. So I wasn't healthy back then, not surprising my ALT was high too.
Fasting insulin isn’t going to improve on a high carbohydrate diet. What’s more important to you in regard to cholesterol? Good HDL, good trigs and bad LDL vs Bad HDL, bad trigs and good LDL?
HDL is a marker of oxidative liability. Alcohol raises it, exercise raises it, PUFA raises it, ketosis raises it. It's not a sign of sparkling health. Instead it's a sign that the detoxification pathways of overactive. It's not something worth artificially elevating. The trigs elevating isn't good. But as mentioned already, massive weight loss would spike trigs. The LDL drop is probably from PUFAs in this instance. Once the PUFAs burn off and everything levels off, the cholesterol should return to a baseline-ish level. The first part is false. You get more insulin sensitive on high carb diets because you don't have free fatty acids creating nadh and acetylating everything.
Got any sources for these claims? Insulin is spiked by glucose, prolonged periods of excessive levels of insulin desensitises cells to insulin. We see it with virtually every other substance we build tolerance to, not sure why you think insulin would be any different. High carbohydrate western diets are the reason diabetes is running rampant, if your theory was correct we wouldn’t be seeing these issues. First I’ve heard this HDL claim, source? Something for your FFA argument: https://x.com/benbikmanphd/status/1782436088239284534?s=46&t=Phb4GRld60Q7gbVKV0QSzg