Transcription
The point of this diet is optimizing insulin sensitivity. In the video "Keto Versus the Potato Hack," I discussed this Kevin Hall paper where humans either went on a very low-fat diet, uh, with about 75% of calories from carbohydrate, very little fat, and moderate protein, versus a low-carb diet. The high-carbohydrate, low-fat diet had impressive results in lowering both, uh, glucose from around 91 at baseline down to 85, and insulin around 11.3 baseline down to 8.3. In that diet, one of the best results, I thought, branch-chain amino acids went from 456 at baseline down to 353. They were at the top. Your branch-chain amino acids equal insulin resistance.
And so I like the results of the Kevin Hall diet. I don't like the food. And so I want to ask the question of, can we do better? And what I mean by this is, I really want to drill into the protein composition of the diet. I think this diet made some really good points about the fat versus carbohydrate portion of the diet, but they were not focused on what are the best proteins to consume. We're going to dig into that here, and we're going to focus on palatability. I think one of the most important things of a diet is it has to be a diet that someone wants to eat if people are going to stay on it long-term.
As to protein, this paper is actually from 1969, and you can see these are the three branching amino acids: valine, isoleucine, and leucine, in the yellow. And this is, uh, lean subjects, and this is obese subjects. And you can see that all of those branch-chain amino acids are, in fact, elevated in obese subjects. The levels of these branch-chain amino acids correlate very strongly with fasting insulin levels. So there's this very tight correlation between high levels of branch-chain amino acids and insulin resistance.
Furthermore, another amino acid called glycine is significantly low in obese subjects, and this correlation was not significant, but it is negatively correlated with insulin resistance. So the less glycine you have, the more likely you are to be insulin resistant. This recent paper also showed that in humans, circulating branch-chain amino acid levels are very responsive to lowering dietary branch-chain amino acids. So this was a short-term diet. Uh, this is the black bars are people who had pretty dramatic branch-chain amino acid reduction. Um, it was like a 75% reduction, and you can see that after only 3 days, uh, they have a pretty dramatic drop in circulating branch-chain amino acids, and after 7 days, it declines even further.
And you can see the mice given a high-fat diet with restricted branch-chain amino acids stay just as lean, in fact, even perhaps a bit leaner than mice, uh, with the white dots, which are on a standard chow diet. Restricting the branch-chain amino acids in a high-fat diet reverses the high glucose and the high insulin of, of the high-fat diet, reversing the insulin resistance. This paper found a metabolite of valine called, uh, three-HIB. These are humans with type 2 diabetes. They found elevated levels of circulating three-HIB. In normal humans, the level was about 60. In type 2 diabetes, the level was about 150. So that's two and a half fold. So that's a two and a half fold increase. They fed the three-HIB, which is the breakdown product of the branching amino acids, to mice, and it caused glucose intolerance and increased triglycerides. And so this three-HIB can be used to actually cause insulin resistance in these mice.
This is a very new study showing three-HIB levels in humans with fatty liver disease. There's a very tight correlation between liver fat levels and three-HIB, insulin levels, HOMA-IR is a score of insulin resistance, triglycerides, and even down here, uh, BMI, waist circumference are not statistically significant, but they do correlate with high levels of three-HIB.
Now, this is a second mechanistic paper, and this one is really interesting because it connects the high levels of branch-chain amino acids and the low levels of glycine. So what they found was that high levels of branch-chain amino acids drive the obesity-associated decline in circulating and muscle glycine levels. And they found that branch-chain amino acid-driven glycine depletion restricts formation of acyl glycine adducts for excretion in urine. When they looked in muscle tissues, what they found was that the muscle tissues were lower in all of these short-chain fats. So when your muscle tissue fills up with these short-chain fats, that suggests that you're not efficiently burning your fats. They're not breaking all the way down. When you have high acetyl groups, that's part of reductive stress, or sometimes it's called energy toxicity. And the glycine, if you get rid of the extra branch-chain amino acids, you'll have more glycine. The glycine in your muscles gets conjugated to these acetyl groups, and you simply urinate them out, and that allows you to get out of reductive stress, get out of energy toxicity, and actually burn your fuel effectively again.
What do we want to do to optimize insulin sensitivity? I would argue that, uh, we should have a starch-based diet that's less than 10% fat. And this is based on that Kevin Hall study, among other things. I think the diet should be palatable, and that's just so that people actually want to eat the diet and stay on it. I think we should minimize branch-chain amino acids and maximize glycine.
If you have 500 grams of cornmeal, uh, in your diet, you are already maxed out. If I assume that I'm going to eat 500 grams of cornmeal in a day, for instance, I pick cornmeal because I like, uh, corn tortillas, right? That means I would get 1,800 calories from the corn, and I would already be at, uh, 100% of my. You can see here's, uh, in red is the isoleucine, the leucine, and the valine. I'm, I've already hit my branch-chain amino acid targets for the day, and I haven't had any protein foods, right? I haven't had any quote unquote protein food. Conversely, if you get the same number of calories, or 500 grams of cassava flour, essentially the same number of calories, you get almost none of the branch-chain amino acids. If you're using cassava flour as the base of your diet, you can get your calories from starch in, and you haven't burned through your amino acid budget for the day.
If I'm talking about an optimum diet that's minimizing branching amino acids for insulin sensitivity, I'm going to go with cassava flour versus cornmeal versus rice. And what I'm going to do is I'm going to choose a protein source that I know is a very high-quality protein source. Uh, in my case, I might choose something like 6 ounces of lean pork. 6 ounces of lean pork essentially provides a balanced protein for the day. And so how much protein do we need? Most sources say somewhere in this range, about three-quarters of a gram of protein per kilogram of body weight. For women, this is about 45 grams. For men, this is about 55 grams. The 6 ounces of lean pork provided about 35 grams of protein, and so that leaves us about 20 grams short of our total needs.
So what we want to do is we want to have some source of protein that fills in those 20 grams that is not providing a huge amount of branch-chain amino acids, right? And so this is gelatin here. Uh, the blue line is branch-chain amino acids. The one protein in the world that is very low in branch-chain amino acids that you can use to fill in that gap without blowing your BCAA budget is gelatin. And gelatin, just so happens to be the single best source of glycine. Uh, gelatin has about four times as much glycine as it does branch-chain amino acids, whereas pork has three times as many branch-chain amino acids as it has glycine. Rice has four times as many branching amino acids as it has glycine. And so the obvious thing to do here is to fill in those last 20 grams with gelatin protein.
The corn-based diet provides 16 grams of branch-chain amino acids, whereas the cassava-based diet provides 8 grams of branch-chain amino acids. So this gives us a really pretty simple, uh, diet spec, pretty easy to remember, right? It's based on starch. You have 6 ounces of lean meat, and your goal is to consume about 1 ounce of gelatin. That ounce is 28 grams. And if you want to consume any fruit or non-starchy vegetables, have a salad, that's fine, as we want to keep the diet less than 10% of fat calories. Uh, and I think moderate sugar, uh, moderate alcohol, if you want to have, uh, some wine with dinner.
Really, the star of this show is probably going to be starch noodles. These noodles are called glass or cellophane noodles. They're eaten in China, they're eaten in Japan, Korea, India, really across Asia, Thailand. You can see here they're made from sweet potato starch, and that's why they're translucent. Uh, they don't have any protein, and that's why you can see right through them. If you're worried that these glass noodles are going to blow up your blood glucose, you don't have to worry about that. They're very low on the glycemic index, which is a measure of how quickly that starch is absorbed and made into blood glucose. Cassava flour is another excellent, uh, source of starch. It's 46 on the glycemic index.
Clearly, if we picked a canonical recipe for this diet, it would be something like this. Uh, obviously, this is a Korean recipe, kimchi soup with glass noodles. I made some alterations. I would say in this case, leave off the eggs, leave out the sesame oil, leave out the sesame seeds, and brown that ground pork first and pour off the fat. If you'd like, the amount of pork fat in 6 ounces of ground pork will not blow your fat budget for the day, if that's the only source of fat that you're getting.
So there's a bunch of different ways you can get bone broth and gelatin and glycine. Most things that are called beef broth or beef stock or chicken stock or chicken broth have about 3 grams of protein in a cup. And so this is a, this is a quart container. So this whole quart has 12 grams of gelatin protein. Uh, this is called bone broth specifically, and if it says bone broth, it's going to have a lot more protein per volume. And so this is only an 8-ounce container, and it has 9 grams of protein. So this is would check in at about 36 grams of, of gelatin protein per quart.
You can also use something like this. This is culinary gelatin from Great Lakes Wellness. What I will sometimes do is I'll just use regular beef stock from the store. I'll put a quart of that in, and I'll add a tablespoon of this gelatin to it, and I'll boil the noodles right in there, and then add whatever protein or vegetables or kimchi or chili paste or whatever I want to that. Here's another very easy thing you can do with noodles. Pad Thai sauce. You basically just take these four ingredients, you boil them together, you toss the noodles in them, tada, you have Pad Thai. These glass noodles are often served in cold salads. This is a fat-free Asian dressing. Make this dressing, toss it on the glass noodles, tada, you have salad.
There are also some gluten-free pancake mixes based on cassava flour. Uh, this is a cool trick. So when you make pancakes, you're often adding eggs, which you might want not want to do if you're limiting your protein. What you can do is, is this is called a gelatin egg. You essentially, instead of using an egg in your recipe, you mix up water and gelatin, and you add that to the mix instead. You can also just buy cassava flour and make these tortillas. Fun fact, you can make green plantains into tortillas as well.
Okay, so that Kevin Hall study showed that a very low-fat, very high-starch diet is a good step on the way to an insulin-sensitizing diet. If you want to truly optimize this type of diet, in my opinion, you will want to avoid grain protein. Once you've hit your basic protein requirements for your essential amino acids, fill out your protein budget for the day with gelatin. That's going to give you the glycine that you need to help remove unburned fats from your skeletal muscle, and those effects of glycine are going to help you get your insulin sensitivity back.