The Insulin-Illness Connection

Inline_The Insulin-Illness ConnectionMost discussion of chronically-elevated insulin levels (hyperinsulinemia) and insulin resistance revolves around their relationship to bodyweight. This is unsurprising. Bodyweight’s what “sells tickets.” It’s why most people get interested in diet, health, fitness, and nutrition—to lose weight or avoid gaining it.

But improving insulin sensitivity and reducing fasting insulin levels have major ramifications for your health, longevity, and resistance to disease. And it’s not just because “weight gain is unhealthy.” Insulin itself, in excess, exerts seriously damaging effects. Today, I want to impress upon you the importance of controlling your insulin response by laying out some of the health problems that stem from not controlling it.


If you’re insulin resistant, insulin doesn’t work very well. You need more of it to get the same effect an insulin sensitive person would get. When insulin doesn’t work, its ability to shuttle glucose out of the blood suffers, and blood glucose goes up and stays up. That’s hyperglycemia. Everyone “knows” that high blood sugar is bad, but why? What exactly goes wrong?

Some cells are passive recipients of blood sugar, while others have mechanisms that prevent excess blood sugar from entering their membranes. In the presence of high blood sugar, the passive recipients begin producing excessive amounts of reactive oxygen species (ROS). ROS aren’t pathological in and of themselves. They’re signaling molecules that our bodies need for healthy cellular function. But unchecked ROS generation induced by hyperglycemia causes a lot of problems.

In endothelial cells, hyperglycemia inhibits the production of nitric oxide. Nitric oxide is a vasodilator—it helps our blood vessels widen to accommodate increased blood flow and reduce shear stress. Without sufficient nitric oxide, our blood vessels are more susceptible to high blood pressure and our risk for heart disease and atherosclerosis goes up.

In neurons, hyperglycemia causes shrinkage. No one likes shrinkage, especially not in the brain cells where thinking occurs.

In pancreatic beta cells, hyperglycemia reduces cell mass, induces oxidative stress, and reduces functionality. Since the pancreas secretes insulin—the stuff used to deal with excess blood glucose—this is disastrous.


Insulin is a growth promoting agent, and cancer is a disease of unchecked cellular growth. There are nuances to this of course. But by and large, those are true statements. It’s no surprise that hyperinsulinemia is a risk factor for most, if not all cancers.

While insulin isn’t everything when it comes to cancer, the links are undeniable and myriad—and worrying.

The link between colon cancer and hyperinsulinemia likely involves the increased availability of insulin-like growth factor in a hyperinsulinemic state. Post-menopausal women with genetic variants related to insulin resistance and hyperinsulinemia have a greater risk of colorectal cancer, and colon cancer patients who eat the most insulinogenic foods have poorer outcomes.

In breast cancer, hyperglycemia increases the tumors’ resistance to chemotherapy. Fixing the hyperglycemia makes chemotherapy more effective.

People with a genetic predisposition toward hyperinsulinemia have a higher chance of developing pancreatic cancer.

Independent of bodyweight, hyperinsulinemia predicts endometrial cancer; so does a high postprandial insulin response.

Diabetics who use insulin therapy have an increased risk of liver cancer.  One study of Taiwanese diabetics found that those on insulin therapy have an elevated risk of dying from cancer and from non-cancer.

Across the board, in both obese and people of normal bodyweight, hyperinsulinemia, whether it’s genetic, simulated, or diet-driven, increases cancer incidence and mortality. 

Okay, okay. That’s all rather convincing, but there’s a chance that these are merely associations and some common factor is causing both the hyperinsulinemia/insulin resistance and the cancer. Right?

What seems to counter that hypothesis is the effect of metformin, an anti-diabetic drug, on cancer. Compared to other diabetic drugs, metformin reduces the risk of cancer in type 2 diabetics. Metformin’s mechanism of action? A reduction in insulin levels and improvement of insulin resistance.

Alzheimer’s Disease

Alzheimer’s hits families like a freight train, but if you know what to look for you can see it coming.

Alzheimer’s and other forms of dementia are characterized by brain insulin resistance. In experiments where researchers simulate brain diabetes by administering drugs known to induce brain insulin resistance, it looks almost exactly like Alzheimer’s. Some people even call Alzheimer’s type 3 diabetes, so closely is it linked to insulin resistance.

Alzheimer’s patients have high blood sugar, but their neurons are so resistant to the effects of insulin that they’re unable to utilize the available glucose for energy. That’s why ketogenic diets and ketones in particular are so helpful for Alzheimer’s; they offer an alternative fuel source that even the insulin resistant brain can utilize.

Heart Disease

Independent of most other factors, insulin resistance predicts heart disease riskOne of the best predictors of heart disease risk—the HDL:triglyceride ratio—also happens to be an accurate barometer of insulin resistance. The lower your HDL and the higher your triglycerides, the more likely you are to be insulin resistant.

The two go hand in hand, and it’s not just a coincidence.

As you saw in the hyperglycemia section, insulin resistance can increase the risk of heart disease by increasing hyperglycemia and reducing endothelial function. This impairs the blood vessels’ ability to react to stressors and makes them more vulnerable to atherosclerosis.

What You Can Do

A big step, maybe the first step when you’re insulin resistant with hyperinsulinemia, or even just suspect you are, is to reduce your intake of the most insulinogenic macronutrient around: carbs. This stems the tide and stops feeding the fire until you can figure out and resolve the root cause of your dysfunction.

That next part is harder. Some of it is genetic; there will be people who simply make more insulin than others, or who are more insulin resistant as a baseline. Oftentimes the dysfunction is multifactorial, stemming from a dozen different causes, all of which require your attention. In past posts, I’ve explained strategies for combating insulin resistance and reducing hyperinsulinemia. If you haven’t read those yet, do so.

Take the issue seriously, whatever you do. An expanding waistline might be unsightly and undesirable, but it usually doesn’t strike fear into hearts and minds. You know what does, and what should?

  • Developing a cancer you didn’t have to develop and dying earlier than you should have.
  • Seeing your sanity and identity slip away as your helpless family members watch in vain.
  • Bathing your neurons and arteries in a toxic hyperglycemic soup until they wither and atrophy.

Take care of your insulin response, folks. It’s fundamental.

Thanks for reading, everyone. Take care, be well, and let me know what you think about all this down below!

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

If you'd like to add an avatar to all of your comments click here!

75 thoughts on “The Insulin-Illness Connection”

Leave a Reply

Your email address will not be published. Required fields are marked *

  1. Don’t know about hyperglycemia, but Primal got rid of my hypoglycemia. No more carrying around emergency food in case of a blood sugar crash. Thinking of food 24-7 is a long gone, distant memory.

  2. It’s so very frustrating to have all this info at your finger tips and for people (coworkers/family) to simply shrug and say, “The doctor says I’m doing fine.” And, “I have to eat 45grams of carbs a day, the lady at the diabetes clinic told me.”
    Says my mom eating a loaded bagel. So sad and afraid for them.

  3. Here’s an interesting article that says just the opposite about Alzheimer’s and the ketogenic diet: Some of the comments are pretty interesting too.

    I think we have to ask ourselves why Alzheimer’s has become so much more common, and what, if anything, can we do about it. I’m not a fan of dietary extremism, which also means I’m not a fan of long-term ketosis. In its strictest form, it works–sometimes–for various intractable illnesses, and it’s great for weight loss. But how much do we really know about the effects of long-term adherence? Maybe not nearly enough.

    Without factoring in the uncontrollables, such as genetics, heredity, etc., it seems to me that a Paleo/Primal diet/lifestyle averaging around 85/15 to 90/10 would serve most of us just as well if not better. Eat close to nature and avoid the manmade stuff. Get sufficient exercise, both physical and mental, without becoming obsessed by it. Learn to keep stress to a minimum. And stay as far away from pharmaceuticals (including OTC) as you possibly can. (That includes medical procedures that involve the use of chemicals, which is almost all of them.)

    Life doesn’t offer guarantees, but these things are simple, doable long-term, and relatively easy to adhere to. They will go a long way toward protecting your brain as well as the rest of your body.

    1. ” And stay as far away from pharmaceuticals (including OTC) as you possibly can.” WHY? There is so much fear on this site of pharms and vaccines I sometimes think I’m dealing with dogma driven idiots. And yet, most here are pretty smart.

      Why not take certain, no side effect drugs? Despite eating pretty much true to form , weight only abou 7% over Ideal, getting exercise, I have to take metformin and losartan, a blood pressure med to keep things better. I took myself off of metformin a few months ago, things looked for some weeks, then the creeping back up.

      Metformin is a favorite of the life extension crowd for the reasons Mark cites. The only dowside, and not for everyone, loose stools to diarrhea. So, I do have to take a loperimide every day, too.

      Dismissing all pharmaceuticals is a broad brush condemnation which could be cutting your nose off to spite your ideological face. Just be smart about the subject.

      1. OTB, there’s no such thing as a drug without side effects. It’s more a case that not everyone is adversely affected. And not everyone is “smart” about the subject. Many older people take multiple prescriptions for anything and everything, thinking it’s a lot easier than making lifestyle changes. Yes, it probably is easier, but that doesn’t mean it’s a better idea. If you need to ask why, then you haven’t done enough research.

        Without getting into the many, very valid reasons, my comment was intended to mean that we should lose the cavalier attitude that has become so prevalent. It’s a much better idea to take drugs only when absolutely necessary (when lifestyle changes won’t do the trick) and only for as long as necessary.

    2. there is a connection between hyperglycemia and Alzheimer’s Disease that has some research proving that a low carb & ketogenic diet may prevent onset.

  4. Mark, what do you think of Denise Minger’s hypothesis that one can increase insulin sensitivity by ‘carbosis’ (i.e., carb cycling). Is it worth pursuing? I am on a ketogenic diet (and produce ketones) but my insulin sensitivity is still poor.

    1. While we await Mark’s reply, here is the take from Peter and Hyperlipid, with lots of lively discussion in the comments. The basic summary, as is so often the case, is that some people can do fairly well on fairly high carb ( I used to be one of them), but they rarely do better than lowish carb , and many people cannot tolerate high carb even intermittently.

      Some related discussion more focused on insulin is here:

    2. “Carbosis” seems to work well for me! I did low carb for a few years, and became very sensitive to carbs, while still having borderline high blood sugar. For the past year, I’ve had a moderate carb, low fat, high quality diet, and my carb tolerance and general sense of health has improved dramatically. I’ll get blood work and hbA1c done soon. That’ll be interesting!

      My ancestors probably ate this kind of diet. Where I had issues on a low carb diet, my husband, who is a different ethnicity than me, thrives. Our bodies are all different! But it’s a good idea for all of us to figure how to have healthy blood sugars and insulin levels.

    3. You should read the works of Dr. Jason Fung. He is a nephrologist with a practice in Canada. Most of his patients have adult onset diabetes. His low carb and intermittant fasting programs have reversed many patients’ diabetes. He explains how fasting is necessary to reduce overall insulin levels.

  5. I recently wrote an article about Type 3 Diabetes– otherwise known as Alzheimers. I think we need to continually refer to Type 3 diabetes as Alzheimers in the same sentence, because it helps people draw the very real connection between insulin resistance and the damage that excessive carbs create for the brain. It may pierce the buffer of denial that many people have, especially if they are not overweight. And when people say “I’m so forgetful these days” as if that is a normal part of aging, that can be a “teachable moment” to point out that they could always try reducing carbs and seeing if their memory and concentration improve. If people aren’t willing to protect their brains….. (shudder) I don’t know what will get through to them. And I’d be willing to bet that people who walk into churches, music events, school yards, night clubs, synagogues, mosques, etc and open fire with a gun have very sick, carb laden brains. It’s important that we as a society address this, as a matter of survival.

    1. My experience is that teaching the ill effects of carbohydrate dependence is generally ineffective in changing behavior, for the same reason that teaching the ill effects of alcohol or opiate dependence is generally ineffective in changing behavior.

      What “gets through” to people seems to be highly individual, but usually requires some kind of crisis, often family-related. Many, however, will pursue their addictions to the end regardless of consequences.

      I’d be curious to read your article if you wouldn’t mind linking it…

      1. “Many, however, will pursue their addictions to the end regardless of consequences.”

        That is the same logic that doctors have been using regarding their obese patients. If you only had more will power you would not be fat. As all who browse the health blogs know, the battle against obesity continues to be lost. Like you said, some people respond to a crisis but not as many as we would like. My father died believing that the he was receiving the proper standard of care vice trying some of the alternatives that we see in the paleo/keto community.

        For many alcoholics and opiate dependant I am sure they would love to quit. Their brains are seriously messed up and no 12 step method is going to work. The will is no where to be found. More radical approaches like the Sinclair Method are showing real promise in breaking these addictions. But again, like Paleo, getting people to step outside of accepted norms to make changes for the better is a step too far. Easier to have that krispy creame followed with some metformin.

        1. Like you, I agree that “willpower” is not a helpful explanation. It may not even be a coherent concept. Perhaps there are only things we want to do, and things we don’t want to do.

          Like you, I have had several family members that died — quite horribly — convinced they were getting the highest standard of care. Convinced that the increasing mountain of pills they took was far more important than the food they ate, and that going under the knife was as benign and straightforward as an extensive automobile repair job.

          One obese family member was told by her surgeon that he would not perform a knee replacement unless she lost weight. She simply shopped around for another surgeon that would. She is now virtually immobile, convinced that she received the highest standard of care.

          The difference between those who recover from self-destructive addictions seems to me not willpower, but honesty. Someone who is dishonest can always find an authority figure to justify whatever it is they were going to do anyway. Someone who is honest is going to experiment for themselves to find out the truth.

          The arguments for doing a 30-day carb-restriction experiment are compelling. Why, then, wouldn’t someone do it? Only if their ability to tolerate cognitive dissonance was stronger than their desire to know the truth.

          All those who I’ve seen adopt healthy habits were unable to unsee the truth once it was shown to them. That is certainly what happened to me, and I assure you I have little, if any, willpower, though people often tell me that I have a lot.

          1. Timothy, I doubt that people are deliberately dishonest regarding their own health. I think it’s more that they become very adept at twisting the truth into whatever they want it to be. Willpower IS important in making difficult changes. In fact, it’s absolutely critical for success. However, willpower won’t even enter the picture if a person rationalizes away the need to make any changes.

      2. Aye, eat carbs, and you may die. Don’t eat them, and you’ll live — at least a while. And dying in your beds many years from now, would you be willing to trade all the carbs from this day to that for one chance, just one chance to come back here and tell our enemies that they may take our carbs, but they’ll never take our freedom!!!

      3. Sugar is the issue, not “carbs” in general. Putting them on the same level as alcohol or drugs is exagerated.

        1. What makes “carbs” so different from sugar? They both become glucose immediately after passing through the walls of our digestive tract. Yes, I know that some carbs (fiber) are not digested at all and that for instance fructose is an even more dangerous type of sugar than glucose, but what exactly is your point?

          What concerns alcohol and drugs vs. sugar, I tend to agree with you.

    2. yes there is some much to address in terms of the sickness that pervades American Society (I’m in Canada, not so much better but an outside perspective and I’ve lived in the states). I think mark even did a post that contained a hypothesis, or i read somewhere else, that the diet of americans in breeding increasing stupidity. This is really sad and coupled with a denial about the issue of guns and a frustrated populace who can’t take it out on the government and military, take it out on the general population. We canadians learned that americans had guns for one reason, so that they could always mount a revolution in case the government went awry, but now that the society has not taken care of the people at the bottom they feel like it has gone awry. In canada a single mother on welfare with two kids makes more that my husband working a decent full time job (union), its not unfair, we are looking after those kids so they have hope and opportunity and good food, and we (most of us) happily do it for a healthier caring society. In the states the poverty is intense and people left out and combined with the factors of: completely insular media, poor food, poverty and subsequent lack of education, leading to general anger at the state, leads to acting out. The state is too heavily armed to fight, even with machine guns, so they take it out on general people who viewed throught the eyes of a nutrient devoid brain, have no more value than themselves. Umm off topic much, sorry..

  6. If one is insulin resistant (prediabetic), should coconut butter be skipped as a high fat snack? I know it does have sugar in it, but it does take the edge off hunger and I enjoy it.

    1. My experience is that you need not go very-low-carb immediately (although that certainly works if you can handle strong side effects of low energy and hormonal disruption for a week or so).

      Mark’s recommendation of cutting down to ~100g for the first three weeks, then to ~50g, and perhaps then gradually to 20g, works easily for many people.

      Coconut butter gives you 9g of fairly high quality fat for only 2.5g net carb. So if you ate a ridiculously large portion like ten tbsp that would still only be 25g carb, but 90g fat for a total of 910 calories.

      You could do a lot worse! If it was me, I’d fill up on fatty animal foods and non-starchy veg first, then have the coconut butter for dessert.

  7. Oh insulin. I went primal years ago and felt great, but I slipped back to eating more and more garbage and ended up with nasty episodes of reactive hypoglycemia. Recently my blood glucose levels were falling to the 40s and 50s. I tried to fix it by conventional means – “healthy whole grains!” and snacks every 2 hours. Constant eating, no energy, and regular hypo symptoms. I’m back on strict primal and feeling so much better. Yet, a nutritionist looked at my meal log and kept telling me I need to eat more carbs – even though I feel better on low-carb! The meal plans also suggested low-fat dairy, which is more insulinogenic than full-fat. It’s so disheartening to not find actual help from medical professionals. I’m on the wait list now to see an endocrinologist who can hopefully set me straight. I am so thankful for the PB – otherwise I’d be a total non-functioning wreck.

    1. Hypo Harriet, If you haven’t heard of Jason Fung MD, you really need to read about how he has helped his patients with adult onset diabetes reduce and in many cases eliminate the need for insulin and oral meds. He explains how to reduce insulin levels through low carb diets and intermittent fasting. He is a nephrologist in Canada. Most of his patients were needing dialysis due to kidney damage from diabetes. He also has different interviews on you tube.His website explains the program and has a blog with many videos explaining different aspects of insulin resistance and the research that is showing high insulin levels seem to be at the root of many of our modern diseases (heart disease, dementia, auto immune disorders and even cancer) He has 2 books out, also.

      1. I’ll look into his work. Thanks so much for the recommendation!

  8. Funny thing is, I have really low insulin levels and run borderline high fasting glucose levels. My (former) FP knee-jerked a diagnosis of pre diabetes, but I am not overweight, in good shape, strictly primal, and clearly not insulin resistant. My suspicion is LADA (latent autoimmune diabetes of adults), sometimes labeled as Type 2.5 diabetes. My family is full of members with autoimmune issues. But antibodies are negative. It’s a mystery to me what’s going on, and I don’t expect you to have an answer. But if anyone out there has a bead on an explanation, I’d be interested.

    1. Have you checked your A1C and post-meal glucose? I’m 50 and have the same issue but no answers. Weight training helps and I’m trying to get back into it.

      1. Not sure if you’ve checked out Dr. Ted Naiman on this topic. I believe, but am not sure you are talking about something called Physiologic Insulin Resistance, not a bad thing to have. There is a calculation to make which gives one a HOMA-IR value. Not sure how high your FBG is, but with a low fasting insulin value, you are likely in good shape. I’m sorry but I don’t have the link to Dr. Naiman’s work, but he has a FB page “Burn Fat Not Sugar” where you can probably find lots of good info.

        1. Thank you both. FBG runs 98-105, used to be consistently under 75. A1c was borderline…5.7 with upper limit 5.6. No retest. Which is what triggered the diagnosis and why I left the FP and found a functional doc. She’s not fond of A1c, nor am I. I have considered the physiologic insulin resistance, but my insulin is low. Colleen, I have 15 years on you, and I haven’t been consistent with my weight work, so more is on the schedule. Charles, I’ll look up Dr. Naiman’s blog and see what’s there. Thanks!

          1. Another thing to consider with the A1c is that is based on the average life of red blood cells. If you are a really healthy person, your red blood cells will last longer and have more time to pick up glucose. One of my friends has never been overweight, walks a lot and eats a healthy diet (lots of vegetables, meats and fish, and not a lot of carbs). His A1c is similar to yours.

    2. In my experience (over 26 years) Type 2 diabet(es) is really more than 1 sub-type. Some folks have lower amounts of beta & alpha cells in their pancreas & develop hyperglycemia….No matter what you eat, you may be getting insulin deficient diabetes. Get a referral to an endocrine physician ASAP please…I am a Diabetes Educator x 16 years & I have studied type 2 for over 30 years. We now have a “cure” for one sub-type of type 2 which is ketogenesis via diet & exercise. there is one commercial start-up out there in the world doing intervention care. I have a FB page & sub page.

  9. I have a question. I have been on the 21 day ketosis plan and have actually continued so this is my 5th week. I am concerned because I have only lost 5 lbs and I am am a big guy at 6’2 and 333 pounds. Should I be concerned?

    1. How are the details? Is there any aspect of the plan you are not making sure to follow? I’m thinking here of the synergy that results from not only maintaining the recommended carb/protein/good fats ratio, but also the exercise and 16 hour daily intermittent fast. Are you lifting something heavy and sprinting once a week, for example?

      1. I eat a balanced Paleo meal 3 Times a day. My exercise may not be enough but I do lift weights. No sprinting, bad knees.

    2. Some ideas:
      1) First of all, are you sure you’re actually in ketosis?
      2) Are you eating too much fat? The idea that fat won’t make you fat is an internet meme that is total BS. Unless fat is all you eat, too much of it can stall weight loss. Try cutting back your fat intake.
      3) Are you eating overly large portions of protein?
      4) Ketosis doesn’t work well for everyone. Most people lose weight like crazy but you might be one of those who loses very slowly, if at all.
      5) Instead of winging it, you might consider talking to a weight loss doctor.

      1. Thanks for your response. I eat prepared Paleo meals which are under 150 g of carbs and protein on average 65-75 g per day.

        1. A couple thoughts:

          150 gm of carbs is on the high side for getting into ketosis (particularly if you meant 150 gm per meal, instead of 150 gm per day). You might try getting your carbs below 100 gm per day, or even lower.

          And for a guy your size, 65-75gm of protein per day is on the low side, but that may not be a factor here. But if your weight routines are strenuous, you should probably be getting more protein.

          1. +1. I thought 150gm of carbs sounded way too high as well. A lot of people seem to think they are in ketosis when they probably aren’t. Sometimes (judging from what I read) they aren’t even doing low-carb Paleo, much less keto. It’s a learning experience and mistakes along the way are to be expected. The only way to know for sure is to test.

  10. This is a good one to send off to the primal resistant types. The SAD diet fuels insulin resistance and insulin resistance is the precursor to preventable disease.

    1. Amy Berger’s series are incredibly good and I also recommend it to anyone who wants to know all about insulin. Her writing style is in layman terms, so they are very easy to understand. I’ve read many of her blogs posts, they are always interesting.

    2. Agreed; Amy Berger gets into certain details that really get my attention. She (and Ted Naiman) especially helped me when I lowered my protein too much because some were telling people that ‘too much protein spikes insulin’. The problem was they weren’t telling people that you can consume hundreds of grams of protein without problems. A lot of people suddenly became scared of protein intake. When I went low (35-50g per day) weight loss stalled completely and hunger returned, even with extra fat intake. Now, I’m eating about 100g+ pro; moderate fat, low carb and losing weight again.

  11. Valuable information on “The Insulin-Illness Connection.”

  12. Not much talk here about actual insulin levels. My doc says below 7 is preferred. Mine is 4 after three years of LCHF. But doc says the important number is HOMA-IR, which is insulin times blood glucose. That is the number to be aware of (should be below 400).

    The old engineering saying is, “what gets measured gets managed”.

    Strangely, I meet few people who have ever had their insulin measured…

    1. I’d like to have my insulin tested, but as with other tests, the doc won’t order it unless it’s somehow connected to a diagnosis. And my A1C is 5.0%, so he says there is no need for testing insulin. My triglyceride/HDL ratio is 0.77, which I think is pretty good, so I have to assume that my insulin is fine.

      1. You can use an on line lab like Life Extension to order a Fasting Insulin with your doctor being involved. Costs about 30.00.

  13. Fantastic article. My weight struggles were due to hyperinsulinemia. It did require adding a prescription medication (metformin), combined with fasting, to reverse this awful condition of hyperinsulinemia. With a strong family history of diabetes, getting control of hyperinsulinemia had kept over 50lb weight off and likely spared me from a diabetic fate.

  14. Across the board, in both obese and people of normal bodyweight, hyperinsulinemia, whether it’s genetic, simulated, or diet-driven, increases cancer incidence and mortality.

    simulated? stimulated?

    1. I’m thinking that’s when they do animal studies, Vincente. They purposely give them the conditions they want to study and test drugs on.

  15. What would someone who is APOE 3/4 and insulin resistant do? Is a ketogenic diet contraindicated?

  16. Got our lab results last night. We had baseline labs done prior to switching and another panel done 3 1/2 months after changing to a high fat low carb lifestyle. My insulin levels dropped from 2.1 down to 1.2. My wife’s were more dramatic, dropping from 4.8 all the way down to 1.6. In a little over 3 months! Better yet, both of our total cholesterol levels dropped 25 points, while the good HDL levels rose and our triglycerides dropped dramatically. Both of our glucose levels dropped 20 points also. Not a bad start!

  17. your information is correct as per my research. I follow type 2 diabetes via online peer reviewed research & the exact cause for type 2 diabetes was found & published. Yet I hear nothing about it via the popular press.

  18. This is scary information. I wish more people knew the dangers of high insulin levels and were open to lowering insulin through diet.

    Interestingly, my last lab work showed an insulin level of 1.9 uIU/mL, which the lab report marked in the red, as in dangerously low. (The lab report said a normal range would be 2.0-19.6 uIU/mL.)

    My naturopath wasn’t worried at all. She said my body probably didn’t need to produce much insulin as my primal/keto lifestyle involves minimal sugar/starchy carbs/glucose.

    I feel amazing, and that is what is most important to me!

  19. I think this may be your best post ever, Mark. Thanks for changing my life.

  20. Great post Mark, very thought-provoking. However it throws up a big question for me: you wrote that “colon cancer patients who eat the most insulinogenic foods have poorer outcomes” and from clicking through to the study it appears this was based on the insulin index of foods. Now, as I understand it, whey protein is one of the most insulinogenic of foods (higher even than white bread), so is this something we should be avoiding? I take 40g of your ‘Primal Whey Protein’ every morning before breakfast, but is that going to cause me problems down the line? From your 2011 article on dairy you wrote: “It comes down to the amino acid composition of dairy proteins, specifically the amino acids leucine, valine, lysine, and isoleucine. These are the truly insulinogenic proteins, and they’re highest in whey (which is probably why whey protein elicits the biggest insulin response).” Does this mean we should be avoiding whey protein if the insulin response it produces fuels pre-cancerous growth (often very commonplace) into full-blown tumours?

    1. There may be valid reasons for consuming whey protein, but I think you answered your own question with your last sentence. For most of us, real food is always going to be superior to something that’s so highly processed..

      1. Hi Shary, I hear what you’re saying but I don’t think it’s that simple. I either use Mark’s ‘Primal Fuel’ or Bulk Powders Pure undenatured unflavoured whey protein isolate. This product is actually not highly processed at all: apparently it is not heat-processed (12 degrees celsius) and only uses ultra and micro-filtration. The only agent used to help is rennet, an enzyme used to separate whey from milk, and it contains no additional ingredients. Moreover, whey protein has a multitude of benefits, including anti-tumor effects: to quote Mark’s “Not just for bodybuilders” article on whey protein, it contains the following constituents:


        – Promotes glutathione synthesis and reduces allergic disease incidence.
        – Improves retinol/vitamin A absorption and uptake.


        – Protects against seizure in epileptic rats.
        – Increases serotonin levels in plasma.
        – May have anti-tumor effects.


        – Improves bone healing and prevents bone loss.
        – Chelates excessive iron, preventing it from fueling infections (many bacteria require iron), increasing inflammation, or becoming carcinogenic.
        – Has anti-bacterial effects against food pathogens like E. coli and Listeria.

        Immuno-globulins (A, M, G):

        – Neutralize toxins from viruses and bacteria.
        – Prevent adhesion of bacteria to tissues.
        – Inhibit bacterial growth.

        So my question to Mark is how does whey protein isolate pan out on balance? It seems that on the one hand it contains compounds which have anti-tumor effects, yet on the other hand it unquestionably leads to a large insulin spike shortly after consumption. If you want my POV then I would say frequent large insulin spikes throughout the day are actually a good thing: hence why I take whey protein (twice today in fact: once after my HIT workout this morning and again before dinner to get my protein up to 50g/ meal). My belief is that it is only chronically elevated insulin which is harmful – and I believe that this relates more to excessive carb consumption than to whey protein consumption. That’s just my POV though and it doesn’t seem to jibe with what Mark wrote in the article above, ie that highly insulinogenic foods such as whey protein fuel tumor growth. Would be great to get some clarification on which way the chips fall on balance. Sorry for posting the longest comment ever!

        1. Agree!! Whey is a super food! Sure it’s a food component , but so is olive oil , another super food. The use of whey goes back to the Renaissance , when it was used to help recover from illness.
          This is a case where purifying is a good thing . A truly great supplement,
          You’re correct. Acute insulin spiked from from whey are good, unlike CHRONIC insulin elevation from excess carbs.

    2. This is very scary, as we take cold processed Whey daily too!
      But how do we explain all those long lives race like Okinawans who eat a lot of rice, and those who eat a lot of bread in the Blue Zone book? Their main diets are mostly carbs…

      1. Jacqueline,
        I’ll be the first to admit that I don’t know what Okinawans eat. However, I know that many Chinese who immigrate here become type 2 diabetics at an alarming rate. My take on it is that their diet in China, even though it is high in starches, is probably low in fructose. It’s the fructose in everything here that causes the beginning of insulin resistance by building up fat in the liver. Starches convert strictly to glucose which has a very different effect on the body.
        There are articles on the Internet about a man who ate nothing but 20 potatoes a day for 60 days. Google “20 potatoes a day” and choose the Forks over Knives article. This is a vegan propaganda website but it is the best article on this man’s experiment that I know of.
        He lost weight and all of his lab numbers improved. My explanation is that, while he was eating a very starchy diet, he was getting zero fructose.

  21. Even more issues pertaining to dementia: brain is more insulin resistant (glucose unusable) than the body and the same enzyme that cleans up excess insulin (insulin degrading enzyme) would otherwise be busy cleaning up amyloid!
    “Oops sorry, no time, got to go clean up some more excessive insulin!”

  22. Insulin resistance is no match for a bowl of cannabis at least according to some not often cited research out there.
    May not be for everyone esp those with jobs that test or where it’s still illegal but I can swear by it. Used it nearly daily to fuel the ‘fun fsctor’ of going keto. Even with deep cases of the munchies eating a small hoard of calories (keto aligned), I often look leaner the next day. I can’t explain it so I don’t try. I just keep it mostly to myself.

  23. Love the post. I am keto, all the way. I was low carb, years ago for like 8 years and was healthy and sharp then I met my husband… dunt, dunt, dunt… He can pretty eat anything and so my low carb life become much less so. I went full keto about a year ago and although I haven’t lost as much weight as I would have liked at this point, there is NO QUESTION that my brain fog is gone! Obviously, a sign of metabolic syndrome. My family is a T2D family and so, without a doubt, I must stay away from carbs.

    Again, love the article.

  24. Hey Shary,
    I assume you realize that article you cited is from the king of the vegan cult (dare I say that wacko Campbell). I started perusing the research articles the authors cited, and sure enough, they’re all flawed and garbage studies. For example, in one rat study, the saturated fat group consumed a diet with 10% HYDROGENATED coconut oil (trans fat anybody??), along with sucrose, soybean oil, and other garbage foods. Not to mention casein ( no whey). Study is completely worthless. The author even cited a another study IN FAVOR of LC diets, i.e., they RAISE HDL..of course they do!!..
    Many scientists studying ketosis have been in ketosis (most of the time) for years with no problems at all. It’s our natural state. We evolved with feast and famine, and when we did eat, it was the animals with the most body fat. I’ve been I ketosis for about 3 years running and doing awesome.

    Vegans will do anything to discredit a normal diet that includes animal protein and fat..

    Veganism is a cult…it’s nonsense…

  25. Thyroid nodules are also a culprit of insulin resistance according to these studies.

    “It is concluded that the higher circulating levels of insulin cause increased thyroid proliferation. The clinical manifestations are the larger thyroid volume and the formation of nodules. Thus, the thyroid gland appears to be another victim of the insulin resistance syndrome.”
    Thyroid. 2008 Apr;18(4):461-4. doi: 10.1089/thy.2007.0223.
    Introducing the thyroid gland as another victim of the insulin resistance syndrome.
    Rezzonico J1, Rezzonico M, Pusiol E, Pitoia F, Niepomniszcze H.

    ” The presence of disorders of carbohydrate metabolism has been demonstrated in thyroid disease involving either overt hyperthyroidism or overt hypothyroidism. ”
    Endokrynol Pol. 2014;65(1):70-6. doi: 10.5603/EP.2014.0010.
    Insulin resistance and thyroid disorders.
    Gierach M1, Gierach J, Junik R.

  26. Hyperglycemia:
    High Insulin is not the same as high glucose.
    You can be low on glucose and still have high insulin levels circling in the blood stream. This excessive insulin then breaks down proteins in the body to bring glucose levels in the blood back to normal.
    Over years, this results in a fatty body with atrophied muscles.
    Usually it’s the skinny fat and weak bodies that suffer from this the most because their body just doesnt produce enough fat cells to store the excess energy.
    This person usually eats small meals but high in sugar (doughnuts, pizza, bagels with jam) and snacks tiny amounts throughout the day because they ‘get away with it’.
    It eventually catches up….maybe not on the scale, but in overall health.
    Just wanted to clear this up because the article under Hyperglycemia throws both terms in the same meaning.