Insulin secretagogue

14. March 2011 William Davis (34)
Dairy products have the peculiar property of triggering pancreatic release of insulin. The research group at Lund University in Sweden have contributed the most to documenting this phenomenon:




Mean (±SEM) incremental changes (?) in serum insulin in response to equal amounts of carbohydrate from a white-wheat-bread reference meal (x) and test meals of whey (?), milk (?), cheese (?), cod (?), gluten-low (?), and gluten-high (?) meals. From Nilsson 2004.

Note that it is the area under the curve (AUC), not the peak value, that assumes greatest importance.

Dairy products, especially milk, whey, and yogurt, are insulin secretagogues: they stimulate pancreatic release of insulin. The effect is likely due to amino acids and/or polypeptides in dairy products. (The effect is less prominent with cheese. Also see this study.)

By conventional wisdom, this may be a good thing, since the excess insulin will blunt the glucose rise after consumption. However, in my book, this is not such a good thing, since most of us have tired, beaten, overworked pancreatic beta cells from our decades of carbohydrate overconsumption. I fear that the effect of dairy products just take us a bit closer to beta cell failure: diabetes.

Good news: The effect is least with cheese.
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Comments (34) -

  • praguestepchild

    3/14/2011 8:49:45 AM |

    Dr Davis, interesting study. But both links go to the same study, Nilsson 2004, shouldn't the second link go to second study?

  • Dr. William Davis

    3/14/2011 12:00:13 PM |

    Hi, Prague-

    Absolutely right. Thanks for catching that.

    Actually, both observations were best made in the same study. While the effect of milk on insulin secretion is firm, the question of cheese has not been as well explored. There's also the possibility that, because cheese is like wine in that there are thousands of variations (organism chosen for fermentation, fat content, etc.), there might even be variation from cheese to cheese.

  • Stephen

    3/14/2011 12:31:43 PM |

    I would assume that heavy cream devoid of proteins and carbohydrates would result in less area under the curve?  Are there any studies of this?

  • Brent

    3/14/2011 2:21:34 PM |

    How can you have a test meal of cod which contains the same carbohydrate count as a reference bread meal when cod has no carbohydrates?

  • praguestepchild

    3/14/2011 5:32:53 PM |

    But I'm not sure why they used reconstituted milk. Why not normal (3.5%) milk, or perhaps normal and skim? They do say, "Interestingly, there is epidemiologic evidence suggesting that overweight subjects with a high intake of milk and dairy products are at a lower risk of developing diseases related to the insulin resistance syndrome" Perhaps because the SFA content?

    I know that a tall glass of milk can surprisingly jack up blood sugar, and they say that "The insulin response to milk products does not relate solely on the lactose component." Interesting. Still, much better a glass of milk than a glass of apple juice.

  • Dr. William Davis

    3/14/2011 10:19:50 PM |

    Hi, Stephen--

    Yes, crucial distinction. To my knowledge, that has not been done, though I would fully expect that there is no effect.

    Hi, Brent--

    The cod must have been breaded. The cod they used was purchased in a grocery store.

  • Cheryl

    3/14/2011 11:04:02 PM |

    What about the recent information on trans-palmetic (spc) acid formation being BENEFICIAL to diabetes? More so, forms from raw, full fat dairy?

  • Might-o'chondri-AL

    3/15/2011 12:00:55 AM |

    It would be interesting to see how different sources of milk influence insulin secretion. Aside from the distinct breeds of cattle many pastoralists use goat & sheep; plowmen milk  buffalo and some artic milking of reindeer (it takes 2 people, one to hold the horns).

    My dairy consumption is in the form of Kefir "Quark". This is cultured milk that is then drained of it's whey. In the Mediterranean & Mid-east regions they use yogurt "quark"; but named differently by each culture in their own vernacular. In India it would be "curd", and usually from water buffalo milk.

    "Quark" is a fermentation process byproduct and the minerals in milk are lost (soluble) in the whey. In other words, there is minimal calcium in "quark".(A few Posts back readers may recall Doc restricting calcium for reducing aortic calcification. Elsewhere, some men may recall having seen prostate studies suggesting excess calcium is not ideal.)

  • Anonymous

    3/15/2011 12:50:16 AM |

    What about full-fat kefir? I no longer consume grains and eat raw cranberries as my small daily portion of fruit. But I will not give up my kefir even if it takes 10 years off my life! So be it.

  • Ken

    3/15/2011 1:27:36 AM |

    Heck, no more yoghurt.I'll have to grind flaxseeds or eat eggs for breakfast.

  • Donna

    3/15/2011 1:53:58 AM |

    What about heavy whipping cream?  It has low carbohydrate content and high fat.  Did the study differentiate between the different fat contents of milk/cream?

  • Paul

    3/15/2011 7:39:40 AM |

    Don't forget "Butter and Insulin".

    It was one of Dr. Davis' more controversial blog posts, especially among us butter lovers...

    I'm also not quite so eager to throw out my whey protein and BCAA supplements either. Not when they provide the most bio-available protein that has long been proven to be beneficial for human muscle synthesis.  Why eliminate a dietary source that can help tip the balance toward a favorable muscle to fat composition ratio?... that in turn actually improves fat metabolism and insulin sensitivity?

  • Might-o'chondri-AL

    3/15/2011 8:55:39 AM |

    Study used 28 gr. spray dried whey (among other items) that was reconstituted in 550 gr. water. It showed that whey had fastest uptake of insulin-otrophic (secretagogue) amino acids (namely leucine, valine, isoleucine, lysine and theonine).

    Compared over 1.5 hours to same gr. weight of white bread (studies reference food) whey's insulin reaction was 90% greater. It's blood glucose however rose notably less than the reference food's blood sugar did.

    I'd like to understand better the way insulin "spikes" have beneficial functions in non-diabetics. It seems to me that there may be times of day (circadian) when elevated insulin serves a signalling purpose; late night in front of the TV seems unlikely. Anybody?

  • What will there be left to eat

    3/15/2011 11:09:38 AM |

    Pretty damn depressing. Is it safe to breathe still? Can someone explain what the observed danger of eating Whey Protein actually is. This seems to be quite speculative.

  • Terry

    3/15/2011 4:10:25 PM |

    Someone please correct me if I am mistaken - but I think that what this boils down to is the amount of lactose in a particular dairy product and would that not explain the difference between, for example, the effects of milk v.s cheese?

  • Might-o'chondri-AL

    3/15/2011 7:02:59 PM |

    Hi Terry,
    Cheese doesn't have the whey any more; it gets drained off. The whey proteins are the insulin spiker (Doc's post is on how insulin reacts). Milk's lactose (milk sugar) apparently has more to do with the way blood glucose (sugar)reacts to milk, irregardless of the milk still containing it's whey.

  • Karn

    3/16/2011 1:14:36 AM |

    Did anyone actually read the study.  The cod was not breaded, they added lactose to each product to bring the carb count up to 25g, including the cod.

    Also, yogurt is not mentioned at all in this study, so not sure why you are lumping it in here.

  • Anonymous

    3/16/2011 7:04:00 AM |

    It would be difficult to design a diet using the II of these two papers, because their insulin index (II) is based on equal carb portions. Some foods do not have much carbs, so they add carb (lactose) to them.  A better table for a variety of foods is given in this  paper * where II is calculated based on equal calorie portions, so we know the weight of each portion (from Table 2).  In this paper the values for GI (glucose index) and II are (from Table 4)

    Food
    Weight gr
    GI
    II
    White bread
    Yogurt
    Cheese
    Eggs
    Beef
    94
    241
    59
    159
    158
    100
    62
    55
    42
    21
    100
    115
    45
    31
    51

    (how do you paste atable here???)

    Some of the GI of the protein-rich foods is due to  glucagon  which raises blood sugar levels by gluconeogenesis.  The GI and II of cheese, eggs and beef are not much different,  but for yogurt II is almost double of its GI.

    * An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods
    http://www.ajcn.org/content/66/5/1264.full.pdf+html

  • Elliot

    3/17/2011 12:18:16 PM |

    Don't forget they are testing isolated products for blood sugar impact. The impact will be blunted if combined with something that has that effect. Like adding eggs to a whey protein shake.

  • Terry

    3/17/2011 3:54:43 PM |

    So the whey protein isolate (100%) protein that I add to my morning smoothie is causing an insulin spike?

    My greek yogurt as well? (high protein, low carb)

    I always understood that milk was high carb and would cause a spike, but these others are bewildering.

  • Mike

    3/17/2011 6:26:49 PM |

    Bodybuilders favor whey protein for its insulin spiking properties. Their idea that the insuin drives creatine and amino acids to muscle tissue Ne c'est pas?

    Could they be engaging in diabetogenic behavior?

    These insulin-boosting properties of some foods (especially dairy, and yes, fish) appear to have been well known for awhile:

    http://www.mendosa.com/insulin_index.htm

    The site lined below suggests eating carbs in the morning before and immediately after working out, to help achieve the holy grail of nearly all who work out -- that is, lose fat, build muscle. Can't vouch for the validity of this, but here it is:

    http://shadowfit.com/articles/index.php/archives/794

    So, the fundamental question remains. Is it the spike or the area under the curve that is the worst? Kind of like radiation, now back in the news because of Fukishima

    Mike

  • Might-o'chondri-AL

    3/17/2011 7:17:20 PM |

    Hi Terry,
    Greek yogurt is reduced whey (they drain some off); that's how they make it thicker.
    Yogurt's carb level is less than milk because the fermentation bacteria mainly fed on the milk sugar(lactose).

  • Anonymous

    3/17/2011 8:14:36 PM |

    Bodybuilders favor whey protein for its insulin spiking properties. Their idea that the insuin drives creatine and amino acids to muscle tissue Ne c'est pas?

    Could they be engaging in diabetogenic behavior?

    These insulin-boosting properties of some foods (especially dairy, and yes, fish) appear to have been well known for awhile:

    http://www.mendosa.com/insulin_index.htm

    The site lined below suggests eating carbs in the morning before and immediately after working out, to help achieve the holy grail of nearly all who work out -- that is, lose fat, build muscle. Can't vouch for the validity of this, but here it is:

    http://shadowfit.com/articles/index.php/archives/794

    So, the fundamental question remains. Is it the spike or the area under the curve that is the worst? Kind of like radiation, now back in the news because of Fukishima.

    Mike

  • Jason R.

    3/17/2011 8:36:03 PM |

    Right thats dairy of the list now. Not much left to eat!

  • What will there be left to eat said...

    3/17/2011 9:12:10 PM |

    @Jason R. lol too right... there will be an epidemic of malnourished dead people with perfect arteries !

    Just don't understand (other than water and air) what's ok to eat...

  • Terry

    3/18/2011 12:59:07 PM |

    It appears we can safely conclude that just eating (anything!) will spike your insulin!

  • Terry

    3/18/2011 1:04:11 PM |

    I am not sure what's left that hasn't been found to be problematic to health in some way Smile

    It all makes for good news stories though!

  • Anonymous

    3/18/2011 8:33:00 PM |

    praguestepchild gives us the money quote which I shamelessly repeat here:

    "Interestingly, there is epidemiologic evidence suggesting that overweight subjects with a high intake of milk and dairy products are at a lower risk of developing diseases related to the insulin resistance syndrome"

    We are left to conclude that with dairy you look bad on paper but turn out to look pretty darn good in real life.  Especially considering that overweight would be associated with higher risk of insulin resistance syndrome indicating, potentially, that dairy actually has a powerful protective effect.

    So Terry, Jason cheer up! Smile

  • Anonymous

    3/18/2011 9:52:34 PM |

    It would be difficult to design a diet using the insulin index (II) given in these two papers, because their  II values are based on equal carb portions. Some foods do not have much carbs, so the studies of both papers add carb (lactose) to them and that creates unrealistic foods (but proves their point).   A better table for a variety of foods is given in the paper * below where II is calculated based on equal calorie portions, so we know the weight of each portion (see Table 2). See Table 4  for the values for GI (glucose index) and II.

    I think, some of the high GI of the protein-rich foods is not due to their high carb content, but their release of glucagon,  which raises blood sugar levels by gluconeogenesis.  The GI and II of cheese, eggs and beef are not much different, but for yogurt, II is almost double of its GI.

    * An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods
    Susanne HA Holt, Janette C Brand Miller, and Peter Petocz
    http://www.ajcn.org/content/66/5/1264.full.pdf+html

  • Might-o'chondri-AL

    3/19/2011 7:15:38 PM |

    Is it not possible whey's sustained insulin response indicates it is part of a feed back loop? For active people (ex: body builders, herdsmen) the dynamic is more valuable than for the sedentary; modern sedentary lifestyle & insulin spike are a different dynamic.  

    Many crucial cells must get their glucose diffused to the extra-cellular spaces; blood doesn't get to touch every cell.
    Insulin "spike" and steady reign may be evolutionary to give crucial cells chance to sip some glucose. The spike is a signal
    there's plenty for every cell; it prevents first come first served cells from going into overdrive and pulling in all the blood glucose.

  • Anonymous

    3/20/2011 5:38:44 PM |

    "By conventional wisdom, this may be a good thing, but not in my book."

    Well dear doctor we are all entitled to opinions, but in this particular case your book needs revision:

    A population-based prospective study (CARDIA) revealed that dairy consumption was inversely associated with the incidence of all components of the insulin resistance syndrome (IRS) among overweight individuals (BMI>=25kg/m2).

    *** Each daily occasion of dairy consumption was associated with 21% lower odds of IRS. ***

    These associations were similar for blacks and whites and for men and women.


    If you believe this to wrong, please direct us to what bases your conclusion.

  • Might-o'chondri-AL

    3/20/2011 10:13:27 PM |

    Hi Annon.,
    ? Insulin resistance decreased by dairy in what form; ie:
    hard cheese (essentially no whey), klabbered (yogurt/kefir) with bacteria, fluid w/or w/o "x" % milk fat ...? My reply to you on "Smoothies" thread got lost, so am pleased you posted again here.

    BMI is a ratio of proportionality to the persons height. A tall and thin individual can score a higher BMI than a short and fat one. BMI doesn't tell ratio of lean:fat in our body mass.

    One day I'd like to see all studies use their subject's "Ponderal" proportion. This is the individual weight (in kilograms) divided by their height cubed (in meters).

    It is superior for assesing what's happening with obesity. The "ponderal" change will reflect basal inflammation and can be cross-referenced to previous C Reactive Protein measurements to track if any complication are occuring.

  • Anonymous

    3/21/2011 9:08:05 PM |

    Is there a home insulin meter, like the home glucose meter? It would help a lot.

  • Stephen

    3/23/2011 11:41:15 AM |

    We tend to over think things latching on to this isolated nutrient or that. Your overall diet is what counts. People have been drinking milk/yoghurt/kefir and eating cheese for thousands of years. Dairy is a pretty damned good food (especially cheese).

    It seems to me that Weston Price (the man and organization) has it just about right.

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