1st Diabetes Video Transcript (Patreon)

Hey everyone,

Here's the transcript. Not much to add at the moment other than I was hoping to mention the Randle Cycle when debunking the "Fat causes insulin resistance" idea.. Here's a snippet from "The Obesity Code"

   "DR. PHILIP RANDLE first described the glucose– fatty acid, or Randle, cycle in 1963.26 Working with isolated heart and skeletal muscle cell preparations, Randle demonstrated that cells burning glucose could not burn fat and vice versa. Furthermore, this phenomenon did not require the assistance of insulin or any other hormones. Your body simply cannot use both fuels simultaneously. You either burn sugar or fat, but not both.
   Most cells can use fat directly for energy but certain key cells, notably the brain, cannot. During the fasting state, large organs such as the liver, heart, pancreas, and skeletal muscles burn fat to conserve what little glucose is available for the brain. This essential survival mechanism maximizes the time humans can survive without eating. Since the liver cannot produce enough new glucose by the process of gluconeogenesis for the entire body, the Randle cycle helps conserve glucose for where it is needed the most. The liver also produces ketone bodies from fat, which provides up to 75 percent of the brain’s energy requirements, and further conserves glucose.
   The body’s ability to block the use of glucose by relying on fatty acids instead has also been called physiological insulin resistance. When the body is mostly burning fat, such as during very low– carbohydrate diets or fasting, it cannot burn glucose. Therefore, if you start to eat carbohydrates, the cells temporarily cannot handle the glucose load and your blood glucose levels rise. This phenomenon looks like insulin resistance but is not really the same mechanism at all. As insulin rises, the body switches to burning glucose and the blood glucose levels fall back.
  The opposite is also true. When the body is burning glucose, it cannot burn fat, but saves stored fat for later consumption. The Randle cycle ensures the skeletal muscle cells cannot simply burn off the excess fat when they are fully saturated with glucose. They are burning glucose, not fat, so it accumulates. Voilà! Fatty muscle and insulin resistance. Fatty muscle and fatty liver lead to rising insulin resistance, provoking the compensatory hyperinsulinemia that keeps blood glucose normal. But as we’ve seen, this cycle eventually leads to the development of more insulin resistance in a classic, self-reinforcing cycle. Over time, the insulin levels march relentlessly higher, as does the insulin resistance. Ultimately, something’s gotta give." [Fung, Jason. The Diabetes Code: Prevent and Reverse Type 2 Diabetes Naturally (Kindle Locations 1469-1475). Greystone Books. Kindle Edition.] 

I hope this isn't too confusing considering my pointing out the "athlete's paradox" in the video (where athletes have higher fat in the muscle yet have higher insulin sensitivity.) It seems that fat in the muscle is a contributor to insulin resistance, not the root cause of it. Notice that Dr. Fung says "Fatty muscle and fatty liver lead to rising insulin resistance..." rather than "insulin resistance begins with the accumulation of fat in the muscle..." or "fatty muscle causes insulin resistance" etc. I might clarify this in the upcoming video, but my point was that the cause of insulin resistance is not (as Neal Barnard says) "dietary fat putting fat in the muscle."

Looking forward to any questions you might have!

-Joseph