Key Points

1. *Dietary Spectrum:*
  - Contrasts high-carb/low-fat with low-carb/high-fat diets, both beneficial.
  - Western diet, combining high carbs and fats, is seen as harmful.

2. *Insulin Resistance:*
  - Linked to obesity but can affect non-obese individuals too.
  - Influenced by body composition, exercise, and inflammation from excess fat.

3. *Role of Exercise:*
  - Exercise boosts insulin sensitivity, lasting hours to days.
  - Muscle engagement is more critical than muscle mass for managing insulin resistance.

4. *Mechanisms of Insulin Resistance:*
  - Inflammation from excess fat hinders insulin signaling, reducing glucose uptake.
  - Insulin resistance mechanisms involve glucose metabolism and liver function.

5. *Complexities of Carbohydrates:*
  - Carbs aren't inherently bad; reducing them can help insulin resistance but can benefit athletes in specific contexts.

6. *Diabetes Context:*
  - Type 1 diabetes insights reveal glucose variability impacts microvascular and macrovascular health.

7. *Individualized Nutrition:*
  - Emphasizes personalized dietary approaches; responses to diets vary due to genetics, lifestyle, and health.

8. *Research and Evidence:*
  - Stresses the need for evidence-based nutrition, recognizing individualized solutions.

*Conclusion:*
- Highlights the multifactorial nature of insulin resistance and metabolic health.
- Advocates personalized diets and physical activity over one-size-fits-all approaches.

damn man, this guy looks like he hasnt slept since before med school. props.

The irony of this fella asking where the stigmatisation of sugar comes from

Thank you for doing this! Preventing and reversing metabolic illness is, or at least should be, the top issue for most people.

Just played in a golf tournament with 56 guys. They literally called me- unicorn. Because im 6'2, 200 pounds and in decent shape. Plus i wasn't drinking alcohol. Mostly guys in their 40's-50's. It was really sad to see 99% of them were definitely pre diabetic. Or on their way. Its become the norm. I need Thomas & his guests to make me feel normal. 💙

It’s crazy the amount of ppl that will spend hours on hours with Tic Toc, but when it comes to something actually productive and informative like this channel and many others out there; complain about their situation whatever it may be, don’t have any care to watch stuff like this that will truly help them achieve their goals.

Both look like real siblings

😂 running from a dinosaur “historically speaking” 😂

As a T1D of 50 years getting into exercise again, I found this hugely beneficial. Thank you.

There are also other diseases that cause insulin resistance which then turns into Diabetes, even though the person isn’t necessarily genetically diabetic.  Just ask any woman who has battled PCOS their whole life.  They aren’t diabetics BUT the disease causes differences in insulin response that we call “diabetes”.  Treat the disease (PCOS) and you can help the individual … treat them as diabetics and you are only treating the insulin resistance as a symptom, but the other issues of the disease go untreated.

Insulin resistance means your nocturnal insulin levels will tend to be high, often between about 10:00 pm and 2:00 am when you are supposed to get your natural peak of growth hormone.  Insulin blocks the release of growth hormone.  So people with insulin resistance do not get the natural healing of microtrauma on a day to day basis, and as a result they get a chronic elevation of counterregulatory hormones like cortisol and adrenaline, plus uric acid that is often liberated by stress hormones.  These two hormones + uric acid make you need even more fasting insulin blocking nocturnal HGH.  It's a positive feedback syndrome where insulin resistance raises insulin resistance.   There are 3 main mechanisms of insulin resistance.  1) Basically blood and liver triglycerides reducing the ability of insulin to keep the liver from releasing glucose and blocking the movement of glucose into liver and muscles, 2) Overexposure to insulin which downregulates insulin receptors and 3) Excessive counterregulatory hormone release.  #3, resulting from chronic inflammation causes #1 and #2.

So glad my functional medicine doctor prescribed me a CGM at a fasting glucose of 88. It used to be between 70-80 when I wore my CGM years ago. Then I had gotten up to 99 and mainstream doctor said oh you’re fine. Now that I have my CGM my baseline is horrific. So glad I can see it now and get it under control. I refuse to be a part of this generational condition. Screw that!

another great guest. you're awesome, thomas.

Many Thanks for this video, as it helps me with understanding my problem of excess VAT.
I did have to chuckle when your guest illustrated his point by saying “historically speaking; in case you needed to run from a dinosaur”
That covers a lot of ground, since there’s so much (unwritten) history from the demise of dinosaurs and the emergence of H. Sapiens.
In case you want to suggest to your guest to adjust time scales for congruence, lol
Thanks Again!

Thx, this discussion has convinced me of my need to do more anaerobic exercise to fight my metabolic disorders.

Thanks Tom. Very good resource person. Very knowledgeable.

where was the how to?

Makes sense why A1C is higher on low carb diet; you're not stimulating insulin (which lowers your glucose) so your glucose will be higher than if you have lots of over-production of insulin.  When I was extremely unhealthy with fasting insulin of 56 I had an A1C of 5.2!  Now on low carb (almost carnivore) for 5 years, I'm only able to get a 5.5 A1C!  But my insulin is not high to keep it there!

Always feel smarter after watching Dr. Koutnik

This was great. Thank you!🙏🏻