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Understanding carbohydrates and their role in Fat Loss and Health Carbohydrates in our diets essentially come in two forms, sugar and starch. While sugar and starch may seem two separate things, they are in essence the same thing, starch is just a chain of glucose molecules stuck together rather than in the simpler form of sugar. When we eat a carbohydrate and this phenomenon can be experienced as soon as it is in the mouth it starts to get broken down in to a very simple form of sugar , glucose, and ingested in to the blood stream. This means that if we consume sugar or starch or a combination of both, blood sugar levels will start to rise. Why do we need to stabilise blood sugar levels for fat loss and health? From a health prospective blood sugar levels that remain high over a long period can lead to heath related problems such strokes, eye and nerve disorders, the need to urinate frequently, and kidney or heart disease. Dangerously high glucose levels are those over 200 mg/dL. From a fat prospective we need to understand the role of insulin in the body.

Insulin As we eat a carbohydrate and blood sugar levels start to rise, the body via the pancreas triggers off the secretion of a hormone called insulin. Insulin major role is to help transport sugar from the blood stream into the cells of the body. The major area of concern is the impact that this hormone has on the fat regulation in the body. Instead of viewing excess fat as a consequence of calorie excess, some scientists and doctors a taking the view that it as a disorder of ‘fatty accumulation’ instead. In this sense they are suggesting that the body tends to accumulate and store fat in a way that is, essentially, irrespective of calories.

The Science… In the body fat can circulate in the blood stream in the form of what are known as ‘free fatty acids” Free fatty acids have the capacity to float in and out of fat cells. The fatty acids can become fixed in the fat cells, which is not an ideal outcome. The free fatty acids only become fixed when they are converted in to a substance known as a ‘triglyceride’. Take a handful of the excess flesh around your mid riff and most of what you have between your fingers is triglyceride. What causes triglycerides to form in fat cells? Triglycerides are formed not just of free fatty acids but also of another substance called ‘glycerol’. Glycerol is essentially derived from glucose (sugar) . Bottom Line – Sugar provides an essential element for the fixing of fat in the fat cells. So the more carbohydrate you eat the more opportunity there is for fat to get stuck in the fat cells and the fatter you become….

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It is important to note that sugar’s passage into the fat cells depends in the first place on insulin as it is secreted in response to eating carbohydrates.

How does blood sugar control work? The key to understanding blood sugar control is to understand the role played by special cells called Beta-Cells and Alpha cells. These tiny cells are scattered through an organ called the pancreas, which is located just under your stomach. The job of the beta cell is to produce insulin, store it, and release it into the blood stream at appropriate times. Basal Insulin Release The beta-cells of a healthy person who has not eaten in a while release a small amount of insulin into the blood stream throughout the day and night in the form of very small pulses every few minutes. This is called "basal insulin release." Maintaining this steady supply of insulin is important. It allows the cells of the body to utilize blood sugar even if some time has passed since a meal. Insulin Levels Signal to the Liver Whether More Glucose is Needed The regulating of insulin levels has another function other than regulating blood sugar levels. A dropping insulin level signals to the liver that blood sugar is getting low and that it is time to add more glucose. The liver converts the carbohydrate it has stored, (known as glycogen) into glucose, and releases it into the blood stream. This raises the blood sugar back to its normal level. If a person has exhausted their glycogen stores the alpha cells produce a hormone called glucagon, which converts fat and protein into glucose in response to a low level of insulin in the blood. The protein can come from dietary protein or from your body's own muscles, thus making it important to ensure a healthy level of protein is present in ones’ day to day diet. Clearly insulin has a role in fatty accumulation and the above explanation shows that if blood sugar levels drop significantly and the glycogen stores are exhausted the it is glucagons that is utilized to stabilize blood sugar levels and this was the premise for the Atkins diet. While we have seen that insulin plays a role in the accumulation of triglycerides it also has other effects. 1. Activation of an enzyme called c0-A-carboxlase, which in turns stimulates fat production in a process known as lipogenesis 2. Activation of the enzyme called lipase, which also stimulates lipogenesis. 3. Inhibition of the enzyme lipase, which inhibits the process of fat breakdown lipolysis.

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The science‌ First Phase Insulin Release When a healthy person starts to eat a meal, the beta-cells kick into high gear. Their stored insulin is released immediately. Then, if the blood sugar concentration rises over 100 mg/dl, (5.5 mmol/L) the beta-cells start secreting more insulin into the blood stream. This early release of stored insulin after a meal is called "First Phase Insulin Release." In a healthy person it keeps the blood sugar from rising very high because it is available to meet most of the glucose that comes from the digestion of the current meal. The amount of insulin secreted in the first phase response to a meal is usually determined by the amount of glucose encountered in the previous meal. In a healthy person, this first phase response peaks a few minutes after you've started your a meal. The blood sugar rise caused by the meal peaks about half an hour after you start eating. Second Phase Insulin Release After completing the first phase insulin release, the beta-cells pause. Then, if blood sugar is still not back under 100 mg/dl (5.5 mmol/L) ten to twenty minutes later, they push out another, smaller second phase insulin response which, in a healthy person, brings the blood sugar back down to its starting level, usually within an hour to an hour and a half after the start of a meal. It is this combination of a robust first phase insulin response followed by a functional second phase insulin response that keeps the blood sugar of a normal person from ever rising over 140 mg/dl(7.8 mmol/L) even after a high carbohydrate meal. When first phase insulin response is completely functional, the blood sugar level at two hours should be back to the normal fasting blood sugar level which is somewhere in the mid 80 mg/dl range (4.5 mmol/L). When first phase release fails, or when second phase insulin response is sluggish, blood sugars start to rise to higher levels after a meal and take longer to return to normal. This condition is called "impaired glucose tolerance." If the blood sugar rises over 200 mg/dl (11 mmol/L) after a meal the same condition is called "Diabetes."

Conclusion A long term raised level of Insulin stimulates the accumulation of fat in the fat cells, at the same time it also slows down the bodies ability to break fat down. Carbohydrate is the chief driver of insulin and therefore clearly has fattening potential. Body Works Limited | Triq Wied il-Ghomor, The Gardens, St. Julians, STJ 2043, Malta T + 356 2138 4957 | bookings@bodyworks.com.mt www.bodyworks.com.mt | www.facebook.com/bodyworksmalta

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