LONGECITY

Hey Nate, 

Seen your posts in Turnbuckles thread on Fusion/Fision and now here in the Keto Blog.

Found this study where it kind of ties everything together for ya, including Keto, tremors (actually, more about seizures) and NAD+

LINK

Ketogenic Diet-Induced Increase in Brain NAD+/NADH Ratio Is Rapid, Persistent and Region Specific

Here we outline the overall implications and evidence for a rapid and region-specific change in NAD+/NADH as a direct result of consuming a KD. We hypothesize this as a new and fundamental addition to potential key mechanisms underlying beneficial antiseizure, neuroprotective and disease-modifying effects of KD. Because NAD+ can modulate ion channels, enhance mitochondrial health, decrease oxidative stress, and impact gene expression, an increase in NAD+ and/or NAD+/NADH ratio is a mechanism that can account for several diverse (and seemingly-unrelated) effects of ketogenic therapy. Furthermore, benefits of increasing NAD+ such as life-span extension and enhancing cellular health have long been documented (Lin et al., 2000), and pharmaceutical companies are currently manufacturing and selling supplements that contain NAD+ precursors such as nicotinamide or nicotinamide riboside in an attempt to increase endogenous NAD+ levels and enhance metabolic resilience—an outcome that may also be achieved physiologically by ketogenic strategies.

Hope all is going well for ya, dude.

I wanted to add this information. Since going very strict Keto, I have had the best numbers for a long time. This is possibly effected by adding Bergamot on 12/30/2017, but the 11/8/2017 number already showed a much lower Hgb A1c.

                                    12-1-15   3-31-16  10-13-16   11-8-16    11-8-17    5-2-18

Fasting Glucose             104        106           100            96            97            93

Hgb A1c                          5.5         NA            5.7            5.9           5.1           5.1

For years, I had been eating around 30 to 50 gms total carbs. When I would break this, maybe around a holiday, I would sometimes eat very poorly for weeks. Things like cake, cookies and ice cream most days. My current way of eating is very low carb (20 total grams) , moderate protein (60 to 70 grams) and mostly saturated fat enough to maintain my weight .I have been eating about 3 tablespoons of Ghee, 4 tablespoons or more of C8 Mct oil, fat from an avocado every day and maybe 10 tablespoons animal based fat (varies due to needing enough to maintain my weight.) When I break this now, I stop after a day.

what else do you feel different positive or negative on the keto diet? there isnt much report here

I wanted to add this information. Since going very strict Keto, I have had the best numbers for a long time. This is possibly effected by adding Bergamot on 12/30/2017, but the 11/8/2017 number already showed a much lower Hgb A1c.

                                    

                                    12-1-15   3-31-16  10-13-16   11-8-16    11-8-17    5-2-18

 

Fasting Glucose             104        106           100            96            97            93

Hgb A1c                          5.5         NA            5.7            5.9           5.1           5.1

 

For years, I had been eating around 30 to 50 gms total carbs. When I would break this, maybe around a holiday, I would sometimes eat very poorly for weeks. Things like cake, cookies and ice cream most days. My current way of eating is very low carb (20 total grams) , moderate protein (60 to 70 grams) and mostly saturated fat enough to maintain my weight .I have been eating about 3 tablespoons of Ghee, 4 tablespoons or more of C8 Mct oil, fat from an avocado every day and maybe 10 tablespoons animal based fat (varies due to needing enough to maintain my weight.) When I break this now, I stop after a day.

It's impressing to notice that it took 2 years to decrease your fasting glucose from 106 to 93 while eating almost no sugars. I would imagine a drop down to 75 or 80 mg/dL. Also, if you eat that moderate amount of protein, excessive gluconeogenesis should not be a factor. I'm baffled.

Even though 93 mg/DL is no more prediabetic.

Bottom line, in your case the benefits of a keto diet in relation to your blood glucose would not seem to be outstanding.

If you monitored your lipids panel, it would also be interesting to notice whether such parameters have changed significantly, if so whether in a favourable or unfavourable way.

Bottom line, in your case the benefits of a keto diet in relation to your blood glucose would not seem to be outstanding.

As a prediabetic myself I made the experience that fasting glucose can still by prediabetic for various other reasons than diet, while postprandials have reversed from prediabetic levels. For example comparing average glucose to HbA1c:

 

The HbA1c of 5.9% of only 2 years ago usually correlates to an average blood glucose (between fasted and highest spikes after postprandial) of 124 mg/dl. While the now  5.1% to an average of 100 only.

So the most blood-glucose reducing-action obviously happened postprandially. If one doesn't tests postprandial, one usually doesn't know. Reversing prediabetes to me is always 'outstanding', since the usual course - even with meditations -  is to proceed to full T2D in a few years time.

Pamojia, you have a point, although the keto diet is such a strict and stoic regime that I still would expect better results, especially from the blood glucose standpoint. I mean, there are other less extreme protocols to use to reverse diabetes like the one which Brenda Davis applied in the MArshall islands, that's sure less drastic than a keto diet, which is not tolerated by everyone (potential serious probs with blood lipids).

Pleaswe note that I'm not being an advocate of plant-based diet here, which may even be applied in a keto variation (ultra-stoic).

http://www.brendadav...ype-2-diabetes/

Thanks Pamojja.  mccoy, I get your point.

I am neutral about the Ketogenic diet, but it is easy for me. I do not recommend any way of eating to others. There are likely other ways which could result in as good or better blood glucose control for me. I do not believe that I have reversed the damage to my system which causes poor blood sugar control given a less strict way of eating. Go back to my poor way of eating, and my numbers would be at best pre-diabetic; and given what other family members experience, full diabetes would be likely. Going a little further back, I had one test of 116 and another of 124 for fasting blood glucose. I will add that I have not had significant weight changes in 5 plus years averaging about 175 pounds at 6 feet 1 inch tall.

I will clarify what I wrote concerning the period of low carb eating (30-50 grams of carbs) to transitioning to a strict less than 20 total carbs per day. It has been about the last year that I have limited my binges to 1 day, and this is not done except every few months or so. I think that those long binge periods, in addition to being less strict on carbs might have maintained a level of poor glucose control overall.

As far as lipids, I do not know if risk factors can be fully defined in my case without more advanced lipid panels, and that Keto lipid debate can go around in circles.

            12-1-15     3-31-16   11-8-16    11-8-17     5-2-18

Total      240           206           207          234          195

HDL       71             68             58            92             72

LDL       153          125           129          131            106

Trig         80            67           100            57              83

I prick my finger every day, sometimes few times a day and my conclusion is that fasting BG levels are irrelevant. 

FBG depends a lot on cortisol level and protein intake and probably a lot on something I haven't figured out yet too. Like I could have 3.5 one day and 5.7 second day.

hbA1c also not that helpful as low average glucose prolong RBC cell lives and it skews results a lot. 

You could look at Shawn Bakers(famous carnivore) lab results where his BG is prediabetic but his insulin is 2. Basically his as far from diabetes 2 as a human could be.

I concur that figures on fasting BG may be erratic. Dr Jason Fung even reported that morning hormonal pulses are responsible to increase BG to make up for the nocturnal lack of dietary intake.

I looked up Dr. Shawn baker's diet, very interesting. My take is that, since protein causes insulin spikes similarly to carbs and his diet provides an obvious excess of protein, he became very insulin sensitive.

He feels good but objectively he's taking a lot of risks as far as longevity is concerned, huge amounts of leucine and methionine, overamplifying mTOR activity and IGF-1 growth factors.

Sorry about the previous post, I meant: his diet may have damaged his pancreas (too much heme iron) which is not producing enough insulin. I bet he's not insulin sensitive, because of all the insulin spikes caused by leucine-rich protein.

Dr. Baker was recently on Robb Wolf's podcast. They discuss MTOR. Their position seems to be that it is not the problem it is made out to be.

The podcast discusses many things including labwork. Fasting insulin was 2.6 which is still close to the bottom of what his labs show as the range. I am not challenging carnivore just context specific to Dr. Baker who has been training for 40 years. He is doing great things at around 50 years old. I know there are a lot of people who also seem to have great results. He actually is on very high fat. 

" I've broken world records in a number of  diferent sports  now and been training for 40years." "I think there's applicatons for both (Keto/Carnivore). And you're right.I 'm 6'5". I'm 245.  I'm lean. I'm relatvely low body fat.  I'm stll  deadlifing 500"

"I'm probably still hitting a relatvely high fat macro rato, probably still  at the 65%,70% fat level"

Just to give context. Assume I eat 2500 calories per day. That would put me at 1625 calories from fat. This would put me at about 218 grams protein per day which is 2.5 pounds of 80-20 % ground beef. At 80 kilos I would be at 2.7 grams protein per kilo or 1.24 grams per pound.

Here is a link to the popdcast page. There is a timeline of topics, and links to a transcript, and the labwork. https://robbwolf.com...ers-blood-work/

Transcript: http://robbwolf.com/...olution-385.pdf

Labwork: http://robbwolf.com/...hawn-Labs.pdf  

               http://robbwolf.com/...aker-labs-2.png

               http://robbwolf.com/...er-labs-3.jpeg 

               http://robbwolf.com/...aker-labs-4.png

               http://robbwolf.com/...aker-labs-5.jpg

"Most  of  the folks  that  do a lot  of  hand wringing about mTOR,  man,  there's nothing about their performance or physique that I  would want to emulate inthe least. They might outlive me, I don't know. You don't know untl it's all said
and done. I'll take my dirt nap earlier so long as my quality of life is beter alongthe way.

Shawn: Yeah.  I  think that's  crucial.  We also know there are some studies that   show strength is ted in to longevity. There are some studies that show that strength shows  increased longevity.  Having muscle mass  is incredibly important.  It's  a metabolic sync. You need that to help with insulin resistance. It's important for longevity. It's important for functon. It's important for quality of life.And I agree, if I live to 90 rather than 93, high quality of functon, I'm going to be
much happier."

I prick my finger every day, sometimes few times a day and my conclusion is that fasting BG levels are irrelevant. 

FBG depends a lot on cortisol level and protein intake and probably a lot on something I haven't figured out yet too. Like I could have 3.5 one day and 5.7 second day.

hbA1c also not that helpful as low average glucose prolong RBC cell lives and it skews results a lot.

Agree, also this study for many things that can alter HbA1c. Then there would be Homa Calculator for calculating Insulinresistance, -sensitivity and beta-cell function. Since it depend on fasting glucose and fasting insulin (or c-peptide), which too could react unexpected postprandially, all one is left with as prediabetic is pricking one's finger after every meal.

That's what I do beside keep an eye on all these markers. Take periodically for up to 1 month every day fasting and post-prandial blood-glucose, like 2-3 times a year, and only take the averages to see in which direction it moves.
 

I'm sure going to listen to the linked podcasts, but, for the sake of balanced reasoning, do not let's try and find, in an extreme diet, any value which can be applied to the general public.

At one extreme there is Dr. Baker, at the other Kristina Lopez-Carrillo, eating only raw fruits and vegetables. They are n=1 cases. 

The excerpts from the podcasts are not promising. Excessive mTOR downregulation may be harmful, but that's the other extreme. Dr. Baker is undisputably at the upper extreme. He's taking big risks, no matter what he says, he's gambling with his health. Strength is sure important for longevity, but who says that you must eat pounds of meat and fish to be strong? And again, with excessive anabolism, there come higher cancer and cardiovascualr hazards. Dr. Baker may survive his excesses. Time will say, but n=1 is a dataset which has no statistical value.

Also, in the optimalnutrition site, a blog on Dr. Baker and zero carb, I read about a zero carb carnivorous named amy who had big issues after a few years and was able to regain health by resuming a regular diet. Similar stories we hear about extreme vegans. Such diets seem to be beneficial, for unknown reason, to very very few people, but are detrimental for most people.

mccoy, I only posted in post #92 due to that relating directly to Nate-2004's topic. About:

Ketoginic Diet, Insulin, A1C and Blood Glucose

I think it might have strayed too far at this stage. I probably should not have gone down the path of looking at Dr. Bakers information.  Maybe you could start a thread addressing the issues related to the various diets other than Ketogenic? There also has been a lot of debate back and forth about ways of eating in other threads.

(Sorry for the odd formatting of my post. I can not seem to be able to correct it)

Sorry about the previous post, I meant: his diet may have damaged his pancreas (too much heme iron) which is not producing enough insulin. I bet he's not insulin sensitive, because of all the insulin spikes caused by leucine-rich protein.

  Aminoacids insulin activation is very mild compared to carbohydrates. The main factor anyways is insulin/glucagon ratio and it doesn't go up much without carbohydrates.

As for mTor, reportedly, mr Baker eats once a day or two, that means that his mTor is down most of the time compared with a regular person with 3 mTor activations per day.

To be honest, you are talking nonsense in this thread, better to educate yourself first. Benjamin Bikman(scientist in metabolic partitioning) is a nice source of information, there are a lot of podcasts with him including role of protein.

I think it might have strayed too far at this stage. I probably should not have gone down the path of looking at Dr. Bakers information.  Maybe you could start a thread addressing the issues related to the various diets other than Ketogenic? There also has been a lot of debate back and forth about ways of eating in other threads.

 

  I would say zerocarb is a subset of ketogenic diet. I give it a go sometimes for a week and I haven't fall from ketosis no matter how much protein I would eat. Like 2 pounds of beef in one meal is totally ok and it's not even a fatty one.

P.S. Setting font size helps.

  Aminoacids insulin activation is very mild compared to carbohydrates. The main factor anyways is insulin/glucagon ratio and it doesn't go up much without carbohydrates.

As for mTor, reportedly, mr Baker eats once a day or two, that means that his mTor is down most of the time compared with a regular person with 3 mTor activations per day.

 

To be honest, you are talking nonsense in this thread, better to educate yourself first. Benjamin Bikman(scientist in metabolic partitioning) is a nice source of information, there are a lot of podcasts with him including role of protein.

Andey, you are making me smile here!!

I'm talking nonsense, not Dr. Baker who eats, according to the data posted by himself, hundreds or thousands of times the RDA of leucine and methionine and says that mTOR is not overamplified. He may eat twice a day but the protein he eats is colossal amounts. There are literature data indicating very significant insulin spikes with any protein, especially so lleucine rich. Sorry But i don't know about the insulin/glucacon, whether it may be significant or not to this issue, I'm going to look up and thanks for the tip on Benjamin bikman, curious to listen to him, I'm developing an interest on protein.

Besides, a diet very rich in heme iron may be destructive to pancreas cells. What's Dr. Baker's ferritine levels? Are they sustainable on the long run?

Please post metabolic charts on the mTOR activators and explain to us what is preventing mTOR to be over-phosphorylated in the case of Dr. Baker. Maybe the low AMP-kinase? With such a high value of fasting blood glucose and no evident lack of energy?

By the way, I'm listening to Joe rogan's podcast with Dr. Baker. So far, it's all purely, purely anecdotal. Dr. Baker might have a freaky metabolism where he's well with his cockamamie diet. Well, best wishes to him, he may be the only person in the world, for what I know.

Last but not least: how do these guys evacuate their bowels? Do they have to take laxatives every day?

mccoy, I only posted in post #92 due to that relating directly to Nate-2004's topic. About:

 

Ketoginic Diet, Insulin, A1C and Blood Glucose

 

 

I think it might have strayed too far at this stage. I probably should not have gone down the path of looking at Dr. Bakers information.  Maybe you could start a thread addressing the issues related to the various diets other than Ketogenic? There also has been a lot of debate back and forth about ways of eating in other threads.

 

(Sorry for the odd formatting of my post. I can not seem to be able to correct it)

Sorry heisok for the OT, but I couldn't abstain from disclosing my objections on Dr. baker's diet, once he was cited. At least, he may be cited as an example of freakish regimen or metabolism, sure not as an example to follow.

Pls note that, even if I'm vegan, I reason the same way about fruitarians and any restricted raw vegan diets: examples absolutely not to follow, unless you want to take huge risks.

By the way, Dr. Baker is an athlete, was deployed in Afghanistan as a surgeon and went thru some ordeal during his orthopedic practice for having proposed patients not to undergo surgery.

After having heard this, I'm a fan of him, even though I do not agree with his dietary choices. Well, good for him, good for all, as I said, unique metabolism.

Of course his choice is extreme and science suggests that most people won't benefit from prolonged periods of that regime.

Of course his choice is extreme and science suggests that most people won't benefit from prolonged periods of that regime.

I've been downvoted that I provided no references, but I give it for granted that everyone knows the basic literature on the adverse effects of excessive protein. Maybe there is too much distorting advocacy from the paleo and high carbs groups and that's too bad. Even strong advocates of low carb and keto diets like Ron Rosedale and Jason Fung insist on low protein, sometimes very low protein (Ron Rosedale, I'm going to link his book).

All cited authors are not vegan advocates.

• Valter Longo, The longevity diet, Avery, 2018, https://www.amazon.c...k/dp/B073YMYX7H
• Fung et al., Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies, 2010. https://www.ncbi.nlm...pubmed/20820038
• IARC monographs n° 114, 2018: http://monographs.ia...114/mono114.pdf
• Levine et al., Low Protein Intake is Associated with a Major Reduction in IGF-1, Cancer, and Overall Mortality in the 65 and Younger but Not Older Population, : https://www.ncbi.nlm...les/PMC3988204/
• Rosedale, Colman, The rosedale diet, HArper-Collins, 2009: https://books.google...ver&redir_esc=y

I must agree, this thread was hijacked. The last thing I want is to argue here with somebody uninvolved about the utility of ketogenic diet compared to a vegan diet.

The hormone known as kerrygold butter make the hemoglobin mature very early. But it grows up. Take it from experience using something that dissolves low potential cells and leaves a bloodless wound.

Dr. Baker's BUN/Urea/eGFR look pretty bad.  His kidneys don't seem to be enjoying this high carnivore diet.

Dr. Baker's glucose and A1C is pretty bad.  Prediabetic at the very least.

I listened to this guy on Joe Rogan.  In the first 30 minutes, he talks about how he has never gotten any bloodwork while on this high protein, meat diet and I immediately dismissed him as not a credible person.  Any person who would adopt such an extreme diet approach, have a licensed MD and not order bloodwork to check his own metabolism, has clearly got a screw loose.

You don't start off with the ketogenic  diet vegetables juicing once you get rid of enough infection then you go to iketogenic diet.

Dr. Baker's BUN/Urea/eGFR look pretty bad.  His kidneys don't seem to be enjoying this high carnivore diet.

 

Dr. Baker's glucose and A1C is pretty bad.  Prediabetic at the very least.

 

I listened to this guy on Joe Rogan.  In the first 30 minutes, he talks about how he has never gotten any bloodwork while on this high protein, meat diet and I immediately dismissed him as not a credible person.  Any person who would adopt such an extreme diet approach, have a licensed MD and not order bloodwork to check his own metabolism, has clearly got a screw loose.

  Its an interesting topic but we are definitely in the wrong thread for this)

I would not draw the same conclusions from his tests.

 As for kidney function - if somebody exercises a lot his Urea, Creatinine should be high. It's actually a well-documented fact in athletes population. Would be strange if it would not be there for Dr Baker. Indoor rowing is a work on VOmax limit, its as hard exercise as it could be.

 As for DT2, diabetes is not a sugar disease, it's an insulin disease. Dr. Baker`s fasting insulin is the lowest I ve seen so far. There could be no discussion about DT2 in a context of this person.  I see it as homeostasis point that his body prefer to stay in the mornings. Quite possible that its a result of dawn phenomenon as he mentioned that his sugar is lower during the day and often is around 3.5.  Again, if you exercise a lot body could position blood sugar anywhere it wants - I 've seen BG 6.9 and ketones 3.2 an hour after a gym.

I look at this as the fascinating experiment on the limits of human physiology. It also started to look like that it's not that extreme as a lot of people started it recently and it probably has huge utility for autoimmune conditions.

On the side note when I am trying to imagine what my ancestor's diet was during winter - its hard to find an edible plant under half a meter of snow. From historic reports, it was mostly meat even in summers, so I should have pretty decent genetic machinery for this mode.

I did not study this in detail and do not follow ketogenic while having I guess a reasonable amount of proteins and fats.

I just wonder if you can comment on my numbers (average 20 years, likely not very meaningful I fear!):

A1C 5.4, FG 90, Insulin 5.7, HOMA 1.3

I did not study this in detail and do not follow ketogenic while having I guess a reasonable amount of proteins and fats.

I just wonder if you can comment on my numbers (average 20 years, likely not very meaningful I fear!):

A1C 5.4, FG 90, Insulin 5.7, HOMA 1.3

Looks good. A1C points to a bid too high postprandials, HOMA to a very slight insulin resistance (range ≤ 1.2). However, the development over time would tell where you're moving to.

For example my Numbers in average trough the last 10 years:

HbA1c 5.1, FG 101, PPG 128, Insulin 8.5, HOMA 1.5

(doesn't however tell that I recovered from of HbA1c of 5.7, FG 124, PPG of 147, Insulin of 14, and HOMA of 2.6; which do raise the averages quite some)
 

Thank you Pamojja for the feedback. Good point on the PPG, I am reading more and more on this but tested only once. I do not want to be off topic as this is on ketogenic. I have epilepsy in my family and many doctors recommend to check out this diet when non responsiveness to drugs.

  Its an interesting topic but we are definitely in the wrong thread for this)

  

I would not draw the same conclusions from his tests.

 As for kidney function - if somebody exercises a lot his Urea, Creatinine should be high. It's actually a well-documented fact in athletes population. Would be strange if it would not be there for Dr Baker. Indoor rowing is a work on VOmax limit, its as hard exercise as it could be.

 As for DT2, diabetes is not a sugar disease, it's an insulin disease. Dr. Baker`s fasting insulin is the lowest I ve seen so far. There could be no discussion about DT2 in a context of this person.  I see it as homeostasis point that his body prefer to stay in the mornings. Quite possible that its a result of dawn phenomenon as he mentioned that his sugar is lower during the day and often is around 3.5.  Again, if you exercise a lot body could position blood sugar anywhere it wants - I 've seen BG 6.9 and ketones 3.2 an hour after a gym.

 

I look at this as the fascinating experiment on the limits of human physiology. It also started to look like that it's not that extreme as a lot of people started it recently and it probably has huge utility for autoimmune conditions.

On the side note when I am trying to imagine what my ancestor's diet was during winter - its hard to find an edible plant under half a meter of snow. From historic reports, it was mostly meat even in summers, so I should have pretty decent genetic machinery for this mode.

Given that he is on this high meat diet, I would attribute the BUN and high-end creatinine figures to protein intake, not his workout routine.  I think that's quite wishful thinking to assume he's 'this world class athlete' at age 50+ and that's why his kidney markers are high/elevated.  It's the meat diet.

The comment I made about being prediabetic was probably overblown.  It's more of the physiological insulin resistance that he has due to his quasi-ketogenic state.  It'd be nice to see an advanced lipid profile, so we could see what's going on w/ this guy's particle count and his HDL.  That HDL seems kinda low to me for a guy who is supposedly an athlete and effectively on a high fat diet.  

All in all, there are no long lived populations pursuing a diet like this.  It isn't just that he is sending mtor through the ceiling; it's that he is high on methionine and all the increased ROS associated with that kind of diet.  I hope this guy is taking about 20-30 grams of glycine a day.  This transcript about him living to 90 instead of 93, but having a strong healthy body and feeling good about it, strikes me as just self-rationalization BS.  The guy wants to have his cake and eat it too.  He wants to gorge on high protein, feel 'anabolically' good about it, and just explain it away as though he'll only lose 2-3 years off his life and it's a worthwhile trade-off.

Maybe he is taking breaks long-enough such that he can go 2-3 days without any protein intake (or intake of anything, I guess).  But somehow I doubt it.  The people who end up on these Atkins diets, never really avoid food like they say they do.  I think they use it as an excuse to just gorge on protein.

This guy's diet seems quite stupid to me, especially as an MD.  I can appreciate people like Ted Naiman on a HF ketogenic diet w/ moderate protein.  But a high protein, high fat diet, I can't get my head around why anyone would be doing this.  But to each his own.

tunt01, Atkins is not zero carbs like what Dr. Baker is practicing. It also has changed through the years to market many products ( , bars and drinks and pre made meals........ JUNK in my opinion) which supposedly accomplish what Atkins had in mind.

I have attached the NMR Lipo Profile results. Hopefully this is what you wanted.

Here are the numbers if I copied them correctly. The report has all the details, and ranges.

LDL-P             1273

LDL-C               141

HDL-C                40

Trig                    54

Total                 192

HDL-P(Total)     28

Small LDL-P    283

LDL Size            21.3

Lipoprotein(a)      2

LP-IR Score 36 Scale <= 45

(Insulin Resistance indicator which puts him in about the 40^th percentile where lower is more insulin sensitive. This is a lab developed score which was looked at in the study below.

"The LP-IR test described here fulfills this need by employing six simultaneously measured NMR lipoprotein subclass and size variables that are each associated with IR.^14,17,26 The combination of these measures into a single multiplex LP-IR score yielded a parameter exhibiting strong associations with two different research measures of IR, HOMA-IR, and GDR, thereby offering a simple and reliable way to assess a patient's IR status in a clinical setting “

https://www.ncbi.nlm...les/PMC4175429/

For a discussion of Carb/Protein/Fat intake related to Insulin/Glucagon levels see the work by Dr. Bickman who Andy mentioned in a post above.