T Nation

John M Berardi

I saw in another post that you said a study showed milk causes the same insulin response as white bread. Should I return Ol’ Bessy to Farmer Bob so I don’t turn into a fat pig from drinking a gallon of milk every two days?

milk supposedly has a GI rating of 40-something, depending on the fat content…this was based on a scale where white bread is 100…so milk is fairly low glycemic

Milk also has protein and (maybe)fat which slow absorption, which is a good thing.

I don’t have the answer for you although I use plenty of milk when I’m bulking (which is just about perpetual for me :)) - but Prime, I can tell you that what was mentioned was that milk causes a spike in insulin DESPITE having a low GI.

I think the main concern here is that GI and insulin response does not directly correspond in some cases. I have read somewhere that adding fat to a high GI food, though it loweres the GI, does not change the high insulin response. Therefore, the high insulin causes the added fat to be more easily stored as adipose. This might also be the case with milk. In any case, just to be safe, I consume most of my fats with protein, rather than with carbs, and I only eat carbs that are both low fat AND low GI.

Anyway, to answer your question BMJ, I think you already have the answer. If you have been consuming milk so far without porking up, it probably won’t happen in the future. I know from past experience that if I eat a lot of white rice, I get fat, so I avoid it. I think you’re okay.

This situation seems to be one where glycemic index and insulin response are not correlated. It makes me wonder what other foods are low GI but have a high insulin response. Im looking into that right now. Again, as science progresses, we find out more of our past “truths” may not be as accurate as we thought them to be. As far as the consequences of milk drinking, it may not be the optimal drink in terms of insulin response, but many of us have been drinking it for quite some time without negative effects (or maybe we could all be leaner without it). I know many disagree, but I dont think insulin is the demon many make it out to be. I am working on a series of articles on insulin in an attempt to discuss how to manage bodycomp by smart insulin management without fearing every food that gives an insulin response. This is overkill. If you think about it, this very study could actually give creedence to my assertions that insulin isnt is bad as people thought. If we all consume lots of milk and milk gives a big I response (despite the fact that we all thought it would give a low I response), maybe we need not fear the big I.

To answer your question, do you drink milk? Are you a fat pig? Think about it…Also, why dont you experiment? Drop it out of the diet for a few weeks and replace the cals with an other food source and see if your physique changes. The only way to find out the answers to some questions are to do the experiments ourselves in our own homes. By the time all the research solves all our problems for us…they wont be our problems any more. We will be long gone!

After thinking about this a bit, I would think that even though milk causes the same insulin response as white bread, since blood glucose levels will rise less for milk, it wouldn’t matter if insulin levels went to the moon since there is less glucose circulating in the blood. This would lead to less of a chance of fat storage or less being stored as fat, as compared to an equivalent amount of white bread. Does this sound somewhat logical or am I completely nuts?

Wasn’t that milk that was defatted (skim milk) that caused a higher insulin response, and not whole milk?

Deniz, If you are referring to the lethargic feeling after you drink milk, I think it is more due to milk being high in tryptophan, not b/c of a high GI.

No Prime. I didn’t mention anything about a lethargic feeling at all. I was simply stating in response to you that it may cause a spike in insulin without having a high G.I… Read my previous reponse again, isn’t that what I said?

No, I knew what you said…i was just inferring cause I don’t understand how something with a low GI could cause such a high insulin response…i thought that was the definition of GI index, was to determine how much of an insulin response there was after ingesting a food or drink, and the numbers were then based on this…if it is different, tell me so I know.

Strictly speaking, the definition of GI is not the insulin response, but the rise in blood sugar that results from the ingestion of that food. Invariably, a high level of blood sugar results in a high insulin response, but in the case of milk, though it elicits a moderate to low blood sugar rise, apparently it results in a high insulin response nevertheless. So, it appears that insulin responds to other things in addition to glucose levels.

Im pretty sure that they compared several types of milk products (skim, 2%, whole, etc.)…Just for clarification…Glycemic Index is a comparative rating (relative to either glucose for some scales or white bread for others) given to foods based on the rate of glucose appearance in the blood. Although this and insulin are well correlated, they are by no means dependent on one another. Here is another example ( a recent study ):

The postprandial (POST MEAL) insulin requirements after three mixed meals of equal carbohydrate and energy content were assessed in 10 type-1 and 12 type-2 diabetics by a glucose-ontrolled insulin infusion system (THIS MEANS INSULIN WAS INFUSED BASED ON SPECIFIC BLOOD GLUCOSE CRITERION---WHEN BLOOD GLUCOSE WAS A CERTAIN RANGE, SPECIFIC INSULIN WAS INFUSED TO REGULATE IT) These were compared with the glycemic response to the same meals of 10 healthy individuals requirements after consumption of a continental breakfast (low fibre, low protein, high fat). Ten percent less insulin was infused after milk (low fat, high protein) and 30% less after an English breakfast (high fibre, high protein) (IT APPEARS THAT THE CONTINENTAL BREAKFAST NEEDED THE MOST INSULIN TO REGULATE IT). Type-2 diabetics showed no significant differences in insulin requirements between the three test meals. The glycemic response in healthy individuals had no relation to these insulin requirements. Continental and English breakfast had a similar glycemic effect, whereas milk produced only 30% of the blood glucose response observed after the continental breakfast (MILK SEEMED TO HAVE THE LOWEST GI OF THE 3 BUT DIDNT REQUIRE LESS INSULIN FOR DISPOSAL). These results indicate that neither the carbohydrate content (exchange lists) nor the glycemic index enable prediction of postprandial insulin requirements in insulin-deficient diabetes. For this purpose, we propose the insulin-need index, elaborated by testing whole meals in closed-loop experiments with type-1 diabetics. (THIS MEANS THAT ESP IN TYPE ONE - BUT MAYBE IN OTHER DIABETICS AND NORMAL PEOPLE - A NEW MEAUREMENT IS IN ORDER...EITHER INSULIN_NEED INDEX or MAYBE EVEN INSULIN RELEASE INDEX)...

This is fascinating, and very important. I’ve
always noticed that carbs can have “weird”
reactions relative to their GI - and that
different carbs can have quite different
effects even if their GI is similar. It will
be interesting (and useful) when we have
another rating mechanism for carbs. We have
a rating scale for how much glucose is
released from given foods (GI). What we need
are 2 more scales: one to measure how much
insulin foods cause to be released, and one
to measure how much insulin is needed to
return blood glucose levels back to the pre-
meal state. That would be so cool - then we
could really do some fine tuning of blood
glucose levels.

Does it really matter if milk has a high insulin response? If there isn’t a massive level of blood glucose, isn’t it logical to assume that no matter how high insulin levels are, there isn’t much glucose to be stored (or the possibility to be stored) as fat anyway?

You are exactly right, Free…Ive been saying this for a while now. Unfortunately every time I tell someone this, they tell me I dont know anything (and this usually comes from a reader who emailed me in the first place for advice!). So many are so indoctrinated on the GI thing now that they cant believe anything else. I guess reading one article in muscle and fitness qualifies you as an expert in nutritional biochemistry.
About the blood glucose low, insulin high comment, you make a common mistake. If you get a big I response without carbs, you will have a decrease in blood sugar which will lead to hypoglycemia, hunger, and the need to eat again…not a good prospect for management of body comp. Second, even if you dont eat, your body will become catabolic in order to produce glucose for the blood (that is the priority, not preservation of muscle mass). Third, high blood insulin inhibits lipolysis for a while after the insulin release. Therefore you might inhibit fat loss with this I release. Finally, who drinks milk alone? Everyone I know takes milk with other foods. Therefore if milk gives an insulin spike the other calories in the meal will be influenced by this glucose. There are so many complicate scenarios that I couldnt posibaly discuss them all here. Suffice it to say that it’s not as simple as most people make it out to be.

I’m not sure about this BMJ, but I believe insulin does more than just store glucose as glycogen. It also helps to store amino acids in muscle as protein (good), but circulating triglycerides also gets stored as adipose (bad).

I usually drink 3-4 skim milk/protein powder/EFA oil shakes per day, so the only carbs for those meals are from the milk.

The protein, milk, EFA thing is probably a great idea. I hate to imply that insulin is bad. I dont think so at all (although my buddy Cy might disagree with me - he’s written a bunch of stuff about insulin for the site). Yes, insulin can drive carbs and fats into adipose tissues, it also does drive them into muscle tissue. It also drives aminos into muscle tissue as well. So the protein, milk, efa thing is great. If you get a big insulin spike it makes the protein uptake more efficient. I guess everyone’s big fear with insulin isnt the driving carbs and fat into adipose so much as it is the inhibition of lypolysis. If you eat every 2 hours and you have a constantly high insulin level in the blood, you may be preventing some fat breakdown (no, you may not be promoting fat synthesis at all). This isnt a big deal if you are trying to gain mass. Also, this by no means indicates that you prevent ALL fat breakdown. Ive gotten shreaded before on a moderate carb diet while eating every 2 hours. I guarantee I had moderate-high insulin levels all day long but still got ripped. I guess it all comes down to understanding insulin management. I like getting 2-3 insulin spikes per day to drive anabolism. To do this I eat some insulinemic meals (moderate carb - 50g - moderate protein - 50 moderate fat - 10g) with low carb - 10 g of fibrous carbs - moderate fat - 20g - high protien meals - 75g in between. This way I get an insulin spike at 8am for example and then at 11 I eat a non insulin secretory meal. This way, by 10 or so, until my next meal (2 or so) I get lipolysis. Then at 2, I eat another meal like the one at 8 for some anabolism, then just keep repeating that. My last meal is non insulinogenic so that I dont have an insulin surge while I sleep. Hope that makes sense.

John, I saw a show on TV a while back describing how much fat people lost on a milk-only diet. It would be interesting if the results were published in a peer-reviewed journal.

Personally, I drink a lot of milk, even during diets, and I don’t have trouble losing weight. It would be interesting to see if cutting the milk would make dieting easier, although milk is such a cheap and good tasting source of high-quality protein that it would probably have no effect on my diets.