However, once we get past these minor similarities and review some biochemistry we’ll discover some major differences.
When the body increases its blood sugar level, it uses cortisol, adrenaline or glucagon, to put glucose not fructose into the blood. When the body needs to lower blood sugar level, it takes insulin which grabs glucose not fructose for storage. When the body wants to metabolize food for energy, via the Kreb’s Acid Cycle it uses glucose not fructose, as its only carbohydrate source. The only carbohydrate the brain uses is glucose not fructose; in fact, fructose never crosses the blood brain barrier (BBB). Every cell in the body has a receptor specifically made for glucose not fructose; in fact there are no receptor sites for fructose. The body recognizes glucose not fructose as the universal carbohydrate fuel that the body uses. Besides their functional differences, there are also structural differences (shown below) between these two sugars.
In biochemistry structure is key to function, for example the difference between a healthy double bond known as a cis-bond and a deleterious trans-fat is structure. Carbohydrates are an important class of naturally occurring substances found in both plant and animal matter. Glucose, having both alcohol and aldehyde functional groups and having a reasonably long and flexible backbone, can react with itself to form a six-member-ring structure, as shown in Figure 25.22. FIGURE 25.22 Glucose reacts with itself to form two six-member-ring structures, designated and . During formation of the ring structure of glucose, the OH group on carbon 1 can be on the same side of the ring as the OH group of carbon 2 (giving the cyclic form of glucose) or on the opposite side (giving the cyclic form). The six-member ring results from the reaction between the OH group on carbon 6 and the carbonyl group on carbon 2. Both glucose and fructose are examples of monosaccharides, simple sugars that can't be broken into smaller molecules by hydrolysis with aqueous acids. Polysaccharides are made up of several monosaccharide units joined together by a bonding arrangement similar to those shown for the disaccharides in Figure 25.23.
The distinction between starch and cellulose is made clearer when we examine their structures in a more realistic three-dimensional representation, as shown in Figure 25.26. Let’s turn to a well-respected source of medical information, Lehninger’s Principles of Biochemistry (the so-called “bible” of biochemistry). Pretty straight forward, right?  People get fat because they eat too much relative to how much they exercise. This subtle difference in actual causality, and the resulting misunderstanding that has led to current health and nutrition policies, is the root cause of the health problems afflicting us today. I think you should read a lot more studies on the actual distribution of nutrients rather than fixating on all of the known physiological effects of insulin.
I should add that there is a lot more in all of the biochemistry involved that I truly grasp ?? and so I may have misunderstood some of this stuff. Dr Karim El Harchaoui (Academic Medical Center, Amsterdam, the Netherlands) and colleagues report their findings online January 22, 2007 in the Journal of the American College of Cardiology.
Coauthor Dr Matthijs Boekholdt (Academic Medical Center) told heartwire that, in patients with only moderately elevated LDL-C, clinicians would do better to pay attention to HDL levels and triglycerides as markers for future CAD risk rather than worrying about testing LDL-P.
Sam, it’s certainly a good place to start by looking at TG to HDL-C ratio, and that it probably more helpful than LDL-C, but at least 30-40% of people with low or normal LDL-C have elevated LDL-P.
I think the biggest mistake that many make when studying the etiology of obesity, which is a multi-faceted and multi-dynamic phenomenon, is to simplify it. We can’t pluck one hormone as the culprit because really, insulin is just part of the end game.
I still am confused because I believe in the concept of low carb for insulin resistance and fat and ketosis but research seems to show a clear link between high protein diets and inflammation in the body that leads to disease. So therefore adding the fat keeps the protein lower and keeps inflammation lower in the body? Now we don’t have a nice yearly hungry moon or two or three, and our plenty is doing us in. Question: Is the insulin receptor on a fat cell any different than the ones on a muscle cell?
The first statement in this comment is only applicable if one can accurately measure, for each individual human being, how they actually convert various food substances to energy or to store it as fat, or muscle etc. Although I am not diabetic I have many hypoglycemia crisis, reason why I decided to become fat adapted. I wonder if there is a direct relationship (causation) between the high intake of carbohydrates and the diseases in the diagram. First, I really like the way you put the science back into this discussion and that is what actually prompted me to reach out to you.

Unfortunately I do not have the proper education to really understand what they are talking about but it sounds like they have shown that B-OHB fuels cancer growth. This has been said to keep blood glucose and insulin levels constant, which should, in turn, promote insulin sensitivity. Can this be true, even when fructose is ingested from a natural source and combined with a form of protein?
I am very interested in this due to my current studies on PCOS and its relation to insulin. So what do you call it when you consume something that can only get processed by the liver? The name carbohydrate (hydrate of carbon) comes from the empirical formulas for most substances in this class; they can be written as Cx(H2O)y. Indeed, only a small percentage of the glucose molecules are in the open-chain form in aqueous solution. Another way to distinguish these two forms is to notice that in the form the OH group on carbon 1 and the CH2OH group on carbon 5 point in opposite directions. Two monosaccharide units can be linked together by a condensation reaction to form a disaccharide. All sugars are sweet, but they differ in the degree of sweetness we perceive when we taste them. The most important polysaccharides are starch, glycogen, and cellulose, which are formed from repeating glucose units.
The molecule consists of many units of the kind enclosed in brackets, joined by linkages of the form. You can see that the individual glucose units have different relationships to one another in the two structures.
Insulin also inhibits the breakdown and utilization of fat.  Parenthetically, this means no one disputes this graph.
Will it be possible for the body to change its metabolism to ketosis if the switch is a sudden one, not a gradual one? Richard Johnson finds that Fructose, by raising uric acid and inhibiting nitric oxide, completely blocks the effect of glucose to stimulate the secretion of insulin to increase the uptake of glucose in cells, thus causing insulin resistance.
I have been very low carbing for a few years and had achieved normal weight and good health but since reading your blog I reduced the proteins and increased the fat.
Is it that Ketosis gets rid of this link whereas low fat protein diets like Dukan don’t? Second the assumption does not take into account, gut absorption efficiency of various foods. Third the assumption does not take into account how composition of food effects hormones which have feedback mechanisms to alter how fats, carbs or proteins are metabolized by individual cells and their relative efficiencies.
First attempt was tough, because I would pass out just from fat, if I didn’t ate carbs.
If I understand correctly, the logic is:you get fat because you eat too many carbohydrates. I would be interested to know if you could achieve similar results by changing the fasting days to lipid only days. I have previously thought that cancer cells are exclusively fueled by glucose and never ketones.
The structures of two common disaccharides, sucrose (table sugar) and lactose (milk sugar), are shown in Figure 25.23. Sucrose is about six times sweeter than lactose, slightly sweeter than glucose, but only about half as sweet as fructose.
It is particularly important to note that the glucose units that are linked together are in the form.
Cellulose consists of a straight chain of glucose units, with molecular weights averaging more than 500,000 amu. It is easy to see that the glucose rings are oriented differently with respect to one another in the two structures. His clinical interests are nutrition, lipidology, endocrinology, and a few other cool things.
Wow I now feel fabulous it have given me so much more energy, have more endurance, less hunger, clearer mind.
Most doctors do not look at HDL-C or triglycerides because, unlike LDL-C, treatment for these parameters is not mainstream clinical practice. On my low carb diet I have expected to be safe from developing cancer, but this piece of information suggests that all the ketones in my blood could potentially be feeding cancer cells. The proponents of fructose and high fructose corn syrup (HFCS) namely the packaged food industry,  corn manufacturers and dubious medical experts, will tell you that fructose and HFCS are safe. Table sugar also known as sucrose (shown below), is a disaccharide, meaning that it is composed of two sugars.

Carbohydrates are not really hydrates of carbon; rather, they are polyhydroxy aldehydes and ketones.
Although the difference between the and forms might seem small, it has enormous biological consequences. Disaccharides can be hydrolyzed; that is, they can be reacted with water in the presence of an acid catalyst to form monosaccharides. The linkage in cellulose is of the form, different from that in starch (see Figure 25.24).
Thus, you might eat a pound of cellulose and receive no caloric value from it whatsoever, even though the heat of combustion per unit weight is essentially the same for both cellulose and starch.
While it is true that insulin is an anabolic hormone, the most negative effect of a high carbohydrate diet is that it strongly promotes the oxidation of carbohydrates.
It would be more useful to be aware of these results, particularly in those with the metabolic syndrome, abdominal obesity, or diabetes,” he said.
Experiencing with nutritional ketosis and I don’t need carbs at every hour and I can snack on nuts and fat without feeling hypoglycemia symptoms after.
They will make the comparison between glucose and fructose, saying that they are both classified as a simple sugar. Robert Lustig, a pediatrician endocrinologist, who’s video entitled Sugar-The Bitter Truth (and certainly worth watching) calls it a poison. The two sugars, glucose (left) and fructose (right), is divided equally, while HFCS is 55% fructose; all else is the same. For example, glucose is a six-carbon aldehyde sugar, whereas fructose, the sugar that occurs widely in fruit, is a six-carbon ketone sugar (Figure 25.21). As we will soon see, this one small change in structure accounts for the vast difference between starch and cellulose.
When sucrose is hydrolyzed, the mixture of glucose and fructose that forms, called invert sugar (The term invert sugar comes from the fact that rotation of the plane of polarized light by the glucose-fructose mixture is in the opposite direction, or inverted, from that of the sucrose solution.), is sweeter to the taste than the original sucrose. In muscles it serves as an immediate source of energy; in the liver it serves as a storage place for glucose and helps to maintain a constant glucose level in the blood. You see, the body actually cares about and monitors carbohydrates, while being oblivious to fat intake and storage. So just wanted to be sure that I was giving the correct advice since they all only had the standard lipid panel that the doctor orders. The sweet syrup present in canned fruits and candies is largely invert sugar formed from hydrolysis of added sucrose.
However, the differences in the arrangements of bonds that join the glucose units are important. The difference is that the starch is hydrolyzed to glucose, which is eventually oxidized with release of energy. On a diet high in carbohydrates, ingested fat will be sent directly to adipose tissue while almost all the carbohydrate will be oxidized. Robert Lustig, says that Fructose keeps insulin levels elevated thus causing more fat storage. At the end of the day eating100 grams of lean meat does not equal 100 grams of sucrose in weight control even though they both represent 400 calories. Furthermore, they will tell you that fructose is the sugar found in fruit, and we know that everybody agrees that fruit should be part of a healthy diet, therefore establishing that fructose is not only safe but it’s actually good for you.
Cellulose, however, is not hydrolyzed by any enzymes present in the body, and so it passes through the digestive system unchanged. It may not be a large issue in practical terms (you will still be adding fat) it will not be due to insulin directing glucose into the fat cells to be converted to fat. This is totally giving my life back, the only problem is I’m experiencing a pain in the right side.
In fact, that would be the best possible outcome, since the process is inefficient enough that you would only gain around 65% of the weight you would gain by directly storing fat. These bacteria are present in the digestive systems of grazing animals, such as cattle, that use cellulose for food. It has been calculated (see Hellerstein) that less than 10% of the fat in your body was synthesized by lipogenesis rather than ingested as fat. For folks on a standard diet, a full 50% of their ingested fat will go directly into a fat cell rather than be oxidized. For folks on a high carbohydrate diet, they will have to consume more calories than they can burn or store as glycogen to even begin to show appreciable conversion of carbohydrate into fat. Yes, but it is a minor metabolic pathway in humans, and most glucose will be disposed into muscle and liver.

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