This article discusses the relationship between insulin resistance and atherosclerosis formation and how nattokinase improves both.
In a study that I previously referred to by Ren et al., they compared nattokinase (NK) 6,000 units with simvastatin 20 mg in 72 patients.
After 26 weeks, it showed that nattokinase (NK) and simvastatin could decrease total cholesterol (TC), low-density lipoprotein (LDL), and triglyceride (TG) levels.[1]
What is puzzling to them was that while simvastatin could lower TC, LDL, and TG more than nattokinase (P<0.01), the decrease in the thickness of the carotid atherosclerotic plaque was more in the nattokinase group.
The reduction in the NK group was significantly profound (P<0.01, 36.6% reduction in plaque size in NK group versus 11.5% change in ST group).
How can NK decrease atherosclerosis more without causing the same decrease in lipid levels?
The answer lies in how atherosclerosis forms. The current dogma is the lipid hypothesis which says that it is the cholesterol and LDL that causes atherosclerosis and cardiovascular disease.
Insulin Resistance and Atherosclerosis
In 2000, the Insulin Resistance Atherosclerosis Study (IRAS) was published in Circulation. After reviewing the studies, its authors proposed that insulin resistance leads to chronic inflammation and atherosclerosis formation.[2]
Insulin resistance is when the skeletal muscles and liver do not respond to the physiologic or “normal dose” of insulin. The result is hyperinsulinemia, where there are higher levels of insulin.
Insulin stimulates other tissues other than the liver and skeletal muscles. Too much insulin causes disease.
A review in 1988 explained how hyperinsulinemia accelerates atherosclerosis formation.[3]. Insulin promotes diet-induced atherosclerosis development and overrides healing and estrogen protection against atherosclerosis.[3]
Insulin has been shown to stimulate the smooth muscles and fibroblast cells in the arteries and increase the uptake of lipids by these cells and macrophages. Insulin also induces inhibition of fibrinolysis to allow clot progression.[3]
Diabetes does not have to be present for atherosclerosis to happen. It takes decades for atherosclerosis to present as a stroke or a heart attack. But like in everything else, atherosclerosis starts small and innocent looking.
I’m Only Pre-Diabetic, So I’m Still OK, Right?
Post-prandial hyperglycemia, or the rise in blood sugar (glucose spike) levels after a meal, can induce damage to the inner lining of the arteries.
The body can repair the damage, but repeated insults from the glucose spikes can thicken atherosclerosis.
Intermittent fasting can reverse insulin resistance. Fasting allows the body to use the circulating glucose and improve insulin sensitivity. Fasting can reverse insulin resistance to the point where the body uses its insulin again and be weaned off prescription insulin.
A Case Report of 3 Diabetic Patients that are Weaned Off Insulin
But not all are not inclined to miss a meal. Glucose spikes can be controlled with dietary changes without fasting. Eating vegetables first, then meat and fat, and carbohydrates last, can eliminate glucose spikes. A little walking after helps too.
Blood Glucose Spike and its Prevention
The type of vegetables in the diet can also prevent high blood sugar after a meal. A Japanese study examined how eating viscose vegetables affects after-meal glucose levels in subjects who tend to spike blood sugar after a meal (glucose intolerance).[4]
The test meal included (50 gms natto, 60 gms Japanese yams, or 40 gms okras) with 200 g white rice. The control meal had white rice with non-viscous boiled soybeans, potatoes, and broccoli. Both meals contained comparable carbohydrates, fat, protein, and fiber.[4]
Natto is a traditional Japanese food made with fermented soybeans.
Results showed that eating viscose vegetables improves insulin sensitivity and total and LDL cholesterol. The authors explained that viscous fibers decrease insulin response by delaying gastric emptying and slowing absorption. [4]
Another possible explanation is the presence of nattokinase in natto. 50 gm of natto contains 2,000 Fibrin Units (FU) of nattokinase.
Nattokinase improves insulin sensitivity.
A double-blinded, randomized, controlled clinical trial over three months was conducted on 17 obese female subjects with diabetes. Nine received Natto 2,000 FU daily, and eight received an identical placebo capsule daily.[5]
After three months, both groups had no difference in weight loss. More subjects lost water weight in the Natto group (63%) compared to Placebo (33%).[5]
High insulin levels in insulin resistance promote water retention and add weight. They are stored in the fat and sometimes in the legs. When someone becomes more insulin sensitive, the insulin levels, water retention, and total weight decrease.
More subjects in the Natto group exemplify this. They had lower fasting insulin levels (75% vs. 22%), lower fasting glucose levels (50% vs. 22%), and lower HOMA index (63% vs. 22%).[5]
Homeostatic Insulin Assessment (HOMA) quantifies insulin resistance and the function of the pancreatic beta-cells that secrete insulin.
Additionally, more subjects in the Natto group had a decrease in HbA1c (43%) compared to Placebo (22%), with an average reduction in the Natto group of 0.9%.
Hemoglobin A1c or glycated hemoglobin is a blood test that measures the average blood sugar in three months. It is an indicator of blood sugar control in people with diabetes and is used to guide treatment.
The authors hypothesize that if treatment time was beyond three months, further metabolic improvement would be noted, indicating that natto could have potential as an adjunct to Diabetes Mellitus care.[5]
Natto and Nattokinase intake lower CVD death risk
The Takayama study demonstrated that natto could lower cardiovascular disease mortality. The research involved 13,355 male and 15,724 female participants aged ≥35 years.[6]
They showed that those with the highest natto intake have the lowest risk of death from total cardiovascular disease.
Cardiovascular diseases (CVD) include coronary artery diseases (e.g., angina, heart attack), stroke, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, abnormal heart rhythms, congenital heart disease, valvular heart disease, carditis, aortic aneurysms, peripheral artery disease, thromboembolic disease, and venous thrombosis.
The mechanisms of how natto/ nattokinase intake can lower deaths due to cardiovascular diseases are explained in
- The Outstanding Vascular Effects and Dose of Nattokinase
- High-Dose Nattokinase to Shrink Atherosclerosis and Lower Blood Lipids
Natto is uncommon in the US, but Nattokinase is readily available and inexpensive.
- Doctor’s Best Nattokinase – 2,000 FU of Enzyme – this formulation is NSK-SD with no vitamin K2. Vitamin K2 counters the effect of warfarin.
- Best Naturals Nattokinase, 2000 FU, 100 Mg, 90 Vegetarian Capsules – This has vitamin K2 that is good for cardiovascular and bone health.
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Related readings:
- Nattokinase is Nontoxic with a High Safety Margin
- Bromelain for Long COVID and Post Vaccine Syndrome
- Bromelain and Acetylcysteine Combined Destroy SARS-CoV-2 spike protein
- Nattokinase Degrades the SARS-CoV-2 Spike Protein
- Another Study shows Nattokinase can Destroy the S1 Spike Protein
- Intermittent fasting results in new and stress-resistant blood cells
- Intermittent fasting for Post COVID Vaccine Syndrome: Autophagy
- The I-RECOVER Post-Vaccine Treatment Protocol
- The I-RECOVER Management Protocol for Long Haul COVID-19 Syndrome
- Over The Counter Ivermectin
References:
- Ren NN, Chen HJ, Li Y, Mcgowan GW, Lin YG. [A clinical study on the effect of nattokinase on carotid artery atherosclerosis and hyperlipidaemia]. Zhonghua Yi Xue Za Zhi. 2017 Jul 11;97(26):2038-2042. Chinese. doi: 10.3760/cma.j.issn.0376-2491.2017.26.005. PMID: 28763875.
- Festa A et al. Chronic Subclinical Inflammation as Part of the Insulin Resistance Syndrome. The Insulin Resistance Atherosclerosis Study (IRAS). Circulation. 2000 Jul 4;102(1):42-7. doi: 10.1161/01.cir.102.1.42. PMID: 10880413.
- Stolar MW. Atherosclerosis in diabetes: the role of hyperinsulinemia. Metabolism. 1988 Feb;37(2 Suppl 1):1-9. doi: 10.1016/0026-0495(88)90180-1. PMID: 3277013.
- Taniguchi-Fukatsu A, Yamanaka-Okumura H, Naniwa-Kuroki Y, Nishida Y, Yamamoto H, Taketani Y, Takeda E. Natto and viscous vegetables in a Japanese-style breakfast improved insulin sensitivity, lipid metabolism and oxidative stress in overweight subjects with impaired glucose tolerance. Br J Nutr. 2012 Apr;107(8):1184-91. doi: 10.1017/S0007114511004156. Epub 2011 Sep 7. Erratum in: Br J Nutr. 2013 Oct;110(7):1356. PMID: 21899797.
- Coboes et al. Nattokinase to improve insulin sensitivity and Weight Loss in Women with Obesity +/- Diabetes. Journal of the Endocrine Society 4(Supplement_1). DOI:10.1210/jendso/bvaa046.145
- Nagata C, Wada K, Tamura T, Konishi K, Goto Y, Koda S, Kawachi T, Tsuji M, Nakamura K. Dietary soy and natto intake and cardiovascular disease mortality in Japanese adults: the Takayama study. Am J Clin Nutr. 2017 Feb;105(2):426-431. doi: 10.3945/ajcn.116.137281. Epub 2016 Dec 7. PMID: 27927636.
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