Love Your Liver, Pamper Your Pancreas

Part 2 of 2

Illustration © D. Yael Bernhard

In Part 1 of this article, we explored the liver’s vital and versatile functions in maintaining health – and how to support these functions so your liver can support you. Now let’s focus on the liver’s close partner, the pancreas.

Let’s start with a secret place you may not know about. When I first heard of the Islets of Langerhans, I thought it was a remote and rocky place somewhere in the North Sea; or perhaps a mythic island shrouded in the misty legends of King Arthur. Rather, it’s a place most of us will never see, yet is crucial to our survival – for these “islets” are inside of you. Named for the German scientist who discovered them – not with a ship but with a microscope – the Islets of Langerhans are endocrine cells that produce life-sustaining secretions. Located within the pancreas, they resemble clusters of grapes, and produce hormones that perform vital regulatory functions – such as insulin, which controls the uptake of glucose by body cells and signals your cells to store fat; glucagon, which tells the liver to release stored energy in the form of glycogen; ghrelin, the hormone that triggers sensations of hunger; hormones that control the rate of enzyme secretion and nutrient absorption in the intestines; hypothalamic regulatory hormones; and more. Numbering about one million within a typical healthy adult pancreas, these precious islets receive over ten times the blood flow as the rest of the pancreas, and release their secretions directly into the bloodstream.

Within the Islets of Langerhans are the beta cells that are responsible for producing insulin. These beta cells are vulnerable to an overactive immune system, which for reasons yet to be fully understood, may attack them, disabling their ability to produce insulin – a condition known as Type 1 Diabetes.

Surrounding these precious islets are exocrine tissue¹ that produces pancreatic enzymes for digestion, including protease for digesting proteins; amylase for carbohydrates; and lipase to break down fats. These are released into the small intestines as watery juices.² Pancreatic and intestinal enzymes break down the chemical bonds that hold together macronutrients, making them smaller and smaller so they can pass into the bloodstream. Disaccharide starches are broken into simple monosaccharides, and fats are split into their component parts (primarily fatty acids), which are then absorbed³. The pancreas also produces “pancreatic juice” containing the alkaline compound bicarbonate to neutralize stomach acid as food arrives in the small intestine. 

Like the liver, the pancreas is sensitive to the timing of digestion. It has a circadian rhythm of its own, preferring to sleep from shortly after dusk until sunrise, just as our ancestors did.⁴ Roughly three hours before your usual bedtime, your body starts producing melatonin to put you and your digestive organs to sleep. Refraining from eating after 8pm helps to preserve insulin sensitivity, a major marker for metabolic health. The opposite of insulin sensitivity is insulin resistance, a condition that results from eating too much refined carbohydrates. Insulin resistance causes chronic inflammation, as too much insulin in the bloodstream breaks down into unstable free radicals – rogue cells that directly damage your blood vessels and every cell they touch. Insulin resistance and chronic inflammation are now understood to underlie nearly all chronic diseases. Insulin sensitivity is what sets centenarians in the “blue zones” apart, enabling their remarkable longevity. America, by contrast, is a “red zone.” The average American consumes fifty times as much sugar as our pancreas is evolved to handle. No wonder fully half the population is now diabetic or pre-diabetic (up to 80% of which is undiagnosed), and Alzheimer’s disease (also known as “diabetes of the brain”) is rapidly on the rise. The fewer years your pancreas is overtaxed, the longer your lifespan – and your health span – will be.

Prodding the pancreas to produce insulin at night may overstimulate it, causing even higher levels than during the day (it may also overstimulate the stomach to produce excess hydrochloric acid, resulting in acid reflux). Time-restricted eating allows the pancreas to rest. Your pancreas is most happy when eating is restricted to a 10-12 hour window for women (12-14 hours of complete fasting between dinner and breakfast), and 8-10 hours (14-16 hours between dinner and breakfast) for men. 

Overeating also stresses the pancreas, as it gives those hard-working islets even more work to do. Like the liver, the pancreas is stressed by alcohol, fried foods, and refined carbohydrates such as cookies, candy, cakes, fruit juice, flour-based muffins, breads, pizza, soft drinks, and ultra-processed junk foods. Artificial sweeteners are especially harmful, as the sweet taste they release in your mouth causes your salivary glands to signal the pancreas to release insulin in anticipation of sugary calories coming down the pike. When no calories show up, the pancreas becomes confused, and releases more insulin – and triggers the storage of fat. Contrary to what consumers are led to believe, artificial sweeteners actually cause rather than prevent weight gain, and may damage your pancreas and your microbiome in the process. Even foods that we don’t think of as “sweets” break down into sugar – such as grain and nut milks, fruit juice, bread, pasta, rice, and potatoes – and cause the pancreas to produce more insulin than your receptors can handle, resulting in insulin resistance and chronic inflammation.

The pancreas is easy to please, however, thriving on the same foods that your liver loves: fiber-rich vegetables, whole fruits, lentils and beans; pasture-raised meats, fish, eggs, and dairy; whole grains, nuts, and seeds; herb teas and plenty of water. A plant-rich diet low in carbs and high in fiber, healthy fats, and proteins will keep your pancreas happy and your insulin receptors sensitive. Reducing or eliminating sugar and refined carbohydrates, such as flour-based foods and free fructose (fruit juice, jams, jellies, and fruit-based alcoholic beverages) is the single most powerful tool in your toolbox for maintaining a healthy pancreas. Don’t wait until you have a chronic inflammatory condition or become diabetic – for though these conditions may be reversible to some degree, prevention is always preferable when it comes to metabolic health.

Considering the numerous health problems that result from impaired blood sugar regulation – from increased risk of heart attack to decreased ability to heal wounds, from kidney disease to impaired vision to nerve damage – your pancreas is well worth pampering. Unfortunately, our food industry doesn’t treat this baby so well, promoting inflammatory foods and artificial additives that continue to degrade our nation’s metabolic health to an alarming degree. Less than 12% of Americans are metabolically healthy – defined as healthy blood sugar, blood pressure, cholesterol, and body weight.⁵ Many doctors are not up to date with the latest tests, such as fasting insulin, that show the trajectory of your blood sugar. Among functional and progressive physicians, fasting insulin is considered a far more accurate test than fasting glucose, as the latter may appear normal until your beta cells begin to fail.

For me it took ten months from the time I was diagnosed as prediabetic to achieve a healthy fasting insulin score (below 5). At this writing, that was two years ago. I haven’t eaten sugar, sweets of any kind, bread, fruit juice or high-glycemic fruits since. Nor do I miss these foods, for my addiction to sugar was quickly broken, and the rewards of good energy, stable blood sugar, and lack of inflammation are well worth the sacrifice. My night blindness and tinnitus disappeared, and my chronically achy knee stopped hurting. Even my blood pressure improved, as hyperinsulinemia (too much insulin)⁶ results in sodium retention in the kidneys. When I see a morning glory muffin or a chocolate chip cookie at the café where my daughter works, I think of my good pal the pancreas – and order a hearty lentil soup or salmon salad instead.

Your pancreas is most efficient in the morning. For the first half of the day your insulin is best regulated, and your insulin receptors are most responsive. If you eat dessert, it’s best to do so after lunch. Exercise in the second half of the day is also believed to be more beneficial, as this is when insulin sensitivity begins to decline, and exercise helps to improve it. Research on the circadian rhythms of digestion and other metabolic functions is ongoing,⁷ but even without conclusive studies, I’ve experienced this myself. A fruit compote of stewed apples and cranberries doesn’t rock my metabolism before an afternoon walk – but if I eat the same thing after dinner, it causes an insulin spike that blows through my body like a small hurricane, leaving a wave of fatigue in its wake. My pancreas is talking to me, letting me know it’s tired and wants to go to sleep. Our organs may be wiser than our conscious minds, guiding us to live in accord with our clock genes, which are tethered to the sun, the moon, and the stars. Even in our modern world, we can do much to live in accord with nature’s design, and to create optimal, functional health.

Now when I think of the Islets of Langerhans, I imagine a peaceful place where my pancreas and I are resting in harmony, surrounded by a vast and gentle sea. This is a harmony worth cherishing, if you cherish your own health.

Neither the liver nor the pancreas are the prettiest to look at (or to illustrate), but both play a central role in your present and future health – and you in theirs, through nutrition.

To your good health –

Yael Bernhard
Certified Integrative Health & Nutrition Coach

Have you seen my other Substack, Image of the Week? Check it out here, and learn about my illustrations and fine art paintings, and the stories and creative process behind them.

Yael Bernhard is a writer, illustrator, book designer and fine art painter with a lifelong passion for nutrition and herbal medicine.  She was certified by Duke University as an Integrative Health Coach in 2021 and by Cornell University in Nutrition & Healthy Living in 2022.  For information about private health coaching or nutrition programs for schools, please respond directly to this newsletter, or email dyaelbernhard@protonmail.com. Visit her online gallery of illustration, fine art, and children’s books here.

Information in this newsletter is provided for educational – and inspirational – purposes only.

1. Exocrine tissue secretes hormones through a duct into the epithelial lining of another organ – in this case, the small intestines. Endocrine tissue releases hormones directly into the bloodstream.

2. https://columbiasurgery.org/pancreas/pancreas-and-its-functions

3. Sizer & Whitney; Nutrition: Concepts & Controversies, pp81-83.

4. https://dhrupurohit.com/dp-ep401/

5. Apple podcast: the-real-reason-for-americas-obesity-crisis-and/id1382804627?i=1000470177902

6. https://my.clevelandclinic.org/health/diseases/24178-hyperinsulinemia

7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6533073/#