Diet for Insulin Resistance
by Sue Kira, Naturopath & Clinical Nutritionist
– What is insulin resistance?
– Signs and symptoms of insulin resistance
– Some causes of insulin resistance
– Other factors that may make insulin resistance worse
What is the relationship between food and insulin resistance?
Case study: Insulin resistance bordering on diabetes
What is Insulin?
There are three types of foods we eat: proteins, fats and carbs (carbohydrates). Through digestion, these foods are converted into:
– amino acids (from proteins)
– fatty acids (from fats)
– glucose (from carbs)
These are known as the macro molecules (micro molecules are nutrients such as vitamins and minerals).
Glucose is an energy molecule that is used to fuel every cell in our body. Glucose is produced from carbohydrates which are found in plant-based foods including bread, rice, breakfast cereal, pasta, fruits, vegetables and sugars.
When carbohydrate-rich foods are consumed, insulin is the hormone that controls and regulates where the glucose is distributed throughout the body. Insulin is secreted by the pancreas to take glucose from the food into the blood and then distribute that glucose into our cells for energy, such as our muscles and brain cells. Some of the glucose is also stored as fat and liver cells as an energy reserve.
Another action of insulin is to trigger the body’s muscle and fat cells to remove and use glucose from the blood as needed for energy use.
This storage of glucose in the muscles and fat cells is one way that insulin controls the level of glucose in blood. Insulin has this effect on the cells by binding to insulin receptors on the surface of the cells.
What is Insulin resistance?
To explain insulin resistance, you can think of it as insulin ‘knocking on the doors’ of muscle and fat cells. The cells hear the knock, open up, and let the glucose in to be used as energy. With insulin resistance, the muscle cells don’t hear the knock (they are resistant). When the muscle cells don’t let the glucose in, excess glucose is stored in our fat cells.
Then the pancreas is notified that it needs to make more insulin, which then increases the level of insulin in the blood and causes a ‘louder knock’, but the cells remain deaf to the continued knocking on the door. The resistance of the cells continues to increase over time.
As long as the pancreas can produce enough insulin to overcome this resistance, blood glucose levels remain normal, but when the pancreas can no longer produce enough insulin, glucose levels in the blood begin to rise.
Initially this happens soon after eating, when glucose levels are at their highest and more insulin is needed, but eventually it can also happen while in a fasting state, such as overnight. Finally, when blood sugar rises above a certain level and stays there, type 2 diabetes has formed.
Signs and symptoms of insulin resistance
– Difficult to control weight gain, especially around the middle
– Unusually fatigued
– Bloating
– Sugar cravings
– Acanthosis nigricans, a condition strongly associated with insulin resistance in which the skin darkens and thickens in the creased areas (for example, the neck, armpits, and groin).
– Skin tags occur more frequently with insulin resistance. A skin tag is a common, benign condition where a bit of skin sticks out from the surrounding skin.
Some causes of insulin resistance
– Genetics can predispose someone for insulin resistance
– Some medications can trigger insulin resistance
– The metabolic syndrome: a group of conditions involving excess weight particularly around the middle, elevated levels of cholesterol and triglycerides in the blood, and high blood pressure
– Central obesity
– Pregnancy
– Alcohol consumption
– Infection or severe illness
– Stress, which increases cortisol levels which can increase central obesity
– During steroid use > cortisol (see above)
– Inactivity and excess weight
– A high carbohydrate diet, by far the biggest contributor to insulin resistance
Other factors that may make insulin resistance worse include:
– Taking certain medications
– Older age
– Sleep problems (especially sleep apnea)
– Cigarette smoking
What is the relationship between food and insulin resistance?
A significant contributing factor to the increased incidence of insulin resistance is poor food choices. The highly-processed nature of carbohydrate foods, including breads, breakfast cereal and snack foods, causes much higher amounts of insulin production by the pancreas than less processed, low-GI carbohydrates.
While some cases of insulin resistance require medication, that may not be enough as lifestyle factors such as diet and exercise should be considered. People with insulin resistance need a reduced-carbohydrate diet and an exercise program that integrates cardio sessions with light resistance training.
Essentially, the nucleus of the problem is not to flood the blood with too much glucose in the first place. That means selecting good carbs rather than starchy, sugar producing carbs.
You know, if you experimented and consumed a quantity of calories of good carbs over a period of time, and then consumed the same amount of calories of starchy or sugary carbs over the same time span, with all things being equal, you would put on more weight with the starchy/sugary carbs. That’s because the body converts starch and sugar into excess glucose which is stored in the fat cells.
High-GI, refined sources of carbohydrates, including juices, white bread and refined cereals, should be completely eliminated from the diet.
The benefits of identifying insulin resistance early and committing to a an insulin resistant diet and an exercise program will ultimately help you avoid type 2 diabetes.
Diet for Insulin Resistance
Controlling insulin resistance or preventing diabetes doesn’t mean a life of being deprived of delicious foods, it just means being more selective in the types of foods you eat. There are still plenty of yummy satisfying foods in an insulin resistance diet to help you better manage your insulin levels and feel your best.
Carbohydrates have the biggest impact on your blood sugar levels so you need to be careful about what types of carbohydrates you eat with the focus to be on high fibre complex carbohydrates to prevent your body from getting a sugar spike and producing too much insulin.
The basis of a diet for insulin resistance is to eat: small amounts of healthy fats from raw nuts, seeds, olive oil, fish, coconut and avocados; enjoy good quality proteins such as eggs, beans, seafood, free range grass fed chicken, turkey and other meats; love loads of vegetables but limit the starchy ones. And there are still sweet treats (for example, made from coconut) that won’t upset your blood sugar balance too much.
Sugar is hidden in so many packaged foods that the first step is to use whole foods recipes. But if you are going to eat packaged foods, then there are some hidden sugars you might not be aware of to check on product labels.
These include sugar, honey, molasses, agave nectar, cane crystals, corn sweetener, crystalline fructose, dextrose, evaporated cane juice, fructose, high-fructose corn syrup, invert sugar, lactose, maltose and malt syrup.
While a diet for insulin resistance is not considered a cure, the idea is to eliminate foods considered detrimental, and include foods that support your body to give it the best chance to heal naturally and regain balance and vitality. That’s why it is so important to exclude antagonistic foods and drinks such as gluten, dairy, additives, and sugar.
If your insulin resistance is very resistant, then you may wish to consider a ketogenic diet for fat loss or an Intermittent fasting program, but don’t start these without first speaking with your practitioner to be sure they are right for your body.
Important: Before you commence a new diet, see your medical or health care professional for qualified guidance about what foods and supplements are best for your body. While on the diet do not stop any medications or supplements previously prescribed unless advised otherwise by your medical or health care professional.
Note: During the early stages of a new diet, you may experience symptoms such as fatigue, headaches or body aches, which may occur because your body is detoxifying. However, if you are unsure about a symptom at any time, check immediately with your medical or health care professional.
Case study: Insulin resistance bordering on diabetes
Client name and identifying information changed
Wendy came to see me as she had recently been to her doctor who said she was a borderline diabetic and may need to go onto medication soon if she couldn’t get her blood sugar balanced. The doctor also said she had insulin resistance.
Not knowing much about these things, Wendy did some research and discovered that diet and exercise could play a big role in preventing and treating insulin resistance so she organised to see me.
When Wendy first came in she was quite overweight, especially around the middle of her body. Wendy had previously lived a life of eating whatever she pleased without putting on weight or having any adverse health conditions.
This changed after a car accident had her off her feet and resting in hospital for a few weeks. When back home she couldn’t walk very far, so she just sat in front of the television and ate her favourite foods – chips, chocolate and red wine with corn chips (on top of her normal meals). These foods had never been an issue before, but because of inactivity and the stress of the accident and insurance claims, things were now different for her body.
After a few months, Wendy’s rehabilitation had progressed to the point where she could exercise, but was too tired to do anything else. Meanwhile she had put on weight and diagnosed with insulin resistance.
The first thing we discussed was the importance of changing her diet to have more stable blood sugars. I advised Wendy to go off all sugars and starches including alcohol, corn chips, potato chips and pasta – which she frequently ate for dinner. I recommended to eat foods that were low GI, low sugar impact and higher in protein, with small amounts of good fats.
I encouraged Wendy to get back to the gym and work out a good regime with a trainer with exercises she needed that would not aggravate her injuries until she was more motivated to get outside and do some walks.
Within a few weeks with the new diet and exercise, Wendy’s energy levels returned and she was exercising at the beach, riding her bicycle and going on bushwalks regularly. She even joined a walking group.
Wendy said her diet changes were hard initially, but after a couple of weeks, because of the withdrawal, all sugar cravings had gone and even though she was eating about the same number of calories/kilojoules, she felt satisfied (full enough) and was losing a couple of pounds (a kilo) each week.