MEDICAL MINUTE
Insulin resistance has become a more common topic amongst health and wellness communities. What exactly is it, though? Insulin resistance is a condition in which the body's cells become less responsive to the hormone insulin. Produced by the pancreas, insulin plays a critical role in regulating glucose (sugar) levels in our blood. Insulin enables cells to take in glucose to either be used as energy or stored for later use.
When insulin resistance occurs, the normal response to a given amount of insulin is reduced. As a result, the pancreas compensates by producing more insulin. Over time, this leads to higher levels of insulin circulating in the blood. The problem is, despite the high insulin levels, the body's cells can't absorb glucose effectively, causing elevated levels of glucose in the blood. If left unchecked and untreated, this can progress to type 2 diabetes, a chronic condition that affects the way the body processes blood sugar.
That’s not all, though. Insulin resistance is often associated with other serious health conditions, including obesity, high blood pressure, high cholesterol, heart disease, polycystic ovary syndrome (PCOS), and Alzheimer's disease. It is a key component of metabolic syndrome, a cluster of conditions that increase the risk of heart disease, stroke, and type 2 diabetes.
How to Detect & Measure Insulin Resistance
The exact cause of insulin resistance is not completely understood, but it is associated with a combination of genetic and lifestyle factors, including lack of physical activity, poor diet, and excess weight, particularly around the waist. If you are worried you have insulin resistance, which biomarkers should we be looking at to measure it:
Fasting Insulin: This measures your insulin levels after fasting for 8 to 12 hours. High fasting insulin can indicate insulin resistance.
Fasting Blood Glucose: This test measures your blood glucose levels after fasting for 8 to 12 hours. Elevated fasting glucose can indicate insulin resistance or diabetes.
HbA1c (Glycated Hemoglobin): This measures your average blood glucose levels over the past 2 to 3 months. A high HbA1c level can indicate poor blood sugar control, suggesting insulin resistance or diabetes.
Oral Glucose Tolerance Test (OGTT): This test measures your body's response to glucose. It involves fasting overnight and then drinking a solution containing a specific amount of glucose. Blood glucose levels are measured at intervals for 2 to 3 hours.
Lipid Profile: High levels of triglycerides and low levels of high-density lipoprotein (HDL) cholesterol have been associated with insulin resistance.
The good news is that insulin resistance can often be managed and even reversed through lifestyle modifications.
Nutritional Optimization for Insulin Resistance
Whether you’re predisposed, working to reverse, or not even worried about insulin resistance, adopting a nutrient-dense, whole foods diet is immensely beneficial. Particularly for insulin resistance, a low-glycemic diet, or one that focuses on foods that minimally impact blood sugar levels, is an important added layer.
The Glycemic Index (GI) is a rating system that assigns a numerical value to foods based on how they affect blood glucose levels. Foods with a high GI value cause a rapid increase in blood sugar levels, whereas those with a low GI value result in a slower, more gradual rise. Consuming low glycemic foods and employing smart food combining strategies can be instrumental in avoiding glucose spikes and managing or preventing insulin resistance.
Glycemic Load (GL), on the other hand, combines both the quality and quantity of carbohydrate in a single number. It's calculated by multiplying the amount of carbohydrate in a food (in grams) by the food's GI and then dividing by 100. Therefore, a low GL food is one that has a low GI and is also low in carbohydrates.
Here are some examples of foods that are low in both GI and GL:
Non-Starchy Vegetables: broccoli, spinach, bell peppers, zucchini, tomatoes, cucumbers
Whole Grains: barley, bulgur, quinoa, brown rice
Legumes: lentils, chickpeas, black beans, kidney beans
Fruits: apples, oranges, peaches, pears, berries
Nuts & Seeds: almonds, walnuts, sunflower seeds, flax seeds
Dairy (for those that can tolerate): milk, Greek yogurt, hard cheeses
In general, foods that are high in fiber or protein tend to have a lower GI and GL because these nutrients slow down the digestion and absorption of carbohydrates, leading to a more gradual rise in blood sugar. So, pairing carbohydrates with a quality protein or fat source will slow down the digestion of the carb and thus the release of sugar into the bloodstream. It's also important to note that the GI and GL of a food can vary depending on how it's cooked, what it's eaten with, and even from person to person. That’s why personalization and monitoring your own blood sugar response is so important.
