Posted: Monday, September 21, 2020

Explaining Insulin Resistance

Insulin resistance is a condition that occurs when muscle, liver and fat cells don’t respond well to insulin. Most know that insulin is a hormone that regulates blood sugar, but it also has a role in fat storage and regulation of enzymatic activity in the body. So, if insulin is not able to do its job, it can cause us to have problems, one of which can be especially tough if we’re trying to address obesity. The pancreas responds to insulin resistance by making more insulin, but guess what? Our cells still ignore it. This elevation can cause many issues with our bodies. We know that higher insulin levels are seen in type 2 diabetes, prediabetes and Polycystic Ovarian Syndrome (PCOS). Other clinical presentations include infertility, skin tags, acanthosis nigricans, high triglycerides and possibly more. This elevation in insulin also activates fat synthesis and weight gain. Weight gain makes cells even more resistant to insulin.

Blount Memorial registered dietitian Heather Pierce says this may sound like a downward spiral, but lifestyle choices can improve and often reverse insulin resistance. “Insulin resistance is very prevalent in our country,” she said. “Genetics and environmental factors contribute to this, too, but let’s focus on lifestyle strategies. The core problem is high insulin levels. A fasting level can be obtained, but they are not commonly performed. Waist-to-height ratio is something you can do yourself to assess if you have insulin resistance. Divide your waist measurement by your height. Anything less than 0.5 indicates good insulin sensitivity. Basically, you want your waist to be no more than half of your height,” she explained. “If anything, this can give you the knowledge to begin making changes to your lifestyle, whether or not you are overweight,” she added.

“It’s the abdominal fat that is more likely to cause metabolic issues and insulin resistance,” Pierce continued. “We mentioned that the cells are not responding to this hormone, but how do we make them listen? Movement is one of the greatest ways to make cells more sensitive to insulin. Notice, I said ‘movement,’ not a marathon or exercising to the point that you are injured. All movement is good, but strength training and interval training may be the best bang for your buck if you are limited on time. Our Wellness Centers at Springbrook and Cherokee are doing an excellent job of maintaining services safely through the pandemic,” she said. “There are also quite a few free apps and online videos that can help if you’d rather exercise in your home. Either way, look at exercise as a medicine to help reverse insulin resistance, and find something that works for you,” she added.

Next, Pierce says what we eat is essential to lowering insulin resistance. “To reduce the amount of insulin circulating in the blood, we must understand what causes elevations,” Pierce said. “Elevation occurs slightly with protein intake, but there’s no impact from fat. Carbohydrate is the main nutrient that raises blood sugar and then activates insulin to be secreted, so think of bread, cereals, crackers, pasta, rice, potatoes, snack cakes, sugary beverages and fruit. The goal is to get the sugar into cells to be used as energy or stored. Once our cells have stored enough sugar, the energy may wind up being stored as fat long-term,” she explained. “I don’t usually recommend taking out all carbs and creating a cycle of dieting; I prefer to decrease the obvious culprits such as sweetened beverages and snacks, then tackle finding replacements for the common carbohydrates that are overconsumed,” she added.

“Finally, when we eat can also be a game changer for insulin resistance, as well,” Pierce said. “Remember, when we eat our insulin goes up, and as long as insulin is up, weight loss is hindered. This just might explain why smaller meals throughout the day is not working for everyone. If we start limiting our eating times, we can lower our insulin levels. You’ve probably heard of intermittent fasting and there are several ways to implement this safely. I recommend researching the options and reviewing them with your doctor first,” she said.

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