Overcoming Insulin Resistance
Growing up, I was often described as a “string bean”. I reached my height of 6’0 ft by the age of 13 or 14. I was an active kid, and my mother always prepared healthy, home cooked meals. I grew up in Europe, where things like Doritos, Pop Tarts, and mac and cheese were occasional treats only available when you visited a friend whose parents had access to the US commissary.
During my senior year of high school at the American International School in Vienna, Austria, I decided that I wanted to go to college in the US. I figured, why not? If I was ever going to experience living in the US, this was my opportunity. I was also aching to get out of the cold winters of Vienna, and thus, I decided to go to the University of Arizona in Tucson, where the sun was always shining, and you could lie by the pool in February!
Once there, I joined the University’s club volleyball team. We played year-round, and in addition to our practices and tournaments, we also had conditioning several times a week, AND I would work out on my own at our state-of-the-art rec center. In addition to all my exercise, I also continued to eat, what I considered, a reasonably healthy diet. True, I was in college, so I’m sure my nutrition wasn’t ideal, but I tried to stick to low-fat foods like rice cakes, fruit smoothies, and whole grains like oatmeal, brown rice, and whole wheat bread. Although, my friends’ favorite game was finding out which foods I had never eaten, and watching me eat it for the first time…
I’m not sure how much weight I gained in my first year of college, but the changes in my body were recognizable even to my grandmother, who had severe dementia. What bothered me most was not so much the weight, but the fact that, the more weight I gained, the hungrier I became! I also noticed that my neck and my armpits always looked dirty. This was strange to me, since I often showered multiple times a day, as active as I was. At the time, I did not realize that this had anything to do with my recent weight gain. I just thought it was weird and kinda gross.
My sophomore year of college, I decided that I wanted to lose the weight I had gained during the previous year (which was probably around 20 lbs). I doubled down on my low-fat lifestyle and my rice cakes. I would avoid eating real meals, and mostly just grazed throughout the day on low fat foods. I was ALWAYS hungry and thinking about what I would eat next. In my apartment, I could control my environment, and avoid bringing candy into the house, but on weekends and at friend’s places… it was BAD. I even got the nickname “Cookie Monster” because I could not control myself around cookies. I also became really “hangry” if I didn’t eat every 2-3 hours. And yet, no matter how much I tried to restrict my diet or how much more I exercised, I couldn’t seem to lose the weight. I tried SlimFast for a whole summer, I tried the Cabbage Soup diet more times than I care to admit, I counted every calorie I consumed… and yet, no real change in my weight. Does this experience sound familiar to any of you??
After graduating from the University of Arizona, I went to the University of Texas to study exercise physiology. Since I was no longer playing volleyball, but wanted to stay active and challenge myself, I decided I was going to train for a marathon (even though I had never even run a 5K). I thought: if I can’t lose weight training for a MARATHON, then I give up. I was about half-way through my marathon training (and no, I hadn’t lost any weight yet) when I was sitting in one of my graduate classes, and we were discussing substrate utilization, which basically means, studying which fuel your body uses. Your body pretty much has two major fuel sources: glucose and fat. And the graph that popped up next changed my life.
What the graph showed, was that, when our insulin levels are LOW, we use primarily fat as our primary fuel source. As insulin goes UP, we start burning less fat (and start burning more glucose). AHA! LIGHT BULB MOMENT!!
What I realized in that moment, was why my low-fat, calorie counting approach wasn’t working. Insulin doesn’t rise in response to eating fat, it rises in response to eating carbohydrates! Maybe I was crazy, because this contradicted everything I had heard growing up about fat and calories, but I decided in that moment that I was going to reduce foods that cause insulin to spike and see what would happen. I cut out bread, rice, tortillas, rice cakes, sugar, pasta, oatmeal, cereal, and potatoes, and started reading labels not to check for calories or fat, but for carbs and sugar. And guess what happened? The first thing that I noticed was changes in my hunger and my mood. I was no longer obsessing about my next meal or thinking about food all the time. I could go hours without eating without feeling “hangry”. Low and behold, I lost around 15 lbs within a few weeks. And despite what all the experts were saying at the time I didn’t need those carbs for my marathon training. By looking at the science, I knew that I could rely on my fat stores to carry me through my runs. I didn’t “bonk” or “hit the wall” when I got to mile 17, 20, or 25. Instead, I qualified for the Boston marathon in my very first marathon.
So, in a nutshell, that was my experience with insulin resistance. I battled it again with both of my pregnancies (pregnancy is a time of natural insulin resistance), gaining 60 lbs with each of my pregnancies, but again, I was able to turn my ship around by going back to the principles that I knew worked for me. To this day, almost 20 years later, I maintain my lifestyle that helps me keep my insulin resistance at bay.
In case you were wondering if I was going to get back to my dirty-looking neck and armpits (or maybe you were hoping I wouldn’t go back there), I learned a few years later in my medical training that this is called “acanthosis nigricans”, and this is a sign of insulin resistance. I also had many of the other signs of insulin resistance: Cravings for sweet and salty foods, fatigue, increased hunger, and weight gain. I did not experience increased frequency of urination (that I can recall) or tingling in the hands and feet, which can also be signs of later-stage insulin resistance. Other signs of insulin resistance include skin tags and dry, cracked heels.
Before we go any further, we should answer the question: What exactly is insulin resistance? Insulin resistance is when the cells in your body stop listening to the insulin signal, and as a result, your body has to make more and more insulin to get the job done. Insulin is the hormone that prevents your blood glucose from getting too high. It causes the glucose in the blood stream to be taken up by cells so that these cells can use the glucose for energy. Insulin also signals that we shouldn’t be using fat as a fuel source, since we need to get rid of the glucose first. In fact, any extra glucose gets sent to the liver to be converted to fat. As such, the process of making new fat is driven by insulin.
In insulin resistance, the cells stop listening to the insulin signal, which makes it harder to get the glucose into the cells and out of the blood stream. Your body knows that you can only have a teaspoon of glucose in your blood at any given time, so it just tells your pancreas to pump out more and more insulin, resulting in more and more fat storage, and less and less fat burning. Eventually, the pancreas can no longer keep up with making that much insulin, and that’s the point when blood glucose starts to rise above what are considered “normal” levels. The individual develops prediabetes, which can eventually develop into type 2 diabetes.
Why did I develop insulin resistance in college? And why do some people develop it while others don’t? Part of that answer is genetics. Those who have a genetic predisposition to insulin resistance or type 2 diabetes, which is the end-stage result of insulin resistance, are more likely to develop it if they are exposed to the right environmental triggers. The easiest way to find out your genetic predisposition is to ask about any relatives with type 2 diabetes. Turns out, I have a number of aunts and uncles with type 2 diabetes, and I recall the numerous skin tags on my grandmother’s neck, and the common complaint of dry, cracked heels from my own mom. My low-fat, high carb nutrition, with increased processed foods in college, paired with sleep deprivation and the stress of college (and moving a continent away from my home), on the background of my genetic predisposition, is what likely caused me to develop insulin resistance, despite my high levels of physical activity.
I was lucky that I happened to attend that one class that allowed me to turn my health around for the better. I don’t know where I would be today without that knowledge. Chances are, if you have a lot of the signs and symptoms that I described above, you may also have insulin resistance.
Now, to the real question: what can you do about it?
Eat whole, minimally processed foods, primarily non-starchy veggies (which includes most veggies other than corn, potatoes, sweet potatoes, and peas), nuts and seeds, , natural oils like olive oil and avocado oil, low sugar dairy like fermented plain Greek yogurt and cheese, minimally processed meats, eggs, poultry and fish. Avoid processed foods and starchy, sugary foods. While all whole-food plans, whether they are vegan, Mediterranean, low fat, or low carb, help to reduce insulin levels compared to the Standard American Diet, low carb diets have been shown to reduce insulin levels the most.
Be as active as you can be. Avoid sitting for long periods of time. Break up sedentary time with short walks or bursts of activity throughout the day. Work your way up to 30-60 minutes of activity per day, which can be split up into several bouts throughout the day.
Aim for 7-8 hours of high quality sleep every night.
Manage your stress by actively engaging in self-care, which may include meditation, yoga, prayer, deep breathing, or joyful activities such as hobbies, music, art, reading, journaling (a gratitude journal is a great idea), gardening, or anything else that brings you joy (but is not food-related).
Nutrition is a controversial topic, and admittedly, I have a bias based on my personal experience. I believe that there is no “one size fits all”, but I also believe in following the science and connecting basic biology and physiology to dietary recommendations. To learn more about insulin resistance and how to overcome it, check out these additional resources:
https://www.healthline.com/nutrition/improve-insulin-sensitivity
https://www.dietdoctor.com/health/treating-insulin-resistance
Subscribe to Gaining Health on our website www.GainingHealth.com to be notified of new content, and join our Facebook community at www.Facebook.com/MyGainingHealth