Insulin Resistance: What it is and what you can do about it.

Insulin is the hormone whose main function is to process sugar in the bloodstream and carry it to fat, liver, and muscle cells to be stored for later use.  When your body is flooded with too much insulin too much of the time, your cells can become resistant, or desensitized, to its effects.  Insulin resistance over the long term will result in Metabolic Dysfunction.

Causes of Excess Insulin

The most common cause is the consumption of too much nutrient-poor carbohydrate.  Other causes include: the use of artificial sweeteners, an insufficient protein intake, chronic stress, erratic or irregular mealtimes, over-exercising or lack of exercise, poor liver function, excess alcohol consumption or an existing hormonal imbalance – ie. excess cortisol or estrogen.

Symptoms of Insulin Resistance

Short-term side effects of high insulin include heart palpitations, sweating, poor concentration, weakness, anxiety, fogginess, fatigue, irritability, increased hunger and sugar cravings. 

Over the long term, signs of excess insulin include a tendency to hold extra weight abdominally, around your hips or over your triceps; an inability to lose weight in spite of a healthy diet and regular exercise; water retention or a puffiness in the face and extremities, fatigue, burning feet at night, skin tags, infertility or irregular menses, erectile dysfunction, gout, vision changes or sleep disruption.

Beyond obesity and type 2 diabetes, metabolic syndrome is associated with an increased risk of heart disease, stroke, cancer, Alzheimer’s disease, reproductive abnormalities, androgen imbalance in women and osteoporosis.

Diagnosing Insulin Resistance/Metabolic Syndrome

In addition to the clinical symptoms above, according to the current medical guidelines, metabolic syndrome is diagnosed when three or more of the following risk factors are identified:

·       Low levels of ‘good’ cholesterol (HDL)

·       High levels of ‘bad’ cholesterol (LDL)

·       Elevated triglycerides

·       Increased waist to hip ratio

·       High blood pressure

·       Elevated fasting blood sugar

·       Elevated fasting insulin

·       High uric acid

Reversing Insulin Resistance

The following are the most important steps you can take to improve insulin receptor sensitivity and restore optimal metabolic function.

1)    Limit your sugar intake – Sugar in the form of high dose fructose impairs insulin sensitivity more than any other food.  Examples of high dose fructose foods are: cakes, candy, fruit juice, dried fruit, agave, honey, sweetened milks.  Whole fresh fruit okay to eat as it is considered a low dose fructose, which actually improves insulin sensitivity.  The American Health Association recommends a maximum daily intake of sugar for women of 25g, and for men 37.5g.  Most people eat close to 100g/day, so making this adjustment can make a huge difference.

2)    Increase your muscle mass – The more muscle you have the more sensitive it will be to insulin.  With just 3 weeks of strength exercises for 30 minutes 3 times/week, you can increase your insulin sensitivity by 24%.

3)    Improve your stress response – Chronically elevated cortisol gives your body the message to increase abdominal fat storage and further depresses your metabolic rate by increasing muscle breakdown.  Developing good self care that effectively lowers your cortisol levels and keeps you out of a regular ‘fight or flight’ response is essential.  Some examples include: meditation, yoga, dancing, laughing with friends or walking in nature.

4)    Sleep – Chronic insomnia is a major cause of insulin resistance.  Four consecutive nights of poor sleep (less than 5 hours) is enough to reduce insulin sensitivity by 30 percent. 

5)    Supplement Magnesium – Magnesium deficiency can cause insulin resistance.  A magnesium rich diet improves insulin sensitivity so well it can be used instead of Metformin – the insulin-sensitizing drug prescribed for pre-diabetes and PCOS.  Magnesium rich foods include: green leafy vegetables, nuts and seeds and legumes.  Stress and exercise deplete magnesium levels, so supplementation is often indicated.   Magnesium glycinate is the best form of magnesium – usually 300-400mg/day taken with food. 

Insulin Resistance is unfortunately increasingly common, affecting one in four adults.  It is often the basis of other hormonal imbalances and it must be addressed in order for other imbalances to resolve and for optimal wellbeing. 

References: 

Pailosso, G. (1997). Hypertension, Diabetes Mellitus, and Insulin Resistance: The Role of Intracellular Magnesium.   American Journal of Hypertension, Vol 10, Issue 3, p.346-355
Basciano, H, Federico, L., Adeli, K. (2005), Fructose, insulin resistance, and metabolic dyslipidemia. Nutritional Metabolism. Feb 21;2(1):5..
Spiegel, K, Knutson, K, Leproult, R, Tasali, E, Van Cauter, E. (2005) Sleep loss: a novel risk factor for insulin resistance and Type 2 diabetes.  Journal of Applied Physiology Vol. 99 no. 5, 2008-2019
 

 

Caffeine and Hormonal Balance

I truly appreciate a perfectly brewed, artfully crafted organic espresso – these days this happens about once every couple of months.  I love the taste of coffee and the relaxing ritual of lingering over a matcha hemp milk latte while engrossed in thought-provoking conversation or some interesting reading material.  I can understand the appeal of this as a daily ritual.  While I have never had a daily attachment to caffeine in general, during the first year of my daughter’s life when sleep was at a premium, I gave serious thought to developing one.

Working with hormonal balance, I often advise people to decrease or come off coffee or caffeine completely.   For some people, this is incredibly challenging, and it is difficult to understand how even one cup/day, for some people can be an issue.    

Caffeine is an addictive CNS stimulant.  It works by blocking adenosine receptors in the brain.  Adenosine is a neuromodulator, which inhibits the release of neurotransmitters.  When the receptors are blocked by caffeine, there is increase in central nervous system stimulation.  To take this one step further, the binding of caffeine to the adenosine receptors means that instead of slowing down, the brain/nerve cells fire up. The pituitary notices this increased action and sends hormones to tell the adrenal glands to increase production of adrenaline, activating a fight or flight energy. At the same time, caffeine slows down the reabsorption of dopamine, which is our pleasure neurotransmitter. With extra dopamine, you not only feel alert, but you feel really good.   Until, these levels drop, usually about 5 hours after ingestion.  No wonder it is hard to give up.

It is a challenge in terms of hormonal balance, because with daily coffee use, your body becomes used to this cycle, cortisol and dopamine levels are pushed beyond their natural limits of production and this is not sustainable, your nervous system becomes chronically stimulated, magnesium levels are depleted, and you are likely chronically dehydrated.

Giving your body a break from this cycle allows for an opportunity to restore adrenal and hormonal health, balance your brain chemistry, improve your liver function and achieve mood stability.  After the first few days, most people report stable more consistent energy levels.

http://science.howstuffworks.com/caffeine5.htm

Arousal effect of caffeine depends on adenosine A2A receptors in the shell of the nucleus accumbens. The Journal Of Neuroscience: The Official Journal Of The Society For Neuroscience [J Neurosci] 2011 Jul 6; Vol. 31 (27), pp. 10067-75.