Shabnam Das Kar and Michal Ofer
Nutrition Science Meets Medicine

Insulin Resistance

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Major Concerns Of Women With PCOS

What Is PCOS?

Polycystic Ovarian Syndrome or Polycystic Ovarian Disease (PCOD) is a complex genetic, hormonal and metabolic disorder that affects the whole body, not just the ovaries.

Many of you have been frustrated at the insufficient information provided to you by your healthcare provider. PCOS presents differently in different parts of the world. Those of you from India have often struggled with losing weight or maintaining your weight loss. Caucasian women may have struggled with getting an accurate diagnosis because they seemed “normal”.

[Read more…] about Major Concerns Of Women With PCOS

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Obesity, Diabetes And Covid 19

The Coronavirus disease 2019 (COVID-19) caused by the SARS CoV2 virus (Severe Acute Respiratory Syndrome Coronavirus 2 ) was first reported in China in late December, 2019. It has has since evolved into a global pandemic (present all over the world).

Quick Facts About Covid 19:

  • It is highly contagious. It can spread very easily. Unlike previous SARS viruses, the SARS CoV2 settles in the nose and throat. This means it can spread when you talk or laugh or sing, particularly in confined spaces (super-spreader events).
  • Asymptomatic spread. People may have the virus and potentially spread the disease even when they do not have symptoms of Covid 19.
  • It is a new virus. However, in a short span of 6 months, scientists have already found out quite a lot about this virus. By January 12, 2020, the virus was sequenced in China. This means that the genetic signature of the virus is known. This is important from the perspective of testing and treatment. 1)Ref
  • Vaccine: There is no vaccine against the SARS CoV2 available now, but many promising ones are in development.
  • At present, there is no specific treatment available for Covid 19. However, the search is on!
  • The Coronavirus is here to stay. It is not going anywhere. This means that measures of physical distancing will remain even after the lockdown. For how long? We do not know as yet.
  • Wearing face masks help!
  • Young people are not immune to Covid 19, particularly if they are overweight and/or have a chronic disease.
[Read more…] about Obesity, Diabetes And Covid 19

References   [ + ]

1. ↑ Ref

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High Carbohydrate Food To Minimize or Avoid

While it is true that on the MDS Program we do not recommend meal plans or measuring food or counting calories, it is true that if you are insulin resistant your chances of losing weight on a low carbohydrate diet are higher.

Listen to your body. “Eat when you are hungry, drink when you are thirsty.”

In the sections below are food and drink that you may consider avoiding or minimizing.

All Sugars

  • White sugar
  • Brown sugar
  • Powdered sugar
  • Any food with added sugar
  • Processed food with added sugar
  • Junk food with added sugar
  • Jams and Preserves
  • Some Sauces (check nutritional label and ingredients)
  • Fructose (sugar in fruit)
  • Some Salad Dressings (check nutritional label and ingredients)
  • Cocoa mix
  • Molasses
  • Honey
  • Jaggery
  • High-fructose corn syrup and foods made with it
  • Syrups

Baked Goods and Sweets

  • Cookies / Biscuits
  • Cake
  • Pie
  • Brownies
  • Donuts
  • Pastries
  • Muffins

Candy

  • Chocolate Bars
  • Hard Candy
  • Milk Chocolate
  • Cotton Candy
  • And all others made with sugar

Packaged/Processed Snacks

  • Flavoured Nuts
  • Pretzels
  • Rice Cakes
  • Breakfast Bars
  • Cheese and Crackers Snacks
  • Raisins
  • Potato Chips
  • Tortilla Chips
  • Popcorn
  • Pop-tarts
  • Granola Bars
  • Twinkies
  • Cupcakes
  • “Heathy” Nut Bars
  • And other boxed snacks and products

Dairy

  • Flavoured Dairy
  • Added Sugar Dairy
  • Fruit At The Bottom or Sugar Added Yogurt
  • Whole and Skim Milk
  • Soy Milk
  • Ice Cream
  • Margarine
  • Pudding

Sugary And Starchy Fruit

High Sugar Fruit
  • Oranges
  • Kiwifruit
  • Pears
  • Pineapple
  • Plums
  • Cherries
  • Grapes
  • Figs (Also Starchy)
  • Bananas (Also Starchy)
  • Mangoes
  • Tangerines
  • Pomegranates
  • Dates
  • Applesauce
  • Dried fruit (worst choice as it has very high concentrations of sugar from the drying process)
Medium Sugar Fruit
  • Blueberries
  • Coconut Meat
  • Cantaloupes
  • Watermelons
  • Nectarines
  • Papaya
  • Peaches
  • Apples
  • Grapefruit
  • Honeydew Melons
  • Guavas
  • Apricots
Starchy Vegetables
  • White Potatoes (French fries and potato chips)
  • Sweet Potatoes or Yams
  • Corn
  • Peas
  • Squash
  • Root vegetables not advised for very low carb diets (beets, carrots, parsnips, rutabaga, turnips, butternut squash, and winter squash)

Grains And Other Starches

  • White Rice
  • Bread, Bagels and English Muffins
  • Croissants
  • Tortillas
  • Pasta
  • Cold Breakfast Cereals
  • Oatmeal
  • Cream of Wheat
  • Porridge
  • Barley
  • Amaranth
  • Millet
  • Quinoa
  • Spelt
  • Couscous
  • Bulgur
  • Rye
  • Muesli
  • Crackers
  • Pizza
  • Corn Starch
  • Pancakes
  • Waffles
  • French Toast
  • White Flour
  • Whole-Wheat Flour
  • Rice Flour
  • Corn Flour
  • All Whole Grains Too

Legumes

  • Pinto Beans
  • Black Beans
  • Kidney Beans
  • Chickpeas
  • Navy Beans
  • Lima Beans
  • Baked Beans
  • Lentils
  • Soy

Drinks

  • Soda
  • Juice
  • All Sweetened Drinks
  • Artificially Sweetened Beverages
  • Sweetened Or Flavored Tea
  • Sweetened Or Flavored Coffee
  • Frappuccino Coffee Drinks
  • Milk Shakes
  • Root Beer Floats
  • Malts
  • Frozen Coffee Drinks
  • Sports Drinks
  • Beer
  • Sweet cocktails – (Pina Colada, Daiquiri, Mai Tai, Bloody Mary, Margaritas, Screwdriver, White Russian, Rum Drinks etc.)
  • Wine coolers and alcopops

Other Articles

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Intermittent Fasting Deciphered Part 1

The problem of obesity.

Why are there more overweight people now than ever before? There are a few reasons for this. Some of the reasons are included in the free eBook Why Can’t I Lose Weight?

  • The first reason is the changing diet. Far too many people are reliant on or addicted to nutrient-poor, energy-dense junk food, processed food, white flour products, etc. All these foods cause blood sugar levels to spike and this, in turn, leads to fat storage and insulin insensitivity.
  • A sedentary lifestyle is another reason. With the advent of technology, many manual tasks have become easier and less demanding.

Need to go to the supermarket that’s a 20-minute walk away? Get the car instead of walking. Need to go up to level 3 in your office building?

Take the elevator instead of the stairs. All these activities that move our bodies, use our muscles and keep things working well are avoided and replaced with easier alternatives. As a result, people are much more prone to gaining weight.

It’s so much simpler to watch TV with a bag of potato chips than to go for a run. It’s so much easier to drink a bottle of processed apple juice than eating a raw apple.

Each of these actions, no matter how small, do matter.

  • Poor quality of food. To exacerbate the situation, in much of the world, low-quality junk food is often cheaper than healthy, nutritious food. Low-income families are able to easily purchase these nutrient-depleted products but struggle to pay for “real food”. This is one of the many confounding reasons why obesity affects low-income families at a higher percentage.

One of the solutions to the problem of obesity.

There is one cure to reversing weight gain and obesity. In fact, it is so powerful that people are able to lose weight even on a junk food diet just by adopting this method. It should be noted that I never recommend consuming potentially toxic food-like substances, but this method is so powerful that it has been shown to work even in the presence of a poor diet.

Intermittent Fasting (IF)

[Read more…] about Intermittent Fasting Deciphered Part 1

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What Is The Ketogenic Diet?

The Ketogenic diet (keto) is an eating plan that features a very low intake of carbohydrates.

Why Is It Called A Ketogenic Diet?

This is called a Ketogenic Diet because this low carbohydrate diet causes your body to release ketones into the bloodstream. It pushes your body into a state called nutritional ketosis.

When you eat carbohydrates your cells utilize it for providing energy. But when you stop eating carbohydrates and get into ketosis, your body has the ability to use your body fat stores to provide ketones for fuel.

Nutritional ketosis is not to be confused with diabetic ketoacidosis, which is a serious life-threatening condition. The two are not the same.

[Read more…] about What Is The Ketogenic Diet?

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Why Can’t I Lose Weight? Part 2 Insulin Resistance.

Insulin resistance is a condition when your cells stop responding to the insulin that is produced in your body. This is a highly simplified explanation.

Insulin is your “fat fertilizer” hormone. This is in the words of Harvard endocrinologist, Dr. David Ludwig. Most of you probably know insulin as the injection that people with diabetes (types 1 and 2) take to manage their blood glucose levels. However, here I am talking about the hormone insulin that is produced by the beta cells in your pancreas.

What Does Insulin Do In Your Body?

Insulin helps

  • In maintaining blood glucose levels in the blood.
  • Glucose to enter into the muscles.
  • Stops breakdown of fat.
  • Stimulates the liver to store glucose as glycogen.

Insulin Resistance or Metabolic Syndrome or Syndrome X?

Metabolic Syndrome has been called by various names, Syndrome X, Insulin Resistance Syndrome. It was originally called Syndrome X by Stanford Professor Dr. Gerald Reaven, who is known as the “Father of Insulin Resistance”. His 1988 Banting Lecture is legendary among those interested in this field. He passed away in February 2018 at the age of 89.

A syndrome is a group of symptoms that together are characteristic of a specific disorder or disease. In the original definition of Syndrome X, Dr. Reaven had included several criteria as shown in the image below. (Fig 1)

Criteria for Metabolic Syndrome or Syndrome X
Fig 1 Syndrome X

The common factor underlying Syndrome X is insulin resistance. The X has been dropped from the description because the relationship of insulin resistance and heart disease is no longer disputed. Now it is called Metabolic Syndrome or MetS.

Your risk for developing diabetes , dementia,stroke or heart disease is very high if you have Metabolic Syndrome.

Criteria for Metabolic Syndrome:

According to guidelines from the National Heart, Lung, and Blood Institute (NHLBI) and the American Heart Association (AHA), metabolic syndrome is diagnosed when you have at least 3 of the following 5 conditions:

  • High Fasting Blood Glucose
  • High Blood Pressure
  • High Triglycerides
  • Low HDL-C
  • Waist circumference ≥102 cm (40 in) in men or ≥88 cm (35 in) in women; if Asian, ≥90 cm (35 in) in men or ≥80 cm (32 in) in women.

Insulin Resistance/Metabolic Syndrome and Other Disease

I am stressing on this again. As you can see in the image here (Fig 2) if you have insulin resistance or MetS, your risk for many diseases increases dramatically.

Fig 2 Diseases Related To Insulin Resistance

The Relation Of Carbohydrates To Insulin Resistance

Your food is a combination of carbohydrates, fat and protein. When you eat food your insulin levels go up.

How much insulin goes up will depend on (besides other factors) the protein, fat and carbohydrate content of your food.

As you can see in the image (Fig 3) here, insulin levels are highest after a high-carbohydrate (HC) diet, followed by a high-protein (HP) diet. A high-fat (HF) diet raises insulin the least. Fasting doesn’t raise insulin levels at all.

In this study, the high-carbohydrate diet included about 60% of carbohydrates.

Fig 3 Insulin Levels after food. dit El Khoury 2006

Glycogen And Triglycerides

Fatty acids are used by fat cells to make triglycerides. Triglycerides consist of 3 fatty acids joined to a glycerol spine. When the liver is full of glycogen, any extra glucose gets diverted into making free fatty acids.

Therefore, high triglycerides in your blood is a problem of insulin resistance and carbohydrate intolerance.

It cannot be corrected by taking a cholesterol-lowering drug or by eating a diet low in good fat and high in carbohydrates. Insulin targets the heart and the lining of the blood vessels that supply the heart and brain. This is why those of you with diabetes or pre-diabetes have a high risk of heart disease, stroke and dementia.

How Will You Manage Insulin Resistance?

  • Low-carbohydrate diet. How low will depend on individual variations.
  • Eat “real food”. This does not include highly processed high carbohydrate food and sugar.
  • Time-Restricted Eating/Intermittent Fasting (TRE-IF)

Benefits Of Low-Carbohydrate Diet

As you can see in Fig 4, the effects of a low-carbohydrate diet are many. The pathways affected are numerous. Does it have to be high-fat? This will be discussed in a separate post.

Effects of Low-Carbohydrate High-Fat Diets
Fig 4 Effects of Low-Carbohydrate High-Fat Diets, Ludwig 2018

Bottom Line

  • If you have insulin resistance a low carbohydrate diet will work better for reducing weight and improving your metabolism.
  • How little carbohydrates you eat will depend on several factors. How much you exercise, sleep, your medications, genes, gut microbiome all impact your carbohydrate tolerance.

Other Articles

Why Can’t I Lose Weight Part 1

Is Intermittent Fasting Just A Low-Calorie Diet?