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?
- 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)
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.
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.
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.
- 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.