I’ve had the distinct pleasure and incredible opportunities to learn from some of the world’s leading researchers and practitioners in the realm of wellness; and a common thread weaved through all of my interviews, travels and conversations with these experts is the concept that insulin resistance is the primary factor in chronic disease.
In fact, this concept is so pervasive in health and wellness that the subject “autophagy,” in my New York Times bestselling book, Glow15, depends on having tight control of insulin. In Glow15, I walk you through a series of simple ways to activate your autophagy – your cellular detox mechanism that keeps you looking and feeling young. In order for autophagy to be activated, however, insulin levels need to be low. In my 15-day program, you’ll receive the most current science on how to eat and when to eat to regulate insulin and get your autophagy going. What I love about this program is that it’s not a quick, fad diet but a launch point into a way of living to keep you healthy for the rest of your life. Disease doesn’t happen overnight. It occurs as a reaction to the countless decisions we make regarding our diet and lifestyle day in and day out.
Likewise, insulin resistance does not happen overnight. In fact, it happens over many years largely due to a diet high in processed foods that are rich in simple carbohydrates and sugar. Other factors such as obesity, a sedentary lifestyle, chronic stress and a family history of diabetes, exposure to toxins in your environment, and rampant inflammation contribute to insulin resistance. Insulin resistance occurs after your pancreas has been pumping out loads of insulin over a long period of time to normalize blood glucose levels and eventually reaches a threshold where it can’t keep up with the demand. It’s at this point that your cells become resistant. Insulin knocks but nobody answers, and this deteriorates your health.
High insulin levels and insulin resistance are at the root of many chronic diseases in modern-day society such as heart disease, obesity, dementia, cancer, mood conditions and more. The problem is that most symptoms of insulin resistance such as increased inflammation, sugar and carb cravings, increased visceral (mid-section) fat, feeling fatigued after meals, high triglycerides and high blood pressure only become apparent once you’ve already reached a higher level of insulin resistance.
Testing your fasting insulin can give you the power to stop the process of insulin resistance in its tracks.
Request This Test
This is what to do: request a fasting insulin test from your doctor along with several other key labs. This will provide a valuable tool so you have a true snapshot of your metabolic health. Fasting insulin should be less than 5 uIU/mL, and later in this article, you’ll learn the ranges for insulin resistance, pre-diabetes and diabetes.
The thing is, most medical doctors are in the habit of measuring only fasting blood glucose, which in many cases can present as perfectly normal even if fasting insulin is high. If the result is normal, you are sent home thinking your health is in tip-top shape, when really you could be on your way to insulin resistance.
It’s actually quite common for glucose levels to be completely in range while insulin is quite high. Sadly, insulin resistance is almost always diagnosed way too late in the game, but this doesn’t have to be the case. If you have insulin resistance, that usually means your insulin levels have been high for a very long time. By testing fasting insulin, you have the opportunity to catch this disease before it progresses to something much more serious.
Other key markers that can give you important information as to how metabolically healthy you are include:
- post-prandial (post-meal) blood glucose
- hemoglobin A1c
- LDL to HDL cholesterol ratio
- LDL particle size
- vitamin D
- uric acid
- serum ferritin
- body fat percentage
- waist-to-hip ratio
Keeping a close eye on all of these potential red flags of insulin resistance developing is critical for health and disease prevention.
Why Do Doctor’s Miss Insulin Resistance?
The current standard-of-care testing doesn’t usually move outside the bounds of fasting glucose and maybe hemoglobin A1c, which are both important pieces of the puzzle but do not provide the complete picture. The A1c blood test looks at your average blood sugar levels for the past three months by measuring the percentage of red blood cells (hemoglobin) that are coated with sugar (glycated). While this test has its imperfections, it can be an important predictor of your potential risk for diabetes and other metabolic issues.
However, what is so misunderstood is that fasting glucose only starts to rise after long periods of the pancreas producing and releasing huge amounts of insulin. Each time the pancreas secretes insulin, it brings high blood sugars down in order to protect you from high blood sugar levels, which is very dangerous for health. Chronically elevated blood glucose levels can lead to an increased risk of heart disease and stroke, nerve and kidney damage, skin problems, decreased eye health and more. Thankfully insulin is very good at doing its job — it is constantly working in overdrive to lower elevated blood sugar levels and prevent these problems.
After a long period of time with elevated blood glucose, the pancreas can either slowly burn out its insulin production and/or your cells can become desensitized to insulin. Beta cells are pancreatic cells that hold the huge responsibility of producing and secreting insulin in response to blood sugar spikes. A long-term increased demand for insulin leaves the beta cells exhausted and leads to dysfunction. As the body becomes insulin resistant, blood sugars begin to rise since the cells are no longer sensitive to insulin and won’t allow sugar to enter. As the sugars get locked out, fasting glucose rises, and this is when your doctor likely sounds the alarm.
The tricky part is that there are often no obvious symptoms telling you that you are insulin resistant until it’s too late. Aside from insulin resistance showing up in blood work, other symptoms might be increased thirst and hunger, feeling tired and still hungry after meals or frequent infections. Paying attention to other signs of metabolic dysfunction that can present themselves earlier is important; such as constant cravings for carbs and sugars, fatigue, an inability to lose weight even with a healthy diet, excess body fat around the waist, abnormal cholesterol readings and increased blood pressure, among others.
Many people diagnosed with insulin resistance are actually at a perfectly normal, healthy weight, which makes it even more unlikely that a doctor will think to test fasting insulin levels. Believe it or not, you absolutely can be skinny on the outside but metabolically obese on the inside, and many experts call this skinny-fat syndrome or TOFI (thin-on-the-outside-fat-on-the-inside).
For many, this means you are thin but your body composition is more fat and less lean muscle, and much of your fat probably centers around the mid-section. Sadly, your doctor is less prone to run blood tests to uncover metabolic issues, and studies show that thin people who are diagnosed with diabetes actually have twice the likelihood of dying from the disease than overweight people. Adopting not only dietary strategies but also a combination of high-intensity interval training and resistance exercise training as I describe in Glow15 is essential to improving body composition and increasing insulin sensitivity. Just because you are thin on the outside does not mean that these key lifestyle components are not an absolute must.
If you are skinny but have excess fat around your abdomen, a family history of heart disease or diabetes, it’s important that you request the above-mentioned labs from your doctor, fasting insulin first and foremost. Particularly if you know your diet is high in sugar, refined carbohydrates and/or alcohol, don’t wait to take a look at what’s happening on the inside.
How to Avoid Insulin Resistance
Thankfully, there are some simple yet important steps you can start taking today to decrease your chances of developing insulin resistance. Glow15 is specifically targeted at lowering insulin levels to prevent chronic disease, slowing the aging process and feeling your best each and every day. Simply put, chronically elevated cortisol and insulin levels (remember these often go hand in hand) do not allow you to glow. Whether your fasting insulin came back normal or elevated, implementing the following strategies can keep you metabolically healthy for the rest of your life.
Dietary changes are foundational in improving insulin sensitivity. Glow15 teaches you how to easily avoid refined and simple carbohydrate foods that offer little to no nutritional value such as breads, pastas, commercial baked goods, muffins, cookies, cakes, etc. Refined sugars found in candy, sodas, fruit juices and other packaged foods are also detrimental in the development of insulin resistance. Instead, you’ll be focusing on moderate intake of complex carbohydrates such as starchy vegetables, low glycemic fruits, whole grains and legumes will provide more fiber and nutrient content, and timing matters too.
Centering your diet around healthy fats is a research-backed method to both avoid insulin resistance and turn your body into a fat-burning machine that does not rely on a constant stream of sugar (glucose) for fuel. Glow15’s revolutionary approach to becoming fat-adapted and metabolically flexible by eating fat first and carbs last is a real game-changer, and it’s so easy to implement. All it entails is saving your complex carbohydrates for your evening meal and allowing your body to spend more time earlier in the day burning fat for fuel and eating fat-based meals. It’s easy because you will feel incredibly satisfied.
Healthy fats to include every day such can be olive, coconut, avocado and tea seed oils, nuts and seeds, grass-fed butter and ghee, avocado and wild-caught, fatty fish. At the same time, avoid rancid and highly processed vegetable oils like canola, safflower, soy, and corn that contribute to systemic inflammation.
Excellent protein sources to enjoy might be grass-fed meats, pastured poultry and eggs, full-fat organic yogurt and other dairy sources if you tolerate them well. Another key practice of Glow15 is Intermittent Fasting Protein Cycling (IFPC), which is the powerful combination of fasting with alternating days of low and higher protein consumption. Lower protein intake actually works to lower insulin, and this has a see-saw effect that raises glucagon. Glucagon is a key hormone that activates your autophagy. This practice absolutely took my health to a level I never could have imagined, and I can’t wait for you to experience the same revolutionary shifts.
Of course, eating unlimited and abundant amounts of nutrient-dense, non-starchy vegetables every day will ensure your body’s micronutrient needs are being met, and that your microbiome is being fed and nourished.
In case you missed it…
Watch the interview with Dr. Mike Hoaglin from uBiome
and learn about your microbiome
Exercise can be a powerful tool in promoting healthy insulin levels, particularly high-intensity interval training (HIIT) and resistance strength training (RET). HIIT has been shown to improve all metrics of cardiometabolic health in women at risk for type 2 diabetes as it reduces insulin resistance and blood glucose. Similarly, studies have found that strength training also works to improve insulin sensitivity. My exercise program in Glow15 invites you to try my less-is-more approach to an effective, yet simple, combination of these two exercise modalities as an excellent strategy to increase insulin sensitivity and metabolic health.
Alongside these higher intensity forms of exercise, low-level aerobic activity plays a major role in improving insulin sensitivity. In fact, studies show that just one 15+ minute walk after a meal can greatly reduce both insulin and blood glucose levels.
To find out if your exercise routine is working in your favor to promote optimal health and insulin sensitivity, check out my article here.
Though I am a firm believer that not even the best of supplement protocols can replace a healthy whole foods diet, it certainly can help to fill in some detrimental (and sometimes unavoidable) nutritional gaps. When it comes to insulin, certain key supplements can help to make your body more sensitive to its effects, not to mention improve your body’s ability to metabolize both fat and sugar as fuel.
My top supplement recommendations for increasing insulin sensitivity are one of Glow15’s foundations for lowering insulin levels and filling in those nutritional gaps. Powerphenols are the most potent of polyphenols, which are naturally occurring plant compounds that have the ability to increase brain health, support smooth skin, balance blood sugar, control cholesterol and increase insulin sensitivity, among other benefits. Powerphenols include EGCG, found in green tea, curcumin, berberine and resveratrol. Berberine is especially effective at managing blood sugar levels and improving insulin sensitivity, and metabolic experts compare its effects to regular exercise.
Two other important supplements to consider for supporting healthy insulin levels are a high-quality multivitamin and mineral along with one to two grams per day of Omega Fish Oil.
Lifestyle factors are equally as important as exercise and diet, if not even more so, in some cases. The main factor I’m referring to is stress, which can truly undermine the healthiest of diet, exercise and supplement plans.
Cortisol is the body’s primary stress hormone and is released when the body senses danger and goes into “fight or flight” mode. While this is perfectly natural and necessary for human survival, chronically elevated cortisol levels due to ongoing stressors can create serious metabolic dysfunction. One of cortisol’s jobs is to thwart insulin effects so that your body can divert its resources toward other tasks, and the continuous combination of high blood glucose levels with suppression of insulin is a fast track to insulin resistance.
For this reason, practices such as meditation, deep breathing, restorative yoga, gentle walking, journaling and any other self-care routine that brings you peace is vital for your mental, emotional and physical well-being. Calming herbal teas such as chamomile or adaptogenic herbs that support hormonal balance such as licorice can also be incredibly beneficial.
My mission is for you to be empowered, and knowing the importance of checking your fasting insulin is a step you can take that provides pertinent information and is key in disease prevention. You deserve to be the healthiest you possible, so do not hesitate to demand this important lab!