Sally had been a slim 58-60kg through her 20’s and 30’s. Ten years later, in her mid-40’s and after the birth of 3 children, juggling a demanding job as a marketing consultant and despite regular trips to the gym and following a healthy, low fat diet the scales were tipping 75kg. No diet or exercise program seemed to be able to help Sally lose weight. In fact, the more Sally exercised the more she seemed to weigh. Sally was tired, constantly bloated and craving sugar – a classic presentation of a client with insulin resistance.
Insulin resistance (IR) is a clinical condition in which insulin, the hormone secreted by the pancreas to control blood glucose levels in the body is no longer working as efficiently as it should. Over time, numerous factors including a diet high in processed carbohydrates, a relatively inactive lifestyle and often genetics insulin becomes less and less efficient at processing the glucose we consume in carbohydrate based foods such as bread, cereals, fruit and sugars. When insulin is not working properly, the body is forced to produce more and more insulin to process the same amount of glucose that we consume in food to fuel the muscles and the brain. The unfortunate thing when it comes to weight control is that the higher the amount of insulin that you have circulating in the body, the harder it becomes to burn body fat. This means that if you have insulin resistance, you can be eating an extremely healthy diet, exercising as recommended and actually physically unable to lose weight. In fact, as insulin is the central regulator of both glucose and fat metabolism in the body, when it is not working, the basic energy balance equation when it comes to weight loss, calories in versus calories out simply does not hold true.
Enter the situation Sally faces – getting older, the hormonal fluctuations associated with pregnancy and moving closer to menopause, an inactive job, along with a high carbohydrate, low fat diet all combining to result in 10-20kg weight gain over 10-20 years. Left unmanaged, insulin resistance will ultimately lead to Type 2 diabetes. The good news is that if diagnosed early, insulin resistance can not only be managed but even reversed with the right mix of diet, training and movement.
The body may show signs of insulin resistance in a number of ways. As resistance builds up over many months if not years, these signs and symptoms can be subtle before become more noticeable over time. Fatigue is common as glucose is not being taken to the cells as efficiently as it should be. Sugar cravings are too common, as insulin and glucose levels fluctuate widely during the day. Perhaps the most powerful sign that a degree of insulin resistance may be present is in the way that fat is deposited on the body. Insulin likes to deposit fat around the abdominal area, which is why women (and men) with severe insulin resistance have a large belly, and the reason that a waist measurement greater than 80cm for a female too may be a sign that insulin resistance is present.
From a lifestyle perspective, the irony of IR that the standard low fat, high carbohydrate diet filled with wholegrains, fruit and low fat snacks may actually exacerbate insulin resistance and may even act to prevent weight loss. While a high carb diet is ‘healthy’, highly processed carbohydrate rich foods result in a relatively high release of insulin. The more insulin we have circulating at any one time, the less likely it is we will burn body fat. For this reason, those with IR require a high protein, moderate carbohydrate diet which eliminates as much processed carbohydrate from the diet as possible. This does not mean eliminating all carbs, rather working to combine both small amounts of carbohydrates with protein rich foods such as eggs, fish, meat, dairy or nuts at each meal and snack. This ensures that the body has small amounts of carbohydrate at any one time, which in turn helps to regulate the release of insulin, while the proteins help to, keep you full and provide essential nutrients including the good fats, calcium and iron.
Sample High Carb Diet / Sample IR Diet
Breakfast: Cereal + milk / Egg on wholegrain toast
Morning Tea: Fruit / Cheese and crackers
Lunch: Ham sandwich / Tuna on crisp bread
Afternoon Tea: Low fat muesli bar / Nut bar
Dinner: Tuna pasta / Tuna steak and salad
Dessert: Yoghurt + fruit / 20g dark chocolate
If you are experiencing any of the symptoms of IR and find that you are constantly struggling with your weight, the best thing you can do is visit your GP or endocrinologist and have a glucose tolerance test to identify if IR is present. IR is a clinical condition and does need to be managed accordingly, with good dietary and exercise advice. Once though you do have IR under control not only are your likely to prevent getting diabetes, but you are also likely to be able to get your weight under control, and nothing is more empowering than that.
To read more about IR, buy my eBook ‘Is Insulin Resistance Making You Fat?’ here. To get your own personalised IR weight loss plan with over 400 recipes to cater for insulin resistance, try my online program, Shape Me, the day plan now.