Metabolic dysregulation is perhaps one of the biggest reasons why I see people struggling to lose weight.
Metabolic dysregulation is marked by insulin resistance (impaired glucose handling) dyslipidemia (abnormal blood lipids) and inflammation.
(My preferred tests for identifying these conditions are a glucose tolerance test, a lipid panel, and homocysteine.)
Metabolic dysregulation is often a byproduct of the standard American diet, high in refined carbohydrates and sugar while low in nutrient density and fiber.
However metabolic dysregulation, leading to an inability to lose weight are also commonly found in those with any endocrine disorder such as low sex hormones, low adrenal or low thyroid function, chronic infections, sleep disorders, and autoimmunity.
Addressing metabolic flexibility and subsequently insulin resistance is a profoundly useful tool for reversing chronic disease and weight loss.
Nerdy aside: Did you know that glucose metabolism directly influences our immune system’s function? The B cells can grow dysfunctional with insulin resistance and result in chronic immune activation, inflammation and inability to lose weight.
As a result of a diet high in carbohydrates, continued exposure all day long to “sugar” and or a decrease in insulin sensitivity the body will lose its ability to use stored fat as fuel, this is known as losing metabolic flexibility.
Blood Sugar’s Role in Insulin Resistance
Blood sugar or glucose is the sugar we carry in the bloodstream to supply energy to our cells.
The body naturally attempts to keep the blood sugar within a tight range by releasing insulin to bind the sugar so it may be utilized as fuel and to prevent damage to the body.
If the blood sugar is chronically elevated due to excessive consumption of carbohydrates or even protein it will first lead to an elevation in insulin production and much later on the pancreas loses its ability to produce adequate insulin, insulin resistance, aka type 2 diabetes.
Blood sugar monitoring measures the amount of sugar being transported in the blood at that single instant, so it’s a great way to see how the body responds to the ingestion of a food.
Generally when we have our blood sugar tested in the lab we are collected a fasted blood sugar, so it’s the very best we can expect it to ever look on paper!
The problem with just testing blood sugar when fasting, is it tells us nothing about how your body responds to food, and if you are able to produce enough insulin to bind the “sugars” in the blood and keep the blood glucose relatively level.
The problem with only testing the fasting blood sugar or at best this and a HgA1C (this is like the receipt for how your body has been handling sugar for the last 3 months) is we are missing millions of Americans who have dysglycemia, a dysregulation of blood sugar throughout the day.
We now know that dysglycemia is the 1st step toward insulin resistance, and diabetes.
Dysglycemia is any gap in your blood sugar reading whether it prior to or after eating greater than 20 points.
Dysglycemia or poor glucose handling, can be evident with a glucose challenge test or insulin test a good decade or longer prior to developing prediabetes or diabetes.
I don’t know about you, but I want to intervene well before my pancreas has lost function.
Steps to take to increase insulin sensitivity and decrease metabolic syndrome
Monitor your blood sugar
Ultimately my goal for everyone who works with me is to learn to eat intuitively and have a healthy relationship with food free of cravings and negative associations with food, however sometimes when we are ill our body reacts to the foods we love.
In these situations we sometimes need to follow a special diet for a period of time. One such type of common sensitivity is to simple sugars and carbohydrates.
This sensitivity may be to specific carbohydrates such as wheat, an overgrowth of bacteria or yeast who feed on these carbohydrates, or it may be due to decreased pancreatic function.
The major functions of the pancreas are to 1. produce digestive enzymes to break down the carbohydrates, fat, and protein we eat and to produce insulin to fuel our bodies with energy. When the pancreas is chronically overworked as evidenced by an inability of the pancreas to produce adequate insulin for the load of carbohydrates that was eaten, this is insulin resistance.
When one eats carbohydrates and protein the pancreas releases insulin to bind to the glucose created by the digestion of these food items and it can not keep up, this excess glucose in the bloodstream causes an inflammatory response in the body.
At first the excess sugar is pushed into storage in the liver and muscle tissues as glycogen. However once these stores are full the body has to get clever! The body will move the excess sugar into muscle and joint spaces, which creates an inflammatory response and pain. The body also creates fatty deposits from this sugar excess, this may be seen as excess body fat, non-alcoholic fatty liver, and on blood tests an elevation in triglycerides, LDL cholesterol, or total cholesterol..
When the body is inflamed from chronic exposure to excess sugar it will inform the body it’s not a good time to let go of excess weight by activating the immune system to fight this foreign invader, excess sugar!
When this is the case, it can be very helpful to learn to count macronutrients and find the amount your body is able to process while your pancreas heals and recovers the ability to produce insulin in response to the presence of carbohydrates in the digestive system.
The macronutrient apps I use with patients include my net diary, my fitness pal and carbmanager.
For even more precise monitoring I suggest investing in a glucose monitor and tracking pre and post prandial blood sugars (before you eat and at 1 and 2 hours after eating.) The ideal glucose range is typically between 80 under 100, however if you are eating a ketogenic diet you may find your numbers are healthy and you feel great as low as 60.
*I have an affiliate link to save 15% on your kit if you’re interested in the glucose & ketone monitor I use personally: http://bit.ly/2Io5F1z
Monitor protein intake
When protein is digested it forms amino acids once oxidized (with glutamate dehydrogenase) produces energy, ATP which triggers insulin secretion.
So, if you are over-consuming protein, it’s actually still possible to be thwarting your efforts to reduce insulin resistance/reverse diabetes even when you’ve gone carnivore low carb or keto.
When one has impaired blood sugar handling the body has a hard to pairing the release of glucagon with insulin in the presence of digested protein, aka amino acids.
This impaired insulin response can cause our blood sugar to rise precipitously several hours after a meal high in protein (without carbohydrates)! I know, you’re thinking WHAT the H!!
So, if you’ve gone carnivore, low carb or keto and are not seeing improvements in your blood sugar numbers this may be the cause.
For optimizing protein utilization and preventing insulin release consider limiting protein intake to 0.8g/kg of body weight for a period of time and see if your blood sugar numbers begin to regulate.
All resistance training can be beneficial for increasing insulin sensitivity, however research suggests insulin resistance is first evident in the lower extremities, so to get the best “bang for your buck” resistance train those legs! It could be as simple as squats and lunges with body weight.
Intermittent Fasting and extended fasting
Even simply elongating your overnight fast to 12+ hours daily may over the course of months provides a regular “time-out” for the digestive system, thus allow digestion to heal and digestive function, ie pancreatic enzymes and insulin secretion but improve. Greater improvements in less time, when healthy enough to do so may provide greater results in less time. 3 day water fasts, and fasting mimicking diets for 5 days at a time have been shown to produce pancreatic stem cell production for instance.
The supplements identified to support glucose metabolism include Berberine HCl, chromium dinicocysteinate, alpha lipoic acid, trans-resveratrol, reduced iso-alpha acids and acacia nilotica and heartwood extract, cinnamon, American ginseng, and magnesium. Warning* these products can have a profound impact on lowering your blood glucose, do not use these without the guidance of your clinician.
Get 7.5 hours of quality sleep per night. The brain and the body upregulate processes to clean up inflammation and heal while we sleep. It is also when key hormones are produced like growth hormone that helps regulate the hormones related to muscle growth and maintenance as well as metabolic, such as thyroid hormone as well as the satiety hormone, leptin.
If you are interested in a free, no obligation 15 minute transformational health consultation to talk more about the role of insulin sensitivity in your body, please schedule HERE.
* Please be safe! Before implementing any dietary changes, please seek the guidance of your medical professional. The content here is intended for educational purposes only.