Insulin Resistance and Weight Management: Educate for Empowerment

Written by: Mason M. New III

Maintaining a healthy weight can be a challenging journey, but making lifestyle changes can not only help prevent the onset of insulin resistance or diabetes but also enable us to adopt a lasting approach to healthier eating.

In 2003, a study using data from the National Health and Nutrition Examination Survey (NHANES) revealed that approximately 22% of American adults over 20 years old were impacted by insulin resistance. A more recent examination of NHANES data from 2021 indicated that 40% of adults in the United States between the ages of 18 and 44 exhibit insulin resistance as determined by Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) measurements [1]. A long-term side effect of insulin resistance is what we all struggle to maintain, whether insulin-sensitive or not; weight gain.

What is Insulin Resistance?

Insulin resistance is characterized by the reduced biological reaction of target tissues to insulin stimulation. While all tissues with insulin receptors can develop insulin resistance, the key tissues responsible for driving this condition are the liver, skeletal muscle, and adipose tissue. Insulin resistance hinders glucose disposal, leading to a compensatory rise in beta-cell insulin secretion and hyperinsulinemia [1].

The pancreatic Beta-cell secretes insulin, playing a vital role in regulating glucose levels by being the sole hormone capable of lowering blood glucose levels [2].

As we consume food, it gets converted into glucose to serve as an energy source. This glucose then enters the bloodstream, prompting the pancreas to release insulin. Excessive conversion of glucose leads to the pancreas secreting an excess amount of insulin, which can desensitize the beta cells and disrupt the body's ability to regulate blood sugar levels.

This ongoing fluctuation creates side effects, other than blood sugar spikes, that increase weight, extreme hunger, thirst, fatigue, and difficulties losing weight.

Signs of insulin resistance

• High blood sugar levels

• High blood pressure

• High blood levels of triglycerides (a type of fat)

• High LDL (bad cholesterol)

• Low HDL (good cholesterol)

Symptoms of insulin resistance

Symptoms of insulin resistance are associated with high blood glucose levels and include:

• Increased thirst

• Frequent urination

• Increased hunger

• Blurred vision

• Headaches

• Vaginal and skin infections

• Slow healing cuts and sores

Insulin Resistance and Weight Gain

Insulin action can be influenced by various factors, including physical activity. Individuals leading a sedentary lifestyle are at a higher risk of insulin resistance and have an increased likelihood of developing type 2 diabetes compared to those who are physically active.

Excessive body fat, especially around the waist, and a lack of physical activity are the primary causes of insulin resistance. Furthermore, a diet rich in processed carbohydrates and saturated fats contributes to this condition. In addition, insulin resistance can be influenced by specific medications and genetic factors. Adopting low-carb diets that prioritize healthy sources of carbohydrates, fats, and proteins may help decrease insulin resistance.

Using insulin allows sugar to enter your cells, thus lowering the sugar levels in your blood, which is the objective of the treatment. Consuming more calories than needed can result in your cells getting an excess of sugar, even in non-diabetic individuals. The necessary calorie intake depends on your level of physical activity. Any extra sugar in your cells that remains unused will be stored as fat.

To avoid gaining weight, it is beneficial to consume nutritious foods and engage in regular physical activity. The suggestions below can assist in maintaining a healthy weight:

• Count calories/ macronutrients. To prevent weight gain, it is beneficial to consume fewer calories through your diet. Make sure to stock your refrigerator and pantry with fruits, vegetables, and whole grains. Aim to include a balanced mix of starches, fruits, vegetables, proteins, and fats in each meal. Typically, a recommended meal would include half non-starchy vegetables, one-quarter protein, and one-quarter starch like rice or a starchy vegetable such as corn or peas.

  • Reduce the sizes of your servings, avoid going for seconds, and opt for water over high-calorie beverages. Consult with your healthcare provider, nurse, dietitian, or nutritionist for guidance on meal planning and accessing resources.

• Don't skip meals. Avoid attempting to reduce calorie intake by skipping meals. Skipping a meal may lead to making poor dietary decisions during the next meal due to increased hunger. Additionally, skipping meals can result in low blood sugar levels if insulin dosage is not adjusted accordingly.

• Stay active. Calories are burned through physical activity. Most adults are advised to aim for a minimum of 150 minutes per week (or 30 minutes for five days) of moderately intense aerobic exercise, coupled with muscle-strengthening routines at least twice weekly. Examples of aerobic activities are walking, cycling, water aerobics, dancing, or gardening. Consult your healthcare provider to determine the most suitable activities and exercises for your needs.

  • Additionally, inquire with your provider about managing physical activity. Engaging in exercise can enhance your body's insulin utilization. Depending on the intensity of your workout, you may need to adjust your insulin intake or consume a snack. It is important to note that your blood sugar levels could drop several hours post-exercise.

• Ask your provider about other diabetes medicines. Certain medications used to control blood sugar levels in diabetes may also aid in weight loss and reduce the need for insulin.

  • These medications include metformin (Fortamet, Glumetza, among others), exenatide (Byetta), liraglutide (Victoza, Saxenda), dulaglutide (Trulicity), sitagliptin (Januvia), saxagliptin (Onglyza), canagliflozin (Invokana), dapagliflozin (Farxiga), empagliflozin (Jardiance), and pramlintide (Symlin). Consult your healthcare provider to determine if incorporating these or other medications into your diabetes management plan is appropriate.

• Take your insulin only as directed. Avoid skipping or decreasing your insulin doses in an attempt to prevent weight gain. While reducing your insulin intake may lead to weight loss, the consequences can be severe. Insufficient insulin levels can result in elevated blood sugar levels, increasing your susceptibility to complications associated with diabetes.

Insulin Resistance and Eating Healthy

Altering dietary habits may pose the greatest challenge in self-managing diabetes, yet it can significantly aid in controlling blood sugar levels [3].

Ensuring a balance in the foods you consume is crucial for maintaining healthy blood sugar levels, in addition to taking prescribed medication and engaging in physical activity

• Eat a variety of foods. Select foods from all food groups daily and be open to experimenting with new foods.

• Make half your plate fruits and vegetables. Fruits are rich in dietary fiber, vitamins, and minerals, offering a satisfying sweet treat. Increase your intake of non-starchy vegetables like leafy greens, asparagus, carrots, and broccoli daily. Opt for whole fruits over fruit juice more frequently.

• Choose whole grains. Ensure that a minimum of fifty percent of your daily grain intake consists of whole-grain foods that are rich in dietary fiber. Whole-grain cereals, bulgur, barley, and oats are excellent sources of fiber.

• Focus on unsaturated fats. Reduce intake of saturated fat and choose unsaturated fat sources when preparing meals. Opt for lean meats, poultry, and fish. Use baking, broiling, roasting, grilling, boiling, or steaming methods instead of frying. Select low-fat or fat-free dairy options. Try meatless dishes by replacing meat with lentils or tofu.
  

• Cut the salt. Cut down on your salt intake and experiment with pepper, herbs, and other seasonings as alternatives. Consuming less salt aids in managing high blood pressure.
  

• Focus on your food. Choose a specific spot to sit and enjoy your meal at home. Eating while multitasking can result in consuming more food than you realize.

• Watch portions. There is no need to eliminate foods high in carbohydrates, but it is crucial to consume them in a well-balanced manner throughout the day. Be sure to check food labels, monitor portion sizes, and be mindful of the carbohydrate content.

Diabetes is a long-lasting illness that results in many fatalities and puts a significant strain on healthcare systems across the globe. The World Health Organization (WHO) highlights that with the current worldwide diabetes prevalence rate among adults exceeding 8.5% now [4], nutrition coaches help prioritize the prevention, treatment, and regulation of diabetes risk factors.

Coaches Corner

There is a misconception that traditional African American cuisine lacks nutrition, but this idea is far from accurate. Exploring the history of food can empower us to reshape the conversation around nutrition and well-being.

During my childhood, our family connected through soul food during special occasions like holidays, birthdays, family reunions, and gatherings. Each of us has cherished memories of grandma's best desserts - for me, it was lemon bars - and how our uncles excelled at grilling. As I matured and took on cooking duties for the family, I stuck to recipes passed down through generations. When my blood pressure began to rise, I decided to adopt healthier eating habits by educating myself on the necessary changes.

Traditional African American cuisine, like soul food, commonly features leafy greens, vegetables, and complex carbohydrates. These dishes may aid in blood sugar control and lower the chances of diabetes-related complications. However, the conventional preparation methods of soul food dishes often involve unhealthy practices such as deep frying and the use of animal fats. This results in meals that are rich in fats, salt, and carbohydrates, potentially elevating the risk of diabetes.

Changing one's diet to align with recommended guidelines may be challenging when it clashes with individual food preferences and the cultural significance attached to certain foods. Nonetheless, adapting traditional recipes to suit commonly consumed foods can help in compliance with dietary recommendations.

Minority communities face obstacles in accessing healthy resources that can help reduce the likelihood of chronic diseases such as insulin resistance and diabetes. Our communities are filled with fast food establishments serving high amounts of saturated fat and processed foods. The scarcity of quality produce further contributes to health barriers. Education plays a crucial role in addressing the risks linked to inadequate resources and chronic diseases. When we know how to improve, we should try to improve. Let us help our community, our homes, and our health by learning how and teaching others.

References

1. Freeman, A. M., Acevedo, L. A., & Pennings, N. (2023). Insulin Resistance. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK507839/#:~:text=A%20more%20recent%20analysis%20of

2. Rorsman, P., & Ashcroft, F. M. (2018). Pancreatic β-Cell Electrical Activity and Insulin Secretion: Of Mice and Men. Physiological Reviews, 98(1), 117–214. https://doi.org/10.1152/physrev.00008.2017

3. Ellis, E. (2021, November 11). Healthful Eating with Diabetes. Www.eatright.org. https://www.eatright.org/health/health-conditions/diabetes/healthful-eating-with-diabetes

4. Lin, C.-L., Huang, L.-C., Chang, Y.-T., Chen, R.-Y., & Yang, S.-H. (2021). Effectiveness of Health Coaching in Diabetes Control and Lifestyle Improvement: A Randomized-Controlled Trial. Nutrients, 13(11), 3878. https://doi.org/10.3390/nu13113878