Sensible-Alternative Naturopathic Clinic

A problem with insulin could be preventing your from losing weight.

Insulin resistance is a common problem and causes obesity, heart disease, Polycystic Ovarian Syndrome and rapid ageing. It also increases the risk for cancer,  Alzheimer's disease and osteoporosis.

How could one little hormone do all that?

What is Insulin?

Insulin is an ancient, anabolic hormone, which is found in all forms of animal life.

Insulin's main function is to stimulate the cell to store nutrients. This was important in the days when starvation was a real possibility for our ancestors. In our modern era of abundant food, "nutrient storage" is not something that we want to promote in our bodies.

Hormone of Ageing

Insulin does more than store nutrition. It has been shown to limit the lifespan of cells. In other words, it is the chemical signal that determines when a cell has lived long enough and it's time to die. In this way, insulin can be thought of as the hormone that promotes ageing. Certainly in humans, excess insulin accelerates the rate of ageing.

Insulin sounds bad, and yes, in excess it is harmful, but do not forget that it is essential for life. Without insulin, our cells cannot use food for energy. Before the invention of injectable insulin, diabetes was a life-threatening disease.

What is Insulin Resistance?

Under normal circumstances, insulin is tightly controlled by a natural homoeostatic feedback mechanism. With every meal, insulin is released as carbohydrates enter the blood stream. In a healthy body, the insulin receptors in the cell membranes respond to the hormone, and take up carbohydrates and other nutrients. This, in turn, reduces the production of insulin.

The problem starts when the tissue fails to respond to insulin. When this happens, the sugar in the blood remains high despite the presence of insulin, and the body has no choice but to release more insulin. It becomes a vicious cycle because it is actually the presence of insulin that makes the tissue more and more resistant to it.

This is how insulin exposure determines the rate of ageing: with every insulin release, cell membranes become a little bit more insulin resistant. A gradual increase in insulin concentration over time is normal, but the current epidemic of severe insulin resistance is a modern phenomenon.

When your body becomes resistant to insulin, it cannot metabolise carbohydrates properly. Untreated, this leads to Type 2 diabetes, which affects 1 in 200 Australians.

Decades before it becomes diabetes, however, Insulin Resistance can cause real problems. As the master hormone, it's presence in excess can lead to many different conditions such as:

• high cholesterol
• high blood pressure
• heart disease

• Alzheimer's Disease ⁽³⁾
• Polycystic Ovarian Syndrome
• breast cancer ⁽⁴⁾
• prostate cancer ⁽⁵⁾
• Under-active thyroid
• premature ageing
• low libido in women
• osteoporosis
• acne
• hot flushes

As many as 25% of Australians may suffer from this underlying problem of insulin resistance. Many are not aware that they have it.

It may be the single metabolic issue that is manifesting as a variety of different conditions such as cholesterol, blood pressure, thyroid disease, acne etc. You may take many different medications for all of those manifestations, but they are only band-aids. For example, cholesterol- lowering medication does not address the underlying insulin problem that is causing the high cholesterol in the first place.

The Insulin Resistance needs to be addressed.

What Causes Insulin Resistance?

• Pollution: A study published in Diabetes Care has found that people who have the highest level of stored toxins were 38 times more likely to have diabetes than people with a lower level of stored toxins. Even if they were overweight, people with low level of toxins did not develop diabetes.  An editorial about the study published in the Lancet made the following statement: 'This finding might imply that virtually all the risk of diabetes conferred by obesity is attributable to persistent organic pollutants, and that obesity is only a vehicle for such chemicals. This possibility is shocking'. ^(6,7) (In other words, obesity causes diabetes simply because it a vehicle for toxins.)
• Herbicides: Rats exposed to low doses of the common herbicide Atrazine gained 10% more abdominal weight over 5 months than non-exposed animals. The cells of the exposed rats were found to contain damaged mitochondria, which prevents normal cell response to insulin. Blood tests showed significantly higher blood sugar and insulin levels. ⁽⁸⁾
• Smoking: Toxins in cigarette smoke damage the insulin receptor, and cause distinctive weight gain around the waist. ⁽⁹⁾ No more smoking to stay thin!
• Inflammation: New research from the University of Maryland has correlated inflammatory products in the blood with insulin resistance. This means that inflammation caused by infection, stress and pollution may be a direct contributor to insulin resistance and its outcomes: obesity, diabetes and heart disease. ⁽¹⁰⁾
• Excessive carbohydrates (sugar and flour): Carbohydrate intake compared to protein has increased dramatically in the last century. Since the onset of large-scale flour refinement in the 1890's, the average person consumes more fibre-free carbohydrate in a week than a nineteenth century person did in a year!
• Fructose: Studies have shown that fructose is a particularly harmful type of carbohydrate. It inactivates the insulin receptor, and it interferes with the way the brain responds to leptin (the anti-hunger hormone). ⁽¹¹⁾ The result is constant hunger, and a progression towards insulin resistance and fatty liver. Fructose is in modern sweeteners such as high-fructose corn syrup and sucrose (table sugar). It is in prepared foods like fizzy drinks and baked goods, and even so-called healthy foods like yoghurt and muesli bars. Whole pieces of fruit do contain fructose, but it is balanced by healthy fibre, so fruit is ok to eat in moderation. Care should be taken with dried fruit and fruit juice.
• Thrifty Gene: Carbohydrates are not healthy for anyone, but some people are very sensitive to carbohydrates. About 25% of people are genetically predisposed to a heightened insulin response. They have inherited a 'thrifty gene', which allowed their ancestors to survive famine, but which now makes them gain fat very easily!
• Trans Fat: Trans fats are damaged polyunsaturated fatty acids, found in processed vegetable oil such as margarine, deep-fried food, or commercially prepared oil. Conventionally touted as the healthy oils, these Frankenstein molecules have become a large part of the modern diet. They are damaged, distorted molecules, and when they are incorporated into the cell membrane, then interfere with the functioning of the insulin and other receptors.
• Vitamin D deficiency has been linked with Insulin Resistance.
• Lack of exercise

Diagnosis of Insulin Resistance

The most characteristics symptoms of insulin resistance are apple shaped obesity with high cholesterol and high blood pressure. There is usually a family history of heart disease and/ or diabetes, and a strong craving for bread.

Measure your waist. Research has found a waist measure to be as reliable as blood test for predicting insulin resistance. At the navel, men should be less than 100cm. Women should be less than 90cm.  For other symptoms, see Insulin Resistance Quiz.

Insulin resistance is detectable with a blood test. The definitive pathology test for insulin resistance is the Glucose Tolerance Test (GTT) with insulin. One hour after the glucose load, normal insulin should be less than 60mU/L. Other useful tests include fasting insulin, fasting glucose, liver function test, lipid profile, C-RP, thyroid function and serum vitamin D.

Natural Treatment for Insulin Resistance

The good news is that insulin resistance is reversible with diet and lifestyle.

• Detoxify. Help your body to remove stored residues of pollutants, cigarette smoke and herbicides.
• Intermittent fasting. Research from the Institute on Aging has shown that intermittent fasting improves insulin sensitivity. When participants skipped the evening meal, their fasting insulin improved, and they had fewer inflammatory markers on blood tests. ⁽¹²⁾ How to do it: Always have a large breakfast and lunch. (As you become healthier, you will find that you regain an appetite for breakfast.) Then 1 to 3 nights per week, you must skip dinner, or replace dinner with a protein smoothie. They should not be consecutive nights.
  
• Reduce carbohydrates, especially fructose sweeteners. During the first couple of months of treatment, carbohydrate intake should be less than 50 grams per day. With a diet of meat and salad vegetables, this is not difficult. An average serving of broccoli, for example, contains only 13 grams of carbohydrate. Compare this to a serving of pasta, which contains over 40 grams of carbohydrate, or to refined sugar, the worst carbohydrate. A small can of soft drink contains at least 40 grams of carbohydrate. If you are addicted to a sweet taste, you can try the herbal sweetener Stevia, which has the added benefit of improving insulin sensitivity.
• Eliminate refined sugar from your diet. Sugar is the worst kind of carbohydrate.
• Eat protein regularly. Protein curbs the release of insulin and stimulates the production of the hormone glucagon, which opposes insulin. (Do not increase protein if you have kidney problems, and do not exceed 90-100 grams of protein per day.) Good sources include: 2 eggs (12 grams protein), 1 chicken breast (25 grams protein), 2 lamb chops (29 grams protein), 25 grams whey protein (23 grams protein).
• Avoid Trans fat. Eliminate soy oil, corn oil, cottonseed oil or any generic "vegetable oil". Particularly bad are margarine, vegetable oil spreads and deep-fried food. Eat only naturally occurring fats such as butter, avocado, olive oil, coconut milk, meat, fish, and nuts and seeds. It can take up to 6 months to give your cell membranes an "oil change".
• Exercise. Strength training dramatically improves insulin sensitivity. When the muscles increase their energy expenditure, they re-learn how to use carbohydrates rather than store them. Weight loss occurs not simply because of the calories burned, but because of a shift in metabolism. Exercise is also effective to relieve stress, a common cause of inflammation and insulin resistance.
• Avoid Wheat. Gluten generates inflammation and disrupts the insulin receptor, thereby worsening insulin resistance. ⁽¹³⁾ Avoid flour-containing bread, pasta, cereal, and biscuits. If you do have flour, choose flour made from rice, oats, barley, spelt, and rye. Ordinary "flour" is wheat.
• Mediterranean diet. Newly diagnosed diabetics can reduce their need for medication by following the Mediterranean diet. Only 44% of patients on a Mediterranean diet required sugar lowering medication compared to 70% of patients who followed a standard low fat diet.⁽¹⁴⁾ See Mediterranean diet with menu.
• Nutritional supplements and herbs. Chromium, magnesium, selenium and omega 3 fatty acids will improve insulin's effectiveness at the cell membrane. B-vitamins and amino acids assist the liver to remove pollutants. Antioxidants such as vitamin C and vitamin E will act as natural anti-inflammatories. Gymnema and Bitter Melon have been documented to improve insulin sensitivity. Vitamin D should be supplemented once a deficiency has been determined on blood test.

For more information on weight loss, click here.

Appointments at Sensible-Alternative Clinic

For professional advice regarding insulin resistance, please call to make an appointment...

Sensible-Alternative Hormone Clinic
Suite 1 Berry Rd Medical Centre
1A Berry Rd, St Leonards NSW
phone: 02 9438 3448

For email, please visit our contact page.

References:

1. Eaton SB, et al. An evolutionary perspective enhances understanding of human nutritional requirements. Journal of Nutrition 1996:126:1732-1740.
2. Ron Rosedale. Insulin and its Metabolic Effects. 1999. Designs for Health Institute.
3. De Felice et al. Protection of synapses against Alzheimer's-linked toxins: Insulin signaling prevents the pathogenic binding of A%u03B2 oligomers. PNAS, 2009; DOI: 10.1073/pnas.0809158106
4. DelGiudice, ME et al. Insulin and Related Factors in Premenopausal Breast Cancer Risk. Breast Cancer Res Treat 47
5. Wolk A. et al. Insulin-like growth factor 1 and prostate cancer risk: a population-based, case-control study. J Natl Cancer Inst. 1998 Jun 17;90(12):911-5
6. Lee, DH et al. A strong dose-response relation between serum concentration of persistent organic pollutants and diabetes: Results from the National Health and Examination Survey 1999-2002. Diabetes Care. 2006: 29: 1638-1644.
7. Porta, M. Persistent organics pollutants and the burden of diabetes. Lancet. 2006: 368: 558-559.
8. Lim S et al. Chronic Exposure to the Herbicide, Atrazine, Causes Mitochondrial Dysfunction and Insulin Resistance. PloS One. 2009; 4(4): e5186
9. Weitzman M et al. Tobacco Smoke Exposure Is Associated With the Metabolic Syndrome in Adolescents Circulation 2005 :S1524-4539
10. Ryan, A. Inflammation linked to postmenopausal glucose metabolism. Diabetes Care 2004; 27: 1699-705
11. Elliot, SS et al. Fructose, weight gain, and the insulin resistance syndrome1,2,3. American Journal of Clinical Nutrition 2002 76(5): 911-922
12. Mattson, MP et al. Beneficial effects of intermittent fasting and caloric restriction on the cardiovascular and cerebrovascular systems. The Journal of Nutritional Biochemistry 2005. 16(3): 129-137
13. Yevdokimova, N. and Andrej Yefimov. Effects of wheat germ agglutin and concanavalin A on the accumulation of glycosaminoglycans in pericelluar matrix of human dermal fibroblasts. A comparison with insulin. Acta Biochemica Polonica 2001, 48(2):563-572
14. Esposito, K et al. Effects of a Mediterranean-style diet on the need for antihyperglycemic drug therapy in patients with newly diagnosed tyep 2 diabetes: a randomized trial. Ann Intern Med. 2009; 151(5): 306-314.