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Insulin is the key hormone in fat storage. In previous post we have talked about leptin, the thermostat switch of the body. Read my post on leptin – the fat burning switch to know more. Now is the time to think about the key player of the game,the hormone insulin.
Anyway remember one point. Leptin and insulin resistance are related. But the response to carbs are different. In insulin, the hormonal response may be from minutes to hours but it may take hours to days in case of leptin.
Beta cells of pancreas secrete the hormone insulin. But when? It occurs primarily in response to increased glucose levels in the body. This may come from digestion and absorption of carbs and even from protein. The complex mechanisms of those pathways are beyond scope of this post.
Insulin is the true anabolic or building hormone of the body. This comes in picture whenever there is energy excess by intake over burning. Its effects are countered by glucagon, epinephrine, cortisol etc., they all have role in catabolism or breakdown.
Yes, they do. Remember how bodybuilders have used it’s powerful anabolic property to their advantage. Having complex carbs before exercise and simple carbs after exercise is the way to go for them and even for insulin sensitive gym buddies. The high insulin level helps them to preferably use the carbs and protein to their advantage for building muscles (and not fat!).
This smart energy partitioning helps them grow muscular and not fat. (By the way, don’t expect similar response from a pot bellied insulin resistant guy!)
Few bodybuilders have even gone overboard to inject insulin for quick results. They had been using it in addition to steroids to squeeze in even better muscle gain. There had been stories around where over enthusiastic bodybuilders have died of injecting too much exogenous insulin!
Remember that without insulin as a key player, you can neither gain fat, nor gain muscles. In an energy surplus condition, the primary job of insulin is to take care of the glucose, the primary fuel of the body. Increased glucose level in blood is toxic for the body, every diabetic is a living example for that.
When your muscles and liver are filled up with glycogen, insulin carries those glucose to the fat cells. The process of ‘de novo lipogenesis’ starts and those are converted into fat and stored in the adipose cells. Just don’t get into the details, the excess energy is stores as fat.
Even for fat mobilization from adipose tissues insulin has a big role. Those fat cells use an enzyme, ‘hormone sensitive lipase’. This is inhibited by insulin hormone.
Thus remember, in a high insulin environment, fat loss is never going to be easy. The excess glucose will be stored as fat and even that fat can’t be easily removed.
But with advent of civilization, our diet has been loaded with too much simple carbs, processed food, sugary drinks. These foods have been termed high G. I. (glycemic index) food. They are heavily insulinogenic, i.e. causes insulin spiking that leads to greater propensity to fat gain. (Even protein like whey protein has insulin spiking effect. So never go overboard with anything!)
Well, this leads to a new story. A habitually high intake of simple carbs, simple sugars, and particularly fructose rich food like sweetened beverages, contributes to insulin resistance and has been linked to weight gain and obesity. But those cells response to insulin hormone has to get down with time.
Enter insulin resistance. Insulin resistance is a condition in which cell receptors fail to respond normally to the hormone insulin. To prevent high glucose and any organ damage later, the body produces insulin. The glucose starts to be released into the bloodstream from the digestion of carbs in the diet.
Remember, it is not a disease per se. It is the protective mechanism of the body to save brain and other vital organs. As body cells become non responsive to insulin (insulin resistance), the excess glucose must be moved to those vital organs by increasing insulin secretion.
Beta cells of the pancreas reacts and increase their production of insulin, further contributing to a high blood insulin level. This often remains undetected and can contribute to the development of type 2 diabetes, obesity and metabolic syndrome.
Vitamin D deficiency also is associated with insulin resistance.Elevated levels of free fatty acids and triglycerides in the blood also have been found in many studies to occur in states of insulin resistance
Definitely chronic insulin resistance is harmful, but in acute illness, it is actually a well-evolved protective mechanism. But as the the beta cells try to secrete more and more insulin in face of resistance, it can fail at a stage. That is where the dreaded diabetes comes in picture,when excess blood glucose cannot be moved away from the body.
Recent investigations even have revealed that insulin resistance helps to conserve the brain’s glucose supply by preventing muscles from taking up excessive glucose. For more details read insulin resistance.
A fasting serum insulin level greater than 25 mIU/L is considered insulin resistance. Even an OGTT (oral glucose tolerance test), measuring plasma glucose between 140 – 197 is indicative of impaired glucose tolerance which shows insulin resistance. The gold standard is ‘hyperinsulinemic euglycemic clamp’ which is of academic interest and rarely done clinically.
The sign of insulin resistance, that pops up before everybody’s eyes, is the accumulation of visceral fat. This mostly consists of the belly fat, or the bear belly (besides those below skin). This is situated around the various organs of the body, mostly in the abdominal cavity. The typical skinny fat type with pot belly is a common manifestation of insulin resistance. Remember, this is actually the worst type of fat that can lead to atherosclerosis, diabetes and cardiovascular diseases in near future.
Although insulin resistance is a disease of the middle age, (commonly around 40 to 45 years of age) , Indians have tendency to have it much earlier, even in late twenties. People explain it this way:“Whatever I eat, gets deposited in my tummy”
These have been explained by thrifty gene hypothesis and in a narrative story style in my post, The story of Raj and GetIndiafit.
Besides, please keep in mind that hypertension, increased triglycerides, polycystic ovarian syndrome, atherosclerosis complicated pregnancies are commonly associated with insulin resistance. Even progressive abdominal obesity to full fledged diabetes is not uncommon.
It is fought by mainly diet and exercise. Diet low in carbs have shown great results. Keto diet with <5% carbs have shown really promising results though long term study results are really unknown. Even there are some role of medications too. The actual focus should be on a holistic approach to proper diet, exercise, medications (if prescribed).
Even lifestyle changes and e psychological well being have role too. Stress can only make things worse for you.
Specific food pattern to overcome insulin resistance:
Exercise has a huge role in insulin hormone control. American Heart Association (A. H. A.) recommends at least 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise (or a combination of moderate and vigorous activity). This is mostly aerobic type of activity. Besides, at least twice a week whole body strength training is recommended.
Remember, that as more glycogen is burnt during a bout of exercise activity, the longer the body’s insulin sensitivity gets improved. “While aerobic exercise is the common choice of modality for intervention programs with glucose intolerant individuals, current recommendations for physical activity include both aerobic and resistance exercises.” Read this study for details.
For even better results, HIIT (High intensity interval training) can e of more help. Insulin resistance has been managed successfully with proper and guided resistance training and aerobics balong with properly guided diet (with proper quantitative measures).
Anyway, please remember, certified fitness/personal trainer guidance is critical to fight this monster. Simple motivation and willpower will help but won’t see you through. Don’t mess up with Internet knowledge and blogs. Go for expert advice in this regard.
Besides exercise and diet, medications have some role too. Medicines that reduce insulin resistance include biguanides (like Metformin) and thiazolidinediones. But the mainstay of the treatment is still proper guided diet and exercise.
Remember that everyone is different and proper guidance regarding diet/exercise and medications must be highly personalised. This is a major lifestyle change, can lead to make or break situation in life. Take professional advice to succeed and have sustainable results.
Take guided advice from your physician, dietitian/nutritionist and certified fitness/personal trainer. Be disciplined and calculation in lifestyle, the food you eat and grind it hard at gym. Remember, controlling insulin resistance and preventing diabetes can give you a new life to enjoy.
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