Insulin’s primary role is to control your blood sugar.

I’ll get into more about insulin in a minute. But first, a quick orientation. This is the second in a series of posts where we dive into specific hormones and their connection with nutrition. (Check out the first article on thyroid hormones.) Why am I doing this series? Because “hormones” is one of the latest buzzwords in health on the internet. And, there’s both truth and manipulation intertwined in those messages. In this series, I’m teasing out the scientific evidence so you can spot the manipulation. Let’s start with a definition of hormones. What are hormones? Hormones are chemicals that your body creates to send a signal from one part of the body, through your bloodstream, to another part of your body.

Now, let’s get into the details about insulin.

We help a lot of people with managing blood sugar and insulin resistance. So, I wanted to cover it next in this series.

What Does Insulin Do?

Insulin is a hormone made in your pancreas. Your pancreas is a gland located near your stomach. As I shared already, insulin’s primary role is to control your blood sugar. When you digest carbohydrates (carbs), they’re broken down in your intestine into a sugar called glucose, which is absorbed into your bloodstream to be circulated to cells around your body such as your muscles and your liver. When glucose enters your blood, it signals your pancreas to release insulin. Insulin allows the glucose to move from your blood into the cells of your body where it’s needed for fuel. And, insulin helps your blood glucose to move into your liver where it’s stored to be used for energy later on.

Insulin Problems- What is Insulin Resistance?

There are two main types of problems with insulin.

Type 1 Diabetes (what used to be called juvenile or child-onset diabetes) is when the part of your pancreas that makes insulin has been damaged. This damage impairs your ability to produce insulin. That’s why people with type 1 diabetes need to take insulin (via needles or a pump). None of the dietitians currently on our team support people with type 1 diabetes so I won’t go further into this condition.

The second problem with insulin is more common: insulin resistance. In insulin resistance, your body’s cells aren’t responding to the insulin that you make and aren’t letting glucose into your cells. At first, your pancreas will release more and more insulin to get the results – i.e. move the sugar from your blood into your cells. It does this because your body is like Goldilocks – it wants just the right amount of sugar in your blood – not too much and not too little. When you have too much sugar in your blood, over a long period of time, it causes damage to your blood vessels. Those are the side effects of uncontrolled diabetes that you may be familiar with such as blindness, nerve damage (pain & tingling in feet and hands), and amputation. High blood sugar also is associated with inflammation. To prevent this damage, your body produces more and more insulin to get the job done of moving the glucose from your blood into your cells.

Over time, despite your pancreas producing extra insulin, the resistance is so great that your blood sugar remains high. It’s this stage when blood sugar levels are high despite your body producing insulin, that is called “pre-diabetes”. When blood sugar levels rise even higher, it’s called Type 2 Diabetes (what used to be called “adult-onset diabetes”).

Risks of Insulin Resistance

Several factors increase the risk of insulin resistance. For almost all of these factors, it’s not known how or why they increase the risk of insulin resistance.

Age: People over age 45 are at increased risk of insulin resistance.
Genetics: Insulin resistance has a genetic component. It runs in families. People of certain cultural/ ethnic backgrounds have higher rates of insulin resistance. However, it’s not certain how much is related to genetics and how much is related to the social determinants of health (or the interaction of the two as in epigenetics). Some cultural groups that experience higher rates of insulin resistance are Indigenous, Hispanic/Latinx, and Pacific Islander people.
Menopause: While the relationship is not fully understood, estrogen helps insulin do its work. When estrogen levels drop in the menopause transition, insulin resistance increases.
PCOS: It’s estimated that 75% of women with PCOS experience insulin resistance.
Sleep Apnea: Sleep apnea increases the risk of insulin resistance.
Larger Body Size: Insulin resistance rates are higher amongst people who carry more fat on their bodies. It’s not yet known whether the amount of fat causes insulin resistance or whether there is an unknown third factor that contributes to both the increased amount of fat and insulin resistance.
Physical Inactivity: Physical activity helps insulin do its job. Therefore, a sedentary lifestyle means that insulin must do all the heavy lifting by itself.

How to Support Insulin with Nutrition (Nutrition for Blood Sugar Control)

Move Your Body: Going for a walk or doing other forms of physical activity after you’ve eaten helps insulin clear blood sugar.
Choose Less Refined Carbs: When carbs are more refined, they take a shorter time to digest, resulting in the glucose hitting your bloodstream faster, i.e. a blood sugar spike. Choose whole grains so that they are digested more slowly. It’s easier for your body to handle the slower arrival of glucose into your bloodstream.
No Naked Carbs: Eat foods containing protein and/or fat when you have foods that contain carbs. I.e., don’t eat carbs alone (a.k.a. naked). Protein and fat help to slow the release of sugar into your blood – a similar result as #2 above.
Eat Fewer Carbs: It’s logical that if you eat fewer carbohydrates, you will have less glucose entering your blood. Your body will be less stimulated to release insulin. Ketogenic (“keto”) diets are very, very low carb. But you can also eat lower or low-ish carb too. It doesn’t have to be a choice of high carb or keto. Those are just the two ends of the spectrum. Many factors go into deciding what level of carbs is a fit for you, including your physical activity, what foods you enjoy, how frequently you eat socially, and who else is in your household. What’s important is choosing a way to eat that fits your life long-term. Two weeks of doing keto isn’t going to fix your insulin resistance.
Have Good Vitamin D Status: A meta-analysis found that having good vitamin D levels in your body reduces insulin resistance. To achieve a healthy vitamin D status, most of us will require vitamin D supplementation. I don’t have a specific amount to recommend because we customize our supplement recommendations to each individual.
Consider Other Supplements: There are supplements that have intriguing, although not definitive, scientific evidence regarding their impact on lowering blood sugar. Examples include berberine, chromium, and magnesium. As I shared above, I don’t give supplement recommendations in blog posts. We always individualize supplement recommendations because we take into consideration: what you eat, health diagnoses, medications, and other factors.

Want more information on managing your hormones? Check out this article on Nutrition for Thyroid (Supporting Metabolism).

Photo by Alexander Grey on Unsplash

References

Centers for Disease Control and Prevention: Insulin Resistance and Diabetes

Moghetti, P., Tosi, F. Insulin resistance and PCOS: chicken or egg?. J Endocrinol Invest 44, 233–244 (2021). https://doi.org/10.1007/s40618-020-01351-0

Gabryelska Agata, Karuga Filip Franciszek, Szmyd Bartosz, Białasiewicz Piotr. HIF-1α as a Mediator of Insulin Resistance, T2DM, and Its Complications: Potential Links With Obstructive Sleep Apnea. Frontiers in Physiology.11. 2020. DOI 10.3389/fphys.2020.01035

Vitamin D and Risk for Type 2 Diabetes in People With Prediabetes: A Systematic Review and Meta-analysis of Individual Participant Data From 3 Randomized Clinical Trials https://doi.org/10.7326/M22-3018

Fibre. It’s not exactly the sexiest topic. But it actually is a NGC* if you want to love your body. Which really is sexy, isn’t it? It’s recommended that adults eat 25 – 38 grams of fibre each day. But most Canadians don’t get nearly enough (usually only half the recommendation). Here’s why you will want to get enough and what foods to find it in. And, a couple of words of warning when it comes to increasing your intake.

Why You Want Fibre:

There are two main reasons why it's is a NGC: 1) steady blood sugar; 2) large, regular bowel movements.

Fibre helps to lower blood cholesterol and keep blood sugar levels steady. Yes, these both help prevent and manage heart health and diabetes. But there’s also a more immediate reason why you want this. Steady blood sugar means consistent energy levels. No more roller coasters of highs, followed by crashing lows. This means no “hangry” feelings and less cravings for junk food. It means that fibre fills you up and helps you stay feeling full for longer.

Fibre also helps keep your bowels regular and may protect against colon cancer. It binds bile secreted by your liver. Large, easy to pass, bowl movements remove toxins and waste from your body. You don’t want tiny little pellets. In other words, yes, it's the original “detox”. We’re learning more about the role of having a healthy microflora in our digestive tracts. Fibre is considered a “pre-biotic” in that it creates an environment that supports the healthy bacteria.

Words of Warning:

I have two important words of warning when it comes to increasing the amount you eat:

Drink lots of water! Lots of fibre without fluids will have the opposite effect of what you want (namely: constipation). I recommend that we women drink 2.5 Litres of non-sugary fluids each day. Men: drink 3.5 Litres of non-sugary fluids each day.
Increase your intake slowly. Think of fibre like exercise for your digestive tract. If you’ve been eating highly processed foods with little fibre, your digestive tract has been a couch potato. Increase your fibre slowly and steadily. Think of it like an exercise training regimen. Going too fast too soon will result in constipation.

Foods to Eat:

A good general rule is that foods that need lots of chewing contain lots of fibre. The first step in digesting fibre is a thorough chewing (see warning #2 above). If you don’t have to do much chewing of a food, it’s a sign that the fibre has been removed by machines (i.e. processing). Of course there are exceptions to this, but it’s a good general rule when looking for fibre-rich foods.

Great sources of fibre are:

Vegetable and fruit. Eat 7 servings a day. As often as possible, eat the peels of your veggies and fruit – there’s lots of fibre in those peels. Juice, including fresh press juice, doesn’t have the same fibre as eating the whole vegetable/ fruit.
Pulses: beans, lentils, and peas.
Nuts and seeds.
Intact whole grains. Examples include brown rice, wild rice, quinoa, steel cut oats, and pot barley. Look for breads that are heavy when you lift the loaf and need lots of chewing. Light, fluffy “whole wheat” bread really isn’t an intact whole grain. There are lots of bakeries and brands out there making bread from intact whole grains. One brand that’s widely available is Silver Hills.

The best way to get fibre is to eat foods closest to the way nature made them. Be wary of “high fibre” or “fibre added” foods that are highly processed (e.g. many “healthy” bars, some yogurt) because it hasn’t been scientifically proven that adding fibre to highly refined foods has the same results in our bodies as eating the fibre that was present when mother nature made the food.

*A Nutrition Game Changer (NGC) is a food or habit that has made a big impact on the nutritional health of clients I’ve worked with. And, in my life too. Some may call these nutrition hacks. But I'm not a fan of that phrase. I share one NGC each month.

Curious about how I can help you achieve your health and nutrition goals? Schedule a (free) call to find out.

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Nutrition for Insulin Resistance (Nutrition for Managing Blood Sugar)