Insulin Resistance Scientist on How to Reduce Abdominal Fat & Lower Insulin Resistance | Dr. Koutnik
10 Sep 2024 (8 days ago)
Intro
- Diets with either high carbohydrates and low fat or low carbohydrates and high fat can produce health benefits.
- Combining high levels of both carbohydrates and fat, as in a Western diet, is usually unhealthy.
- Andrew Kutnik is mentioned.
The Relationship Between Insulin Resistance & Weight Gain
- There is a strong correlation between increased body fat and insulin resistance, but it's not a simple cause-and-effect relationship.
- While obesity is a strong predictor of developing type 2 diabetes, individuals can develop insulin resistance without being obese.
- Factors like exercise can significantly impact insulin sensitivity, demonstrating that body composition is not the sole determinant of insulin resistance.
How Body Fat Affects Insulin Resistance
- Adipose tissue is linked to low-grade inflammation, which can lead to insulin resistance.
- Inflammation can hinder the insulin signaling pathway, preventing glucose uptake into cells.
- Muscle tissue is a primary site of glucose uptake and is often associated with insulin resistance.
How Insulin Resistance Develops
- When food is consumed, the carbohydrates, fat, and protein are broken down into smaller molecules, including sugars.
- The rise in blood glucose levels triggers the pancreas to release insulin, which helps cells absorb and use glucose for energy.
- Over time, with increased obesity and inflammation, the body's cells can become resistant to insulin, requiring more insulin to be produced to maintain healthy blood glucose levels.
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Physical Activity & Exercise for Insulin Resistance
- Engaging in regular physical activity, such as purposeful exercise or simply standing up and moving around, is crucial for improving metabolic health and reducing insulin resistance.
- While short bursts of intense exercise can temporarily increase insulin sensitivity, maintaining a consistent exercise routine is essential for long-term benefits, especially for individuals with type 2 diabetes.
- Actively using and engaging muscles through regular physical activity is more critical for improving insulin sensitivity and glucose uptake than muscle size or function alone.
Is Muscle Size Important?
- Muscle in motion is more important than sheer muscle mass for glucose control.
- Individuals with large amounts of muscle mass typically engage in high volumes of physical activity to maintain it.
- It is difficult to maintain significant muscle mass without also being physically active.
Demonization of Sugar & Carbs
- Excess carbohydrates leading to excess blood glucose can cause acute and chronic complications, especially in the context of diabetes.
- Reducing carbohydrates can have a potent therapeutic response in individuals with dysglycemia and insulin resistance, leading some to believe that sugar and carbohydrates are the cause of these problems.
- While carbohydrates are important for athletic performance, reducing them can be beneficial for individuals with dysglycemia and insulin resistance, but this does not mean that carbohydrates are bad in all contexts.
Type-1 Diabetes
- Individuals with Type 1 diabetes typically have a normal or low body weight and do not exhibit excess adiposity or lipid levels commonly observed in Type 2 diabetes.
- The primary distinction of Type 1 diabetes is the loss of beta cell function, responsible for insulin production and blood glucose regulation.
- High and variable glucose levels in individuals with Type 1 diabetes are linked to an increased risk of microvascular complications, such as retinopathy and nephropathy, as well as a tenfold higher risk of cardiovascular disease.
HbA1c
- HbA1c is a strong predictor of chronic glucose exposure in the blood, with a predictive value of over 70%.
- Higher variability in glucose levels, such as spikes after consuming sugary drinks, can lead to higher HbA1c levels.
- While HbA1c is a good indicator of chronic glucose exposure, individual variability exists in the process of glucose sticking to tissues.
Pathological vs Physiological Insulin Resistance
- Pathological insulin resistance is a resistance to insulin at the receptor often caused by excess inflammation or insulin in the blood.
- Physiological insulin resistance is often used to describe when a healthy person on a low carbohydrate diet does not use carbohydrates as efficiently and may have higher glucose levels when consuming them.
- When a person adapts to a low carbohydrate diet long-term, their body becomes more efficient at utilizing fat and less efficient at utilizing carbohydrates.
Effects of Eating a Western Diet When Insulin Resistant
- Individuals who primarily metabolize carbohydrates and consume a standard American diet will likely oxidize most of the carbohydrates due to their metabolic preference.
- Excess fatty acids from the diet must be stored somewhere in the body.
- Infusing lipids into individuals consuming a high-carbohydrate diet reliably induces insulin resistance, making it a model for studying insulin resistance.
Physiology of Low-Fat vs Low-Carb Diets
- There are key differences in the physiology of low-carbohydrate and high-carbohydrate diets.
- High-carbohydrate diets, when combined with increased fat intake, can lead to insulin resistance.
- High-fat diets do not inherently cause insulin resistance and can reduce insulin levels and markers of insulin resistance in certain individuals.
Mixing High-Fat & High-Carb Diets
- Combining high levels of fat and carbohydrates in a diet, as seen in the Western diet, generally leads to negative health outcomes such as insulin resistance and weight gain.
- Consuming high levels of both fat and carbohydrates simultaneously appears to be more challenging for the body to process compared to adhering to a diet that prioritizes one macronutrient over the other.
- While elite athletes may benefit from consuming a high-calorie diet with diverse macronutrients to support their training demands, this approach is not suitable for the average person and can lead to adverse metabolic consequences.
Find What Style of Eating Works Best for You
- Different individuals may find different dietary strategies, such as low-carb diets, more effective based on their individual needs and responses.
- Factors such as genetics, lifestyle, disease context, and type of physical activity can influence which dietary approach is most suitable for an individual.
- It is essential to experiment and determine what dietary approach works best for you personally, as individual responses to diets can vary significantly.
Where to Find More of Dr. Koutnik's Content
- The speaker's Twitter handle is ackakutnik.
- The speaker is a researcher at Sansum Diabetes Research Institute, which has a website, Sansum.org.
- The speaker's website, andrutnick.com, contains free information and materials for people who have or are at risk for diabetes.