What is Insulin Resistance (IR)? | Explain more about this carbohydrate/insulin regulation problem.
How do I know if I should be tested for IR? | How do I manage IR?
What about dieting and IR? | Helpful books
-------------------------------------------------------------------------

What is Insulin Resistance (IR)?

    IR is a person's inability to process carbohydrates.  It is estimated that a third to a half or more of our American population is unable to process carbohydrates-sugars and starches efficiently. This is due in part to genetics and in part to lifestyle choices. 
    We have evolved for many years on the "cave man's diet," of meat and vegetables.  When modern civilization began about 5,000 years ago, our physiology suddenly was asked to digest and metabolize larger amounts of sugar and starch, especially refined sugars.
    This inability to utilize carbohydrates efficiently is called Insulin Resistance or IR.  IR itself should not be thought of as a disease.  Like many health problems, IR affects different people in different ways.  It may be quite normal for some humans to be unable to eat large or even moderate amounts of carbohydrates.  But, if we are unable to utilize the amount of carbohydrates we eat for whatever reason, certain symptoms will develop and if left unchecked, it can create problems that lead to disease.
Genetically this is possible.  One might hypothesis that since Type O blood group people are the oldest blood type and have more "hunter-gather" in them, they may have more IR.  Type AB people who are the latest evolved blood type and more likely to be true vegetarians might be less likely to express IR because they are better equipped genetically to process high glycemic grains.  [This would be a good research project for some resident somewhere.]
    As we acknowledge the "biological individuality" of each and every person, the many presentations of IR are understandable.  Following are some disease presentations recognized by the knowledgeable medical community that posses a component of IR

* Diabetes Mellitus - Type II
* Obesity
* Hypertension
* PCOS - Polycystic Ovarian Syndrome
* HAIR-AN Syndrome - Hyperandrogen insulin resistance-acanthosis nigrans
* Gestational Diabetes
* Angina
* Coronary Heart Disease
* Auto-Immune Disorders
* Insulin-Like Growth Factor (IGF) Deficiency

    Some of the other health states that are not readily recognized by the medical community, but may never-the-less be associated with IR are:

* Arthritis
* Impaired Glucose Tolerance (IGT)
* Chronic Fatigue
* Chronic Urticaria (Hives)
* Intense Itching, often at night
* Disturbing, anxious dreams at night
* Sweating at night
* Panic/Anxiety Attacks
* Drug and Multiple Chemical Allergy
* Multiple food allergies
* Headaches/Migraine
* "Muddled head", poor memory and dizzy spells
* Various rashes
* Chronic infection in the nose, sinuses, lungs
* Irritable Bowel Syndrome (IBS)
* Hypoglycemia (with and without normal blood glucose)
* Hotflushes and clammy feelings during the day
* Impotence
* Enlarged thyroid and apparent thyroid deficiency
* Arthralgia (muscle and joint pain)
* High Cholesterol

Explain more about this carbohydrate/insulin regulation problem.

    To understand IR we need to understand carbohydrate metabolism and insulin regulation of that metabolism.
    Carbohydrates are merely different forms of simple sugars linked together in polymers - something like rock-candy crystals.  Sweets, pasta, vegetables and fruits - are all carbohydrates.  When they are digested in our stomachs and small intestines, they all are broken down into simple sugars and absorbed over our intestinal wall as these simple sugars.
    We eat food because we can not make sugars from the sun as plants do!  We have to use sugars made by the plants for the energy source for our muscles and brain.  Interestingly our heart needs fats for it's energy source! That's why you can't entirely cut fats out of your diet .
   The brain uses two thirds of the circulating carbohydrates in the bloodstream while you are at rest and more when it's thinking!  Why, 25% of an ingested meal's energy goes toward just breaking the foods into simple sugars, lipids and amino acids.  To be sure your body has enough sugar around, the body continually takes carbohydrates and converts them to glucose. Any carbohydrates not immediately used by the body are then stored in the liver and muscles in the form of glycogen (a long string of glucose molecules linked together). 
     Muscles can store about three hundred to four hundred grams of carbohydrate as glycogen.  The brain,however, has no access to this "muscle sugar," it can only obtain sugar from glycogen stored in the liver. 
    The liver's glycogen stores is also limited to ten to twelve hours or about sixty to ninety grams of glycogen before it is depleted.  This is equivalent to about two cups of cooked pasta or three typical candy bars, and it represents your total reserve capacity to keep the brain working properly. Thus we have to eat!

   BUT,what happens when you eat too much carbohydrate?
Once the glycogen levels are filled in both the liver and the muscles [4 candy bars!], excess carbohydrates can only  be converted into fat and stored as fat.  Thus, even though carbohydrates themselves are fat-free, excess carbohydrates end up as excess fat.
    Metabolism, however, does not stop here! Any meal or snack high in carbohydrates will generate a rapid rise in blood glucose. To adjust for this rapid rise, the pancreas secretes the hormone insulin into the bloodstream. Insulin then lowers the levels of blood glucose.
   Insulin is used as a storage hormone.   When the body is exposed to a high level of sugar, insulin secretion insures storing excess sugars as fats in case of future famine.  Insulin can convert almost half of your dietary carbohydrate into fat for storage.
    When we eat too much carbohydrate, we're sending a hormonal message, via insulin, to the body to "Store fat" and to not release any already stored fat!! BUT this insulin response varies greatly from person to person.
    If you are genetically setup for IR, the excess carbohydrates in your diet not only make you fat, they make sure you stay fat. It's a double whammy, and it can be lethal.

    When you eat carbohydrates, there is a rise in your blood sugar, which causes insulin to be released by the pancreas and the more refined the food the stronger and/or more rapid the insulin reaction.  This reaction is independent of your genetic makeup and a lifestyle/environmental cause of IR!!!!
    Insulin will store a specific amount of this sugar in your muscles and liver, and then move the remaining sugar into fat. However, at this same time, insulin dictates that your body use more carbohydrate, and less fat, as fuel.
    Diets high in refined sugars release more insulin thereby allowing less stored fat to be burned.
    High insulin levels also suppress two important hormones: glucagon and growth hormone. Glucagon promotes the burning of fat and sugar. Growth hormone is used for muscle development and building new muscle mass.
    Insulin also causes hunger!  A high carbohydrate meal causes blood sugar to increase followed by an insulin rises with a resulting low blood sugar, which results in hunger, often only a couple of hours (or less) after the meal. Which starts the whole cycle over!
    Not eating makes you feel ravenous shaky, moody and ready to "crash."
    Cravings, usually for sweets, are frequently part of this cycle.   If the problem is chronic, you never get rid of that extra stored fat, and your energy is adversely affected.

     In a state of insulin resistance, insulin can't get glucose into the cells efficiently, BUT it still performs its other tasks, like converting carbohydrates to fat and inhibiting stored fat from being burned. In a normal person, 40% of the carbohydrates eaten is converted to fat. In the IR person, that number may be much higher.

How do I know if I should be tested for IR?

Below is a list of some of the most common complaints of people with IR Many symptoms occur immediately following a meal of carbo-hydrates, and others are constant. Keep in mind that these symptoms may also be related to other problems.

Family History. We know that many people with IR have a family history of diabetes.  IR, in many ways, can be termed "Pre-diabetes."
Fatigue. Whether you call it fatigue or exhaustion, the most common feature of IR is that it wears people out. Some are tired just in the morning or afternoon; others are exhausted all day.
Brain fogginess. Sometimes the fatigue of IR is physical, but often it's mental (as opposed to psychological); the inability to concentrate is the most evident symptom. Loss of creativity, poor memory, failing or poor grades in school often accompany IR, as do various forms of "learning disabilities."
Low blood sugar. Brief, mild periods of low blood sugar are normal during the day, especially if meals are not eaten on a regular schedule. But prolonged periods of this "hypoglycemia," accompanied by many of the symptoms listed here, especially mental and physical fatigue, are not normal. Feeling jittery agitated and moody is common in IR, with an almost immediate relief once food is eaten. Dizziness is also common, as is the craving for sweets, chocolate or caffeine. These bouts occur more frequently before meals or first thing in the morning. The old hypoglycemic diet, still in use today, recommends frequent snacks, and individuals with IR usually know to eat often. However, the hypoglycemic diet contains too much carbohydrate for most IR people.
Intestinal bloating. Most intestinal gas is produced from dietary carbohydrates. IR sufferers who eat carbohydrates suffer from gas, lots of it. Antacids or other remedies for symptomatic relief, are not very successful in dealing with the problem. Sometimes the intestinal distress becomes quite severe, resulting in a diagnosis of "colitis" or "ileitis," although this is usually not a true disease state. However, IR is often associated with true gastrointestinal disease, which must be differentiated from simple intestinal bloating.
Sleepiness. Many people with IR get sleepy immediately after meals containing more than 20% or 30% carbohydrates. This is typically a pasta meal, or even a meat meal which includes bread or potatoes and a sweet dessert.
Increased fat storage and weight. For most people, too much weight is too much fat. In males, a large abdomen is the more evident and earliest sign of IR. In females, it's prominent buttocks, frequently accompanied by "chipmunk cheeks."
Increased triglycerides. High triglycerides in the blood are often seen in overweight persons. But even those who are not too fat may have stores of fat in their arteries as a result of IR. These triglycerides are the direct result of carbohydrates from the diet being converted by insulin. In my experience, fasting triglycerides levels over 100 may be an indication of a carbohydrate problem, even though 100 is in the so-called "normal" range.
Increased blood pressure. It is well known that most people with hypertension have too much insulin and are IR. It is often possible to show a direct relationship between the level of insulin and the level of blood pressure: as insulin levels elevate, so does blood pressure
Depression. Because carbohydrates are a natural "downer," depressing the brain, it is not uncommon to see many depressed persons also having IR. Carbohydrates do this by changing the brain chemistry. Carbohydrates increase serotonin, which produces a depressing or sleepy feeling. This is the reason nice hotels place candy on your pillow in the evening; it literally helps you sleep. (Protein, on the other hand, is a brain stimulant, picking you up mentally. Here's another example of how trends distort the real picture: many people have been taught that sugar is stimulating. This is a significant consideration for those trying to learn, whether at school, home or work.)
Addictions. IR is also prevalent in persons addicted to alcohol, caffeine, cigarettes or other drugs. Often, the drug is the secondary problem, with IR being the primary one. Treating this primary problem should obviously be a major focus of any therapy.

    If you have any of the above symptoms, you need to determine if you are carbohydrate intolerant.  If you don't, it may mean your future will be rittled with chronic diseases. 
    Seek IR testing by a Functional Medicine Physician (FMP).  This is because the traditional blood tests most doctors perform are looking for disease and FMP's are looking for metabolic changes indicating a future problem. 
    FMP's believe that if you change genetic expression, you can change the diseases' presentation.  We don't believe that you just have to wait until you "catch" diabetes to do something about it.  You may be genetically "set-up" to express diabetes during your lifetime BUT by modulating that expression through lifestyle changes and supplements, you can postpone that expression to an older age or possibly never even express it!
    FMP's also break IR up into three subcategories:

* Nutritional Deficiencies
* Endocrine Imbalances
* Oxidative Stress

    IR sufferers may have other symptoms than just those listed above. However, when a person with this problem finally lowers carbohydrate intake to tolerable levels, many if not most of the symptoms may disappear. With the stress of IR eliminated, the body is finally able to correct many of its own problems.
    It is possible, although unlikely, that many of these symptoms can be found in someone who tolerates carbohydrates quite well.

How do I manage IR?

    If our goal is to burn fats for energy, the insulin response must be moderated.  We can moderate this insulin response by:

Limiting (ideally, eliminating) the intake of refined sugars, and keeping all other carbohydrate intake to about 40% of the diet.   Non-carbohydrate foods-proteins and fats-don't produce much insulin

Moderate Protein. Know how much protein your body needs. Never consume more protein than your body requires. And never consume less. This allows for proper protein metabolism without over taxing your kidneys.   You can calculate this need by reviewing the calculations in The Zone.

* Generally adult protein requirements range from a low of 35 grams per day for a sedentary 100 pound obese individual to as much as 200 grams per day for a lean heavily exercising 250 pound athlete.
* You should have protein at EVERY meal and the total per day should equal your daily requirement. For every three grams of protein at a meal you need to have four grams of carbohydrate and 1.5 grams of fat. You can multiply protein by 1.25 to obtain the amount of carbohydrate and by 0.5 to obtain the amount of fat. This is a rough estimate and you should not become overwhelmed trying to get this absolutely precise. It is important though to be in the general area.
Corrinne Netzer wrote a book "The Complete Book of Food Counts" that can help you make this calculation.
Choose your protein based on those recommended for your blood type. This can be found in Dr. D'Adamo's book Eat Right For Your Type. If you are seriously ill you should have your blood subtyped so we can provide an even more accurate recommendation for you.

Carbohydrate. You should also chose your carbohydrates from Dr. D'Adamo's book. If you are insulin resistant, (have high blood pressure, high cholesterol, high blood pressure or are overweight) then you need to specifically restrict your carbohydrates based on the Heller's book "The Carbohydrate Addict's Lifespan Program". Combining all three authors is the most powerful method know to lower your insulin levels and produce optimum health.
    By moderating carbohydrate intake you can increase your fat burning as an optimal and efficient source of almost unlimited energy.

Fats. Adding some fats to the diet, digestion and absorption is slower, and the insulin reaction is moderated. Choose your fats based on Dr. D'Adamo's recommendations. Most people can tolerate olive oil and is the oil of choice.  Cold water fishes like Salmon is a good source of EPA which is beneficial fat that will help balance out your hormone levels and decrease inflammation.

Decrease total calories.

Balance your meals. If you find yourself hungry and craving sugar or sweets two to three hours after a meal, you probably consumed too many carbohydrates that last meal. Whenever you have a problem with hunger or carbohydrate cravings, look to your last meal for a clue to the reason why. No matter how consistently you follow this dietary strategy, you are bound to make mistakes. This is especially true at parties or when traveling. Remember, if you're only unbalanced for a short period of time, you're only one meal away from rebalancing. It's like falling off a bike-you just get back up and continue your journey.  Use the Glycemic Index found at Richard Mendosa's cyberhome to balance your meals.  It's the best on the web.

Eat 6 small meals a day. Don't eat once or even three times a day, make it 6 times a day but divide the calories, carbohydrates, protein, and fats evenly.  This keeps the blood sugar and responding insulin levels more constant.

Consume natural fiber daily with carbohydrates which helps minimize the carbohydrate/insulin response.  Use 40 - 50 GM/day of a product high in insoluble fiber.

Add herbs that help support glycemic control.   Chronium Picolinate, Fenugreek, Vanadium.

Go on a fast.  A short fast of 24 hours will help reset some of the insulin receptors a longer fast of four to five days does even better.  BUT don't fast on a whim!  This is a serious undertaking because of resulting hypoglycemia.  A coach is a necessity if fasting greater than 24 hours. If you are Diabetic, don't do this at all without a physician's advise.

Water. Try to drink at least 64 ounces of pure water per day.

Caffeine. If you are a heavy caffeine user, gradually reduce caffeine intake to zero whenever possible as the breakdown products of caffeine will tend to increase insulin levels.

Exercise. Try to get 30 to 60 minutes of walking in four to five days a week if the weather permits.  As you are healthier and if you are blood type 0 or B you can shift to more aggressive exercises.

Take supplements as indicated. The three subcategories when present and determined by testing indicates a nutritional deficiency that when replaced, changes the genetic expression of IR.  If these conditions are caught in childhood, chronic illnesses will be totally eliminated and a thing of the past, listed in history books as the plague of the end of the 20th century.

What about dieting and IR?

    Going on a  high-carbohydrate, low-fat diet is dangerous to your health.  Eating fat does not make you fat, but eating high carbohydrates raises your blood sugar, that raises your insulin level, that stops the burning of fats...that is dangerous.  This diet generates a series of biochemical signals in your body that will take you out of homeostasis, making it more difficult to access the stored body fat you already have.   
    Even if you restrict calories, overeating carbohydrate foods in relation to fats and proteins can prevent fats from being used for energy.  Eating less and losing excess body fat do not automatically go hand in hand. 
    If you go on a high-carbohydrate, low-fat diet, you'll eventually reach a weight-loss plateau, beyond which you simply can't lose any more weight.
    Diets based on choice restriction and calorie limits usually fail. People on restrictive diets get tired of feeling hungry and deprived. They go off their diets, put the weight back on (primarily as increased body fat), and then feel bad about themselves for not having enough will power, discipline, or motivation.
    You need information, not will power to lose weight.  If you change what you eat, you don't have to be overly concerned about how much you eat.
    Adhering to a diet of low carbohydrate meals, you can eat enough to feel satisfied and still wind up losing fat-without obsessively counting calories or fat grams.
    Food can be good or bad. The ratio of macronutrients protein, carbohydrate, and fat-in the meals you eat is the key to permanent weight loss and optimal health. Unless you understand the rules that control the powerful biochemical responses generated by food, you will never achieve optimal wellness.

For Helpful books click on this link: