Dear Dietitian,

My doctor says I have insulin resistance, and I need to lose about 40 pounds. He gave me a sheet with diet information, but I need more help.

Janet

Dear Janet,

Insulin resistance is a condition in which the pancreas secretes insulin, but it has difficulty reaching the cells where it is needed. As a result, glucose (blood sugar) levels rise, and the pancreas secretes more insulin to get blood sugar into the cells where it is needed for energy. Insulin resistance is also known as metabolic syndrome.

Researchers aren’t sure what causes insulin resistance, but genetics are likely a factor. The American Association of Clinical Endocrinologists (AACE) has established the following criteria for the diagnosis of insulin resistance:

• Overweight with a body mass index (BMI) of 25 or higher
• Triglycerides of 150 mg/dl or higher
• High-Density Lipoprotein (HDL) of less than 40 mg/dl in men or less than 50 mg/dL in women
• High blood pressure
• Fasting glucose of 110-126 mg/dL
• A glucose level of more than 140 mg/dL 2 hours after consuming 75 grams of glucose

Does this mean you will automatically develop diabetes? Thankfully, it does not, but it is time to make some lifestyle changes. The first step is exercise. When you exercise, insulin sensitivity is improved, so your muscle cells can use insulin to take up glucose during and after activity. When your muscles contract during exercise, your cells can take up glucose and use it for energy, whether insulin is available or not (1). Moderate exercise of 30 minutes 5 times a week improves insulin sensitivity. Other benefits of regular exercise include improved mood and better sleep.

Weight loss will improve insulin resistance. Fat blocks the insulin receptors on cells, thereby preventing insulin from bringing glucose into the cells where it belongs. Once weight comes down, glucose can enter the cells instead of staying in the bloodstream.

When beginning a weight loss program, consider a plan that offers group support, which is an essential factor for success. If you make no other change in your diet, avoid added sugars, like those in regular soda. Opt for whole grains instead of refined carbohydrates. Choose fresh or frozen fruits and vegetables, healthy fats such as polyunsaturated (nuts, seeds, seed oil), monounsaturated fats (olive or canola oil), and lean proteins.  If you need more education on your diet, consult a Registered Dietitian Nutritionist (RDN). Most insurances will cover the cost of the consultation, but contact your provider to be sure. 

Until next time, be healthy!

Dear Dietitian

Reference

1. Blood sugar and exercise (n.d.) https://www.diabetes.org/fitness/get-and-stay-fit/getting-started-safely/blood-glucose-and-exercise