Insulin... Friend or Foe?

So as the title says, is insulin good or bad? We know that problems with insulin can lead to weight gain and eventually diabetes. The fact is it is very, very good - we just need to know we have control of it. We need to understand how insulin works and what its job is.

To start, lets look at our relationship with food in simple terms.

We eat food and it is digested into smaller molecules in the stomach. These molecules pass into the gut and by this stage they are small enough to pass through the gut wall into the blood stream. From the blood stream, the now useable form of food is now transported to cells of muscle, tissues and organs where it can be used as fuel, stored for later (fat or glycogen [stored glucose]) or used for maintenance in the cells (cell renewal, muscular growth).

The brain monitors this system constantly. The HTPA axis is the system responsible for monitoring the body's hormones, stress, digestive and immune systems, mood, and behaviour. These systems are closely related and can have positive or adverse effects on each other. Don't feel hungry when you're nervous? Head for the fridge when you are stressed? Blame the HTPA axis.

With this regulatory system in place, we build a rhythm and schedule around food and the timing of our intake. When we need food we activate hormones that signal hunger (grehlin) and signal us to eat (leptin). When enough food is eaten leptin tells us to stop eating. Insulin is released into the bloodstream and as the digested food molecules arrive, they combine to pass through the cell wall. Once the food molecules are exhausted (used up for maintenance or physical activity), space is created in the cell and the insulin is dissipated. This is vital for continuing sensitivity in the cell.

I'm a big fan of Phil Learney's metaphor here (find out more about Phil at www.phillearney.com). It really lays out how dysfunction occurs.

[Paraphrased]

"Glucose cannot get across the cell wall by itself. It needs a carrier. The glucose molecule is like shopping and the insulin is the carrier bag. The glucose comes along, combines with the insulin and is absorbed into the cell."

As the body gets used to an eating pattern it starts to release insulin at regular intervals. Daily, we release 1 unit of insulin per hour plus 3-5 units at meal times. 1 unit of insulin can carry 10g of glucose.

Now, this system will keep moving comfortably. We have control of the system, we send food in and we use physical movement to clear the cells.

But, if we do not empty the cell via physical activity or we are sending too much too quickly, then resistance occurs. The bag full of shopping goes back into the bloodstream and empties. The brain detects insulin and sugar in the blood. This is Insulin Resistance and we are now in the stages of pre diabetes. The brain knows it needs to release more insulin to carry the sugar into the cell but it also knows it needs more sugar to deal with the insulin build up in the blood. So a signal is sent via leptin and grehlin to take in more food. But the body knows really sugary food will clear the most insulin so we crave sweet foods, junk food. This is how we start to crave more food and how runaway weight gain occurs.

The problem is we follow these instructions, but don't do any physical activity - so there still isn't any space in the cell and the problem repeats itself. The brain detects a problem and tries to deal with it by starting to intermittently shut down insulin production. We are now at Type 2 Diabetes. This is how people become diabetic. Untreated, eventually the beta cells on the pancreas will cease insulin production all together and we will have Type 1 Diabetes which is irreversible. You can be born with Beta Cell Dysfunction and Type 1 Diabetes but you can also develop it due to bad eating and lifestyle habits.

To undo the damage when we get to pre-diabetes and type 2 diabetes, we need to keep active to exhaust the cell, create space and keep the flow going. This what we call maintaining sensitivity. Activity needs to be progressive and at an intensity that will challenge us and cause us to use up fuel stores.

Some people will say that you can deal with this simply by managing diet or simply by managing physical activity. I believe you need a healthy assimilation of both. You can reduce blood glucose by fasting and help bring down insulin sensitivity but if you get active and create space in the cell you will restore sensitivity.

From a food perspective we can reduce our dependence on carbohydrates and switch to fats and proteins as fuel, as they require less insulin. Out of the three macronutrients (protein, fats & carbohydrates) carbs are the only one that is proven we can live without (arctic cultures have no access to grains and starches). Fats and proteins are essential for the body to survive as they are the building blocks for tissue and we can also convert them to fuel via different mechanisms. We can also release preexisting fat and glycogen stores for fuel. But we can survive with out starches and grains.

Action plan, maintain cellular sensitivity. Keep active, keep the flow of the system going. Aim to eat your fats and proteins and only eat carbohydrate to requirements. If you are more physically active, you are more sensitive to carbs and can eat more (5-7g per kg of bodyweight). If you are not, start to eat less and see how your sensitivity to carbs improves. Most people who are currently overweight will have a degree of insulin resistance and should reduce their intake. As you can see from the explanation above, you are just adding fuel to the fire.

Increase proteins, fats and vegetable intake and see how things improve.

Have a great weekend.

Best regards

Chris Adams