Monthly Archives: December 2017

This may be your best way to lose weight

You want to lose weight, but your insulin might not be working well. You’re not alone. Almost a third of our country is in the same boat.

Impaired insulin function is genetic. It’s the precursor to diabetes that may go undetected for years. It gradually damages the insulin-producing pancreas to the point it stops making enough insulin and blood sugars rise eventually to the diabetes range. In the early phase of impaired insulin function, the pancreas makes extra insulin. This extra insulin causes our body store more fat.

If you have a family history of diabetes, then there is a good chance your insulin levels are high. Diabetes is often not diagnosed. You may not think you have a family history of diabetes, however if you have a family history of stroke or heart attack, there was probably undiagnosed diabetes lurking in the background as well. Diabetes is a vascular disease, so strokes and heart attacks are complications of diabetes.

The best way to lose weight if you have high insulin levels

The best way to lose weight for people with high insulin levels, in addition to regular exercise, should focus on limiting carbs, getting adequate protein and fiber, and topping it off with good fat to keep you full between meals.

When it comes to eating this way, the best metaphor comes from a friend. If you’ve ever sat by a campfire and observed how different types of wood burn, you will understand.

If you don’t add any wood to a fire, the flames will fade away. Add soft wood like pine to the fire and “snap, crackle, pop” sparks will fly, the flames will roar and the wood will disappear in no time. Add hardwood like oak and you’ll get a nice even burn that will last much longer than soft wood.

Skipping meals is like not adding any wood to the fire. Your energy level will slowly fade away.

Eating a meal consisting of a heavy dose of simple carbs with little protein or fiber is like the soft wood fire. You may get a surge of energy but it will quickly flame out leaving you tired and ready for a nap. Examples of meals like this might be a few bowls of Corn Flakes or heavy portions of Chinese food with white rice or a bag of chips or pretzels with a soda.

But make your meals mostly “hardwood” and you will have more energy and stay fuller longer between meals. You will also keep your insulin levels lower which will aid in weight loss.

Getting your meal planning to burn like hardwood

Don’t worry, eating this way won’t taste like hardwood. You can still enjoy your favorite foods, just do so in moderation and plan for it in how you combine your foods.

My recommendations are based on information from the American Diabetes Association, the 2015 dietary guidelines, the 2015 Protein Summit  and the Institute of Medicine.

The ADA recommends people with diabetes limit their carbs to 45-60 g of carbs per meal and carbs from snacks limited to 15 gm. Some of the people I worked with preferred eating even fewer carbs in order to avoid going on medicine to manage their blood sugars.

The 2015 Nutrition Guidelines recommend getting at least 130 g of carbs daily. Eating fewer carbs than this will zap your energy if you are trying to do any strenuous work or workout – carbs are the gasoline for your body, you just want to learn how to make them the premium carbs.

The Institute of Medicine recommends 10-35% of total daily calories come from protein. For a 2000 calorie diet that’s about 50 – 175 g.

The 2015 Protein Summit recommended a higher level of dietary protein, particularly in older adults, for improved muscle health and satiety and to aid in weight management. Furthermore, they suggest:

“Emerging science supports a protein intake for adults of 25–30 g/meal”

When you put all this information together your daily total of carbs, fiber, protein and fat should look like this:

daily carbs, protein and fat

Impaired insulin function?  This is your meal goal

You want each meal to burn like hardwood. That means you want to get the right amount of carbs, fiber, protein and fat each time you eat. Most people fail on getting adequate protein and fiber at most of their meals. Each of these components is essential not only for health, but for satiety. The goal is to slow down digestion so you stay fuller longer and reduce the demand for insulin.

Each of your meals should contain just a serving or two of carbs, no more than 60 g per meal. Your carb choices should be high in fiber to slow down the rise in blood sugar, decreasing the need for insulin.

Your protein goal at each meal should be at least 25 g per meal. An ounce of meat, fish and even an egg is about 6-7 g.

Since dietary fat takes longer to digest and helps with satiety, you should also try to get about 10 g per meal with the focus being on heart healthy unsaturated fat.

The ideal goal for each meal should look something like this:  

  • 50 g of carbs
  • 8-10 g of fiber
  • 25 g of protein
  • 10 g of heart healthy fat.

That’s the hardwood that will help you lose weight. Now, let’s look at the big picture at what kinds of foods will meet the “hardwood” criteria.

“Hardwood” foods

Some foods are combination foods. Quality carbs are also high in fiber. Whole grains, citrus fruit, and beans are all examples of quality carbs. Fatty fish is both an excellent source of protein and healthy fat. Other protein, like white chicken and fat-free Greek yogurt have little to no fat, so you will need to get your fat from other sources. And there are some foods that contain a small amount of protein, carbs, fiber and healthy fat. They are like “hardwood” bark mulch😊

This is how I breakdown food categories(it’s not a complete list – just some of my favorites). I compose my plate according to how much protein, fat and carbs a food offers. If one food is a combination of carbs or protein or fat, I would combine it accordingly. Most veggies, other than the starchy ones are free territory. Eating as much as you can will help blood pressure, brain function and health in general.

healthy food list

Breakfast

People with high insulin levels should stay away from cereal in my opinion. Cereal does not contain enough protein considering the carbs in a serving. Adding milk only increases the carbs – there are 12 g of carbs in a cup of milk. You are much better off eating your leftover dinner than eating a bowl of cereal. Here are a few suggestions:

  1. Smoothie made with 3/4 cup plain low-fat Greek yogurt, 2 tbsp chia or flax seed, 2 cups baby kale, ¾ cup frozen berries and enough water to blend.
  2. ¾ cup plain low-fat Greek yogurt with ½ cup fresh chopped fruit, and 2 tbsp chopped walnuts or almonds.
  3. ¾ cup low-fat Greek yogurt sprinkled with ¼ cup Uncle Sam’s Cereal, 2 tbsp chia seeds and ¼ cup fresh blueberries.
  4. 2 eggs or egg white combination omelet with spinach and 1 slice of swiss cheese served with one piece of toast.
  5. ¾ cup bean salad with ¾ cup low-fat cottage cheese.
  6. ¾ cup low-fat cottage cheese with ½ cup chopped fruit and 2 tbsp chia seeds.

Lunch/Dinner Ideas

  1. Salad topped with chicken, beans and balsamic dressing and a piece of fruit.
  2. Turkey and arugula sandwich on whole grain bread with mayo and mustard along with celery and carrots and hummus.
  3. 6 oz Greek yogurt, apple and sliced cucumbers.
  4. Tuna and whole grain pasta salad mixed with chopped carrots, celery, cabbage, mayo, salt and pepper
  5. 1 cup lentil or some other bean soup with 2 celery and peanut butter.

Or make your plate look like this:

healthy plate

Emphasize vegetables and limit the carbs most of the time and you will lose weight. If you miss something sweet, then skip the carbs at dinner and have the dessert instead – ideally eating it right after your dinner so you can slow down the blood sugar rise with the fiber and protein from your dinner.

This is the hardwood that will help you lose weight by preserving your muscle mass and keep your metabolism at a steady even burn – even while you’re roasting marshmallows over a campfire.

reduce carbs to lose weight

Losing weight is not just about calories

A calorie is a calorie, is a calorie, right? Can’t you just lose weight by reducing calorie intake?

I don’t think it’s as simple as that and here’s why.

It boils down to insulin resistance. Insulin resistance occurs when cells in the body, particularly the muscle, fat and liver cells, don’t utilize insulin as effectively. Insulin is a hormone that helps glucose get into the cells for energy. The body compensates for insulin resistance by making extra insulin, a condition called hyperinsulinemia.

If someone with high levels of insulin eats a diet high in carbs, then more of those calories are going to be stored in the body because insulin is the gatekeeper to the utilization of digested carbs. The more insulin in the body and the more glucose from digested carbs, the more will be stored in the body. This is my opinion, and it’s based on experience.

It reminds me of a person I knew who tried to lose weight by lowering her calories to 800 a day (way too low) and her diet consisted mainly of carbs. Her weight didn’t budge an ounce. Part of that may have been due to her body thinking she was in starvation mode, and really slowed down metabolism. But I believe the other reason is she also had hyperinsulinemia and all those carb calories were being stored. This doesn’t mean you should avoid carbs. However it does indicate, in my opinion, the importance of eating a balanced diet with adequate protein, healthy fat and fiber. I’ll go more into that in the next blog.

For a while the insulin-producing pancreas can keep up with the increasing demand for insulin and blood glucose levels stay in a healthy range. But eventually, the beta cells of the pancreas stop producing enough insulin and blood glucose levels start to rise leading to prediabetes, and eventually type 2 diabetes.

This period of hyperinsulinemia may go on for years before blood sugar levels rise. And what’s behind it is most likely a genetic component that makes someone prone to insulin resistance and a diet high in quickly digested carbs.

Genetics of type 2 diabetes

Type 2 diabetes is thought to be due to the “thrifty gene”. Certain cultures historically were exposed to periods of food scarcity and their bodies compensated by slowing down metabolism. And then these same cultures over time were exposed to a higher carb diet with foods like processed grains, fried foods, and sweetened drinks. Not what you want to be eating when your body is on the slow burn road. According to the National Institute of Health, these cultures include Pacific Islanders, African Americans, Native Hawaiians, Asian Americans, American Indians and Hispanic or Latino.

Since genetics plays a role, ask your relatives about any family history of type 2 diabetes. Be aware, that out of the 26 million people in the U.S. with type 2 diabetes, there are 7 million who don’t know they have it. Indications that someone may have undiagnosed diabetes include:

  • Excessive thirst – high glucose levels cause dehydration.
  • Frequent infections including yeast infections in folds of skin that are slow to heal.
  • Blurry vision that comes and goes – glucose and fluid collects in the lens of the eye when glucose levels are high causing swelling that distorts vision.
  • Extreme fatigue – glucose is not getting into the cells sufficiently to provide the body with energy.
  • Hunger – people with type 2 diabetes are constantly hungry, even right after eating probably due to changes in other hormones affecting digestion like Leptin and partially due to the cells “starving” for glucose.

Other indications you may have insulin resistance

There are other conditions that may indicate that you have insulin resistance. If you have any of these then you most likely have insulin resistance.

  • Gestational Diabetes
  • Were a large baby at birth, > 9 pounds
  • Polycystic Ovary Syndrome
  • Low (good) HDL and high triglycerides
  • Hypertension
  • Over age 45
  • Depression
  • Have a skin condition called acanthosis nigricans, dark, velvety skin around your neck or armpits
  • Overweight or carry excess weight around your middle

Symptoms of insulin resistance can be very subtle

Perhaps you may notice that you’re more tired and hungry than usual. Perhaps you’ve been a bit down and depressed. Maybe you’ve gained a few pounds. You might chalk it up to stress at work, but perhaps your body is shifting to a more insulin resistant state and you’re developing hyperinsulinemia. Maybe your just don’t want to think about that right now because you’ve got too much on your plate.

Danger of hyperinsulinemia

Insulin makes our body store more calories which contributes to weight gain.

The increased work load on the pancreas eventually exhausts the beta cells of the pancreas and leads to diabetes.

But most people are not aware of the link between high insulin levels and cancer. As I’ve mentioned many times before, insulin is like fertilizer to our body. It does get glucose into the cells for energy, but it is also feeds the “weeds” in our body, those cancerous cells our body is always making but not always destroying. Getting insulin levels down reduces the risk of cancer.

I’ll never forget a patient I worked with who developed type 2 diabetes and eventually used an insulin pump to better manage her blood sugars. Her A1c was at a healthy range, but she gradually gained weight. She was eating pretty much whatever she wanted, and doing an awesome job adjusting her insulin dosage, but over time she was requiring more and more insulin to keep those blood sugars under control. She gained over 30 pounds over that period, despite good blood sugar control, but she was requiring a lot of insulin. She ended up passing away not from complications of diabetes, but from cancer. I always wondered what all that insulin was doing to the other hormones in her body, setting herself up for cancer.

A calorie may be a calorie, but I believe the type of calorie counts

Losing weight is not just about calories. High insulin levels in conjunction with a high carb diet will make weight loss difficult. However, I also don’t believe in a ketogenic diet like Dr. Adkins; it’s a radical way of eating that isn’t sustainable and it omits a lot of vitamins, minerals and cholesterol lowering fiber that grains can provide. But I do believe reducing carbs, and making them whole grain and adding more enough protein and fiber will reduce your insulin levels, improve your insulin resistance, help you lose weight and ward off diabetes, heart disease and cancer.

If you enjoy my tips, please share with your friends and family. You can get healthy on your own with good information and a desire to live a healthier life. Please make a donation to the Saint Vincent De Paul Soup Kitchen. They are in great need of your financial support while they provide over 10,000 meals a year to Portland, Maine’s neediest population.