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Diet for individuals with insulin resistance
Table of Contents
1. What is insulin resistance?
Insulin is a hormone produced by the pancreas that fulfills numerous important functions related to metabolism. These include the transportation of glucose to cells, storage of glucose as glycogen, and involvement in the metabolism of carbohydrates, proteins, and fats. Insulin resistance is a complex pathological condition resulting from a disturbed carbohydrate metabolism. In this state, insulin-dependent cells (including fat cells, muscle cells, and liver cells) exhibit reduced sensitivity to insulin's action, leading to diminished capacity for glucose absorption and utilization. The primary cause of insulin resistance is often an excessive amount of fat tissue resulting from overweight and obesity, triggered by inadequate physical activity and diet. Genetic predisposition, certain medications, and other diseases can also contribute. Symptoms of insulin resistance may include daytime drowsiness (particularly after meals), difficulty falling asleep, fatigue, headache, irritability, cravings for sweets (often after large meals), weight loss resistance, skin changes such as acanthosis nigricans, decreased muscle strength and endurance, as well as co-occurring conditions like hypertension, elevated cholesterol, triglycerides (lipid disorders), and uric acid levels (gout).2. Identification and treatment of insulin resistance
In order to diagnose insulin resistance, certain tests must be performed. The glucose and insulin levels must be checked in a fasting state. Based on these results, the HOMA-IR index is calculated. In people with normal insulin sensitivity under normal physiological conditions, this index should not exceed 2.5. A commonly performed test that evaluates the carbohydrate economy is the OGTT load test. This test involves determining the glucose level in the blood in a fasting state, drinking a solution containing 75 g of glucose, and then measuring the glucose level in the blood again after 2 hours. In the case of insulin resistance, appropriate treatment is required. The most important component of treatment is lifestyle modification, normalization of body weight, introduction of a suitable diet and physical activity, and the elimination of substances such as alcohol and cigarettes. In some cases, pharmacotherapy, such as metformin, may be used.3. Dietary recommendations for insulin resistance
Taking into account the glycemic index (GI), products can be divided into those which are quickly digested after consumption and cause a sudden increase in blood glucose (currently known as sugar levels) and those with a gradual release of glucose after consumption. The first group includes products with a high Glycemic Index which should be best eliminated from the diet. These are: sugar, honey, jam, salt and other high-processed carbohydrate products. The second group is low-glycaemic products, so it should be based on the diet of people with a low glycaemic index.4. The accurate composition of the meal
The correct composition of a meal for insulin-resistant individuals should include protein, fat, and carbohydrates. There is information about the recommended consumption of protein- and fat-rich breakfasts and the reduction of carbohydrates, but this depends on individual circumstances. This approach can be helpful for some people, while it may not be relevant for others. It all depends on your well-being and the results of your tests, but keep an eye on your body. However, carbohydrates should never be consumed without other nutrients, as this prevents a sudden increase in blood sugar and insulin levels. For example, fruits should not be eaten as a standalone snack but combined with yogurt and nuts, so that proteins and healthy fats are also present in the meal. The presence of these nutrients reduces the glycemic index, prolongs the digestion time, and prevents sudden fluctuations in blood sugar levels, while simultaneously increasing the feeling of fullness and reducing the desire for snacks.5. Rhythmicity of meal consumption
Besides the correct composition of meals, rhythmicity is also important. Regular consumption of meals at fixed times of the day, with appropriate breaks, helps to avoid sudden fluctuations in insulin and blood glucose levels. Moreover, it prevents a strong feeling of hunger, uncontrolled appetite and a tendency to overeat. A common problem is skipping meals in the morning and consuming a substantial meal in the evening. Such a rhythm can lead to the accumulation of fat tissue, production of inflammatory substances and reduction of tissue sensitivity to insulin.6. Augmenting the dietary fiber intake
Dietary fibers constitute an exceptionally important component of nutrition. They contribute to a feeling of satiety, as they can absorb water molecules. They expand in the digestive tract, leading to an increase in the size of the consumed meal. They slow down gastric emptying, diminish hunger, and stabilize intestinal functioning. Moreover, products with high fiber content are recognized for their lower glycemic index. The best sources of this substance include whole-grain products, vegetables, fruits, legumes, and nuts. An augmented fiber intake in the diet results in enhanced insulin sensitivity, improved lipid profile, and consequently, a reduced risk of cardiovascular and metabolic diseases.7. Consumption of unsaturated fats
Insulin resistance is very often accompanied by elevated levels of cholesterol and triglycerides. For this reason, the quality of fat consumed should be taken into account. These saturated and trans fats should be eliminated from the diet or, at least, severely limited. They are mainly found in animal products, processed foods and fast foods. They should be replaced with mono- and polyunsaturated fatty acids. Particular importance is attached to omega-3 fatty acids, as they have anti-inflammatory properties, improve lipid profile and insulin sensitivity. Their valuable sources include, above all, fatty sea fish, vegetable oils, walnuts, flaxseed and chia seeds. These products should be consumed regularly.8. Adequate water provision
In the case of insulin resistance, water is the optimal choice. To diversify the flavor, it is beneficial to add lemon slices, cucumber slices, and/or fresh mint leaves. You can also consume unsweetened tea and herbal infusions, specifically from white mulberry and nettle. They demonstrate hypoglycemic properties (lowering blood glucose levels). There are fascinating studies that suggest that black coffee without added sugar and milk consumed in moderate amounts (3-4 cups per day) has a favorable impact on the carbohydrate metabolism, regulates glucose levels, and also increases cellular insulin sensitivity (N. Tajik et al. 2017; C. E. G. Reis, J. G. Dórea, T. H. M. da Costa 2019).9. Should gluten and dairy products be eliminated?
There are often recommendations to remove gluten and dairy products from the diets of people with insulin resistance. However, the only indication for the exclusion of gluten is the presence of celiac disease, gluten intolerance or wheat allergy. Gluten-free products are often made from rice or corn flour, which have low fiber content and a high glycemic index, which can negatively affect people with insulin resistance. Similarly, if no allergy or intolerance has been diagnosed, there is no need to eliminate dairy products from the diet. However, it should be noted that restrictive diets that limit the consumption of different food groups can lead to deficiencies and negative health effects.10. Summary
An appropriate diet forms the foundation of insulin resistance treatment. The daily menu should include fresh fruits and vegetables, as well as foods with a low glycemic index, high in dietary fiber and good quality fats. At the same time, highly processed foods, rich in simple sugars and saturated fatty acids, should be avoided. It is also important to combine various products and maintain regular meal times. In case of overweight or obesity, it is necessary to apply a reductive diet to decrease body weight. Furthermore, introducing individually tailored physical activity is crucial.
