Metabolic weight gain
What is insulin resistance syndrome or metabolic syndrome?
"Let food be your medicine, medicine be your food" - Hippocrates, father of medicine
Before looking at insulin resistance, it is important to understand the hormone insulin. Insulin is the key hormone for body building, fat metabolism and blood glucose control that all human beings must have in order to survive.
How does insulin work?
After you eat carbohydrates, your blood sugar levels will increase. It is the job of the hormone insulin to push the glucose into the cells where it is used for energy or stored for future as fat. Insulin also helps muscles, fat and liver cells store sugar by converting it in to fat that can be released when it is needed.
What happens to all the excess calories we taken in, especially the high glycemic starches, often called "empty calories'?
If the body takes in too much energy, especially simple sugars found in refined carbohydrates, the cells are bombarded with so much insulin that the “doors” begin to malfunction and shut down. If the doors aren’t open, the pancreas feels the need to produce even more insulin to push into the cells because it cannot perform its function to lower sugar levels, tending to leave the insulin floating in the blood stream. A vicious cycle is now in place resulting in a condition called Insulin resistance.
What is insulin resistance?
Over time of getting exposed to high levels of insulin, it is believed that the body fails to respond to insulin the same way and starts becoming resistant.
How does the body react to insulin resistance?
Fortunately, the body can adjust to insulin resistance very well, at least in the initial stages, by increasing the production of insulin by several fold. In fact, the body can increase the production of insulin as high as 100 times normal in many patients!
What side effects does this compensation for insulin resistance has on the body?
Unfortunately, this compensation to insulin resistance comes at a huge cost - this is because insulin is a very powerful anabolic or body building hormone leading excess weight gain especially in the waist, tummy, and upper part of the body!
How does insulin resistance explain my sugar cravings?
Insulin resistance leads to "sugar rush" immediately after a starchy meal such as a meal with high glycemic foods such as bagels, cheerios, rice, wheat, bread etc. This sugar rush is followed by a "crash" 2-4 hours later when the blood sugar starts to drop significantly, sometimes to clinical hypoglycemic levels. This hypoglycemia is the reason for the cravings as your body craves starchy foods again!
What is metabolic starvation?
Insulin resistance is believed to lead to internal starvation in obese people who are insulin resistant due to a peculiar phenomenon called "metabolic starvation". Normally, starvation happens after most of the stores of the fat are used up. But in people who are insulin resistant, their fat stores become "locked" so they can only store fat but unable to get the fat back when they need it due to "metabolic starvation"
How prevalent is insulin resistance?
Currently, up to 71 percent of the population of the United States is estimated to have some degree of Insulin Resistance out of which a third of the population meet the clinical criteria for Metabolic Syndrome.
What is glycemic index of foods and how does this relate to insulin resistance?
The glycemic indexes of foods determine how much glucose is in foods and how fast the glucose is absorbed into the blood stream.
How does the high glycemic food lead to insulin resistance?
Over a time of eating high glycemic index diets such as white bread, white rice, potatoes, French fries, soft drinks etc, the body becomes insulin resistant.
In order to compensate, our body produces more insulin. Since insulin is an anabolic hormone, those with insulin resistance tend to gain weight and this weight is distributed centrally, i.e. around the abdomen. Since abdominal fat produces harmful cytokines leading to body inflammation, it is imperative that reducing insulin resistance would be the key to reduce the risk of metabolic syndrome.
Insulin resistance inhibits our fat cells from giving up their stores of energy to let us lose weight. The more overweight we are, the more insulin resistant we tend to become and can cause adverse health effects. The more insulin that is created leads to more fat cells to store it in, especially around the belly area, which causes less ability or desire to exercise so the glucose cannot be burned.
How did we get here?
About 50 years ago, the food pyramid was compiled by USDA with the understanding that dietary fat was the basis of obesity and reducing the dietary fat from 40% to about 35% percent would reduce the obesity. The food pyramid was constructed with very little scientific evidence and significant carbohydrates, especially the ones with high glycemic index were allowed to be consumed. However, the high starch containing foods lead to the phenomenon of Insulin Resistance which eventually leads to a whole host of metabolic problems including risk of type II diabetes, cardiovascular disease, metabolic syndrome etc.
What are the signs of insulin resistance? Can I check if I am insulin resistant?
Use this free online tool available on w8md called insulin resistance calculator
Metabolic Syndrome definitions
The five conditions as noted below are part of the criteria for metabolic syndrome out of which you need to have any three of the factors to meet the full metabolic syndrome criteria. According to Centers for Disease Control, about 35 percent of all US adults already meet all three criteria while some others meet 1-2 criteria.
- A large waistline is one of the most important criteria for metabolic syndrome. A waist of 40 inches in the mid section of abdomen in men, or 36 in women (Lower in Asians) is considered a risk factor. Many studies have documented the increased health risk that comes from belly fat, so called muffin top bodies or apple shaped bodies. Belly fat increases the risk of heart disease, increased inflammation and increases the risk of many cancers.
- A high triglyceride level, a type of fat found in the blood and is part of the lipid panel. If you take a cholesterol lowering medication, you most likely would meet this criteria automatically. Else, a level of 150 or more of triglycerides is considered a risk factor
- A low good cholesterol or HDL cholesterol level (or you're on medicine to treat low HDL cholesterol). As good cholesterol or HDL cholesterol level is important to protect the heart, a low level of this good fat raises your risk for heart disease.
- High blood pressure (or you're on medicine to treat this).
- High fasting blood glucose or sugar (or you're on medicine to treat high blood sugar) of above 100. Mildly high blood sugar may be an early sign of diabetes also called prediabetes, metabolic syndrome or insulin resistance syndrome.
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