Insulin and Insulin Resistence - Guide

Insulin is an important hormone that controls many processes in the body.

However, problems with this hormone are at the heart of many modern health conditions.

Sometimes our cells stop responding to insulin-like they are supposed to.

This condition is termed insulin resistance and is incredibly common.

In fact, a 2002 study showed that 32.2% of the US population may be insulin resistant.

This number may rise to 70% in obese adult women and over 80% in some patient groups. About a third of obese children and teenagers may also have insulin resistance.

These numbers are scary, but the good news is that insulin resistance can be dramatically improved with simple lifestyle measures.

This article explains what insulin resistance is, why you should care and how you can overcome it.

Insulin and Insulin Resistance Explained

Insulin is a hormone secreted by an organ called the pancreas.

Its main role is to regulate a number of nutrients circulating in the bloodstream.

Although insulin is mostly implicated in blood sugar management, it also affects fat and protein metabolism.

When we eat a meal that contains carbohydrates, the amount of blood sugar in the bloodstream increases.

This is sensed by the cells in the pancreas, which then release insulin into the blood.

Then insulin travels around the bloodstream, telling the body’s cells that they should pick up sugar from the blood and bring it into the cells.

This leads to reduced amounts of sugar in the blood, and puts it where it is intended to go, into the cells for use or storage.

This is important, because high amounts of sugar in the blood can have toxic effects, causing severe harm and potentially leading to death if untreated.

However, due to various reasons (discussed below), sometimes the cells stop responding to the insulin-like they are supposed to.

In other words, they become “resistant” to the insulin.

When this happens, the pancreas starts producing even more insulin to bring the blood sugar levels down. This leads to high insulin levels in the blood, termed hyperinsulinemia.

This may continue to develop for a long time. The cells become increasingly more insulin resistant, and both insulin and blood sugar levels go up.

Eventually, the pancreas may not be able to keep up anymore and the cells in the pancreas may become damaged.

This leads to decreased insulin production, so now there are low amounts of insulinand cells that don’t respond to the little insulin that is available. This can lead to skyrocketing blood sugar levels.

When blood sugar levels exceed a certain threshold, a diagnosis of type 2 diabetes is made. In fact, this is a simplified version of how type 2 diabetes develops.

Insulin resistance is the main cause of this common disease that affects about 9% of people worldwide.

Resistance vs Sensitivity

Insulin resistance and insulin sensitivity are two sides of the same coin.

If you are insulin resistant, then you have low insulin sensitivity. Conversely, if you are insulin sensitive then you have low insulin resistance.

Being insulin resistant is a bad thing while being insulin sensitive is good.

Bottom Line: Insulin resistance implies that the cells are not responding well to the hormone insulin. This causes higher insulin levels, higher blood sugar levels and may lead to type 2 diabetes and other health problems.

What Causes Insulin Resistance?

There are many potential causes and contributors to insulin resistance.

One of the main ones is believed to be increased amount of fats in the blood.

Numerous studies show that high amounts of free fatty acids in the blood cause cells, such as muscle cells, to stop responding properly to insulin.

This may be partly caused by fats and fatty acid metabolites building up inside muscle cells, termed Intra myocellular fat. This disrupts the signalling pathways needed for insulin to work.

The main cause of elevated free fatty acids is eating too many calories and carrying excess body fat. In fact, overeating, weight gain and obesity are all strongly associated with insulin resistance.

Having increased visceral fat, the dangerous belly fat that builds up around the organs, seems to be very important.

This type of fat may release lots of free fatty acids into the blood, and can even release inflammatory hormones that drive insulin resistance.

However, normal weight or thin people can also be insulin resistant, it is just much more common among those who are overweight.

There are several other potential causes of insulin resistance:

• Fructose: A high intake of fructose (from added sugar, not fruit) has been linked to insulin resistance in both rats and humans.
• Inflammation: Increased oxidative stress and inflammation in the body may lead to insulin resistance.
• Inactivity: Physical activity increases insulin sensitivity and being inactive causes insulin resistance.
• Omega-3: Eating omega-3 fatty acids can in many cases reduce insulin resistance. They can also lower blood triglycerides, which are often high in insulin resistant people.
• Gut microbiota: There is evidence that a disruption in the bacterial environment in the gut can cause inflammation that exacerbates insulin resistance and other metabolic problems.

There are also various genetic and social factors, and blacks, Hispanics and Asians are at particularly high risk.

This list is not definitive. There are many other factors that may affect insulin resistance/sensitivity.

Bottom Line: The main causes of insulin resistance may be overeating and increased body fat, especially in the belly area. Other factors include high sugar intake, inflammation, inactivity and genetics.

How to Know if You Are Insulin Resistant

There are several ways that your doctor can determine if you are insulin resistant.

For example, having high fasting insulin levels is a good sign that you have insulin resistance.

A test called HOMA-IR estimates insulin resistance based on your blood sugar and insulin levels, and is fairly accurate.

There are also ways to measure blood sugar control more directly, such as an oral glucose tolerance test, where you are given a dose of glucose and then your blood sugar levels are measured for a few hours.

If you are overweight or obese, especially with large amounts of fat around the belly area, then chances are very high that you are insulin resistant.

There is also a skin condition called acanthosis nigrans, involving dark spots on the skin that can indicate insulin resistance.

Having low HDL (“good” cholesterol) levels and high blood triglycerides are two other markers that are strongly associated with insulin resistance.

Bottom Line: Having high insulin levels and high blood sugar levels are key symptoms of insulin resistance. Other symptoms include lots of belly fat, high blood triglycerides and low HDL levels

Insulin Resistance, Metabolic Syndrome and Type 2 Diabetes

Insulin resistance is a hallmark of two very common conditions, metabolic syndrome and type 2 diabetes.

The metabolic syndrome is a group of risk factors associated with type 2 diabetes, heart disease and other problems.

The symptoms are high blood triglycerides, low HDL levels, elevated blood pressure, central obesity (belly fat) and elevated blood pressure.

Sometimes this condition is referred to as the “insulin resistance syndrome”.

Insulin resistance is also a major driver of type 2 diabetes. The high blood sugar levels are caused by the cells not responding to insulin anymore.

Over time, the insulin-producing cells in the pancreas may stop functioning, leading to insulin deficiency as well.

By stopping the development of insulin resistance, it may be possible to prevent most cases of metabolic syndrome and type 2 diabetes.

Bottom Line: Insulin resistance is at the heart of metabolic syndrome and type 2 diabetes, which are currently among the biggest health problems in the world.

Insulin Resistance is Linked to Heart Disease and All Sorts of Other Health Problems

Insulin resistance is also strongly associated with heart disease, which is the world’s biggest killer.

In fact, people who are insulin resistant or have metabolic syndrome have up to a 93% greater risk of heart disease.

There are many other diseases linked to insulin resistance. This includes non-alcoholic fatty liver disease, polycystic ovarian syndrome (PCOS), Alzheimer’s disease and cancer.

Bottom Line: Insulin resistance may cause a variety of diseases, including heart disease, non-alcoholic fatty liver disease, polycystic ovarian syndrome, Alzheimer’s disease and cancer.

Ways to Reduce Insulin Resistance (Improve Insulin Sensitivity)

The good thing about insulin resistance, is that it is very easy to influence it.

In fact, changing your lifestyle is able to completely reverse insulin resistance in many cases.

Here are several evidence-based ways to reduce insulin resistance:

1. Exercise: This may be the single easiest way to improve insulin sensitivity. The effect is almost immediate.
2. Lose belly fat: Try to lose some fat, especially the deep “visceral” fat from your liver and belly. This article lists several evidence-based tips on how to lose belly fat.
3. Stop Smoking: Tobacco smoking can cause insulin resistance, so quitting should help.
4. Sugar: Try to reduce your intake of added sugars, especially from sugar-sweetened beverages.
5. Eat healthily: Eat a diet based mostly on whole, unprocessed foods. Include nuts and fatty fish.
6. Supplements: Taking a supplement called berberine can be effective to enhance insulin sensitivity and reduce blood sugar. Magnesium supplements may be helpful as well.
7. Sleep: There is some evidence that poor sleep causes insulin resistance, so improving sleep quality should help.
8. Stress: If excessive, try to manage your stress levels. Meditation has been shown to be helpful.
9. Donate blood: High levels of iron in the blood are linked to insulin resistance. For men and postmenopausal women, donating blood may improve insulin sensitivity.

Most of the items on the list also happen to be the same things we generally associate with good health, protection against disease and a long life.

All this being said, keep in mind that nothing in this article is intended as medical advice.

Insulin resistance is linked to various serious health problems, and I recommend that you speak to your doctor about your options. There are also various medical treatments that can work.

Bottom Line: Insulin resistance may be reduced or even completely reversed with simple lifestyle measures. These include exercise, eating healthy, losing belly fat and taking care of your sleep and stress levels.

Take Home Message

Insulin resistance may be one of the key drivers of many (if not most) of today’s chronic diseases, which are collectively killing millions of people every year.

The good news is that it can be significantly improved with simple lifestyle measures, such as losing fat, eating healthy food and exercising.

Preventing insulin resistance may be among the single most powerful things you can do to live a longer, healthier and happier life.

By Kris Gunnars BSc

Read More

A1 vs A2 Milk – Does it Matter?

The health effects of milk may depend on the breed of cow it came from.

Currently, A2 milk is being marketed as a healthier choice than regular milk.

It is claimed to have several health benefits, and to be easier to digest for people who are lactose intolerant.

However, not all scientists agree that A2 milk is better for health.

This article takes an objective look at the science behind A1 and A2 milk.

What Do A1 and A2 Mean?

Casein is the largest group of proteins in milk, making up about 80% of the total protein content.

There are several types of casein in milk, and beta-casein is the second most common. Beta-casein exists in at least 13 different forms.

The two most common forms of beta-casein are:

• A1 beta-casein: Milk from breeds of cows that originated in northern Europe is generally high in A1 beta-casein. A1 milk comes from breeds like the Holstein, Friesian, Ayrshire and British Shorthorn.
• A2 beta-casein: Milk that is high in A2 beta-casein is mainly found in breeds that originated in the Channel Islands and Southern France. This includes breeds like the Guernsey, Jersey, Charolais and Limousin.

Regular milk contains both A1 and A2 beta-casein, but A2 milk contains only A2 beta-casein.

Some studies indicate that A1 beta-casein may be harmful, and that A2 beta-casein is a safer choice. This is the reason for the “A1 vs A2” debate.

(Image from Food Navigator USA).

A2 milk is produced and marketed by the A2 Milk Company, and contains no A1 beta-casein.

Bottom Line: A1 and A2 milk contain different types of a protein called beta-casein. Some studies indicate that A2 milk may be the healthier of the two.

Beta-Casomorphin-7

Beta-casomorphin-7 (BCM-7) is the reason why regular milk is believed to be less healthy than A2 milk.

BCM-7 is an opioid peptide that is released during the digestion of A1 beta-casein.

A few research groups have suggested that BCM-7 may be harmful.

While BCM-7 may affect the digestive system, it is not yet clear to what extent BCM-7 is absorbed intact into the blood.

Studies have not found BCM-7 in the blood of healthy adults after drinking cow’s milk, but a few studies indicate that BCM-7 may be present in infants.

BCM-7 has been extensively studied, but its health relevance still remains unclear.

Below is a review of the scientific evidence linking A1 milk and BCM-7 with type 1 diabetes, heart disease, infant death, autism and digestive problems.

Bottom Line: Regular milk contains A1 beta-casein, which is partly broken down to beta-casomorphin-7 (BCM-7) in the stomach. BCM-7 has been linked with several adverse health effects.

Risk of Type 1 Diabetes

Type 1 diabetes is typically diagnosed in children, and is characterized by a lack of insulin in the body.

Several studies indicate that drinking A1 milk during childhood may increase the risk of type 1 diabetes.

However, these studies are observational in nature.

They cannot prove that A1 beta-casein caused type 1 diabetes, only that those who got more of it were at a higher risk of getting the disease.

Animal studies have provided conflicting results.

Some have found no difference between A1 and A2 beta-casein. Others have shown A1 beta-casein to have either protective or adverse effects on type 1 diabetes.

So far, no clinical trials in humans have investigated the effect of A1 beta-casein on type 1 diabetes.

Bottom Line: Several observational studies have found a link between A1 milk consumption during childhood and increased risk of type 1 diabetes. However, the evidence is mixed and more research is needed.

Risk of Heart Disease

Two observational studies have linked the consumption of A1 milk with an increased risk of heart disease.

This is supported by one experiment in rabbits. It showed that consuming A1 beta-casein promoted fat buildup in injured blood vessels. This buildup was much lower when the rabbits consumed A2 beta-casein.

Fat accumulation may potentially clog blood vessels and cause heart disease. However, the human relevance of the results has been debated.

So far, two human trials have investigated the effects of A1 milk on heart disease risk factors.

One of them included 15 men and women who were at a high risk of heart disease. The study had a crossover design, meaning that all participants received A1 and A2 beta-casein at different periods during the study.

The study didn’t find any significant adverse effects on risk factors for heart disease. Compared with A2 beta-casein, the A1 type had similar effects on blood vessel function, blood pressure, blood fats and inflammatory markers.

Another study found no significant differences in the effects of A1 and A2 casein on blood cholesterol.

Bottom Line: There is no strong evidence that A1 milk increases the risk of heart disease. However, the long-term effects have not been studied.

Sudden Infant Death Syndrome

Sudden infant death syndrome (SIDS) is the most common cause of death in infants less than one year of age.

SIDS is defined as the unexpected death of an infant, without an apparent cause.

Some researchers have speculated that BCM-7 may be involved in some cases of SIDS.

One study found high levels of BCM-7 in the blood of infants who temporarily stopped breathing during sleep. This condition, known as sleep apnea, is linked to an increased risk of SIDS.

These results indicate that some children may be sensitive to the A1 beta-casein found in cow’s milk. However, further studies are needed before any firm conclusions can be reached.

Bottom Line: There is limited evidence that A1 milk may increase the risk of sudden death in infants. More research is needed.

Risk of Autism

Autism is a mental condition characterized by poor social interaction and repetitive behavior.

In theory, peptides like BCM-7 might play a role in the development of autism. However, studies do not support all of the proposed mechanisms.

One study of infants found higher levels of BCM-7 in those who were fed cow’s milk, compared to those who were breastfed. However, levels of BCM-7 dropped quickly in some of the infants, whereas they remained high in others.

For those who retained these high levels, BCM-7 was strongly associated with an impaired ability to plan and perform actions.

Another study indicated that drinking cow’s milk may worsen behavioral symptoms in autistic children.

On the other hand, some studies found no effects on behavior.

So far, no human trials have specifically investigated the effects of A1 and A2 milk on symptoms of autism.

Bottom Line: There is no conclusive evidence about the effects of A1 milk on autism. However, the issue is complicated and needs to be studied further.

Digestive Health

Lactose intolerance is defined as the inability to fully digest the sugar (lactose) found in milk. This is a common cause of bloating, gas and diarrhea.

The amount of lactose found in A1 and A2 milk is the same. However, some people feel that A2 milk causes less bloating than A1 milk.

Supporting this, studies indicate that milk components other than lactose may cause digestive discomfort.

Scientists have suggested that certain milk proteins may be responsible for some people’s milk intolerance.

One trial in 41 men and women showed that A1 milk may cause softer stools than A2 milk in some individuals.

Additionally, studies in rodents indicate that A1 beta-casein may significantly increase inflammation in the digestive system.

Bottom Line: There is growing evidence that A1 beta-casein may affect digestive function. However, further clinical trials are needed to confirm these results.

Take Home Message

The A1/A2 debate is still up in the air.

A few studies indicate that A1 beta-casein may have adverse effects in certain individuals.

However, the evidence is still too weak for any strong conclusions to be made.

That being said, if you feel like you tolerate A2 milk better than A1 milk, then you should definitely stick to it.

By Atli Arnarson, PhD

Read More

13 Foods That Cause Bloating (and What to Eat Instead)

Bloating is when your belly feels swollen or enlarged after eating.

It is usually caused by gas or other digestive issues.

Bloating is very common. About 16–30% of people say they experience it regularly.

Although bloating may be a symptom of a serious medical condition, it is usually caused by something in the diet.

Here are 13 foods that can cause bloating, along with suggestions on what to eat instead.

1. Beans

Beans are a type of legume.

They contain high amounts of protein and healthy carbs. Beans are also very rich in fiber, as well as several vitamins and minerals.

However, most beans contain sugars called alpha-galactosides, which belong to a group of carbs called FODMAPs.

FODMAPs (fermentable oligo-, di-, mono-saccharides and polyols) are short-chain carbohydrates that escape digestion and are then fermented by gut bacteria in the colon. Gas is a byproduct of this process.

For healthy people, FODMAPs simply provide fuel for the beneficial digestive bacteria and should not cause any problems.

However, for individuals with irritable bowel syndrome, another type of gas is formed during the fermentation process. This may cause major discomfort, with symptoms like bloating, flatulence, cramping and diarrhea.

Soaking and sprouting the beans is a good way to reduce the FODMAPs in beans. Changing the soaking water several times can also help.

What to eat instead: Some beans are easier on the digestive system. Pinto beans and black beans may be more digestible, especially after soaking.

You can also replace beans with grains, meat or quinoa.

2. Lentils

Lentils are also legumes. They contain high amounts of protein, fiber and healthy carbs, as well as minerals such as iron, copper and manganese.

Because of their high fiber content, they can cause bloating in sensitive individuals. This is especially true for people who are not used to eating a lot of fiber.

Like beans, lentils also contain FODMAPs. These sugars may contribute to excessive gas production and bloating.

However, soaking or sprouting the lentils before you eat them can make them much easier on the digestive system.

What to eat instead: Light colored lentils are generally lower in fiber than darker ones, and may therefore cause less bloating.

3. Carbonated Drinks

Carbonated drinks are another very common cause of bloating.

These drinks contain high amounts of carbon dioxide, a gas.

When you drink one of these beverages, you end up swallowing large amounts of this gas.

Some of the gas gets trapped in the digestive system, which can cause uncomfortable bloating and even cramping.

What to drink instead: Plain water is always best. Other healthy alternatives include coffee, tea and fruit-flavored still water.

4. Wheat

Wheat has been highly controversial in the past few years, mainly because it contains a protein called gluten.

Despite the controversy, wheat is still very widely consumed. It is an ingredient in most breads, pastas, tortillas and pizzas, as well as baked goods like cakes, biscuits, pancakes and waffles.

For people with celiac disease or gluten sensitivity, wheat causes major digestive problems. This includes bloating, gas, diarrhea and stomach pain.

Wheat is also a major source of FODMAPs, which can cause digestive problems in many people.

What to eat instead: There are many gluten-free alternatives to wheat, such as pure oats, quinoa, buckwheat, almond flour and coconut flour.

There are several alternatives to conventional wheat bread in this article.

5. Broccoli and Other Cruciferous Vegetables

The cruciferous vegetable family includes broccoli, cauliflower, cabbage, brussels sprouts and several others.

These are very healthy, containing many essential nutrients like fiber, vitamin C, vitamin K, iron and potassium.

However, they also contain FODMAPs, so they may cause bloating in some people.

Cooking cruciferous vegetables may make them easier to digest.

What to eat instead: There are many possible alternatives, including spinach, cucumbers, lettuce, sweet potatoes and zucchini.

6. Onions

Onions are underground bulb vegetables with a unique, powerful taste. They are rarely eaten whole, but are popular in cooked meals, side dishes and salads.

Even though they’re usually eaten in small quantities, onions are one of the main dietary sources of fructans. These are soluble fibers that can cause bloating.

Additionally, some people are sensitive or intolerant to other compounds in onions, especially raw onions.

Therefore, onions are a known cause of bloating and other digestive discomforts. Cooking the onions may reduce these digestive effects.

What to eat instead: Try using fresh herbs or spices as an alternative to onions.

7. Barley

Barley is a commonly consumed cereal grain.

It is very nutritious since it is rich in fiber and contains high amounts of vitamins and minerals like molybdenum, manganese and selenium.

Because of its high fiber content, whole grain barley may cause bloating in individuals who are not used to eating a lot of fiber.

Furthermore, barley contains gluten. This may cause problems for people who are intolerant to gluten.

What to eat instead: Refined barley, like pearl or scotch barley, may be tolerated better. Barley can also be replaced with other grains or pseudocereals like oats, brown rice, quinoa or buckwheat.

8. Rye

Rye is a cereal grain that is related to wheat.

It is very nutritious and an excellent source of fiber, manganese, phosphorus, copper and B-vitamins.

However, rye also contains gluten, a protein that many people are sensitive or intolerant to.

Because of its high fiber and gluten content, rye may be a major cause of bloating in sensitive individuals.

What to eat instead: Other grains or pseudocereals, including oats, brown rice, buckwheat or quinoa.

9. Dairy Products

Dairy is highly nutritious, as well as an excellent source of protein and calcium.

There are many dairy products available, including milk, cheese, cream cheese, yogurt and butter.

However, about 75% of the world’s population can’t break down lactose, the sugar found in milk. This condition is known as lactose intolerance.

If you’re lactose intolerant, dairy can cause major digestive problems. Symptoms include bloating, gas, cramping and diarrhea.

What to eat instead: People who are lactose intolerant can sometimes handle cream and butter, or fermented dairy like yogurt.

Lactose-free milk products are also available. Other alternatives to regular milk include coconut, almond, soy or rice milk.

10. Apples

Apples are among the most popular fruits in the world.

They are high in fiber, vitamin C and antioxidants, and have been linked with a range of health benefits.

However, apples have also been known to cause bloating and other digestive issues for some people.

The culprits are fructose (which is a FODMAP) and the high fiber content. Fructose and fiber can both be fermented in the large intestine, and may cause gas and bloating.

Cooked apples may be easier to digest than fresh ones.

What to eat instead: Other fruits, such as bananas, blueberries, grapefruit, mandarins, oranges or strawberries.

11. Garlic

Garlic is incredibly popular, both for flavoring and as a health remedy.

Like onions, garlic contains fructans, which are FODMAPs that can cause bloating.

Allergy or intolerance to other compounds found in garlic is also fairly common, with symptoms such as bloating, belching and gas.

However, cooking the garlic may reduce these effects.

What to eat instead: Try using other herbs and spices in your cooking, such as thyme, parsley, chives or basil.

12. Sugar Alcohols

Sugar alcohols are used to replace sugar in sugar-free foods and chewing gums.

Common types include xylitol, sorbitol and mannitol.

Sugar alcohols are also FODMAPs. They tend to cause digestive problems, since they reach the large intestine unchanged where the gut bacteria feed on them.

Consuming high amounts of sugar alcohols may cause digestive issues, such as bloating, gas and diarrhea.

What to eat instead: Erythritol is also a sugar alcohol, but it is easier on digestion than the ones mentioned above. Stevia is also a healthy alternative to sugar and sugar alcohols.

13. Beer

Everyone has probably heard the term “beer belly” used before.

It refers not only to increased belly fat, but also to the bloating caused by drinking beer.

Beer is a carbonated beverage made from sources of fermentable carbs like barley, maize, wheat and rice, along with some yeast and water.

Therefore, it contains both gas (carbon dioxide) and fermentable carbs, two well-known causes of bloating. The grains used to brew the beer also often contain gluten.

What to drink instead: Water is always the best beverage, but if you are looking for alcoholic alternatives then red wine, white wine or spirits may cause less bloating.

Other Ways to Reduce Bloating

Bloating is a very common problem, but can often be resolved with relatively simple changes.

There are several strategies that can help reduce bloating, outlined in this article.

If you have persistent digestive problems, then you may want to consider a low-FODMAP diet. It can be incredibly effective, not just for bloating but for other digestive issues as well.

However, make sure to also see a doctor to rule out a potentially serious medical condition.

Take Home Message

If you have problems with bloating, then chances are that a food on this list is the culprit.

That being said, there is no reason to avoid all of these foods, only the ones that cause you problems personally.

If you find that a certain food consistently makes you bloated, then simply avoid it. No food is worth suffering for.

By Adda Bjarnadottir, MSc

Read More