So this post tells you exactly how to get rid of big he-man insulin and coax shy glucagon out of the weather house. Long lasting satiety, aka no hunger, depends on glucagon bringing out her picnic basket and scattering the nutrients to the little cells that need them. But she won’t show her face until big ol’ insulin is well gone.
I read a book about making decisions, it said everyone makes lists of pros and cons, but what they don’t tell you is about the 400lb gorilla. That is, one of the pros or cons might outweigh all of the others put together. So if something is killing you, don’t worry about the other factors like ‘you might win a set of coupons’.
I had a wise young doctor (Matt Shelton, if you’re out there reading this, I hope you enjoy working in the symphony orchestra but I’m sad you quit doctoring; you were a rare and valuable holistic doctor). Matt looked at my blood tests and said, you know, your 400lb gorilla is insulin resistance. Stop worrying about anything else and work on lowering that insulin, or it will kill you. (As well as health benefits of lowering insulin, a huge life benefit is that you stop having to endure abnormal levels of hunger, because your glucagon ATM card works quickly and your blood sugar and cell nutrient levels stay stable.)
So Matt said: can you cut refined carbs and lift weights? I said I could, and I’d like to be able to write…and the rest is history. And for many that’s all it takes but for me it was not quite that simple. And because this blog is for the tough cases, who’ve low carbed with the best and not got results, I’ve got some strategies.
Lifting weights is a great strategy for normalising insulin, and a darn sight more fun than metabolism lowering starvation diets or marathon hours on a treadmill, that’s for sure. Women in particular are wary of weights – and that end of the gym seems full of an ‘in clique’ of sweaty, grunting he-men – but trust me, building muscle is definitely a huge weapon in fighting obesity, and very empowering. Muscle soaks up glucose and is the last cell type to get insulin resistant. More muscle, better blood sugar control. And as a bonus, you can physically do more fun stuff, carry heavy groceries, rough-house with your kids or dance until dawn (but only around firelight to the tune of your circadian rhythm).
Don’t be fooled that you need hours every day in a gym. To add muscle, you have to break muscle and signal to your body you don’t have a strong enough one. And after breaking it, you have to let it regrow and that takes 2-3 days. To reduce insulin most, focus on the biggest muscle groups (legs, bum, back, chest) – your legs are the biggest so even just doing squats will get you a long way. Lift something as heavy as you can (or heavier) just a few times, then LEAVE your muscles to re-grow. It’s a big mistake to think more is better. No more will break the jelly as it grows and it won’t set as bigger muscle. (Do your own homework on safety, I’m not giving you training advice. Better still, get a personal trainer to design you a programme and teach you proper form. If you want to read stuff, personally I like Michael Colgan’s thinking).
As for food, if you’re an easy case, simply reduce high glycemic foods. Go read the weight loss successes on (fill in diet here: I Quit Sugar, Wheat Belly, Pete’s Paleo etc). This blog is not for the easy cases. This blog is about deep causes, multiple layers of the obesity onion.
Firstly, high GI carbs are only one possible cause of insulin resistance, what scientists would say is a ‘necessary but not sufficient’ condition; second that glycemic load is also important; and thirdly (shamelessly misquoting the Pirate’s Parley), the Glycemic Index is more what you’d call “guidelines” than actual rules. How various foods affects blood sugar is highly individual. Welcome aboard the Black Pearl, Miss Turner… and the nightmare begins.
Dr William Davis (cardiologist, author of Wheat Belly and trackyourplaque) was the first I read who measured his patients’ blood sugar, took regular measures and found this variation was very relevant. Dr Davis said some people swear by porridge for breakfast, it gave him very high blood sugar. If you’re having trouble losing weight following all the low carb guidelines, you might be like William Davis and me…your blood sugar is super reactive.
So here’s a pro tip: if you want to lose belly fat and drop your risk of heart attack, get yourself a blood sugar meter. Don’t argue, don’t muck around and make excuses. They don’t cost much, you can get ones that download to make cool graphs, and if you have a nice doctor, the test strips may be subsidised. But even if they’re not, just do it. This is a small outlay for a big return in understanding your biggest risk factor. And use it. At different times of day, with different foods, and under different stress levels. Yes it hurts a little. Get over it. Your life is at stake here and it’s not like I’m making you hunt a wild bear. You’ll start to see your own unique patterns.
Dr Davis has some suggested ideal levels, as does all-knowing Google. But limits on official websites are way too generous: these are what you’d call your ‘well on the way to diabetes’ limits. The tighter your blood-sugar control the better. Dr Davis suggests you aim for morning fasting glucose of 5 and no increase in blood sugar after meals (highest levels are around 45 minutes after eating), but that was an impossible dream for me; mine spikes to 8 after eating cabbage. So I try to keep my increases low, and if it spikes up, pro tip, go for a 10-minute walk and test after that.
Dr Davis says your morning ‘fasting’ insulin level changes only slowly, after a long period of keeping tight control. So don’t feel discouraged – like the Pantene shampoo advert, it won’t happen overnight, but it will happen. If you control it intelligently. My dear ol mum was diagnosed diabetic (like all her sisters) in her early 50s. She kept tight control exactly like that, and is now a healthy 80 year old with no diabetes, no nerve damage and no eye damage. Her best friend was told to eat low fat carbs, ended up blind, in a wheelchair then early death. If my mum can do it, you can too and save yourself a world of misery.
The next thing you need to coax out glucagon is protein. You need protein to make glucagon, so a small amount at every meal, never have just a carb meal. You’ll know you have it right when you stop feeling hungry between meals.
Now here’s the other tips I didn’t know about. Stress raises cortisol, cortisol increases blood sugars and insulin. So stress comes out, glucagon hides away again, hungry hungry hippo! Develop a way to reduce stress and make it a priority. It could be meditation, yoga, prayer, watching a river run by, going for a walk in a lovely place…whatever floats your boat. Let go, let the world fade away, go far from the madding crowd and experience that ineffable joy of listening to the birds singing, love yourself, let things go, smell the roses. You get the idea. If you have high stress levels and you’re obese, this is not optional. I thought it was, and had a heart attack. I had ‘to do’ lists each day 10 pages long. Trust me on this, making time to feel peace, love, joy and serenity may be tough but its medicine for the body as well as the soul. Do it for the vanity, keep doing it for the sanity.
Now you may think you have stress sorted. Good for you. But let’s talk about sleep. You know that going to sleep when it is dark helps retrain circadian rhythm (see previous blog post). And you know you should prioritise getting enough sleep, so you do your 8 hours per night. You’d think you’re all good, but you have a hunch that things are not quite gelling. Maybe you feel tired all the time, or brain fog. It’s hard to get out of bed in the morning. Maybe you wake with a dry mouth.
I‘ll tell you a story. My mother had atrial fibrillation and I prodded her to have a sleep apnea test because she had signs: sleep apnea is associated with atrial fibrillation as both a cause and a factor that makes it worse; she snored; and kept falling asleep in front of the TV. Sure enough, she had severe apnea. She raved about how much more energy she had, and convinced my partner to buy me a sleep apnea test for Christmas. (That’s the sort of crazy person I am, to love that sort of present).
I put the little oximeter on my finger one night, couriered it back and thought no more about it. I don’t snore, and never have really. I felt like a fraud going for the debrief with the sleep specialist – thought I’d get a “what have you come for? You’re completely normal”. Hmm no, quite the shock, at 11-12 apneas/hour I have mild to moderate sleep apnea, so a total of 99 apneas that test night. The doc told me it was like being strangled 99 times a night. The body panics, jolts you with stress hormones, wakes you out of deep sleep, and generally mucks up the complex rejuvenation processes that occur in the deeper sleep cycles. While your body fights for its life, you are obliviously asleep, and the only sign is you awake not quite refreshed, maybe grind your teeth at night and have to pay heavily at the dentist.
But it sends up your insulin! And cortisol and other stress hormones, as well as ghrelin, the hunger hormone. And lowers testosterone, and raises estrogen and is associated with PCOS, metabolic syndrome, heart attacks, stroke, cancer.
So to summarise: it is top priority for you to lower insulin. Build muscles, eat low GI foods like veges and at least some protein at each meal (but not too much), test blood glucose before and after meals and eat to minimise the increase, walk after meals, eliminate bad stress (including hating, ignoring or starving yourself – more on this in later blogs), get enough sleep, get a sleep test. Sound hard? You betcha. But effective, unlike ‘just eat less, exercise more’.