how to optimise the insulin load of your diet for better diabetes management
Insulin is the primary hormone that controls your metabolism.
You need some to survive.
But too much can be bad news.
Insulin helps drive amino acids into your muscles to help them grow.
Insulin helps glucose enter the cells to fuel your mitochondria to produce energy.
Meanwhile, insulin also works as a brake to keep energy in storage.
When you eat, your pancreas secretes insulin to slow the release of energy from body fat stores through your liver until the energy coming in from your mouth and in your bloodstream are used up.
How do we become insulin resistant?
I don’t know about you, but I find it hard to resist the yummy food that always seems to be available.
We no longer have to hunt or gather our food. It is always available, relatively cheap and flavoured to ensure we can easily eat lots of it.
In our modern food environment, it’s hard to ‘eat to satiety’ without usually eating a little bit too much. It’s like we’re saving for a winter that never comes.
Then, to make it even harder, the food industry optimises their products for ‘bliss point’ (with just the right amount of sugar, salt, fat and artificial colours and sweeteners) and creates hyper-palatable foods to drive profit.
Unfortunately, this all has an impact on more than just our taste buds.
If excess energy keeps coming in, the pancreas re-doubles its efforts to clear the glucose from the blood with more and more insulin.
First, the fat stores become full, then the bloodstream and eventually insulin drives the excess energy into other areas in the body that are still insulin sensitive such as your liver, heart, pancreas, eyes and brain.
Type 1 diabetes
People with type 1 diabetes, like my wife Monica, give us an opportunity to understand how insulin works.
The picture below shows “JL” one of the first type 1 diabetics to receive insulin treatment in 1922. The picture on the left is after diagnosis with diabetes but before treatment with insulin. The photo on the right is the same child two months.
With insulin injections, he can stop the uncontrolled release of his fat and muscle stores and quickly put weight back on.
For reasons we don’t fully understand, the pancreas can stop producing insulin. People with type 1 diabetes need to inject insulin to “cover” the food they eat as well as “basal insulin” to mimic what a healthy pancreas does automatically between meals.
Wise food choices are critical to stabilising blood sugar levels. Foods that require a significant amount of insulin tend to cause large swings in blood sugar levels.
If your blood levels are high, you will feel tired and will need to take a large dose of insulin to slow the release of glucose from your liver.
If your blood sugars are low, you will feel the need to eat food, preferably something sweet to raise your blood sugars quickly!
It’s hard to control your appetite with these rollercoaster-like swings in blood glucose like the one shown in the chart below. Our appetite and survival instincts are strong, and we will eat to raise our blood glucose levels to feel good again.
Foods with a lower insulin load allow people with type 1 diabetes to smooth out their blood sugar swings and stabilise their food cravings.
Type 2 diabetes
While the cause of the disease is different, people with type 1 and type 2 diabetes are in a similar situation. They both have an overall insulin insufficiency. People with type 1 don’t produce enough insulin and need to inject insulin.
The insulin resistance in people with type 2 diabetes means that their pancreas cannot produce enough insulin to keep their blood sugar levels stable. Their fat stores cannot hold all the energy in the system, so it spills out into the bloodstream, and we see elevated blood glucose levels.
For people with type 2 diabetes, reducing the insulin load of the food they eat will enable their pancreas to keep up to maintain more stable blood sugars. Once the wild swings of glucose and insulin stabilise, it is often easier to go longer between meals or make better food choices.
While insulin resistance and diabetes are often associated with obesity, you can be fat and still have normal blood sugars and be insulin sensitive.
People who are insulin sensitive can easily store energy in their adipose tissue and release energy easily later when they are not eating.
Their fat stores of insulin sensitive people are still functioning well. They take in energy from the food they eat and relatively quickly release it when they are not eating.
If you are insulin sensitive with stable blood sugar levels and want to lose body fat you will probably do well if you focus on eating foods with a higher nutrient density and a lower energy density. However, if you are insulin resistant, you will likely also benefit from eating foods with a smaller insulin load, at least until your blood sugars stabilise.
Which approach is best for you?
Nutrition is complex, and there is still a lot of disagreement about the role that insulin resistance plays in health and weight loss. However ultimately, most of us are trying to hack our system to get the nutrients we need without excessive energy.
The Nutrient Optimiser algorithm considers your blood sugars, HbA1c, triglyceride:HDL ratio and waist:height ratio to optimise your blood sugars are while also maximising nutrient density as much as possible.
The food insulin index data
Now we’re going to take a quick look under the hood of the Nutrient Optimiser algorithm to see how the insulin load parameter works.
The quantity of carbohydrate in your diet explains the majority of your insulin response. However, if you look carefully in the bottom left corner of the chart above, you will see that there are high protein foods that cause a large insulin response and high fibre foods that cause a smaller insulin response.
Once we account for the effect of fibre and protein, we get a much better prediction of our insulin response to food. This understanding of the various factors that influence insulin response enables you to prioritise foods that cause a smaller insulin response, as well as more accurately calculate insulin dosing for people with diabetes.
If you are injecting insulin to manage your diabetes then understanding how to quantify the insulin load of your diet can help you more accurately calculate your insulin dose (as detailed in this post). If you require therapeutic ketosis, you can also identify foods that will minimise your insulin response.
While protein does require some insulin to build and repair our muscles, the chart below shows us that increasing the proportion of energy from protein will typically force out processed carbohydrates and trigger a lower insulin response.
Higher levels of protein also tend to generate a smaller glucose response compared to carbohydrates.
It’s also important to note that protein is the most satiating macronutrient. If you want to reduce your energy intake without having to meticulously track calories and without excessive hunger it’s important not to avoid protein. Reducing the amount of energy in your diet will allow the energy in your bloodstream (i.e. glucose, ketones and free fatty acids) to be used up and your insulin levels will come down even further.
Obtaining more of your energy from fat will decrease your insulin response…
…as well as your glucose response.
However, keep in mind that, as well as the food you eat, your insulin levels are influenced by the food you eat as well as the amount of energy already in your system.
High-fat foods are often energy dense and easy to overeat. Your pancreas will still need to elevate insulin levels while your body uses up the energy from your diet, so they can still drive insulin resistance if eaten to excess.
The insulin load is a great tool to manage the short-term volatility of your blood sugar levels. However, if you look at the big picture, lower insulin levels correspond to lower energy in your system (i.e. from your diet and body fat).
Once your blood sugars are stable, it may be prudent to focus on reducing the fat in your diet if you want to use your excess body fat. This will help to further reduce your blood sugars and insulin levels floating around in your blood towards optimal levels.
Insulin load vs nutrient density
Like many things in life, there is a trade-off as we push things to extremes. The chart below shows that we tend to optimise nutrient density with about 40% insulinogenic calories.
If you are insulin resistant, you will probably do better if you maintained less than 40% insulinogenic calories. If you have diabetes, then you’ll probably need to stay below 25% insulinogenic calories. If you require a therapeutic ketogenic diet (i.e. for the treatment of cancer, epilepsy, Alzheimer’s, dementia or Parkinson), then you will need to maintain a very low insulin load, which typically means consuming more fat and even reducing your protein intake.
It may not be ideal to maintain such a low insulin load for a long time. The more you push the insulin load of your diet to either extreme the more you will compromise your micronutrient profile.
What do I do with all this information?
While you may find all this detail a little confusing, you don’t have to worry too much about all the numbers.
We have designed the Nutrient Optimiser algorithm to calculate your target macronutrient ranges to suit your goals and suggest foods and meals that will help you keep your blood sugars stable and normalise your insulin levels while also maximising the nutrient content of your diet.
Once you attain normal blood sugars, you will ‘level up’ to the next stage of your nutritional journey.
In our next instalment, where we will discuss how we can manage the energy density of your food to enable you to get more calories in if you are running a marathon, or help you to feel more satiated with less energy if you are trying to lose weight.
Nutritious foods tailored to your goals
To help you out all this theory into practice, we have assembled a range of nutrient dense food lists tailored to different goals. The right-hand column shows the nutrient profile of each food list. Click on the ‘food list’ links below to get a free printable pdf food list delivered to your inbox.
|optimal foods for therapeutic ketosis|
|well formulated ketogenic diet|
|nutritious low carb foods|
|fat loss & blood sugar management|
|aggressive fat loss|