How to use insulin index of food 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 your body to allow the energy coming in from your mouth to be 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. It’s relatively cheap and flavoured to ensure we can quickly eat lots of it.
In our modern food environment, it’s hard to ‘eat to satiety’ without eating a bit too much most of the time.
It’s as if we’re saving for a winter that never comes (see Don’t Eat for Winter).
Then, to make it even harder, the food industry optimises for ‘bliss point’ (with just the right amount of sugar, salt, fat and artificial colours and sweeteners) to create 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, your fat stores become full. Then excess energy backs up in your bloodstream. 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 a helpful window to help us 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 significant swings in blood sugar levels.
If your blood levels are high, you will feel tired and will need to take a hefty 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 NOW!
It’s hard to control your appetite with these swings in blood glucose. 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 can not 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. Once you exceed your personal fat threshold your fat stores can no longer hold all the excess energy from your diet, and it overflows into your bloodstream (i.e. as elevated blood sugars, free fatty acids and ketones).
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 complicated, 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 insulin index of food
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.
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).
While protein does require some insulin to build and repair our muscles, 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 track calories meticulously and without excessive hunger, it’s important not to avoid protein.
Reducing the amount of energy in your diet (from fats and carbs) 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 amount of energy already in your system (i.e. the fat stored on your body). If you want to reduce your insulin levels and avoid hyperinsulinemia, you need to find a way to reduce your body fat levels.
High-fat foods are often energy-dense and easy to overeat. Your pancreas still needs to raise insulin while your body uses up the energy coming in from your mouth. So high fat foods 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 stabilise, you should focus on reducing the energy from both carbs and fat if you want to use up your excess body fat for fuel. 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. The more you push the insulin load of your diet to either extreme, the more you will compromise your micronutrient profile.
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 until your blood sugars stabilise.
If you require a therapeutic ketogenic diet (i.e. for the treatment of cancer, epilepsy, Alzheimer’s, dementia or Parkinson) you will need to maintain a very low insulin load. This typically means consuming more fat and even reducing your protein intake. However, given that a very low insulin load diet can compromise nutrient density you should not try to maintain a very low insulin load diet for longer thana you really need to.
What do I do with all this information?
We have created the Nutrient Optimiser to calculate help you apply all this detail. Your Nutrient Optimiser Free Report will give you target macros to align with your goals as well as foods and meals to help you get started on your Nutrient Optimiser journey.
post updated July 2019