What and when to eat to reduce insulin

healthy eating, diet, gesture and people concept – close up of m

Here’s a startling truth. I can make you fat. Actually, I can make anybody fat. How? I simply prescribe insulin injections. Giving people extra insulin inevitably leads to weight gain. In type 1 diabetes, when insulin levels are extremely low, patients lose weight no matter how many calories they eat. Give insulin – gain weight. No insulin – lose weight (even to the point of death). The implication is clear. Insulin causes weight gain. Knowing this is crucial, because if insulin causes weight gain, then lowering insulin should help with losing weight. But this very different than just counting calories.

The standard (failed) weight loss advice is to restrict a few calories every day by reducing dietary fat and eating multiple times per day. This does not lower insulin much since dietary fat has little insulin effect and eating frequently constantly stimulates insulin secretion. This ‘caloric reduction as primary’ advice has an astounding failure rate. So, if you have tried calorie restriction to lose weight and failed, you are not alone.

So here’s the situation. ‘Medicine’ tells you that obesity is a caloric balance problem and that you should eat less and move more. ‘Medicine’ tells you to eat a low-fat diet, and to eat six or more times a day. This advice doesn’t work for most people. When it doesn’t work, ‘Medicine’ frequently assumes it’s your fault for not being able to stick with the advice. Our advice was good, ‘Medicine’ tells you. You just didn’t do it right.

Imagine, though we have a classroom of 100 pupils. One fails. It’s likely his fault. Maybe he played too many video games. But if 99 students fail, then it’s not a problem with the students. The problem is with the teacher. In obesity, the problem of rampant obesity means that it is obviously not the fault of the people. The fault lies with the official dietary advice.

Understanding that obesity is as much a hormonal disorder as it is a caloric imbalance (as discussed in our last post) means that we must also focus on the insulin effect rather than just the number of calories to successfully lose weight. Reducing insulin depends mostly upon 2 things:

  1. What you eat
  2. When you eat

We often think and talk about the first problem, but both are equally important in lowering insulin levels.

What to eat

The three different macronutrients stimulate insulin to different degrees. Carbohydrates, particularly refined carbohydrates raise insulin the most. Protein also raises insulin somewhat, but likely doesn’t contribute to chronic hyperinsulinemia. Dietary fat raises neither glucose nor insulin.

Most natural foods contain varying combinations of the three macronutrients and therefore raise insulin to varying degrees. For example, refined carbohydrate-rich foods like cookies have the greatest effect on raising insulin and glucose. Fat-rich foods like salmon have little effect on insulin. This differing ability to stimulate insulin means that foods also differ in their fattening effect. This is only common sense.

The overlap between calories and insulin effect is what causes the confusion between the hormonal (insulin) hypothesis of obesity and the caloric hypothesis of obesity. Many people say that ‘A calorie is a calorie’, which is, of course, true. But that’s not the question I asked. The question is ‘Do all calories equally lead to weight gain’? To which the answer is an emphatic no. Insulin-stimulating foods like glucose are more likely to lead to weight gain than non-insulin stimulating foods like kale, even if you have the same number of calories.

Certain factors increase insulin which encourages weight gain. The most important factors raising insulin are refined carbohydrates and insulin resistance. Fructose, from added sugar and fruits can directly cause fatty liver and insulin resistance. This leads the body to increase insulin secretion to compensate.

Other factors decrease insulin, protecting against weight gain. Acids found in fermented foods (sauerkraut, kimchee) and vinegar can lower the insulin effect of foods. Animal protein causes the secretion of incretin hormones that slows the absorption of foods thus lowering insulin. Thus meat has both pro- and anti- insulin effects. Fibre also has the same effect of slowing absorption and insulin effect.

NewHOT10-What-to-Eat

Thus, the main principles for lowering insulin and losing weight would include the following, as detailed in The Obesity Code.

Rules for ‘What to Eat’

  1. Avoid added sugar – causes insulin resistance and high insulin
  2. Eat less refined grains – High insulin effect
  3. Eat adequate protein
  4. Don’t be afraid of eating natural fats – Low insulin effect
  5. Eat real unprocessed foods – refining increases insulin effects

Funny. That’s precisely the sort of no-nonsense advice your grandmother would have given.

When to eat

The second and equally important part of lowering insulin is understanding the question of ‘when to eat’. All foods, aside from pure fat, can raise insulin, which can lead to obesity. But there is another important contributor to high insulin levels outside of food – insulin resistance. This refers to the situation where normal insulin levels are unable to force the blood glucose into the cells. In response, the body raises insulin in a knee-jerk reaction to ‘overcome’ this resistance, and these high levels can further drive obesity. But how did insulin resistance develop in the first place?

Our body follows the biologic principle of homeostasis. If exposed to any prolonged stimulus, the body quickly develops resistance. A baby can sleep soundly in a crowded restaurant because the noise is constant, and the baby has become noise ‘resistant’. But that same baby, in a quiet house, will wake instantly at the slightest creak of the floorboards. Since it has been quiet, the baby has no ‘resistance’ against noises and thus awakens quickly.

If you listen to loud music constantly, you will become slightly deaf. This ‘resistance’ to loud noises protects the ear from damage. Raising the volume to ‘overcome’ this resistance works but only temporarily. Volume increases and you become progressively more deaf (resistant to loud noise), which leads you to raise the volume again. The solution is not to keep raising the volume, but to shut it off.

Think about the story of the boy who cries wolf. Raising the alarm constantly may work at first but eventually leads to the villagers becoming resistant to the signal. The more the boy cries, the less effect it has. The solution is to stop crying wolf.

Insulin resistance is simply a reaction to too much insulin. The body compensates by raising insulin, but that only makes things worse because higher insulin levels lead to more resistance. This is a vicious cycle.

  • High insulin leads to insulin resistance.
  • Insulin resistance leads to higher insulin.

The end result is higher and higher insulin levels, which drives weight gain and obesity. Therefore, a high insulin level depends on 2 things.

  1. High insulin levels
  2. Persistence of those high levels

Providing extended periods of low insulin levels can prevent the development of insulin resistance. How to provide those low levels? Periods of fasting.

This may sound strange, but this is the way we used to eat. Suppose you eat breakfast at 8 am and dinner at 6 pm. You eat for 10 hours of the day and fast for 14 hours. This happens every single day, and the reason we use the word ‘break-fast’. This is the meal that breaks our fast implying that fasting is simply a part of everyday life. The body spends roughly equal portions of every day in the fed (insulin high, storing fat) and the fasted state (insulin low, burning fat). Because of this nice balance, weight tends to stay stable over time. Up until the 1980s, this was pretty standard practice and obesity was not a big issue.

Somehow, we moved away from this traditional way of eating and now eat constantly. We frequently eat the minute we get out of bed in the morning whether we are hungry or not, believing that eating white bread and jam or whole grain cereal is better than eating nothing at all. We eat throughout the day and don’t stop until it is time for bed. Large surveys show that most Americans eat 6-10 times per day. Now our body spends the majority of time in the fed state, and we wonder why we can’t lose weight.

Eating constantly does not provide the critical period of very low insulin to balance the high insulin periods. Persistently high insulin leads to insulin resistance, which leads only to higher insulin. This is the vicious cycle of weight gain that we must break with fasting.

NewHOT11-When-to-Eat-1

For the boy who cried wolf, which is the better strategy? Stop crying wolf for a month, and then cry loudly once, or cry wolf constantly, but a little more softly? Similarly, to start burning body fat, you must allow prolonged periods of time of low insulin.

Rules for ‘When to Eat’

  1. Don’t eat all the time (time-restricted eating or intermittent fasting). Stop snacking.
  2. If you want to lose more weight – increase the fasting periods

We often obsess about the foods we should or should not eat, the question of ‘what to eat’. But we often ignore the equally important question of ‘when to eat’. By attacking the insulin problem on both fronts, we have a far higher chance of successfully losing weight.


Dr. Jason Fung

 

Dr. Fung’s top posts

  1. Longer fasting regimens – 24 hours or more
  2. How to renew your body: Fasting and autophagy
  3. My single best weight loss tip

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Dr. Fung has his own blog at idmprogram.com. He is also active on Twitter.

The Obesity CodeThe Complete Guide to Fastingthe-diabetes-code (1)

Dr. Fung’s books The Obesity Code, The Complete Guide to Fasting and The Diabetes Code are available on Amazon.

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60 comments

  1. Old Kodger
    To Krisin,
    I had many health problems also, ALL doctors tried to "fix" them one at a time untill I came across one who said "You're a coeliac, stop eating gluten" which I did, but it wasn't easy back then, there wasn't much gluten free food around. However most of my problems went away. Incidentally, I now live in Australia, my brother still in England.
    With respect to your father, my brother, a type 2 diabetic, visited me in Australia, and whilst here he ate what was in the house......guten free food. His insulin dependence, during his stay dropped by a massive 50%. When he went back home, and resumed his "normal" diet, his insulin dependence went back up.
    It is interesting to note that the Coeliac Society here readily admit that their experience confirmes this as frequently the case.
    Perhaps some research in this area might answer your query.
  2. No thanks
    Oh my gosh, this guy really hates MD and allied health colleagues.
    Not one dietitian or doctor or NP I know gives advice to eat ten times a day, carbs load or any other nonsense Fung pushes.
    But a sarcastic thanks for supporting disordered eating and eating disorders. I’ve had quite a few people with scary blood work after following your advice. Enjoy the money you’ve made off of them.
    The rest of us take our oaths, ethics, and morals seriously
  3. AnonymousePerson
    I am a female in my late 30s, with prediabetes (BMI 44, A1c of 5.6). I've been obese my entire life, even literally born overweight at 10 pounds, though mother said she did not have gestational diabetes. I do not take any medications, and am hoping to reverse my insulin resistance with diet, exercise, and fasting.

    Since I started a 16:8 intermittent fasting routine, I've noticed that my random blood glucose checks are higher. I have a glucometer to monitor my blood sugar every now and then. I took an A1c reading before staring the fasting routine a month ago, and it returned 5.6 (where I have been for the last two years). I also did a few days of blood sugar monitoring to get a starting point to compare against. My previous fasting glucose levels upon waking were in the high but not diabetic range (105 to 109), but since I've been fasting, they're exploding! I am now waking up to blood sugar readings of 115-120, which is extremely worrying. More so since in addition to only eating between 12:30pm - 8:30pm, I have also reduced my caloric intake to an average of 1400kcal per day, and dropped a lot of sugar and refined carbs from my diet.

    Worst of all is the nerve pain. I developed nerve damage in one of my fingers from carpal tunnel, which rarely bothers me. But now that finger hurts all the dang time, and I've noticed that when my blood sugar hits around 115, the pain starts (and it is excruciating). The pain generally starts after about 14 hours of fasting, and goes away when I am not in my fasting window.

    In the month since I've started IF and dropped my calories, I have lost 5-6 pounds, but I feel that my blood sugar is now out of control. I even went on a 72 hour fast, consuming absolutely nothing but water with some minerals thrown in for electrolyte balance. Even then, random blood sugar checks showed my glucose at 120.

    I don't know what to think, except that my liver is undertaking gluconeogenesis but my cells are too insulin resistant to handle the glucose. Is it possible that my lower carb, lower caloric intake is signaling to my liver to go ahead and create more glucose to dump out for energy, but without eating, there is no insulin response, so now my liver is just dumping glucose freely, and all of that sugar remains floating around in my body, doing damage? Should I continue my fasting regime (and the resulting nerve pain from the higher glucose levels) with the hope that my body just needs a few more weeks to get the message and increase insulin sensitivity, or am I doing a lot more harm than good by fasting in this particular situation?

    Reply: #54
  4. Kristin Parker Team Diet Doctor
    You may want to check in with your doctor. While some people may experience higher fasting blood sugar, nerve pain is not an expected side effect. You can also experiment with eating 2-3 meals a day and focusing on eating keto/low carb meals. When each meal has a greatly reduced impact on your blood sugar compared to standard meals, you can lower blood sugar and insulin while also alleviating side effects that some people experience when fasting.
  5. 1 comment removed
  6. Terry
    How does your advice relate to a type 1 diabetic?
    Reply: #57
  7. Dr. Bret Scher, MD Team Diet Doctor
    Thanks for the question Terry. You are right that people with type 1 diabetes need to be more cautious with changing the way they eat to prevent too low or too high insulin levels. Here is a guide we have for type 1 diabetes that should have more specific information for you. I hope that helps! https://www.dietdoctor.com/diabetes/type-1 /Bret Scher MD FACC, Medical Director DietDoctor.com
  8. JessicaNelson
    This is the exact natural remedy I followed to reverse diabetes naturally once and for all ( diabetes.natural-approach.net ) You'll be absolutely thrilled with the step-by-step plan that guides you through the ultimate solution to reverse diabetes naturally, that you'll only have one regret -- and that is this: Not having had this valuable resource years ago!
  9. Pam
    JessicaNelson That is a con for someone (not a doctor) to make money.
  10. Lesley Hodges
    I have had diabetes for over 30 years now . I find that over time my control over diabetes wanes and I need to increase or change medications. I have had associated renal disease for 20 years now and have been restricted to just the one metformin a day plus 100 units of Ryzodeg daily. I have tried to lose weight without success for many years with the common advice to diet and exercise. My diet has been streamlined since diagnosis and usually 1000 calories a day, low carbohydrates, high protein, med fat diet. I rarely have snacks. I also have severe osteoarthritis which limits my exercise. I have had multiple minor strokes which has damaged my mobility. I have tried all the diets without long term success. Insulin resistance has kept me obese, currently 120kg. I am always searching for ways to better my health. Currently if my glucose readings are high or elevated I will not eat until they drop to a normal level and I am working hard to maintain normal glucose levels - this means some days I do not eat. I am restricted to 1 litre of fluid daily due to heart disease. I am a medical scientist and have spent years studying my diet and diabetes control. On numerous occasions I have been able to reduce my weight up to 20kg but each time it is temporary only and it is becoming harder to maintain my weight. I see so many others being able to achieve success and lose weight and in some cases even reverse their diabetes and I start to lose hope that I will ever succeed. My last A1C was 9.2 and I have only 27% kidney function left. I am 72 years old. I do not eat processed foods but cook from raw foods. We live on a pension so our budget is restricted but we have meat every second night and poached eggs most mornings. Please give me any advice you may have in the hope that there may be something I have not tried. Thank you for your understanding.
    Reply: #61
  11. Kristin Parker Team Diet Doctor

    I have had diabetes for over 30 years now . I find that over time my control over diabetes wanes and I need to increase or change medications. I have had associated renal disease for 20 years now and have been restricted to just the one metformin a day plus 100 units of Ryzodeg daily. I have tried to lose weight without success for many years with the common advice to diet and exercise. My diet has been streamlined since diagnosis and usually 1000 calories a day, low carbohydrates, high protein, med fat diet. I rarely have snacks. I also have severe osteoarthritis which limits my exercise. I have had multiple minor strokes which has damaged my mobility. I have tried all the diets without long term success. Insulin resistance has kept me obese, currently 120kg. I am always searching for ways to better my health. Currently if my glucose readings are high or elevated I will not eat until they drop to a normal level and I am working hard to maintain normal glucose levels - this means some days I do not eat. I am restricted to 1 litre of fluid daily due to heart disease. I am a medical scientist and have spent years studying my diet and diabetes control. On numerous occasions I have been able to reduce my weight up to 20kg but each time it is temporary only and it is becoming harder to maintain my weight. I see so many others being able to achieve success and lose weight and in some cases even reverse their diabetes and I start to lose hope that I will ever succeed. My last A1C was 9.2 and I have only 27% kidney function left. I am 72 years old. I do not eat processed foods but cook from raw foods. We live on a pension so our budget is restricted but we have meat every second night and poached eggs most mornings. Please give me any advice you may have in the hope that there may be something I have not tried. Thank you for your understanding.

    Please work with your doctors in order to determine if the medication you're currently on is sufficient or if the dosage or types should be adjusted.

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