How can insulin resistance be reduced?

Insulin resistance often occurs in troublesome conditions such as obesity and polycystic ovary syndrome. Blood glucose and blood insulin tests are objective tests, and the test results can only reflect the situation at the moment when the blood test was taken. The insulin resistance questionnaire attempts to reflect the impact of our recent blood sugar fluctuations on our subjective feelings, because brain cells rely on blood sugar to produce energy. When insulin resistance occurs in the body or brain, it can be roughly reflected through subjective questionnaires, because it is not the feeling at the moment when the blood sugar is checked, but the subjective changes caused by chronic inflammation that last for a period of time. Subjective testing can be performed repeatedly and does not pursue accuracy, but rather reminds us to pay attention to the risk of inflammation caused by fluctuations in blood sugar. Create a self-assessment questionnaire for insulin resistance to facilitate readers' self-assessment. Obesity, metabolic syndrome and type 2 diabetes are the main health problems related to glucose metabolism that currently plague people. Around the issues of how to effectively lose weight, how to prevent the occurrence of insulin resistance, and how to reverse the process of type 2 diabetes, various dietary methods have emerged from clinical nutrition to society, giving people many choices. So, let’s briefly sort out the characteristics of the dietary methods recommended by these professional associations and the popular dietary methods for dealing with obesity or insulin resistance, what problems they target, and what they are unclear about. Common dietary methods and their scope of application 1. The most beneficial dietary method for diabetes. Although the Nutrition Association seriously recommends the Dietary Guidelines for Residents and the Diabetes Dietary Guidelines, if you choose dietary methods and foods according to these guidelines, 1. The blood sugar of people with type 2 diabetes It may still not return to normal, and you still need to rely on oral hypoglycemic drugs or insulin injections. The reason is very simple. After eating a high proportion of carbohydrates, blood sugar will inevitably rise and form a postprandial peak. If it is diabetes, there must be insulin resistance (type 2) or Insufficient insulin (type 1) cannot return blood sugar to normal soon after a meal, so hypoglycemic drugs or insulin injections must be used to lower blood sugar. Therefore, the recommended diet plan for diabetes with a high carbohydrate ratio cannot be separated from the patient answers and professional guidance of clinical experts. As a result, some non-professional doctors around the world began to explore their experiences with insulin and diabetes. It is now a more consistent view that the intake of the three major energy substances, carbohydrates, proteins and fats, will cause the secretion of insulin, and the insulin secretion caused by eating carbohydrates is the most obvious and the largest amount. The insulin secretion caused by various fats is the least obvious and can be completely ignored. Not only does protein cause a slight secretion of insulin when eating, but when the liver uses protein and amino acids for gluconeogenesis, will it also cause the secretion of insulin? Therefore, in addition to the dietary guidelines recommended by professional associations, the most popular in society for the prevention and treatment of diabetes is the ketogenic diet, because the ketogenic diet not only reduces carbohydrates to less than 5%, but also reduces the total amount of protein. It has been controlled to less than 1 gram per kilogram of body weight per day as traditionally considered, but the proportion of animal and plant saturated fat has been increased to more than 70-75%. The intake of fruits has also been limited to very low, such as up to 1/4 of an apple per day. Maximum of 5 strawberries per day. Type 1 diabetes is absolutely deficient in insulin. Therefore, theoretically, a ketogenic diet provides a large amount of fat instead of carbohydrates and glucose, which is beneficial to type 1 diabetes in reducing insulin dependence, because the catabolic process of fat is No need for insulin intervention. The function of insulin is to synthesize fat. Type 2 diabetes adopts a ketogenic diet, which directly avoids carbohydrates that immediately increase blood sugar after ingestion. Therefore, blood sugar should be maintained at normal levels, and there is no need to use oral hypoglycemic drugs or insulin injections. 2. Insulin resistance and weight loss In obesity and type 2 diabetes, there are problems of insulin resistance and metabolic syndrome. The function of insulin is to bring glucose into cells to lower blood sugar. At the same time, the remaining glucose that enters cells and cannot be used will be synthesized into triglycerides by insulin and stored. For obese people, the body already has a lot of fat, and insulin is still constantly synthesizing fat, which will inevitably increase the degree of obesity over time. Therefore, the simplest way to prevent obesity from progressing is actually to stop taking in carbohydrates. In this way, there are no raw materials for insulin to use to synthesize fat. Fat synthesis stops, and people do not need to continue to gain weight. However, to lose weight, fat must be decomposed. To decompose the fat stored in cells, fat synthesis cannot be performed at the same time. Insulin is managing the synthesis of fat. This means that it must be done without the presence of insulin. It is possible to undergo fat catabolism. To lose weight, you must reduce the secretion of insulin as much as possible, so the purpose of the ketogenic diet to almost completely exclude carbohydrates is to reduce the secretion of insulin and prevent the synthesis of fat, thereby initiating the catabolism of fat and achieving the purpose of weight loss. The production of ketone bodies means that fat metabolism is proceeding smoothly, and once the decomposition of fat begins, the amount of ketone bodies produced will be dozens of times higher than usual. Suddenly, so much ketone body energy is produced by decomposing fat, what should the body do if it cannot use it? This is a characteristic that carbohydrates, glucose, and proteins do not have. No matter how much ketone bodies they have, they can be excreted from the body through urine and respiratory gases. Precisely because excess ketone bodies can be exhaled out of the body without physiological burden, various ketogenic diet plans emphasize eating a lot of saturated fat to force the body to start the decomposition of fat. Judging from the reported cases and data, The ketogenic diet is indeed effective for fat loss. The reason why you must choose saturated fats such as fatty meat, butter, avocado, and coconut oil is because the chemical structure of saturated fat is super stable and will not produce inflammatory reactions in the body that cause various chronic diseases. Various vegetable oils are unsaturated fatty acids, and their chemical structures are extremely unstable. They are prone to oxidation reactions to produce free radicals, which are the main culprits in causing chronic inflammation. Therefore, nutrition societies in various countries now call for not eating large amounts of various vegetable oils. vegetable oil. 3. The problem of intermittent fasting. From fasting for a few hours to the longest recorded fasting of 382 days, they are all intermittent fasting. The period between dinner and breakfast the next day is 12 or 13 hours of fasting. The English word fast means fasting, and break means breaking or changing. Breakfast means breaking a fast. Breaking a fast means eating. Therefore, breakfast, which originally means breaking a fast, has become the English breakfast, which means fasting. The concept has existed since ancient times. The most popular method in the world at present is to fast on two days out of seven days, so it is also called the "5/2 fasting method". This is a weight loss method, that is, two non-consecutive days per week, or two consecutive days, every day. Only consume 500 kcal (girls) or 600 kcal (boys) energy foods, and eat freely for the remaining 5 days without any control. This is actually just a reduction in caloric intake on fasting days, because 500 and 600 kcal are only 1/3 of normal caloric consumption, so it is not zero calories at all. There are also methods of fasting on alternate days, 24 hours of fasting, 36 hours of fasting, etc. There are also methods of fasting for several days or dozens of days in a row. The essence of intermittent fasting is to starve people until they break down fat and produce ketones. What are the conditions for lipolysis to produce ketone bodies? There is no unified authoritative statement on this issue, so people are trying to start lipolysis and ketogenesis through short-term hunger, and long-term hunger will deplete the body. The body no longer has glucose to supply energy, so the cells can only break down fat to produce ketone bodies to solve the energy supply problem. Current research does not seem to be able to accurately answer how long it takes to start the ketogenic fat decomposition process. In fact, theoretically, as long as the glycogen in the body is consumed, fat decomposition can begin immediately. This is true in long-distance running, The phenomenon of extremes and hitting the wall in endurance sports such as swimming is fully demonstrated. The emergence of physiological limits is actually the end of the body's glucose energy supply. At this time, lipolysis is starting but insufficient ketone bodies have not been produced, resulting in the body's energy deficit. After passing the physiological limit period of insufficient energy supply, it means that ketone bodies replace glucose and begin to supply energy. At this time, exercise ability, especially endurance, is greatly improved, because the energy provided by fat ketogenesis is extremely large and effective. Glucose is stored in the form of muscle glycogen and liver glycogen. There is only an average of 115 grams of glycogen reserve in the body, which is equivalent to 460 kcal of energy. A person consumes an average of 2,000 kcal of heat a day. Since carbohydrates form a blood sugar peak one hour after they are ingested into the body, and then the blood sugar is transferred to tissue cells under the action of insulin and then converted into fat as an energy reserve. Therefore, when carbohydrates are used as the main energy source, the human body The sufficient energy supply time is the two or three hours after a meal when blood sugar continues to be high. The metabolism time of carbohydrates is within 4 hours. If it exceeds 3 or 4 hours, the blood sugar level will decrease and the body will lack energy, which will cause hunger. and the desire to eat, prompting people to eat again. Therefore, three meals a day will cause blood sugar and insulin fluctuations three times, and four meals a day will cause four fluctuations. In today's life, if snacking is also included, many people actually eat as many times as or more than a day. 5 or 6 meals, blood sugar and insulin are always fluctuating. There is no research on how often you need to eat. The current research only found that the digestion time of carbohydrates is four hours, and the digestion time of fat is slightly longer. This only means that the time between two meals must not be shorter than four hours, and the best interval is 6 or 7 hours. hours or more to allow the body to fully digest the food from the previous meal. The distance between modern breakfast and lunch is generally about 4 hours, which is not enough for the body to return to a hungry state. Generally, the body fat of a normal person accounts for 10-20% of the body weight, ranging from several kilograms to more than ten kilograms. Each kilogram of fat provides 9,000 kcal of energy. 10 kilograms of body fat can provide 90,000 kcal of energy. And our average daily The energy consumption is 2000 kcal, so 10 kilograms of body fat for a person is enough for the person to go without eating or drinking for 45 days. For a woman weighing 50 kilograms, 10 kilograms of body fat accounting for 20% is a must of. We found that the weight loss effect of running, swimming and other exercises is actually not as good as the ketogenic diet and intermittent fasting, which break down fat. The reason is that no matter what kind of exercise, it mainly consumes stress energy, and glucose and glycogen are The energy that humans use for stress is because the speed of glycolysis is much faster than the aerobic metabolism of fat. Fat can only produce energy and ketone bodies through aerobic metabolism of mitochondria, so fat produces energy and ketone bodies slowly. , fat must be broken down after the rapid supply of sugar energy ends. The total human glucose and glycogen reserves are 115 grams, which can provide 460 kcal of energy, which is equivalent to the energy consumed by long-distance running of 7 or 8 kilometers. Therefore, it is almost impossible to lose weight simply by exercising, because of the energy consumed by exercise. It is mainly a stress energy reserve such as glucose, while body fat is a hunger energy reserve. It is a reserve fat formed during human evolution to prevent energy needs when there is no food for one day or even many days. If you rely on exercise to lose weight, the body will not be able to use its own body fat energy unless you exercise a lot, and the body fat will always be retained until you are hungry. In this way, we have figured out why we must be hungry until the glucose is exhausted before we can have the possibility of ketosis. This is the real reason why the ketogenic diet pays special attention to limiting carbohydrates. For people who want to lose weight, if they consume too much carbohydrates such as rice and noodles, it means that it will take longer to use up glucose and glycogen, which means that the time of starvation will be much longer. This is not What adverse side effects carbohydrates have on the human body are not directly related to the level of insulin. The key point is to use up glucose reserves to make people enter a state of hunger as soon as possible. It is often seen that the explanation for advocating a ketogenic diet is that the purpose of restricting carbohydrates is to reduce insulin levels. This statement completely puts the cart before the horse. The reduction of insulin is the inevitable result of restricting carbohydrates, but lowering insulin is not the reason for our ketosis. The reason is that the only condition for ketosis is to find ways to use up the glucose that can quickly supply energy to tissue cells before fat is decomposed, so that the body can start the aerobic metabolism of mitochondria. Once the body's energy metabolism is converted into the catabolism of fat within the mitochondria, the efficiency of bioenergy production will be greatly improved, and the amount of energy produced is far beyond what can be compared with carbohydrate energy supply. The human body's largest energy metabolism mode is actually the basic metabolic state of a person doing nothing. Respiration, sleep, limb activities, heartbeat, gastrointestinal activity, biochemical reactions in the body, etc. account for 90% of a person's total energy consumption. % or more, the average energy consumption of a person is 2000 kcal, and 90% is 1800 kcal. You can consume 1800 kcal of energy by standing still every day, which is equivalent to 200 grams of body fat, four taels. Therefore, for weight loss, exercise to lose weight is inefficient or even ineffective. The average exercise energy consumption does not exceed 5%. Exercise is to build muscles and enhance physical fitness, not to lose weight and consume fat. The most efficient way to lose weight is to make the body After entering the ketogenic mode of fat decomposition, you will lose about 0.5 kilograms a day without doing anything, and losing 2 or 3 kilograms a week is common. Is it possible to lose more? It's impossible, because the average daily energy consumption of a 60-kg person is about 2,000 kcal, which is more or less around 2,000 kcal, even though all of these 2,000 kcal energy is produced by the decomposition of body fat. , which is equivalent to 222 grams of fat being burned, and along with the corresponding water, the total amount lost is within 500 grams. Therefore, there is a commonly observed phenomenon that most people in the early stage of ketosis This is the phenomenon of losing 2 or 3 kilograms of fat per week. After understanding the key point that ketone bodies only need to accelerate the depletion of glucose and glycogen in the body, the fasting time can be greatly shortened. Fasting only requires strict control of carbohydrates, appropriate protein and fat. It does not affect the effect of ketosis. It only requires that the glycogen in the hungry body is exhausted. There is no need to blindly pursue long-term fasting and absolute fasting. As long as it is not carbohydrates, glycogen will not be produced. Can glycogen be produced by gluconeogenesis during fasting, during which the body uses its own tissue proteins? This is a question worthy of further study. Theoretically speaking, when there is no energy available and there is no body fat, or when red blood cells, which can only use glucose, need energy and the body has to produce glucose xenobiotics, it should be xenobiotic. Use as much as you need. There is no possibility that excess xenobiotic glucose will be used to generate reserve forms of glycogen. Insulin should not even be activated to convert xenobiotic glucose into body fat for storage. There is another issue worth noting. In addition to being able to store a large amount of fat, the human body cannot store a large amount of glucose, nor can it store a large amount of amino acids and proteins. Eating too much protein becomes a metabolic burden on the human body, and the human body has to absorb too much. The incoming protein is metabolized into sugar and then converted into fat, so the minimum amount of protein you should eat every day is a big question. The Atkins diet is a low-carbohydrate, high-protein diet. Due to the lack of carbohydrates necessary for the synthesis of fat, the Atkins diet has an obvious weight loss effect in the early stages, but will rebound in the later stages. It is also obvious that the reason may be that excessive animal protein is eventually converted into fat through gluconeogenesis. The ketogenic diet is basically no carbohydrates, very low in protein, and very high in fat. It is designed to lose weight without any problems. In the short term, you will definitely enter a state of ketosis and lose a lot of weight. The biggest question about the ketogenic diet is whether the medium and long-term protein intake can meet the needs of the body’s tissue protein metabolism. So, how many hours after eating does glycogen become depleted? There is still a lack of in-depth research in this area. The dawn phenomenon and Sumuji phenomenon indicate that there is no possibility of depletion of glucose and glycogen in the human body, unless extreme methods such as ketogenic diet and intermittent fasting are adopted. However, through previous physiological research and clinical observation of a large number of type 2 diabetes, it is not difficult to find that blood sugar will gradually return to normal within 4 hours after a normal diet, and the physiological digestion time of carbohydrates is also about 4 hours, so if you want to rush To start ketosis immediately, you can do endurance aerobic exercise such as running. Aerobic exercise can reach the physiological limit in about ten minutes, and it can deplete the glycogen in the body in half an hour and start the body's ketogenic process. For ketosis, long-term starvation is not the only necessary condition. All depletion of glycogen reserves and loss of the body’s rapid glucose stress function (anaerobic glycolysis of sugar) can effectively initiate body fat decomposition and ketogenesis. biochemical process, so there is still a lot of room for choice in weight loss methods. Another question, we all know that many people with diabetes have dawn phenomenon or Sumuji phenomenon, that is, hyperglycemia or hypoglycemia will occur at 3 o'clock in the middle of the night, and then the adrenal hormones, adrenocortical hormones, glucagon, and thyroxine will Under the combined action of blood sugar-raising hormones, blood sugar will slowly rise again, and finally form fasting hyperglycemia after getting up at dawn. Hyperglycemia is called dawn phenomenon, and hypoglycemia is called Su Mujie. Phenomenon. The current explanations for the Dawn Phenomenon and Sumujie Phenomenon are all attributed to the insulin resistance of diabetes. Because of the insulin resistance in tissue cells, insufficient secretion of insulin cannot reduce the blood sugar produced by gluconeogenesis. After careful analysis, this explanation is actually very unreasonable. The purpose of those blood sugar-raising hormones to raise blood sugar is not clearly stated. I am afraid that the purpose of raising blood sugar at dawn is not just to allow insulin to lower blood sugar. Well, because raising blood sugar is just to allow insulin to lower these blood sugars, it is purely a redundant action. Since the ultimate goal is to lower these blood sugars, there is no need to use so many blood sugar-raising hormones to start breaking down proteins. The gluconeogenesis process produces so much blood sugar, because the hypoglycemia that occurs at 3 o'clock in the middle of the night before gluconeogenesis is the result of insulin successfully lowering blood sugar. Then during the gluconeogenesis process, insulin actually No reaction at all? The explanation for this phenomenon is not very reasonable and deserves further study. At present, it seems that the endocrine changes related to type 2 diabetes may not only be related to the hormone insulin. The hormones that increase blood sugar, especially adrenocortical hormones, also undergo certain changes. It is likely that the adrenal cortex changes at dawn. Hormone secretion is increased, but people with diabetes may secrete more adrenocortical hormones. The result is abnormal morning fasting hyperglycemia. Then, if dawn phenomenon and Sumuji phenomenon are caused by abnormal secretion of adrenal hormones, thyroxine and growth hormone in response to stress, gluconeogenesis using protein and amino acids as raw materials, fasting hyperglycemia is only the final result, this is Doesn’t it mean that adrenocortical hormone has a direct inhibitory effect on insulin, which lowers blood sugar and promotes fat synthesis? The Dawn Phenomenon and Sumuji Phenomenon have actually explained the reason why people are always clear-headed and full of energy during fasting. That is, during intermittent fasting, the human body is actually basically in a state of stress response, and the role of insulin is During the stress state, the body is completely suppressed, so whether there is hypoglycemia or not, stress-responsive hyperglycemia will inevitably occur. Intermittent fasting is likely to be achieved by activating the body's stress response. Hunger quickly puts people into a state of stress, and the stress state quickly depletes glycogen reserves and initiates the ketogenic energy supply of lipolysis. If this is the case, it is easy to understand the rapid rebound after weight loss, because the stress state is not sustainable. 4. Reasonable and safe application of various dietary methods. Normal people, especially young people before the age of 30, have sound endocrine functions, so choosing a certain dietary method is actually not too important. After the age of 30, as growth hormone begins to decrease, endocrine changes gradually begin. The secretion of insulin and adrenocortical hormones begins to increase, while other hormones begin to decrease with age. From the amount of insulin secreted and the passive phenomenon of blood sugar, we can actually tell whether the body is in a state of chronic stress, because the changes in insulin, which is responsible for glucose metabolism, and the adrenocortical hormone, which is responsible for stress response, are basically synchronized. From this perspective, obesity, type 2 diabetes and metabolic syndrome are actually all glucose used for acute stress response, which is converted into more body fat to deal with chronic hunger. Insulin resistance and hyperadrenocortical function are just energy. The result of metabolic deviation. It is precisely because the metabolic mechanism of glucose and fat involves a series of chronic disease-related problems caused by insulin resistance and adrenocortical hormone failure. Therefore, everyone must be careful when choosing a reasonable diet plan, especially intermittent fasting and These two methods, the starvation ketogenic method, must be implemented under the guidance and supervision of an experienced doctor, because not only does there exist an obvious rebound mechanism, but there is also the danger of consuming the structural proteins of one's own tissues and organs, which is manifested by the loss of appetite after fasting. Refeeding syndrome and dystrophic hypoprotein edema. It is best to combine light fasting with the ketogenic diet in moderation. The ketogenic diet mainly changes the structure of the diet and provides a large amount of fat enough for the body to produce ketone bodies and utilize ketone bodies. At this time, the concept of light fasting is used to control the time between meals. Adjust the intervals, give up the eating habit of three meals a day, and restore the sensitivity of cells to insulin (shown as a feeling of hunger for a certain period of time every day). Only then can it be possible to achieve sustained burning of body fat, weight loss, and insulin reversal of type 2 diabetes. purpose of resistance.