Great Article on Insulin Sensitivity

**usualsuspect** · 01-30-2004, 10:54 AM

The factors governing your response to different nutritional intakes are pretty diverse, but one major factor I've been focusing on lately is insulin and glucose tolerance. In my mind, insulin sensitivity seems to be the most important factor dictating how the body will handle carbs. For those who have high insulin sensitivity, the body responds to carb intake with small insulin surges. Although the insulin surges are small, the cells are very responsive to that little amount of insulin and do a great job of becoming anabolic . Since lots of insulin can inhibit fat loss, the ideal scenario is to become very insulin sensitive so that only small amounts of insulin are required for anabolism and so that those small amounts of insulin don't prevent fat loss.

In my experience, individuals who have high insulin sensitivity maximize their muscle to fat ratio on diets that are high in carbs and lower in fat (50% carbs, 35% protein, 15% fat). Those with moderate insulin sensitivity tend to do best on diets that are more isocaloric (30% carbs, 40% protein, 30% fat). And those with poor insulin sensitivity do best on diets that are low in carbs (50% protein, 35% fat, 15% carbs).

So within the framework of this article, if you're highly insulin sensitive, more than three of your daily meals would be carb plus protein meals. If your insulin sensitivity isn't so great, more than three of your meals will be protein plus fat.

So the next question is how do you know if you're sensitive or not? Did you cry at the end of Titanic when Leonardo DiCaprio's character sank like a blue Freezer Pop into the North Atlantic? Well, there you go; you're sensitive. Me? I cried like a baby. Okay, okay, actually there are several methods.
The easiest thing to do is just think about what types of diets you respond to best. If low carb diets work great for you, then you're probably insulin insensitive. If you can eat a lot of carbs and not get fat then you're probably insulin sensitive. If you'd like something more concrete than that, read on.

Some experts use very simplistic recommendations for testing insulin sensitivity, methods I disagree with. For example, I've heard the statement that if you have an apple-shaped physique or if you get sleepy after a carb meal then you're insulin resistant (insensitive). In my opinion, these are way too non-specific and tell you very little about your nutrient needs or if you're making progress.

Instead, I prefer methods that, although more time consuming, are objective. The first is an oral glucose tolerance test. For this you need to go to your local pharmacy and purchase a glucometer, some glucose test strips, and a standard glucose beverage (ask your pharmacist about this because it has to be a specific kind. Pepsi won't work). Once you've got the goods, you'll plan your test.

After going at least 24 hours without exercise (do this test after a day off from training), you'll wake up in the morning (fasted at least 12 hours) and you'll take a blood sample from your finger tip. Write down this number. Then drink your glucose beverage and continue to take blood samples at 15, 30, 60, 90, and 120 minutes. Record all the numbers at each time point. Here's a little chart of what you should expect:

Normal Insulin Sensitivity and Glucose Tolerance

Excellent Insulin Sensitivity and Glucose Tolerance

Fasted Blood Glucose

<100mg/dl

<70mg/dl

Peak Blood Glucose

<180mg/dl at peak

<130mg/dl

Time to Maximum Blood Glucose Level

30-60 minutes

15-30 minutes

Time Back to Fasted Glucose Level

30-60 minutes

60-90 minutes

The second test that I like to recommend for assessing insulin sensitivity is a fasted glucose and insulin test. For this you need to see your doctor. This test is simply a blood draw in the fasted state. It's easy to do. Just schedule an appointment, the nurse will do a single blood draw, and then the lab will measure the levels of insulin and glucose in your blood at this time. Using one of the following equations, you'll have both an insulin sensitivity score and a pancreatic responsiveness score:

Insulin Sensitivity =

Fasted Insulin (mU/L) / 22.5 x e ^ -ln(Fasted Glucose (mmol/L))

OR

Fasted Insulin (pmol/L) x (Fasted Glucose (mmol/L) / 135)

Pancreatic Beta Cell Function =

(20 x Fasted Insulin (mU/L)) / (Fasted Glucose (mmol/L)-3.5)

OR

(3.33 x Fasted Insulin (pmol/L) / (Fasted Glucose (mmol/L)-3.5)

If you're not a math whiz or don't own a calculator, have your doctor do the math for you. Remember, you have to go to his office to get the test done in the first place. Once you have these values, compare your numbers to the following to see how sensitive you are:

Insulin Sensitivity

Lower score = more sensitive
Normal insulin sensitivity: score should be below 2
Excellent insulin sensitivity: score will be around 0.5

Pancreatic Beta Cell Function

Higher = better pancreatic function and insulin release
Normal pancreatic function: score should be about 100
Excellent pancreatic function: score will be above 200

Once you've collected these measures, you'll have a better indication of what type of diet you need to consume. I recommend doing these tests at least once every few months to see how your diet and training is impacting your insulin sensitivity.

Let's Get Sensitive!

So let's assume that you've done the tests mentioned above and you weren't happy with the results. You're insulin insensitive and, dammit, you don't like it! Well, instead of resigning yourself to a flabby midsection for the remainder of your days there are some things you can do to increase insulin sensitivity.

Both aerobic and resistance training greatly increase insulin sensitivity through a variety of mechanisms. So include both in your program. I've seen tremendous increases in insulin sensitivity with three to four intense weight training sessions per week lasting 1 to 1.5 hours per session. These sessions should be coupled with at least three or four aerobic sessions lasting 30 minutes per session. To really target insulin sensitivity, you'd want to perform weight training and cardio separately.

In addition, supplements like omega 3 fatty acids, fish oils, alpha-lipoic acid, and chromium can increase insulin sensitivity. I typically recommend starting out with 600 mg of alpha-lipoic acid (ALA) and concentrated fish oils containing a total of six to ten grams of DHA and EPA (the most active omega 3 fats in fish oils).

On the flip side, stimulants like ephedrine and caffeine can decrease insulin sensitivity due to their effects on metabolism. Furthermore, the low carb, high-fat diets that have become popular can also lead to decreased insulin sensitivity. That's why my trainees don't take stimulants or go on no-carb diets (unless they're dieting down for a show and then they'll do occasional no-carb diets every few months for a maximum of three weeks at a time).

So if your insulin sensitivity isn't ideal the first time you measure it, try the approaches I listed above. Then go back after a month or two and re-test. You'll see that the numbers look much better.

Individual Differences - Experimentation

Even though the last section will help you better define where you stand with the insulin issue, probably the most productive way of determining which eating program is best for you is to experiment on yourself. So for eight weeks, I encourage you to follow a 50% carb, 25% protein, and 15% fat diet that exceeds your energy needs (as determined in Part I of this article). During this time, record your gains in terms of muscle mass and fat mass. This will give you a muscle:fat ratio.

Then go back to your normal eating for eight weeks. After those eight weeks, try a new diet of 30% carbs, 40% protein, and 30% fat for eight more weeks. Again record the muscle:fat ratio.

After these 24 weeks you should know which type of diet is more effective for your body type. I know it seems like quite a bit of time to devote to figuring out your eating needs, but assuming that you've been training for years or plan to be training for years to come, 24 weeks is only a small period of time. In addition, the results of your efforts will be applicable for the rest of your life.

Remember, however, that when constructing your eating plan you must realize that just because you're following a diet with 50% carbs, 25% protein, and 15% fat or a diet 30% carbs, 40% protein, and 30% fat, that doesn't mean that each meal is made up of these proportions. In fact, the meals should not all be of these proportions because this will mean undesirable blood levels of fat, carbs, and insulin. So using the techniques I taught you during the meal combination section, design a plan that has different proportions of macronutrients during different meal times but that achieves the optimal proportions of (40-30-30 or 50-25-15) by the end of the day.

Summary

Here's a quick and dirty summary of the Massive Eating plan:

1) Read Part I and determine your daily caloric needs.
2) Eat meals consisting of fat and protein together with very little carbs. Also eat protein and carbs together, but with very little fat in those meals. Don't eat carbs by themselves and don't eat carbs with fat.
3) Determine your macronutrient ratios based on your level of insulin sensitivity. You can do this with the tests I explained or you can just try different diets consisting of different rations of protein, carbs and fat. If you're insulin insensitive you can do something about it by following my suggestions above.

Remember, if you aren't putting on muscle while following a good weight training program, then it's probably your diet that's to blame. With Massive Eating, your problem is solved, so no more excuses! If you ever find yourself making statements about your genetic limitations or your unreasonably fast metabolism, revisit these articles for a wake up call. "Limitations" can become challenges to work through or just weak excuses that keep you down.

Now, shouldn't you go get something to eat?