#385: Insulin Resistance & Diet

Today's Topic in Focus: Insulin Resistance and Diet

In this episode we explore the causes of insulin resistance, and the dietary modifications that may help those with insulin resistance.

We discuss how insulin resistance is a complex metabolic disorder, that goes beyond one single pathway or cause. There is also a discussion on the mechanisms of insulin resistance pathogenesis. Specifically, we talk about the accumulation of ectopic fat. Ectopic fat is the storage of triglycerides in tissues other than fat tissue, such as the liver, skeletal muscle, heart, and pancreas.

There is also an overview of the Twin-Cycle Hypothesis, which was discussed in more detail in a previous episode with Prof. Roy Taylor. In addition, we give special mention to liver fat accumulation and the relationship between insulin resistance and non-alcoholic fatty liver disease (NAFLD).

Then various diet interventions are assessed for their potential usefulness to those with insulin resistnace. This includes different diet types (e.g. whole-food plant-based diet, low-carbohydrate ketogenic diet, etc.), role of macronutrients, pre-loading studies, and the role of meal timing and circadian effects.

Links to Mentioned Resources:

1. Fatty Liver: The Relationship Between Diet & NAFLD
2. #331: Prof. Roy Taylor – Diabetes Remission, Very-low Calorie Diets & the Twin Cycle Hypothesis
3. #155: Kimber Stanhope, PhD – Effects of Sugar Consumption on Body Composition, Lipid Regulation and Insulin Sensitivity
4. Stanhope, 2016 - Sugar consumption, metabolic disease and obesity: The state of the controversy
5. Anderson & Ward, 1979 - High-carbohydrate, high-fiber diets for insulin-treated men with diabetes mellitus
6. Kiehm et al., 1976 - Beneficial effects of a high carbohydrate, high fiber diet on hyperglycemic diabetic men
7. #252: Alpana Shukla, MD – Effect of Food Order on the Glycaemic Response
8. Jakubowicz et al., 2014 - Incretin, insulinotropic and glucose-lowering effects of whey protein pre-load in type 2 diabetes: a randomised clinical trial
9. Kuwata et al., 2016 - Meal sequence and glucose excursion, gastric emptying and incretin secretion in type 2 diabetes: a randomised, controlled crossover, exploratory trial
10. Shukla et al., 2018 - The impact of food order on postprandial glycaemic excursions in prediabetes
11. Jakubowicz et al., 2019 - Reduction in Glycated Hemoglobin and Daily Insulin Dose Alongside Circadian Clock Upregulation in Patients With Type 2 Diabetes Consuming a Three-Meal Diet: A Randomized Clinical Trial
12. Jakubowicz et al., 2013 - High caloric intake at breakfast vs. dinner differentially influences weight loss of overweight and obese women