Insulin Resistance: When the Body’s Energy Management Falters
My mother had a great idea. She gave me a quarter each day to buy snacks for the walk home from school. I was ten years old. Back then, a quarter bought four candy bars and five lollipops! The calories added up and my body changed. But like all children who find themselves in my situation, I had no clue about the cause. Why had I grown so round?
The shift in my metabolism turned out to be long-lasting. For decades to come, I struggled with weight, with fatigue, and with a weakened immune system. And though I didn’t realize it at the time, my sugar habit affected my breast development. It affected my ability to produce milk for my children.
Luckily, having moved to Switzerland, I was able to overcome low milk supply by cultivating a “lactogenic” diet, based on traditional foods and herbs used in Europe to support milk supply. I went on to certify as a Holistic Lactation Consultant and, in 2000, I co-created the first online group for mothers with low milk supply. Soon, insulin resistance surfaced as a common issue among us.
Insulin is a key hormone that helps glucose—our body’s primary energy source—enter our cells. When the body’s cells resist insulin’s action, the cells are deprived of energy. They do not develop or function fully.
My own metabolism was thrown off balance by my innocent candy habit. I had become insulin resistant. It had affected my long-term health and my ability to nourish my children. But, eventually, I would learn how to correct the imbalance and regain my ability to feed my babies.
Many people have the initial stages of insulin resistance but are unaware of its signals.
By reading this article, we hope you will better comprehend what insulin resistance is and learn how to recognize its early signals. But first we need to understand the what the term metabolism means, and why it is important.
What exactly is metabolism? How can it become unbalanced and lead to insulin resistance?
Metabolism: an Energy Managing System
Note: In this post, energy from food roughly translates to calories from food.
Your metabolism is a system to manage how your body uses nutrients from food: for energy, growth, and repair. It is your body’s “energy management” system. To help you grasp what that means, think of a family budgeting plan in which a molecule called glucose—the sugar we get from food—is our daily income that we want to manage wisely.
- Think of blood-glucose as the cash in your wallet. It’s immediately available for all your body’s needs, like breathing, moving, digesting, and thinking. Glucose is your body’s ‘spend now’ money.
Next, we have glycogen, which is like a checking account. While it is not as immediately accessible as cash, glycogen is still quickly available to use. When your “wallet” runs low, meaning, when glucose has been used up, your body will quickly “withdraw” from its glycogen reserve to keep things running smoothly.
- Glycogen is glucose that’s been converted for temporary storage. It is quickly available, as needed.
Lastly, we have triglycerides, the long-term savings bonds of the body. These are not available for day-to-day use but are stored away for the future. Your liver creates triglycerides from glucose, and it stores them in its own tissue. Once the liver’s storage capacity is full, triglycerides are sent off to be stored in our fat cells.
- Triglycerides, which are stored in your fat pads, are glucose that has been converted into stored energy. It is stored for future use.
In essence, your body is a genius when it comes to budgeting energy. It spends what it must, saves what it can, and puts aside the rest for future use.
Now that we’ve got a handle on how our metabolism budgets our energy, it’s time to look at insulin, the hormone that oversees the energy management system.
Insulin’s “Day Job”
When we eat any food, it must be digested into its smallest molecules before it can pass through the gut and enter the bloodstream. In the case of sugar and carbohydrates, that smallest molecule is glucose.
- Carbohydrates, including sugar and starch, are digested into a tiny molecule called glucose. When we say “blood sugar” what we really mean is glucose within in the blood. We also say “blood glucose.”
When glucose enters the bloodstream, it is immediately noticed by the pancreas, a small, long gland on the upper left side of your abdomen. Imagine the pancreas as a finely tuned measuring device; it senses the incoming glucose and, in response, releases just the right amount of insulin to match—not too much, or too little.
Remember: insulin’s primary job is to direct glucose out of the blood and into the cells that need it for energy. Besides providing energy to the body, insulin works hard to clear the blood of glucose because excess glucose in the blood is dangerous. If glucose remains high, it can damage certain organs such as the kidneys, heart and eyes. Therefore, insulin works under time pressure, aiming to reduce blood glucose as quickly as possible.
Where to put the glucose?
Initially, insulin targets large muscles and the liver, where glucose is used immediately for energy, or is stored as glycogen for later use.
It also targets fat cells (adipose tissue), where glucose is converted into fatty acids and stored as triglycerides, serving as a long-term energy reserve.
This clever hormone, insulin, is highly efficient at regulating blood glucose levels. It’s so effective that it can sometimes clear away too much glucose from the bloodstream, leaving the body with insufficient energy. It has swept all the glucose away, and not a speck is left to fuel the body.
This is where the body’s backup systems kick in. The liver and large muscles immediately convert some of their stored glycogen back into glucose, releasing it into the bloodstream. This quickly brings glucose levels back up to a stable ‘maintenance’ level.
These backup systems accommodate insulin’s sweeping action. They restore blood glucose to normal levels and keep our energy levels stable.
However, when insulin resistance develops, together with low-grade inflammation, this back up system may not work. The result is a state called “Reactive Hypoglycemia,” which we’ll talk about at the end of this post and in more detail in a following post.
Tissues involved in Insulin Resistance
Tissues affected by the early stages of insulin resistance are primarily the skeletal muscle, adipose tissue (fat), and liver cells, as these are the major sites of glucose uptake and metabolism. Here’s a breakdown:
Location: This includes muscles throughout the body, not just the thighs and calves. Muscles in the arms, back, and abdomen are also significant sites for glucose uptake.
Role: Skeletal muscle is the largest consumer of glucose, especially after a meal or during physical activity. It’s estimated that up to 80% of glucose disposal occurs in skeletal muscle.
Adipose Tissue (Fat Cells)
Location: Adipose tissue is distributed throughout the body, including subcutaneous fat (under the skin) and visceral fat (around internal organs). This includes fat in the thighs and abdomen, as well as other areas.
Role: Adipose tissue plays a role in long-term energy storage and is also an endocrine organ that releases hormones and fatty acids, which can influence insulin sensitivity.
Location: The liver is a central organ located in the upper right side of the abdomen.
Role: The liver acts as a hub for glucose storage and release. It’s crucial for maintaining blood glucose levels during fasting and is also a site where insulin resistance can develop.
Cardiac Muscle: The heart also uses glucose, although it can adapt to use other fuels like fatty acids.
Brain: While the brain is a significant consumer of glucose, it’s generally not considered a peripheral tissue in the context of insulin resistance because it has unique mechanisms for glucose uptake that are largely independent of insulin.
Kidneys and Lungs: These organs also use glucose but are not the primary focus when discussing insulin resistance.
Insulin resistance can start in any of these tissues but often begins in skeletal muscle and adipose tissue due to their significant roles in glucose metabolism. Over time, the liver also becomes a key player, especially as insulin resistance progresses
Why Some Cells must be sensitive to Insulin
Our “insulin-dependent” cells are primarily those in the large muscles and fat cells. For these cells, insulin acts like a key that unlocks the door. Without insulin, the door remains closed, and the cells are unable to access the energy they need to function.
Insulin’s main job is to help cells absorb glucose. Remember, glucose is energy; it is fuel for the cell’s immediate needs. However, not all cells need energy equally. The muscles in particular can switch from low activity to high activity at a moment’s notice. For instance, when you exercise, the cells of your muscles require an immediate influx of energy—from glucose.
The Fat Cells (adipose tissue)
Fat cells are a key player in our body’s energy manage plans, which we’ll talk about in the next section. Insulin is the director of these plans, and insulin’s access to fat cells is part of this program.
In making specific cells ‘insulin dependent,’ the body hit on a great energy-management solution. The muscles absorb glucose for immediate needs, but they also have to capacity to store glucose as glycogen, for their own use at a later time. This flexibility means that the muscle cells are able to pick up an extra load of insulin, if need be. Directing extra glucose to fat cells for storage is likewise a great plan. Taken together, both muscles and fat give insulin a wide swath of “places” in which to sweep the glucose out of the blood.
The liver is a key player in the body’s energy management system. Unlike muscles and fat cells, the liver doesn’t need insulin to use glucose for its own energy needs. However, does it helps insulin clear the blood of glucose by storing it as glycogen, and it releases the glucose back into the bloodstream when needed, to maintain adequate glucose levels.
Insulin signals to the liver when to switch between these two modes: storing or releasing glucose as needed. But as insulin resistance develops, the liver’s sensitivity to these signals can diminish, leading to inappropriate glucose release or storage.
The Greatest Plans…
So how do things go wrong? Why do cells become resistant to insulin? What does insulin resistance even mean? And what are the first symptoms that signal something’s gone amiss?
It’s not really hard to understand. We just have to look at what happens when the blood is flooded with glucose. Most of us saturate our body with glucose every single day, when we eat the fast and processed foods that comprise the Standard American Diet. Let’s see how this diet challenges the energy management system of the body.
Plans A, B, and C
We grow up in a world where nutrient-poor but calorie-rich food is packaged in bright colors and put at a child’s eye-level in markets. How should a child know that what is specially designed to appeal to them may gradually result in a disorganized metabolism?
Adults, too, tend to underestimate the effects of these ultra-processed foods: on our own metabolism, and on the metabolism of our children.
It’s how we live.
Who among us has not stayed up late at night watching a movie and eating ice cream? Who among us does not know the helpless compulsion to finish that package of cookies, or that bag of chips? We keep going until every last cookie, every last chip is gone.
These foods are designed to cause cravings and binge eating. We’ve all been there.
So now let’s look at what happens to our happy hormone helper, insulin, when a tidal wave of glucose enters the blood, while we sit up late at night, eating that last piece of chocolate cake and watching a horror flick.
The Pancreas Reacts: Plan A
As the wave of glucose enters the bloodstream, the pancreas immediately—not a second later—releases a flood of insulin that is measured precisely to match the influx of glucose.
Remember, insulin’s main job is to shuttle glucose into specific cells that are in immediate need of energy. The other cells in your body will continue to absorb glucose at their usual rate, unaffected by the sudden spike in glucose.
But because you are still sitting on your bed eating cake, and not running a marathon, your muscles don’t need much glucose. This is where insulin shifts to Plan B.
Plan B: Storage Mode Activated
Now insulin directs the liver and muscles to transform the surplus glucose into glycogen, putting it in temporary storage in their tissues.
With the glucose now converted to glycogen, and safely cleared out of the bloodstream, this might have been the end of the story. But now you are sipping on an ice cream float. Again, the pancreas reacts, pouring out even more insulin. But your muscles still do not need extra glucose as you are not working out at the gym, and the liver’s and muscle’s glycogen stores are already completely full. What to do?
Plan C: Last Resort
At this point, the liver shifts gears and begins converting the excess glucose into fat molecules called triglycerides, storing them within its own tissues. When even this storage reaches its limits, these triglycerides are sent out into the bloodstream. Here’s where your fat cells (adipose tissue) come into play. These circulating triglycerides end up being stored in your fat cells for long-term energy reserves.
Long story short: When the body has more energy than it knows what to do with, it stores it as fat. This is why we gain weight when we eat too much and move too little.
Plan A: insulin directs glucose into those cells that require more energy.
Plan B: insulin directs the liver and muscles to transform unused glucose into a storable form, glycogen, which is then stored in the liver and muscles.
Plan C: the liver begins to convert glucose into triglycerides which are also stored within the liver. But when the storage capacity of the liver is full, the triglycerides are sent out into the bloodstream, where they eventually integrate into already-existing fat cells.
When Energy Management Struggles to Keep Up
You might assume that our bodies, with multiple balancing mechanisms and back-up systems for energy management, would adapt smoothly to today’s diets and lifestyles. For a time, they often do. However, continuing to eat poor dietary choices will inevitably begin to strain these systems, leading to metabolic imbalances that contribute to health issues like diabetes, heart disease, and even cancer in the long term.
Our bodies’ methods for managing energy were formed in a different era, one characterized by uncertain food availability and fluctuating conditions. In those times, humans had to maximize nutrient absorption and store energy efficiently to survive.
The proverb, ‘Waste not, want not,’ encapsulates this aspect of our biology. It’s a hint as to why our bodies struggle with the constant intake of processed foods laden with sugar, unhealthy fats, oils, and salt, along with other problematic ingredients like refined carbohydrates, trans fats, and artificial additives.
A diet that continually includes these kinds of foods can trigger insulin resistance, leading to a ripple effect of issues such as cellular inflammation, chronic insufficient hydration, and heightened stress hormones. These imbalances can also be a stumbling block for lactating mothers.
Even if you feel fine while eating a diet heavy in fast foods, snacks, and processed products, these choices will eventually strain your body’s energy management strategies.
Early Symptoms of Insulin Resistance
How Your Body Responds to a Carb-Heavy Meal
When you eat a meal rich in carbohydrates, your metabolism swings into action. Ideally, glucose levels in your blood rise, triggering an insulin response that helps usher the glucose into your cells, where it fuels your body. Then, your liver and muscles release stored glucose to balance your blood sugar levels back to normal.
However, insulin resistance can disrupt this smooth process. In this case, insulin has to work extra hard to manage your blood sugar, as if your cells have become hard of hearing to insulin’s calls. This can make you feel tired soon after eating—a sign your body’s metabolic harmony might be off.
Coffee, Tea, and Temporary Fixes
When faced with this unexpected fatigue, it’s tempting to reach for coffee or tea. The caffeine can jolt your cortisol levels, freeing up stored glucose for that quick energy fix. But this doesn’t address the underlying insulin resistance, it only continues the cycle.
When the Backup Fails: Reactive Hypoglycemia
As insulin resistance advances, you may experience reactive hypoglycemia. In this situation, your pancreas pumps out extra insulin to finally get the glucose into your cells. But once that happens, it removes too much glucose from your blood, causing your energy to plummet. Your liver and muscles, now also less responsive to insulin, aren’t as efficient in releasing stored glucose back into your bloodstream.
So, you may again find yourself reaching for that cup of coffee and maybe even a sugary snack. Though it might seem like you’re fixing the problem, you’re really just applying a temporary solution to a deeper issue: your body’s faltering glucose management system.
The Wider Ramifications of Insulin Resistance
Insulin resistance is more than a metabolic hiccup; it’s often the precursor to various long-term health challenges. Addressing it is not just crucial for immediate wellness; it serves as a proactive step against an array of future health risks.
Further Directions in Understanding Metabolism
While this article focuses on the most frequently encountered pathway to insulin resistance, it’s important to remember that the body’s metabolic network is complex. Factors like familial predisposition, environmental toxins, and even conditions in utero and early infant feeding can have a “programming” effect on your likelihood of developing insulin resistance.
Interestingly, insulin resistance and inflammation are closely linked. The issue often starts at the cellular level—in muscle and fat cells—and evolves into systemic low-grade inflammation affecting various tissues throughout the body. This widespread inflammation can cause a range of organs and tissues to become insulin-resistant, even those that are not typically dependent on insulin for glucose uptake.
In upcoming articles, we’ll explore how insulin resistance and inflammation impact lactation, milk production, and milk supply.
Crafting Your Prevention Plan
Knowledge is your first line of defense against insulin resistance and systemic inflammation. Learning how to build meals that promote metabolic stability is essential. Specific ingredients can fortify what we call the Four Pillars of Metabolic Health, which align closely with the principles of the Lactogenic Diet.
The Four Pillars of Metabolic Health
- Blood Sugar Balance/Insulin Sensitivity: Get acquainted with foods and practices that keep your blood sugar levels steady.
- Anti-Inflammatory Choices: Opt for foods and habits that keep inflammation in check.
- Optimal Hydration: Consider hydration beyond just drinking water. Think about how hydration affects your overall bodily systems.
- Stress Management: Techniques to manage elevated cortisol levels can be both dietary and lifestyle-based and are crucial for metabolic harmony.
I’m currently crafting a detailed series of articles that will expand on the Lactogenic Diet and its Four Pillars. For more immediate guidance, my earlier book, Mother Food, offers relevant insights.
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