We talked all about insulin resistance with registered dietician Emily Cornelius, the creator of Glucoast Nutrition — from what it is, who’s at risk of developing it, what can result from it if left untreated, and more. Here’s what she had to say:
Can you explain what insulin resistance is and what risks are associated with it?
Insulin resistance happens when cells in the muscles, fat, and liver don’t respond well to insulin, so they struggle to take in glucose from the blood. This means more insulin is needed to help the cells absorb glucose. This leads to higher levels of both insulin and glucose in the bloodstream. Over time, this can lead to various health complications like prediabetes and type 2 diabetes. Insulin Resistance is believed to precede the development of type 2 diabetes by up to 15 years!
Risk factors are excessive body fat, abdominal fat, lack of physical activity, high stress levels, a family history of insulin resistance or type two diabetes, PCOS, a diet high in processed foods and sugary drinks, sleep disorders like sleep apnea, and some medical conditions like cardiovascular issues, hypertension, and high cholesterol.
What inspired you to start Glucoast Nutrition?
I started my private practice as a macro coach that helped women to lose weight. I gave guidance and support that was focusing on consuming a total amount of calories per day that were split between protein, fat, and carbohydrates. I found this method really worked for some people but there was always a big handful of people that weren’t getting results no matter what calorie count I had them on.
One of my clients who was struggling to lose weight got a sleep study done and found out she had sleep apnea. When I was looking at my medical nutrition therapy books, I saw that insulin resistance was common in those with sleep apnea. So, we had a conversation about it and decided to try a diet that was designed to reverse insulin resistance. After about a week, the weight just started melting off of her. Fast forward to two years later, she has now lost 95 pounds.
At the time, I was really blown away that the lack of weight loss was connected to insulin resistance. I never knew you could be insulin-resistant and not have diabetes. The information on this topic was pretty limited, so I got on social media to talk about it.
Two years later, I had over 750,000 followers between instagram and Tik Tok. I discovered that many people were suffering from insulin resistance (more than 1 in 3 in America), and I decided to change my practice to focus just on reversing the condition, and Glucoast Nutrition was born.
Is insulin resistance reversible? What can people do to work toward remission?
Yes, insulin resistance is a diet and lifestyle disease, and can be treated with diet and lifestyle changes. Some areas of focus for reversing this condition include a healthy balanced diet, blood sugar-balancing strategies, regular exercise, weight loss, adequate sleep, stress management, not overconsuming caffeine, and gut strengthening.
When working on reversing insulin resistance, it’s critical to look at it from a holistic perspective, but nutrition plays a foundational role. Eating a balanced diet that includes protein, fat, and fiber (I like to call it the PFF Method) helps to lessen spikes during meals.
In addition to meal balance, you can use blood sugar-balancing strategies like eating your food in the right order to lessen spikes, drinking vinegar before meals, portion control, and regular meal times to help reverse insulin resistance.
Carbs can often be confusing to understand in the blood sugar-balancing world, but I believe keeping complex carbohydrates in the diet are essential for improving carbohydrate tolerance. How many carbohydrates you can tolerate per meal depends on the person, severity of insulin resistance, and activity level.
Since it’s different for everyone, there is a lot of confusion surrounding what to do about carbohydrates. I have had a lot of success with starting clients at 1-2 servings of fiber-rich carbohydrates per meal, and then increasing it over time as their tolerance improves. Some foods to avoid with insulin resistance are excessive amounts of refined sugars, saturated fats, and processed foods.
Do you have any advice for people living with insulin resistance who may not know they have the condition?
Yes! Insulin resistance often develops gradually and may not produce noticeable symptoms early on. However, some signs and symptoms include:
- Increased hunger/cravings
- Fatigue
- Difficulty losing weight
- High blood sugar levels
- Belly fat
- Adult acne
- Poor sleep
- Skin tags
You can confirm if you have insulin resistance through lab work by getting a fasting insulin test. Glucose and A1C will not tell you if you have insulin resistance unless you already have prediabetes. Before this, it must be a fasting insulin level. You can request a test like this from your doctor, or there are kits you can order online that you can use to test yourself at home.
Alternatively, if you want to do a quick assessment of your waist-to-hip-ratio (WHR), thatwill tell you if you are at risk for insulin resistance. This is calculated as waist measurement divided by hip measurement (W⁄H). For example, a person with a a 30-inch waist and 38-inch hips has WHR of about 0.79.
Typically, a WHR of 0.85 or higher in women and 0.90 or higher in men is considered indicative of abdominal obesity and an increased risk of insulin resistance. Results may vary depending on individual health considerations.