Insulin Resistance

Nutrition: insulin-centric, not dogmatic

I differentiate between:

• “Overfueled, under-muscled, inflamed” (most IR) vs
• “Lean, high stress, dysregulated cortisol, maybe reactive hypoglycemia” (different handling of carbs)

Baseline nutrition principles (for 90% of IR cases)

Macro structure per meal:

• Protein: 1.6–2.0 g/kg ideal body weight per day; 25–40 g per meal
• Carbs: front-loaded earlier in the day; 15–30 g net per meal to start for most; mostly from whole-food sources
• Fat: fill the remainder with mono- and saturated fats from whole foods, avoid industrial seed oils

Food rules that move the needle:

1. No naked carbs.
   Always pair carbs with protein + fiber + fat.
2. Early time-restricted eating (if adrenals tolerate it):
   • 10–12 hr eating window to start
   • Prefer 8 am–6 pm over skipping breakfast and eating late
3. Prioritize protein at breakfast:
   • 30–40 g protein, minimal sugar, modest carbs
   • Example: 3 eggs + 100 g smoked salmon + sautéed greens in olive oil
4. Carb sourcing and cutoffs:
   • Prefer: root veg, whole fruit (2 servings/day), lentils/beans (if tolerated), quinoa, buckwheat, well-cooked oats (if non-celiac)
   • Reduce drastically: liquid sugar, fruit juice, sweetened coffee/tea, refined grains, most ultra-processed snacks
   • For moderate-to-high IR or NAFLD: start around 50–80 g net carbs/day for 4–8 weeks, then increase based on response
5. Fats:
   • Include: extra virgin olive oil, avocado, pasture-raised eggs, grass-fed meats, fatty fish, nuts/seeds (watch portions), full-fat fermented dairy (if tolerated)
   • Minimize: soybean, corn, canola, cottonseed, “vegetable oil” blends, repeated deep-frying
6. Fiber & polyphenols:
   • Aim: ≥30–40 g/day fiber
   • Ground flax/chia, psyllium, lots of non-starchy veg, berries
   • Polyphenol-rich: green tea, coffee (without sugar), cocoa, berries, olives, herbs/spices (cinnamon, turmeric, rosemary, oregano)

Example day (for a typical overweight IR client):

• Breakfast:
  • Omelet with 3 eggs, spinach, mushrooms, feta in olive oil
  • ½ avocado
  • Green tea or black coffee
• Lunch:
  • 150–200 g grilled chicken or salmon
  • Large mixed salad (olive oil + vinegar), olives
  • ½–1 cup cooked lentils or chickpeas (depending on carb tolerance)
• Snack (usually optional):
  • 20–30 g nuts or a protein shake with unsweetened almond milk + fiber
• Dinner:
  • 150–200 g meat/fish
  • 1–2 cups non-starchy veg with butter/ghee/olive oil
  • Small serving (½–1 cup) starchy veg (sweet potato, winter squash) depending on glucose response

For lean, stressed, “wired-tired” IR or reactive hypoglycemia

• Don’t be too aggressive with carb restriction initially
• Use balanced meals with 25–30 g protein + 20–30 g low-glycemic carbs + 10–20 g fat
• Avoid long fasting windows early; prioritize circadian rhythm first, then consider gentle compression of eating window.

Movement & body composition

Insulin resistance is fundamentally a muscle and liver issue.

Non-negotiables:

1. Resistance training:
   • 3x/week, 30–45 minutes
   • Focus on big patterns: squat, hinge (deadlift/hip thrust), push, pull, loaded carry
   • Goal: progressive overload; even bodyweight + bands will work at first
2. Postprandial walking:
   • 10–15 min walk after main meals (especially largest carb load)
   • This alone can drop postprandial glucose 20–30 points in many people
3. Daily movement target:
   • 7,000–10,000 steps/day as a minimum effective dose
4. For advanced / plateaus:
   • 1–2 sessions/week of higher-intensity intervals (e.g., 6–10 × 30–60 sec fast with full recovery).
   • Use cautiously in those with high cortisol/overtraining.

Sleep & circadian rhythm

One bad night of sleep can create temporary insulin resistance.

Core practices:

• 7.5–9 hours in bed, consistent wake time
• Morning light exposure within 30–60 min of waking, 10–20 min outside
• Block blue light 2–3 hours before bed (or use warm/red lighting)
• Cool, dark, quiet bedroom
• No late heavy meals; finish dinner at least 3 hours before bed

If sleep apnea is suspected (snoring, daytime sleepiness, large neck, refractory IR), push for assessment—treating apnea is a massive IR lever.

Stress & autonomic balance

Chronic sympathetic overdrive worsens hepatic gluconeogenesis and IR.

Minimal effective interventions:

• 10–20 minutes/day of parasympathetic work:
  • Slow breathing (e.g., 4–6 breaths/min)
  • Yoga nidra, meditation, tai chi, qigong
  • Even a daily nature walk without phone
• Track subjective “stress load” and correlate with CGM/ SMBG if using it.