On insulin resistance

Tank Green/ January 26, 2022/ Health, Thoughts

As a recent post indicated, I have been doing a lot of reading around health these last few years. I have primarily concentrated on literature pertaining to metabolic health and literature pertaining to the microbiome. This is all in addition to practising a healthy diet and lifestyle.

The more I read, the more I became interested in learning about my own health markers beneath the visible or easily discoverable. This is mainly due to knowing I have a sweet tooth, knowing that when I do gain weight it is largely around my abdomen, and learning about the phenomenon of TOFI: thin on the outside, fat on the inside.

As the health tests you can get on the NHS are sorely limited, I recently went private to get some more thorough tests through Medichecks. In particular, I was very interested in learning about my HDL:Triglycerides ratio as a more meaningful cholesterol test, and, of course, the biggie for me was insulin resistance. The latter is because I have learnt that many people are insulin resistant and therefore on their way to diabetes, even though their fasting blood glucose levels look fine.

The results surprised me a little and so I thought I would share them to show why it is so important to pay attention to your diet and get more thorough blood tests done than the NHS offers. But first, some basic stats:

  • BMI: 19.9
  • Waist circumference: 69cm
  • Blood pressure: 112/59
  • Resting heart rate: 50bpm

All looks good right? Especially for a 46 year old woman. Remembering also that I do resistance training 3 x per week, yoga 2-3 x per week, and engage in active travel wherever possible (walking and cycling).

The most recent blood tests I got on the NHS were done in July 2021:

  • Total cholesterol: 4.8 mmol/L
  • Non-fasting blood sugar / HbA1c: 34 mmol/mol (range: 20.00 – 41.00 mmol/mol)

At the time, I was a little concerned that my blood sugars were towards the upper end of what is healthy; as for the total cholesterol results, well, that’s a useless test so I don’t know why they bother to do it.

Now, because this matters, I am going to give you an example of what I typically eat and drink on any given day. This is actually what I ate yesterday, but it’s fairly representative. The only real change would be on a weekend, when I typically eat fry ups for breakfast/brunch.

  • Breakfast: smoothie (1 tbsp oats, 1 tbsp milled flax seed, 1 tbsp milled chia, 1/2 tbsp psyllium husk, 1 tbsp sea moss, 1 x scoop hemp protein powder, 1 x banana, bunch of raspberries)
  • Lunch: massive salad (red cabbage, carrot, celery, 1/2 apple, walnuts, olives, pumpkin seeds, sunflower seeds, fresh parsley, 1 x hard boiled egg, homemade mayo and wholegrain mustard dressing)
  • Dinner: Fish stew (cod, prawns, courgette, pak choi, spring onions, fresh chilli, fresh ginger, fresh parsley, lime juice, coconut milk, fish stock), 3 x scoops homemade goats milk and sea moss maple-pecan ice cream, 1 x clementine
  • Snacks: couple of squares 70% dark chocolate, raw almonds, fresh mazafati dates
  • Drinks: 1 x hot lemon, 2 x cup black coffee with 1 sugar, loads of earl grey tea, loads of herbal teas, water
  • Supplements: 4000iu Vitamin D, turmeric, zinc.

The items in bold are the offending items, which, as offending items go, are on the low end of offending items, except for the ice cream and the total of 2 sugars in my coffees. To reiterate, this is a fairly normal day for me in terms of diet. I do eat (delicious) meat, so dinner will either be meat and a bunch of veg, or fish and a bunch of veg. Somedays I do eat potatoes, but only 1-2 times a week max. As a rule, I do not eat bread, pasta, rice, crackers, and so on (although the rule may get broken once a month max). A stray bag of crisps, prawn crackers, or a biscuit will accidentally fall in my mouth once or twice a month, but that’s it as far as junk goes. On days I don’t eat fish, I may add in some Omega-3 supplements. I also randomly supplement other things like quercetin, and an eye health supplement, but I am not consistent with them.

Generally speaking then, my external markers of health are pretty good and my diet is, generally speaking, good. But I wanted to get some more comprehensive tests just to check, especially given what I had been learning about insulin resistance. I settled on two tests heart disease risk and insulin resistance. As an aside, I got my tests done at The Doctors Laboratory and had an excellent experience.

So, the results. My heart disease test had me feeling pretty fucking sanctimonious if I am honest. I won’t bore you with the results, but suffice to say that I am not headed for a heart attack in the foreseeable. Importantly, my Triglycerides:HDL ratio is 0.7 (optimal range: 0.5–1.9) and my C-Reactive Protein (inflammation marker) is less than 0.3 mg/l (range: 0 – 5). Yay, Tank! Pat yourself on your back. You are a healthy BEAST of a middle aged wench.

But wait… there’s more and it’s the one I really care about:

  • Fasting glucose: 5.2 mmol/L (range: 3.9 – 5.8)
  • Insulin resistance: 4.5 mIU/L (range: < 10)
  • Fasting insulin resistance index: 0.9

Now, as you can see, my fasting glucose (and I fasted a full 12 hours) is at the upper end and my insulin resistance is slap bang in the middle. As per the Blood Code calculator, an index result of less than 1.0 means you are insulin sensitive, which is what we should all be aiming for; however, I am barely in that bracket despite eating a low-to-no carb diet, limiting the amount of sugars I eat, and exercising regularly. Clearly, I have not been limiting refined carbs and sugars enough. Whilst I am not at all panicking, I do want to ensure that my insulin resistance number stays below 1.0, because of all the negative health implications of insulin resistance. In short: high levels of insulin in the blood creates inflammation in the body, and inflammation in the body is a fire that will eventually burn you to death. (Okay, I laughed typing that, but in reality it’s true.)

The purpose of sharing all this is to illustrate a point: I think most people would consider my diet to be extremely healthy, I exercise frequently and relevantly, and my external markers of health are all great. Yet and still, I am at the upper end of insulin sensitivity. I have been exercising regularly all my life, but especially so for the last 15 years. I have been steadily reducing the amount of carbs I eat for the last decade (i.e. once I stopped being a vegetarian), but only got more serious about this in the last couple of years. It may well be that I am still on my way down from a higher level of insulin resistance, or it may well be that my beloved ice cream maker and mazafati dates will be the end of me. *sobs* Either way, a very interesting experiment and I would recommend anyone interested in optimising their health gets these blood tests done.

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