Insulin resistance

Currently, about 40% of the French population is overweight and 8 to 10% are obese, especially in the 60-70 age group. Yet, the main cause of these excess weights, which is insulin resistance, is still overlooked by much of the medical community and remains an unsolved and often ignored mystery for patients who suffer from it.

• A gradual food drift.

For 4 million years, men have been hunters - gatherers. The Paleolithic menu consisted mainly of proteins (fish, meat) and vegetables (fruits, vegetables).

With industrialization, the consumption of fish and vegetables has gradually decreased in favor of cereals, bread and refined sugars. This significant increase in the proportion of carbohydrates in our diet is responsible for the overweight that characterizes our current populations, as well as all the harmful consequences on health that this entails.

• Insulin resistance.

Insulin is a pancreatic hormone that maintains blood sugar levels within physiological norms by influencing the metabolism and storage of glucose. As soon as food is absorbed, the digestive process converts carbohydrates into glucose, a simple sugar, which passes from the intestine into the blood. At this point, the blood sugar level rises, which causes the pancreas to respond. The endocrine part of this gland then secretes insulin whose role is to make certain cells (liver, muscles and fat cells) absorb blood glucose.

With age comes a gradual loss of sensitivity of many of our tissue cells to insulin, which is called insulin resistance.

The body then reacts by producing more and more insulin in an attempt to get the glucose into the cells. The consequences are an increase in blood sugar levels and an exhaustion and laziness of the pancreas, which ends up not producing enough insulin.

Insulin resistance can persist for many years before leading to diabetes, but when the pancreas can no longer keep up with the demand for insulin, the body falls into pathology: this is the onset of type 2 diabetes (see next paragraph).

• Insulin resistance and obesity.

There is a close relationship between overweight, insulin resistance (up to non-insulin dependent diabetes) and cardiovascular risk factors. Indeed, hyperinsulinism actively participates in the atherosclerosis process involved in 80% of hypertensions.

While aging is probably the most universal cause of insulin resistance, our Western lifestyle accelerates its progression through our excessive consumption of sugars. Other contributing factors include too much processed and refined food, alcohol, smoking and lack of exercise.

It can be seen that, in many cases, correction of overweight (especially abdominal) is sufficient to treat NIDDM. As we know, reactive hyperinsulinism is itself responsible for lipid disorders that precede the onset of diabetes by several years. The latter appears to be the result of a complex disorder of the metabolism of sugars and fats. It is therefore useless to impose a diet on the patient that advocates the elimination of sugars, as this alone would serve no purpose.

It is obvious that when blood sugar levels are high, insulin levels are automatically high, which inevitably promotes lipogenesis. It's not easy because high levels of insulin decrease the amount of satiety signals sent by the hypothalamus. As a result, the person with excess insulin not only feels hungry, but also produces and stores more fat than normal people. This leads to an inexorable weight gain, which can lead to obesity, and which also promotes diabetes and cardiovascular disease.

• False belief about the subject of fast and slow sugars.

According to popular belief, fast sugars are found in foods with a strong sweet flavor (desserts, candy bars, Coca-Cola) and provide the body with quick energy. Conversely, slow sugars are found in non-sugar-flavored foods (potatoes, bread, pasta) and provide energy less quickly, but for longer. This distinction is erroneous and confusing.

• The rate of sugar assimilation and the glycemic index (GI).

In fact, what characterizes the speed of assimilation of a sugar is its capacity to pass from the intestine to the blood and the extent to which it will increase the level of glucose in the blood.

So it was in order to measure the increase in blood sugar after eating a carbohydrate-rich food that scientists created the concept of glycemic index (GI). The higher the index, the faster the sugar is absorbed, and the faster the amount of blood glucose increases.

The glycemic index of a food is determined by comparison with a reference food, glucose.

Glucose is a sugar that rapidly raises the blood sugar level. It has a glycemic index of 100, so the GI of glucose is 100 and it serves as a reference.

All carbohydrate-containing foods can be classified according to their own glycemic index, i.e., a IG high, above 70, medium between 55 and 70, or low below 55.

A food with a high glycemic index will raise blood sugar levels more and faster than a food with a low glycemic index.

• The glycemic load, the key to diet.

While the glycemic index tells us how a carbohydrate-containing food raises blood sugar and how fast it raises it, it does not take into account the amount of carbohydrates consumed at all.

For example, if you eat two foods with the same glycemic index (e.g., cooked carrots and a Mars bar with a GI of 56 and 57, respectively) in equal amounts, your blood sugar level will rise less with the food that is lower in carbohydrates (cooked carrots).

Cooked carrots have a GI of 56, so if you eat 90g of cooked carrots, this portion contains about 8g of carbohydrates. To calculate the glycemic load, multiply 8 (the amount of carbohydrates) by 0.56 (the glycemic index), resulting in a glycemic load (CG) of 5.

The Mars bar, with a GI of 57, contains 37 grams of carbohydrates, i.e. 37 multiplied by 0.57, which gives a glycemic load of 21.

Hence the interest in using the concept of glycemic load (GL), derived from the concept of GI. The CG measures the total glycemic response after eating a food or meal. It is calculated as follows:

GC = GI of the food ingested divided by 100 and multiplied by the number of grams of carbohydrate per serving ingested, i.e. GI/100 TIMES X g of carbohydrate.

In practice, the CG allows direct comparison of the effect of a food on blood glucose levels by measuring the portion consumed. It also allows us to measure the glycemic impact of one food compared to another.

A glycemic load above 20 is considered high, medium between 11 and 19, and low below 11.

If you suffer from diabetes, cardiovascular disease, obesity or simply want to lose weight effectively, do not eat foods with a GC of more than 40 per day. This means approximately 10 CG for breakfast, 10 for lunch and 20 for dinner. You can also drink 5 CG, so your total daily intake of food and drink will be 45 CG.

Without any particular pathology, a healthy diet should not exceed 80 CG per day.

Below is a table showing the glycemic load of various common foods (in the last column).

Foods that contain no carbohydrates and/or are composed entirely of protein or fat (meat, fish, eggs, cheese, mayonnaise) have a zero CG and are not included in this table.

For more details on this subject, you can consult the following site http://www.ajcn.org/cgi/content/full/76/1/5/T1

• White beans and persimmon to the rescue

Certain fruits and vegetables have been found to be able to help people with insulin resistance who are predisposed to these types of health concerns. One of the natural derivatives of white beans is phaseolamine. It has the property of decreasing the transformation of starch and sugars present in the diet into glucose.

The product containing this active ingredient is therefore of major interest for diabetics and for all those who seek to reduce or control their weight by following a low carbohydrate diet.

The kaki has also proven to be useful and successful in these types of problems. This fruit is excessively rich in polyphenols, anti-oxidant substances that participate in the prevention of cardiovascular diseases. Recent discoveries show that polyphenols act as catalysts and are involved in many biological processes, in particular in the proper functioning of the liver and in the regulation of fat metabolism. The persimmon particularly decreases the absorption and the manufacture of greases by the organization. Moreover, it reduces the appetite by regulating the impression of satiety.