Shilpa Joshi, RD July / 24 / 2019
India does have second largest population with type 2 diabetes in the world. One of the main drivers to Type 2 diabetes is insulin resistance. In this article, we shall discuss this problem in detail. When we eat food, it gets converted to glucose in the process of digestion. Glucose is the source of fuel to body. Each cell of our body requires insulin for transport of glucose across the cell. Insulin acts as a key for transport of glucose into the cell. Insulin resistance is a state in which cells of the body do not respond (or resist) insulin. This results in inability of glucose to pass into the cell. The glucose therefore spills into the blood, leading to high blood glucose or hyper-glycemia, which is characteristic of Diabetes (more specifically type 2 diabetes). Therefore insulin resistance leads to type 2 Diabetes.
The causes of insulin resistances are many. Genetics, aging and ethnicity play roles in developing insulin sensitivity, the driving forces behind insulin resistance include excess body weight, too much belly fat, a lack of exercise, smoking, and even irregular sleep. Among diet, foods high in refined carbohydrates and saturated and trans fats have been implicated in predisposing an individual to insulin resistance and type 2 Diabetes. Lack of protein in Indian diets have led to increased intake of carbohydrates like white rice, maida based products like naan, paratha, pav, bread, toast etc. Also, most of the time presence of invisible fat in excess ( such as in ready to eat snacks and bakery products) adds fuel to the fire and decreases the sensitivity of the cell to insulin.
The major dietary aspects to be considered while treating or preventing insulin resistance is a hypo-caloric diet (eat less). Along with it very important is to include a protein product in every meal like nuts, pulses, milk and milk products like youghurt, low fat paneer or lean non veg foods. Including plenty of vegetables and about two servings of fruits in the diet.All carbohydrates chosen should be complex in nature like brown rice, whole wheat or millets, all in limited quantities. Right cooking methods are also important. Its important to avoid cooking methods like deep fat frying or grilling where meat and vegetables are charred. This leads to increased oxidative burden on the body. Right cooking methods would be boiling, steaming, slow cooking etc using minimum fats. Exercise and physical activity play an important role in preventing and treating insulin resistance. Exercise makes muscles more receptive to insulin, decreases body fat and decreases resistance. It also helps secrete hormones called endorphins ( feel good hormones). Both cardio exercise and strength training (resistance traning) are important to overcome the problem and maintain fitness. Besides all these factors reducing mental stress by meditation, positive reaffirmation is a very important part of life style disease management. A good night sleep is also essential, as it helps body to rejuvenate. Insulin resistance is out come of many factors. While genetic factors and aging is beyond our control all other lifestyle measures are doable.