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Insulin Resistance

Have you ever heard of Insulin Resistance? The term is becoming more and more common these days, because more and more people are suffering from it. As a matter of fact, almost 90% of US adults have at least one sign of it! Tune in to learn more about Insulin Resistance and what you can do to get it under better control, so you can live a longer, happier, healthier life.

Episode Highlights:

20:26 What do you do to keep your insulin levels low? You must be very super careful with how much sugar and flower products you're eating. And I would say if you're serious about this and you really want to get it under control, I would just say no to any kind of processed food, whether it's cereal or bread products and just eat whole foods.

23:59 I think the most important piece of getting insulin resistance under control is learning how to manage your insulin levels by managing what you're eating. That's got to be really your first line of defense thinking about this.

26:58 So insulin resistance is a condition brought on most cases, 99.9, 9% of cases by eating processed food. There's a spectrum of disease from having normal blood sugar, but high insulin levels to having high insulin levels and rising blood sugar. And then finally, the end stage of insulin resistance is the diabetes diagnosis.

--- Full Raw Transcription Below ---

Dr. Angela Zechmann (00:26):
Hey everyone. Welcome back to the podcast today. I am super excited to be here with you. I just got back from a week of vacation for my 60th birthday. We talked about that last week and I'm feeling all rested and relaxed. And, you know, we talked last week about how I was in my hometown of Wichita to visit my mom for our birthdays. We have a birthday on the same day. And then after that, we went to Kauai, which is my absolute favorite Hawaiian island. It's just so stunningly beautiful and so relaxing. And we just had an awesome time. And now we're back and I wanted to talk today about some science. How does that sound?

Marchelle (01:14):
I love when you do these kind of podcasts about science.

Dr. Angela Zechmann (01:17):
Do you? Oh, good. Yes. Yes. Sometimes I wonder because I can get a little bit intense. So here's the interesting thing about me that you don't get from a lot of the other weight loss gurus that are out there. Because I'm a doctor and I understand the science of weight loss, but also I'm a certified life coach. And so I understand how important our thinking is too. And so I know how to help people with their thought work. So it's kind of fun to work on weight loss from this sort of multi-pronged approach. Right? And really, I think that that's, what's necessary. Ultimately, if you want to get this disease under control and thrive in that healthy, vibrant body that you're proud of. It's important to really understand that this is kind of a you can't just be doing only one thing.

Dr. Angela Zechmann (02:11):
So think about it like this. There's the physical body and there's a scientific basis to understand about the physical body and how obesity affects it. And in obesity medicine, we teach people how to use nutrition and medications and exercise to rebalance the body's metabolism. And that's what allows for weight loss. But what I learned pretty quickly is that for most people, not everyone, but most people, this isn't enough. And so what I discovered is that we also need to work at deeper levels and we have to understand that sugar and flour are addictive drugs and they're put into everything. And so we also need to look at what it takes to help people to overcome this highly prevalent addiction. People need support, tons of support. Most people have been dieting for decades and they're sort of traumatized after all that dieting and they need help with their self-esteem and they need help learning to love themselves again. So there's a lot going on when it comes to getting this disease under control. And that's why I'm constantly studying and learning new things and trying to know everything I can to help people. This truly is one of the most difficult problems people face in our modern society. Would you agree with that Marchelle?

Marchelle (03:40):
It's true. It is definitely true. We see it all the time.

Dr. Angela Zechmann (03:44):
Yeah. It's just a tough one.

Marchelle (03:46):
Yeah. Yeah. I'm glad we're talking about it.

Dr. Angela Zechmann (03:49):
Yeah. So today I kind of wanted to go back to some science cause I love science, but I don't want to bore you with a lot of details. I'm specifically going to talk about insulin resistance today because it's so prevalent and such a huge issue for most people struggling with obesity. But I'm going to simplify it. So for those of our listeners who are actually medical experts, just understand that I'm simplifying this a lot purposefully. Okay. I think understanding insulin resistance is important for anyone who struggles with obesity because it's the most basic underlying abnormality going on and it's, what's causing almost all the physical symptoms of this disease that don't have to do with actually carrying around extra weight. So what is insulin resistance and how do we diagnose it and how do we treat it? In order to understand insulin resistance? You need to understand insulin, right?

Dr. Angela Zechmann (04:52):
So insulin is a hormone. It's one of the gastrointestinal hormones. It's secreted by a gland called the pancreas, which is a digestive gland that sits behind the stomach. Insulin does a lot of things, but for our purposes it has three basic jobs. And a lot of people don't understand this. A lot of medical professionals don't understand this. So listen carefully. The first thing that insulin does is it lowers our blood sugar after a meal. And it does this by causing our muscle cells to take up blood sugar, which is called glucose. So it also causes fat cells to take up fat. A lot of people don't know this. So insulin causes fat cells to take up fat and it prevents fat cells from releasing fat. So those are the three jobs, reducing blood sugar, storing fat and preventing fat cells from releasing fat. So whenever insulin is getting secreted by the pancreas, our blood sugar's going to go down we'll store fat and we won't be able to burn it. Does that make sense? Is there any of that?

Marchelle (06:11):
Totally makes sense. It totally makes sense. Funny, cause I think back before I knew this information, you know, before I started working with you and I like, I think of, you know, there's days when I would drink like six sodas in a day. Yeah. And now that I know more, I just can't believe that my poor pancreas didn't keel over a long time ago. Cause I know, I mean you, you know, this kind of information like, wow, I can't believe I did this kinda stuff to my body.

Dr. Angela Zechmann (06:38):
Well, it really helps you to think about how resilient our bodies are. When you think about all the crap that's in the standard American diet. Right. And how much exactly insulin our pancreas has to produce just to keep up. It's amazing that we don't all have burnt out pancreases by the time we're five, really.

Marchelle (06:55):

Dr. Angela Zechmann (06:56):
You Know,

Marchelle (06:56):
That's exactly what I think. I'm just like pancreas, you're doing a good job. I know a whole lot. Exactly. You just working on overtime full of time back then.

Dr. Angela Zechmann (07:06):
It is. Yeah.

Dr. Angela Zechmann (07:08):
All right. So that's insulin. So, so I do want to say, you know, a little bit of insulin is a fine thing. The problem is that we just have to secrete so much of it, that we become insulin resistant. So what is insulin resistance? It's when the muscle cells don't respond to insulin anymore. They've actually figured out why that happens. And if you're interested in learning the detailed science of it, I would refer you to Peter Attia's podcast called, Drive. So Peter has done a couple of brilliant, very scientific podcasts on insulin resistance. And he is the consummate scientist. And I am a huge fan of his. Just FYI. But I didn't want to go into quite that much detail. I just want you to imagine for a moment what would happen if you became insulin resistant and your muscle cells are no longer responding to insulin.

Dr. Angela Zechmann (08:03):
So you eat a meal and your pancreas produces insulin, but it's not working. So the muscle cells don't take up any glucose. So in that case, your pancreas is just going to produce more insulin to get the blood sugar back down. And for a while, that will work. So in the early stages of insulin resistance, we don't see many changes in blood sugar. We just see higher levels of insulin being produced after eating. So what this means is for you, the same food is going to cause you to make fat when, before it wouldn't. Okay. Does that make sense?

Marchelle (08:46):

Dr. Angela Zechmann (08:46):
The same amount of food. So is this a problem? Absolutely. Because all that extra insulin is going to wreak havoc on your body's metabolism. A whole bunch of bad things happen because of the extra insulin. You want to know what they are?

Marchelle (09:04):

Dr. Angela Zechmann (09:04):
Wouldn't it be great. Yeah. So first off there's a buildup of visceral fat and visceral fat is the bad fat that's located inside the abdomen and around the organ. So there are two different types of fat. There's the fat that's in the abdomen. And then there's the fat that's right underneath your skin, which is called subcutaneous fat. Subcutaneous fat is not dangerous. Visceral fat is very dangerous. The visceral fat cells are very active metabolically, meaning they are producing all kinds of hormones and other substances that wreak havoc on your metabolism and your health. So for example, there's an elevation of hormones that create inflammation.

Dr. Angela Zechmann (09:51):
So people with insulin resistance are walking around with a lot of low grade inflammation that will damage the artery walls. And that's what leads to cardiovascular disease like heart attacks and strokes and aortic aneurysms. Okay, that's the number one killer of Americans by the way, is cardiovascular disease. Inflammation will also damage joints and that causes arthritis. So lots and lots of people are struggling with a lot of joint pain. And sometimes at really young ages these days too. Inflammation will trigger cancer growth. So a lot of people don't understand that obesity puts you at risk for cancer. And it's because of the inflammation. Inflammation actually damages the tissue in the heart. It damages the tissue in the brain and it damages the tissue in the kidneys. So we, we see we see effects from that. Inflammation causes asthma. Inflammation causes digestive issues like reflux or gerd and irritable bowel syndrome.

Dr. Angela Zechmann (11:05):
So I could go on and on here, but suffice it to say inflammation, wreaks havoc on the body. And so what I like to say is to just imagine that visceral fat cells are destroying the body from the inside out, it's really pretty awful. So that's one of the effects of high insulin levels even before your blood sugar starts to rise. Okay. Now also what happens when insulin levels run high is that the liver tends to build up fat and we see fatty liver disease. And we have an epidemic of fatty liver disease in the United States right now. It used to be caused most frequently by alcohol. So alcoholic fatty liver disease. Now it's called non-alcoholic fatty liver disease because we're seeing so much of it and that is created because of the high fructose content in our diet. Okay. So how does all of that make sense Marchelle?

Marchelle (12:05):
Yes, it does. I was just, my mind was wondering a little bit, cause I was just kind of thinking, thinking back again. Some of my not so great behavior and like, oh, wreak havoc on your body.

Dr. Angela Zechmann (12:19):
So it really does. It does. Right. But again, I, you know, I want to emphasize all of this is going on before the blood sugar even starts to rise at all. Okay. So that's an important thing to understand. Okay. So you might have perfectly blood sugar, but you could have all of this disease process going on. Now as insulin resistance progresses, the blood sugar will eventually start to rise and we measure something, at lab it's called the hemoglobin A1C. This is a three month average blood sugar reading. And A1C of 5.7 or higher indicates that there's more severe insulin resistance going on. And then the blood sugar is starting to rise. By the time the A1C hits 6.5, this is like the magic number cutoff for a diabetes diagnosis. But I hope that all of you podcast listeners will understand me when I say, even at an A1C of 5.7, you got some serious problems going on. Okay. The, the blood sugar is starting to rise. There's a lot of insulin resistance going on and that, those elevated insulin levels are already wreaking havoc on your metabolism. Okay.

Marchelle (13:35):
So could I ask you a question? What is what's a normal A1C, like just a real healthy number,

Dr. Angela Zechmann (13:40):
Less than 5.7. So 5.3, 5.4.

Marchelle (13:45):
Okay. So then 5.6. That means you're fine.

Dr. Angela Zechmann (13:49):
5.6 is technically still fine. Okay. I, if my A1C was 5.6, I would start to get a little bit worried though, you know? Okay. All right. Cause we're kind of hitting kind of hitting that direction. Now if I was a diabetic and you know, my, my A1C's have been running eight or nine and now they're 5.6, like kudos. That's awesome. So it's all relative. Right.

Marchelle (14:11):
Right, right.

Dr. Angela Zechmann (14:12):
So I want, I want all of us to think about insulin resistance on a spectrum. So early insulin resistance just means that the insulin levels are running higher, but the blood sugar is normal. And then later on, as it progresses, you have elevated insulin levels and elevated blood sugar, but not high enough to be called diabetes yet. And then eventually you have your elevated insulin levels and your elevated blood sugar levels are high enough that you get a diagnosis of diabetes. OK. So people come, people with obesity come into our clinic at all different levels of insulin resistance. And unfortunately many people already have diabetes and don't know it. How often do we see that?

Marchelle (14:58):
Like that happens quite a bit, quite a bit. And people are, yeah. And people are really shocked. They, they come in and, you know, they, because, you know, a lot of times, you know, you're getting the belly fat and you want to come in and lose a little weight. They don't realize, you know, that that type of belly fat is that, you know, has been going on for what that insulin resistance there. And yeah. And then you do some blood work on them and have to talk to them about diabetes.

Dr. Angela Zechmann (15:25):

Marchelle (15:25):
It's not fun. It's not fun.

Dr. Angela Zechmann (15:26):
It's not fun. And unfortunately, I'm having to have this conversation with people who are younger and younger and younger all the time too. Right. So, yeah. So it's tough. It's really tough. So just want you to be aware of what's going on. There are five criteria for insulin resistance. Other than the A1C. I talked about the A1C at 5.7 to 6.5, then you have insulin resistance, not yet full-blown diabetes, but there are other criteria that we can look at to hopefully catch it earlier. The first thing is no, oh, and, and what I want you to know about these five criteria, 90% of Americans have at least one of these five criteria. Almost everyone I see in the clinic has at least two of these criteria. It takes three of these criteria for a diagnosis of metabolic syndrome for, which is insulin resistance, essentially.

Dr. Angela Zechmann (16:25):
So here are the five criteria and those of you who are listening, if you want to get a pen, you can write these down. Or if you want to just go to the show notes later, you read them on our, at on our, on our website. So the first criteria is waist circumference for women 35 inches or more, and for men 40 inches or more. Okay. The second criteria is blood pressure elevation. So your blood pressure's over 140 over 90 consistently. And that is a, a resting blood pressure. So you need to have been seated for at least five minutes before you take it. Or if you have to take blood pressure medications, then your blood pressure's elevated. The third criteria is a fasting blood sugar that is 100 milligrams per deciliter or more. If it hits 126 and you have two times where your blood sugar is 126 or above, that's a diagnosis of diabetes. So the insulin resistance pre-diabetes state is 100 milligrams to one 125, basically. Criteria number four is triglycerides. Those are blood fats. And if they're 150 or more, then that's one of the criteria. And the last one is a good cholesterol. A good cholesterol is called HDL high density lipoprotein. And if that number is less than 50, then that's one of the criteria. So these are all the signs of insulin resistance and reasons that we should be concerned when you're looking out your blood work. Does that make sense?

Marchelle (18:11):
It does. I was just going to ask you to explain HDL because I couldn't remember what that was, but thanks. I think you covered it.

Dr. Angela Zechmann (18:18):
Yeah. I, the way I remember HDL is good cholesterol is I always think of it as the H stands for happy. That tends to help people. Okay. Cause there's HDL, there's LDL. There's VLDL, you know, there's all of these LDLs, so HDL is happy, good cholesterol. And when that's low, that is a high risk state.

Marchelle (18:38):
Yeah. And for people who don't work in the medical field how you would get tested for, you know, this criteria is you're going to see your doctor do a fasting. Yeah. You're going to see your doctor do a fasting, a lipid panel.

Dr. Angela Zechmann (18:51):
Yes. Lipid, a fasting lipid panel and a fasting blood sugar as well. Yes. cause you need that, that to diagnose it too.

Marchelle (18:59):

Dr. Angela Zechmann (19:00):
Yeah. So you know how frequently cause you are the one, Marchelle entering one of the ones entering the data into our system. So we see this all, all the time constantly. So……

Marchelle (19:13):
We do see all the time. And if people, I know if anybody out there that's listening was thinking that maybe there might be something going on, you know, knowledge is power. Talk to your doctor, get tested because I've also seen people turn it around.

Dr. Angela Zechmann (19:27):
Oh for sure. Yeah. And we're going to talk about that. We're going to talk about that. Because that's the next question I always get is is this reversible or am I doomed you know,

Dr. Angela Zechmann (19:39):
Is it possible to make this all go away? And that answer's definitely yes. I mean, I wouldn't say get it, make it go away, but I can say you can get it under really good control and make sure it doesn't progress. Okay. Right. So how do you do that? So you have to be diligent and you have to be focused and you'll, if you are diligent and focused at getting this under control, you can live a much more normal life for the rest of your life and have a much healthier metabolism. That's what we're doing all day, every day. That's what we're helping people with. So yeah, you lose weight, but there's way more to it than that. So the first line of defense is to do whatever you can to keep your insulin levels low. So how would you do that, Marchelle? What do you do to keep your insulin levels low?

Marchelle (20:33):
Don't don't eat sugar,

Dr. Angela Zechmann (20:35):
Right? You be very super careful with how much sugar and flower products you're eating. And I would say, you know, if you're serious about this and you really want to get it under control, I would just say no to any kind of processed food, whether it's cereal or bread products and just eat whole foods. Okay. Now.

Marchelle (20:59):
Yeah. Foods, foods without labels.

Dr. Angela Zechmann (21:01):
Foods without labels.

Marchelle (21:02):
That's what I, that's what I call.

Dr. Angela Zechmann (21:04):
And I recognize that this is a lot easier said than done. And this is why we have all of the resources that we have for you. For example, we have this podcast where you listen to, we have our free Facebook group called Sugar And Flower Buster Society. You are welcome to go into Facebook, type that in the search bar, under groups and join our Sugar And Flower Buster Society. We've got lots of help for you there. We've also got a Done With Dieting Bootcamp. You just go to And there's a tab that says 30 day bootcamp and you can sign up. So learning how to keep your insulin levels low is a process. But it's amazing how much better you'll feel when you learn how to do this consistently.

Dr. Angela Zechmann (21:49):
Now does exercise help with this? Most people exercise to burn off calories. Right? Right. We see that all the time. Like how many calories did I eat? How long do I have to exercise to burn that off? That is not going to be helpful thinking at all. Because if you go eat a treat, that's got a bunch of sugar in it, you're still going to have that insulin rise. And so, right. don't think like that. Okay. This is one of the problems with the diet mentality that I just hate. Don't think like that. What you want to do is to keep your insulin levels as low as possible all the time. But how does exercise help? Well, remember this is a problem of glucose uptake in muscles. And if you can exercise your muscles are going to have to want to take up glucose and you can correct insulin resistance that way by getting in regular consistent exercise. They recommend moderate intensity exercise for 30 minutes a day. But the research also shows that high intensity intervals can really do the trick for helping to correct insulin resistance. And that's a whole nother subject, but I'm just bringing it up here because I want our podcast listeners to know. Use exercise to help correct insulin resistance, not to offset treats. Okay. Does that make sense?

Marchelle (23:17):
Oh, I've been so guilty of that.

Dr. Angela Zechmann (23:19):
I know me too in the old days before I knew better. Yep. Right. So you don't want to burn off calories you ate when you ate, ate a sleeve of Oreos. That's not what exercise is for. Exercise is to keep your muscle cells sensitive to insulin. There's another thing you can do. And that is, there's a drug called Metformin that can be very helpful. And that would be something to talk to your doctor about. It may be a good option for you. It might not be a good option for you. If you've been diagnosed with diabetes that's typically the first line of defense is to get people started on Metformin. So that would be an option. I think the most important piece of getting insulin resistance under control is learning how to manage your insulin levels by managing what you're eating. That's the most important piece. That's got to be really your first line of defense thinking about this. Okay. So any questions about any of that Marchelle?

Marchelle (24:23):
No, not so far.

Dr. Angela Zechmann (24:24):
Okay. It's all clear as mud All right. Good.

Marchelle (24:26):
Yeah. Right. I know.

Dr. Angela Zechmann (24:28):
Now here's a question that people that people might not realize. Is it possible to have insulin resistance without a lot of weight gain? And that answer is a definitive yes. As a matter of fact, 25% of all people who have type two diabetes, that's one in four actually do not have any obvious weight gain. Okay. So you cannot tell if you have insulin resistance based on your weight. That's my point. Okay. Right. Another thing that I just want to say is that the cause of insulin resistance in the majority of cases is processed food. Okay. Processed food causes insulin resistance because there's so much sugar and so much flour and we just have to, we just have to stress our pancreas out so much producing all that insulin. Okay. So we start our children out at very young ages, eating processed foods all day, every day.

Dr. Angela Zechmann (25:32):
And many kids are showing up with the signs of insulin resistance and even type two diabetes these days. And I hear parents say all the time, well, my teenager eats crap constantly, but they can get by with it because they're active and they're not putting on any weight. Well, I guarantee you, the crap is still damaging their metabolism. The weight gain may or may not happen later, but the damage is being done. It's a little bit like saying, yeah, Johnny smokes cigarettes, but he doesn't have lung cancer or emphysema so he can get by with it. You know, it's just, the thinking is just, you wouldn't say that. Right. So I think it's important for all of us to understand that good nutrition is important, no matter how old you are or how much you weigh. Okay. So does that make sense?

Marchelle (26:20):
It does. I just think be a friend of your pancreas and ditch the sugar.

Dr. Angela Zechmann (26:24):
Yeah. You have your poor pancreas at vacation.

Dr. Angela Zechmann (26:29):
All right. So so I, that's pretty much all I have to say today about insulin resistance. Again, if you want to know the scientific details of this, go listen to Dr. Peter Attia's podcast, Drive and he's got some great really, you know, serious science on this with all kinds of names of chemicals and stuff like that and receptors and all of that stuff. But I wanted you to just know the basics of this and I, let me just review it for you. Okay. So insulin resistance is a condition brought on most cases, 99.9, 9% of cases by eating processed food. There's a spectrum of disease from having normal blood sugar, but high insulin levels to having high insulin levels and rising blood sugar. And then finally, the end stage of insulin resistance is the diabetes diagnosis. High insulin levels, wreak havoc on the body, creating visceral fat and a state of low grade inflammation that causes a lot of chronic disease. And by the way, it ages us prematurely. There's actually a lot of complicated science behind all of this, and we're learning more all the time time. And I hope that now that you understand a little bit more about insulin resistance, you'll be motivated to keep your insulin levels low by avoiding processed foods. Not because you're on a diet, but because now you realize how completely toxic they really are. Does that make sense?

Marchelle (28:06):
Yes, it does.

Dr. Angela Zechmann (28:07):
All right. Do you have any last minute comments, Marchelle or questions or anything?

Marchelle (28:10):
No. Just thank you. Yeah. Thank you for talking about this subject. I love when you talk about this, the science of everything, cause cause it helps to to know our bodies.

Dr. Angela Zechmann (28:20):
Yeah. Yeah. I think so too well, thanks to all of our listeners for, and we will see you all next week. Take care everyone. Bye

Marchelle (28:29):
Bye everybody.

--- End of Transcription ---

Dr. Angela



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