Dr. Kristen Mitteness
All about Insulin
Every time you eat, your body releases a cascade of hormones in response. One of them is insulin. It is produced by your pancreas in response to dietary sugar (carbohydrates) to either utilize it as energy immediately or to store it as fat for future use. This mechanism was really, really important up until the last 100 years or so when our access to food became so abundant that, in the Western world, we really don't have to worry too often about when our next meal will come. If you're like me, you've been planning dinner ever since breakfast.
There are foods that result in a very small insulin response (fat and protein) and foods that result in a big insulin response (carbohydrates). The problem with the standard North American diet right now is that it's full of carbohydrates. I'm talking about cereal, bread, wraps, pitas, pasta, pizza, cake, candy, soda and slurpees, just to name a few. Our intake of carbohydrates has greatly exceeded our energy needs resulting in a lot of stored body fat. Once this happens repeatedly, our cells eventually stop responding and the sugar stays in our blood. When this continues to happen we are at risk of diabetes and its complications such as chronic kidney disease, foot problems, lower limb amputation, eye disease that can lead to blindness, heart attack, stroke, anxiety, nerve damage, and erectile dysfunction.
According to Stats Canada, Canadians polled in 2015 get between 45% and 55% of their overall calories from carbohydrates. If we assume that we are eating 2,000 calories per day, for example, that means we are eating, on average, 250g of carbohydrates per day (50% of calories from carbohydrates, carbohydrates have 4 calories per gram). It's brutally hard to find guidelines and recommendations on how many carbohydrates we should be eating. The Mayo Clinic recommends 225g to 325g per day. If that was the case, shouldn't Canadians be totally healthy and fit with what they are eating right now? Instead, 20 Canadians are diagnosed with diabetes every hour of every day. 11 million Canadians are diabetic or pre diabetic. According to Pew Research, just over the past 40 years, we've seen a huge uptick in chicken, grain consumption, cooking oils (which I do not consider quality fat) and corn sweeteners. That's a lot more carbs and processed foods.
Virta Health has been treating type II diabetes with a ketogenic diet and limiting carbohydrates to 30g per day with excellent results. I don't necessarily think we all have to go that low to start balancing our insulin levels. I do think we would all benefit from sticking to between 75g and 175g of carbohydrates per day. Keep it on the lower end if you are over weight, sedentary, pre diabetic or at risk for diabetes. If you are active and consider yourself overall healthy, you might be okay with upwards of 175g per day. Beyond diabetes and it's complications, if your insulin levels are constantly elevated, you are at risk for the following:
Gestational Diabetes (putting your child at risk of all of the above plus malformation and developmental disabilities)
I truly think if more of us make managing insulin levels a priority, our health would be so much better. We can't control everything in our lives, but the food choices we make is something within our control multiple times per day, every day for the rest of our lives.