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Excess adiposity, insulin resistance, and leptin resistance are a trio to avoid (or improve). Obesity triggers insulin resistance8. Insulin resistance makes us less metabolically flexible, making fat and calorie burning difficult. And insulin resistance feeds into leptin resistance, further exacerbating fat metabolism and regulation.
Family physician Bindiya Gandhi, MD previously explained that in working with her patients struggling with leptin resistance, “there’s one very important factor that’s often missing in the conversation about healthy, sustainable weight management and metabolism. Enter: hormones, namely, leptin.”
Leptin is an adipokine hormone9 produced by our fat cells, and is directly related to adiposity levels. When working properly, leptin tells our brain that we’re full from eating and that enough fat has been stored up. Wonky leptin spells metabolic disaster. Some key leptin resistance contributors are chronic stress and insulin resistance.
Cardiometabolic health expert Cate Shanahan, MD says, “if you want to do one thing in 2023 to optimize your metabolism, I would start with getting a blood test called HOMA-IR.” An equation that uses fasting blood glucose and insulin lab results, HOMA-IR is a way to estimate insulin resistance.
The fact is that many of our country’s adults and youths have poor glucose control (ie, blood sugar balance) due to insulin resistance. Cowan shares an incredibly practical and powerful tip to move the needle on insulin resistance: “Perhaps the simplest and most effective strategy at improving metabolic health is by moving your body after each meal. Even a 10 to 15 minute post-meal walk can dramatically increase glucose clearance into muscle.”
Cowan expounds on the mechanism: “Insulin resistance leads to impairment in muscle’s ability to take up glucose out of the circulation following carb-containing meals. Elevated blood sugar levels drive fatigue and brain fog acutely and inflammation and microvasculature damage over time.” That’s where exercise comes in, she says. “Exercise is vital for the reversal of insulin resistance and enhanced glucose clearance. Muscular contraction directly stimulates glucose uptake in an insulin-independent manner. A post-meal walk provides sufficient muscular contraction to clear a significant amount of excess glucose from the bloodstream.”
That’s why a particularly recent technology excites Cowan: continuous glucose monitors (CGMs). She shared that this innovation is “becoming available to the general population at a reasonable cost and with access to user-friendly app interfaces.” (If you’re looking for a product recommendation, a great CGM example would be Levels.)
“CGMs allow individuals to access critical information about their body’s unique response to different foods and meals, sleep quality, stress, and movement. Wearing a monitor for even a few short weeks can provide enough actionable insights to design a personalized diet and lifestyle protocol for an individual and give them rapid and sustainable results. Moreover, the CGM allows individuals to correlate changes to their blood glucose with their felt experiences within their bodies.”
When it comes to promoting insulin sensitivity, along with a plant- and fiber-rich dietary pattern and physical activity, I can’t forget to shout out my favorite nutrient, vitamin D! A growing body of clinical research links vitamin D sufficiency with cardiometabolic health benefits by promoting healthy levels of glucose and insulin.
The fact is that any improvement on the glucose and insulin front is critical. “Optimizing for glucose metabolism and insulin sensitivity is the game changer for longevity and protection against chronic diseases including cardiovascular disease, neurodegenerative diseases, diabetes, and cancer,” Cowan concludes.
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