Keto & Intermittent Fasting: Insulin Resistance "America's Most Elusive Disease"

You may have noticed some changes on my Instagram. I'm switching back to Emily Cornelius nutrition and moving away from calorie and macro counting to hormone health and insulin resistance. In this post, I'm going to tell you guys all about why I'm making the switch, the data I’ve found in my own practice, and what I'm seeing in regards to insulin resistance.

The CDC has actually estimated that more than one in three people have insulin resistance now. So that would mean that 40-50% of people reading this post are actually suffering from insulin resistance. Insulin resistance is an elusive disease because it manifests itself in all different ways. You may have one, two, or all of the symptoms commonly found with insulin resistance, which makes it hard to detect.

What is Insulin Resistance?

So what is insulin resistance? It's basically when your body can't absorb glucose into the cell anymore. It might absorb some, but it doesn't absorb normally anymore. So that glucose gets backed up into the blood and is then transported and stored into fat cells, which triggers you to want carbohydrates and sugar. It creates this insatiable hunger that’s continually triggered by carbohydrates, and not just refined carbs sugar, it can be any carbs. It can be triggered by beans or quinoa. If you're not eating carbohydrates in the right combinations, your blood sugar will go up, which initiates a cycle.

So, how did I get to this point where I'm making this switch? I want to talk about what I've found in my own practice in regards to insulin resistance. Before you're pre-diabetic or even diabetic, you're headed towards insulin resistance. There's this period where people don't know they are becoming insulin resistant. And that's what I'm seeing in my practice. I would say a little over 40% of my clients who cannot lose weight in a calorie deficit, no matter what their macro split is or what their calorie count is, they aren't seeing the scale move, are insulin resistant. These are hardworking clients. They were working so hard with zero scale results. I am all about non-scale wins like more energy, feeling less stressed, feeling more full, or you're eating healthier. But my clients sign on to get weight loss results. And so I was completely frustrated as to why I couldn't get them those results yet. It wasn't until one of my clients, who wasn’t able to lose weight for a month, lowered her carb intake and dropped 2 pounds in a week! I was dumbfounded because we had done moderate carb all along. That's when I took a deep dive into insulin resistance to see what could be behind all of this.

What Causes Insulin Resistance?

There are two conditions the body has to be under in order to have insulin resistance, high hormone levels and constant stimulus. So number one is actually high hormone levels. For example, you get a stressful email first thing in the morning. Your stress hormone cortisol goes up, and you immediately feel stress and anxiety. A spike in cortisol actually raises your blood sugar and triggers your body to secrete insulin, which makes you feel stimulated. Your body then wants more energy and craves carbs and sugar.

The body always tries to return back to something called homeostasis or balance. If you live in a state of chronic stress, you have an underlying health condition like PCOS, or you have a genetic predisposition As your body gets used to those high levels, it gets resistant to insulin. So the body doesn't absorb that glucose into the cell like it used to, and everything's getting backed up. It’s not natural to live in a state of fight or flight all the time, and your body always tries to bring you back to homeostasis.

So what are some of the early warning signs of insulin resistance?

• Anxiety

• Depression

• Difficulty losing weight in a deficit

• Feel like you can’t stick with a diet

• Insatiable hunger

• Bloating

• Obesity is a sign in and of itself that you could have insulin resistance because it causes weight gain.

• Period issues

• History of yoyo dieting and over exercise

Those are all things that could be signs. As I mentioned, you could have one, two or three of those, which makes it such an elusive disease.

Delving into insulin resistance has been a little bit of a self-discovery as I suspect I may have PCOS. I'm actually getting tested right now. I've always struggled with nausea and insatiable hunger, and a big part of that is this shift towards tuning into your hunger and intuitive eating. I think that’s great and productive, and could be helpful for a lot of people, but what if your hunger cues constantly stimulates you to have carbs and sugar? It's the feeling of out-of-control hunger cues. Like you want to be more in control, but you have to eat so you don't feel sick. And then sometimes when you eat, you feel more sick or nauseous.

Keto and Intermittent Fasting

Now let’s bring in keto and intermittent fasting and how they're connected with insulin resistance. First, how did we get to this place of more than one in three people having insulin resistance? Stress, refined carbohydrates, sugar, maybe genetics, to name a few. So why is keto and intermittent fasting so popular now? Well, I'm a firm believer that if people are trying something and it's not working, say they're trying to eat balanced, follow portion sizes, and/or stay in a calorie deficit, and they're not getting those results on the scale, they're seeking alternative options.

Yes, keto is popular because it allows foods like heavy cream, cheese, and meat, and it appeals to a ton of people to eat that way. But people with insulin resistance feel great on keto because a high fat diet is really good for blood sugar. It actually slows the absorption of glucose into the cell. So people are automatically going to feel better on something like keto. The same applies to intermittent fasting. Intermittent fasting is getting more and more popular because fasting is great for blood sugar control. The old way of dieting which involved eating five or six small meals throughout the day is not great for insulin resistance because it actually feeds the insulin resistance. If you have insulin resistance, one of the worst things you can do is snack.

Now those are the positive things about keto and intermittent fasting, but what about the negatives. The problem with keto and intermittent fasting is they are not sustainable. The biggest problem with keto is that it's leading people into non-alcoholic fatty liver disease, because they're eating all of this fat and they have no fiber. Fiber is essential because it expands in the gut and absorbs fat when you eat it. Eating a low carb diet without fiber is going to result in high cholesterol which can result in non-alcoholic fatty liver disease.

The Solution

So what do we do? That's really what it comes down to. I'm actually shifting into teaching a high-fat Mediterranean-style type of eating for insulin resistance, which I'm super excited about. I've been trying this on my clients with insulin resistance for a few weeks now, and they're saying that they feel so much better. They feel more energized and actually feel full.

I received a message from one of my clients that I wanted to share with you all. She’s a client who really struggled with calorie counts because was always hungry. She also lives in New York City and has a high-stress job. She wrote, “The breakfast guide you made is transformative. I've had the most amazing avocado, salmon, GG Crackers, and cheese lunch today. I've been full for hours, and I'm actually so excited about this and genuinely satiated!”

The higher fat, moderate protein, and low carb way of eating truly works for those with insulin resistance, and that’s what I’m doing with my clients! Technically anything below 150 grams of carb is loosely considered a low carb diet. This gives me plenty of wiggle room to recommend carbs on a case-by-case basis and still give my clients room where they can go out to eat and enjoy more carbs at a particular meal. I’m doing a lot of lifestyle mixes with this, and there are enough carbs in the diet to make this part of their lifestyle versus keto, which is very restrictive and hard to stick to. If you have insulin resistance, eating refined carbohydrates is going to hit you a lot harder than somebody who doesn't have insulin resistance. So just keep in mind that you do have a level of responsibility to your blood sugar to eat a little bit more strictly. Eating whole foods is going to be so much better for you than a lot of processed foods. If you resonate with any of this or feel like you have insulin resistance, do not hesitate to reach out to me. DM me on Instagram @emilycorneliusnutrition, or send me at emilycorneliusnutrition@gmail.com.

If you’re ready to get started with addressing your insulin resistance, here are five things that you can do to get started on this plan today.

1. Make time for meals

Something that's been so beneficial for my clients after years of not being able to lose weight, is making time for me. This has actually really helped move the scale for a number of my clients. As I mentioned earlier, the worst thing you can do for insulin resistance is snack. If you are snacking that probably means you didn't eat a satisfying enough meal. So make time for meals. Make sure you sit down and enjoy your food. Also make your meals a little higher in fat to ensure you are actually satiated and full for several hours which help with blood sugar control.

2. Start an anti-stress routine

Recently I talked with someone that had PCOS, and she told me that she was searching for an entire lifestyle overhaul. I completely agree because research has found that glucose isn't the only thing that raises blood sugar. Glucose is what you would get from food, but other factors that increase blood sugar are lifestyle factors. Again, stress increases your blood sugar which forces your body to secrete insulin. So you have these other things impacting that blood sugar all day long. So addressing insulin resistance is a lifestyle overhaul. You can't just change your diet and see results with this. You need to make sure that you are doing all these different things within your lifestyle to keep your blood sugars as balanced as possible.

Some things you could do to combat stress include yoga or going on a walk outside. I've talked a lot about this before, how being outside actually lowers cortisol levels, and in turn helps you with insulin resistance. So get outside! Spend time hiking, walking, gardening, roller blading, even yoga in the park. Be careful about a lot of high intensity training. A lot of my clients who have insulin resistance, actually love to exercise. They were just going to town on the Peloton, and while it may seem healthy it actually puts more stress on the body. It's just a vicious cycle, and maybe the best thing for your body at this time is just to rest, relax, and walk. So adding in these lifestyle changes will hopefully help you to manage stress a lot better.

3. Fasting

Fasting , as I mentioned before, is super beneficial for insulin resistance. Now, I wouldn't recommend doing intermittent fasting because it’s not sustainable for most people. Instead, I would recommend starting with a short overnight fast. Remember that the top two things that lead to insulin resistance are high hormone (cortisol) levels and constant stimulus. We want to get you out of constant stimulus, and how do you do that? Well, fasting gives your body a chance to come out of high stimulation, especially an overnight fast. In general, research says that for most people cortisol is higher in the mornings to give you energy to get up and going. So fasting can actually be really good for people with insulin resistance in the morning, because if they hit this blood sugar with a bunch of, let's say sugary cereal or oatmeal without protein, their likely not going to feel good or they’ll crash an hour later.

With fasting, start slow. Start with 12 hours and then work your way up to 13, 14, 15, or 16. Just pay attention to how you feel. Everybody is so different, so you really want to stay in tune with yourself when you fast to see what feels good to you.

4. Focus on healthy fats

If you have insulin resistance, you are going to want to up your fat intake. A great way to do that is by eating avocados, olive oil, coconut oil, nuts, salmon, and dark chocolate (at least 72% dark chocolate). Check out this post for the top ten healthy high fat foods.

5. Reduce refined carbohydrates and sugar and focus on whole foods

One of the best things you can do for your blood sugar is to reduce your consumption of refined carbs and sugars. What I’ve been having my clients do that has been super successful, is to jam their meals full of satisfying fat, protein, and lower carbs that you don't feel an urgency to have the refined carbs.

I hope you guys found this post helpful! If you are really trying to lose weight, but you’re seeing no progress, or you have questions about insulin resistance, again don't hesitate to reach out to me on Instagram or by email (emilycorneliusnutrition@gmail.com)