Glycemic Index, Insulin Resistance and Belly Fat

In the battle of the bulge (the belly bulge that is) testing and treating imbalances in adrenal hormones as well as fixing any estrogen dominance is imperative, however one of the most important hormones when it comes to belly fat is insulin. Visceral adipose cells are more likely to be insulin resistant than other cells in the body and when the cells are resistant to insulin and can't use glucose, they store glucose as glycogen and as fatty acids!

Insulin resistance can, in turn, cause many additional problems within the endocrine system. For example in women, developing insulin resistance will often lead to increased production of androgen hormones, (testosterone and DHEA) and symptoms such as increased facial and body hair, acne, scalp hair loss and infertility. For men, insulin resistance goes hand in hand with low testosterone levels. Low testosterone and impaired mitochondrial function will further promote insulin resistance, and this condition can be treated with testosterone replacement; however it is always important to take a look at one of the primary causes of insulin resistance in the first place: the diet.

Just a quick recap; insulin resistance occurs when the insulin receptors in a cell become less sensitive to insulin, resulting in an inefficient lowering of glucose levels after eating. Insulin is required for uptake of glucose into the cells of most tissues including fat and muscle, therefore there is often a surge of insulin following the ingestion of a sugary meal or spike in blood glucose levels. When insulin levels are chronically elevated due to repeated sugar spikes, the insulin receptors become less sensitive to the insulin, resulting in a need for even more insulin. This condition is a precursor to type II diabetes, and can even lead to insulin dependent diabetes if the pancreas becomes unable to keep up with demand for increased insulin.

One of the most effective and least invasive ways to treat this problem is through a balanced diet that is centered around foods with a low glycemic index. Glycemic index refers to the measured effects that various carbohydrates have on blood sugar levels. Compounds that are quickly broken down into glucose have a high index, while compounds that release glucose more gradually into the blood have a lower index. Most carbohydrate foods have been analyzed for their glycemic index, and tables of this information are readily available in books and on the internet. The standard glycemic index is determined using a standard 50 g of glucose and watching blood sugars over a two hour interval following ingestion. When these values are graphed, the area under that curve is multiplied by 100 and the glycemic index is determined. 50 g of glucose has a glycemic index of 100 (by definition) and all other foods are compared to that standard.

Generally foods that have a GI of 55 or less are considered low glycemic index foods and are preferred, especially in people with developing or ongoing insulin resistance. This value is typically a function of not only how much sugar a given food has, but also how much fiber, as fiber will act to slow the absorption of the sugar into the blood stream and "flatten" out the curve. Because we know that insulin levels typically follow blood glucose levels, reducing the spikes in blood glucose will also result in a steadier, and overall lower volume of insulin released. By preventing the insulin receptors from being flooded with excess insulin, their sensitivity will often improve.

By targeting foods that are lower in glycemic index, we can prevent blood sugar and insulin levels from spiking which in turn keeps insulin levels modulated, prevents the storage of excess glucose as fat, and help to keep androgen hormones within balance.

Clinical Pearl:
Saw Palmetto (320 mg bid) and Fenugreek (750 mg 2 bid) are both helpful tools for facilitating glucose uptake.

For more information on individual glycemic index levels for specific foods, visit www.glycemicindex.com or pick up a copy of "The Complete Idiot's Guide to Glycemic Index Weight Loss".

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The Canary Club is an educational advisory group with a team of medical advisors headed by Richard Shames, M.D.