Stress, Insulin Resistance and Belly Fat

AUGUST 25, 2015 by DR. HEATHER MODAY, MD

So what does insulin resistance mean and why does it make us fat?

Well, this is sort of the chicken and the egg story. But really it comes down to  stress, sugar and hormones. You see insulin is a hormone that is released from our pancreas every time we eat carbohydrates and sugars. Now not all carbs are created equally (there is something called the glycemic index which determines how quickly our blood sugar rises after eating certain foods.) Insulin is not really triggered significantly with intake of protein or fats.

So let’s say you eat a piece of toast and your blood sugar rises, triggering insulin to be released. It signals your cells in your muscles and liver to take up the sugar (glucose) and stores it as  as glycogen for future use. If your liver and muscle glycogen stores are full, you will then store the glucose as fat, specifically as triglycerides. Now, if after awhile you are eating a diet high in processed sugars and carbs all the time, your insulin is going to be chronically elevated. After a while your cells don’t even react any more- you become “resistant” to insulin, you store more and more fat, often around the liver and in the abdomen- hence the dreaded “belly fat.”

So what does stress have to do with all of this? Well when we are under chronic stress we secrete high levels of the hormone cortisol from our adrenal glands.

Basically our body thinks it’s in battle mode all the time so we start conserving all the fuel that we can.

High amounts of circulating cortisol keeps our insulin levels high and tells us to store fat! So we do- again mostly in the abdominal area.

Cortisol causes loss of muscle mass mostly from breakdown for fuel. Wasting of muscles slows our metabolism as well.

Increased cortisol causes lower levels of  DHEA  (an androgen hormone), testosterone, growth hormone and thyroid-stimulating hormone (TSH) which then leads to decreased muscle mass,  decreased energy and slower metabolism.

Cortisol also acts on the brain increasing our appetite and our carbohydrate/sugar cravings.

So there we are with high blood sugar, high Insulin, elevated cortisol, high triglycerides and decreasing muscle mass. It’s not pretty! This is what we call metabolic syndrome. And yet, most of us don’t realize that this is not just about getting fat, it’s the gateway to diabetes and all its complications, including heart disease, blindness,kidney disease etc. In fact most doctors wait until someone has full-blown Diabetes to act, and the treatment then is medications, which do not change a thing and often make the situation worse.

This problem is completely and permanently reversible.

Many people do the wrong thing at this point to try and get out of the situation, they severely limit their calories, they eat nutrient poor diet food which is full of chemicals like frozen “lean cuisines”, fake sugars and low fat foods. They take up running on the treadmill at a very slow pace which given their very low metabolic rate burns hardly any calories, and is terribly boring so they give up completely.

So what is one to do?

You have to attack it on all fronts. That is insulin resistance, metabolic syndrome and belly fat are not going to go away with just some exercise and cutting calories.

However if you apply these 5 principles, you will be well on your way to whittling your waistline and more importantly preventing or reversing diabetes.

Manage your stress– Now we all have stress, and some of us have more than others however; we all have the capacity to react to it differently. As I said in another blog, taking a few minutes each day to do some breathing exercises, practicing gratitude or a few minutes of meditation go a long way in lowering our cortisol. Don’t wear the badge of “I’m so busy”. It gets you nowhere. Get your cortisol levels checked by an integrative practitioner. There are safe and natural ways to nudge the cortisol levels back into a normal circadian rhythm. Your sex hormones will also improve if this is done.

Sleep. Quite simply this is the best thing you can do to regulate  your cortisol. Also, when we are sleep deprived, we crave sugar, and carbs and reach fro unhealthy foods to give us energy. Sleep deprivation itself is a major stressor and our cortisol soars. Do yourself a favor and get at least 7-8 hours of shut eye a night.

Do low carb right– Many people try to do low carb by cutting out fruit and veggies in place of excess amounts of animal protein and fat. You must remember that fruit and veggies are our biggest sources of soluble and insoluble fiber, which makes us feel full, and lowers our cholesterol. They also provide tons of phytonutrients, minerals and vitamins which we need desperately. Instead, take out the empty calories and inflammatory foods– cereals, white rice, all bread (yes whole wheat and gluten free bread), industrial vegetable oils, all fruit juices, all sugar, all flours, all sugared yogurts and other “low fat” foods, processed foods and all diet drinks/fake sugar and excess alcohol. Choose foods lower on the glycemic index.

Add in healthy fats, fiber and a good dose of protein. Don’t be fat phobic. Eat avocados, coconut products, tree nuts and butters like almond and cashew butter, and seeds. Use olive oil, ghee, grapeseed oil and nut oils. Eat lots of legumes, and lean cuts of organic meats, poultry and fish and eggs. Make sure you get protein at every meal. Don’t severely calorie restrict either as this end up backfiring on us, as our body will try to conserve calories and slow its metabolic rate.

Exercise right– Instead of long slow exercises that barely raises your heart rate, do short high intensity workouts lasting 15- 20 minutes along with resistance exercises a few times a week to increase your growth hormone, and DHEA. You will spend way less time in the gym and have better results to show for it. Aerobic exercise is fine too; just don’t burn yourself out on it.

Although there may be other challenges to losing belly fat and improving insulin resistance, this is good place to start. You should also ask your doctor to check the following:

Hemoglobin A1c

Fasting Insulin

C-reactive protein and homocysteine levels

Vap cholesterol test (which is much better at predicting cardiovascular risk)

DHEA-s

4 point Salivary cortisol (not done by conventional labs, but most functional medicine doctors offer this)