Insulin Sensitivity: 5 Ways to Improve It

Insulin Sensitivity: 5 Ways to Improve It

Insulin Sensitivity: 5 Ways to Improve It

2 comments 📅08 June 2015, 12:27
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Written by Adel Moussa & translated by Damian Minichowski (see original German article for reference)

I hope you had a good night’s sleep. Why I am asking? Well, after reading part one of this small article series (“Insulin Sensitivity: 5 Ways to Ruin It”) you should know already, that the lack of sleep (and even worse – bad sleep) is one of 5 DON’T’s from the first installment in this “10-step-plan for improving your insulin sensitivity”.

Rest assured: Enough sleep, the usage of sleep masks and ear plugs for sleep quality enhancement and – of course – some melatonin supplements are 4 out of 5 DO’s you can write down on your list to escape insulin resistance. And that will be the topic for the second part: The optimization of insulin sensitivity!

Alright, it cannot be that easy, right?

Insulin Sensitivity: 5 Ways to Improve It

5 Things You Have to Do Regularly to Stay Insulin Sensitive

Before we dive into this complex topic, I need to summarize and clarify the DO’s in the context of the DON’Ts from the last part.

Step #1: Avoid Overweight, Stay / Get Active, Sleep Enough and Relax

I think that the easiest way to improve your insulin sensitivity would be to invest some time in working on point 5 out of the list of DON’T’s. No TV in the evening hours, getting a quality sleep mask (those things you usually take with yourself on a flight) and maybe a pack of Ohropax ear plugs. For those of you that don’t work on night shifts you don’t need anything else to improve your sleep.

On the other hand: Reducing weight might be a little bit trickier. You will only make it, if you take heed of the advice on points 2 – 4 of the DON’T list. To be more precisely:

  • Reduce the consumption of sugar-rich food stuffs (and beverages)
  • Eliminate fat- AND carbohydrate-rich, heavily processed stuff from your grocery list.
  • Start working out (I suggest a combination of strength and endurance training)
HIIT Vs. Cardio

High Intensity Interval Training (HIIT) turns out to be more effective than classic “steady state cardio training” (LISS) for non-overweight persons. At least for these young women who participated in the study conducted by Trapp et al. (2008).

For this, you don’t need to do never ending cardio sessions on the treadmill. Participating in spinning classes two times a week for about 30 minutes should get the job done.

Let’s take the study of Trapp et al. (2008) for example, which focused on a training modus called “High Intensity Interval Training” (HIIT) on a cycle ergometer. Participants lost more weight (in terms of body fat) in contrast to a (similar demanding) “steady state” cardio approach [28].

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Did you know already? Eccentric training reduces insulin sensitivity. This was demonstrated by Kirwan et al. in 1992 on 6 young and healthy males and females. Participants had to run downhill on a treadmill (which is known to cause heavy muscle damage). This resulted in a blunted insulin sensitivity by as much as 36 % [15] and the outcome was verified by the work of Del Aguila et al. (2000). It was suggested that this effect manifests because the glucose uptake in muscle tissue gets impaired. [6].
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Keeping this in mind it should be clear that you have to reduce the visceral body fat around the belly and maximize fat-free muscle mass for maximum benefit on improving your insulin sensitivity. Therefore it is really odd (and outlandish) if you take into consideration, that the girls from the study of Trapp et al (see figure 8) still are working out on a medium intensity level on the treadmill for approx.. 90 % of the time invested in exercise, although it should be clear that no “fat burning zone” exists (at least in classical terms).

Decline in insulin sensitivity in athletes on a low carb diet

Carbohydrate reduced diets lead to a (reversible) reduction in insulin sensitivity in athletes (bf% 7,5 %) (Adapted from: Goedecke et al. (1999))

There is another paradoxical trend towards an extreme reduction of the intake of carbohydrates. This might be the only (non-operative) solution for overweight diabetics who want to lose body fat and it, too, is a very effective way of losing fat for people with a normal weight – but on the long-term this does not lead to an improved insulin sensitivity. This was shown by Goedecke et al. (1999): The so-called “fat adaption” leads to a significant reduction in insulin sensitivity [12].

You can find the reason for this outcome in the first part of this article series and it should be mostly attributable to the rise in triglycerides in the blood circulation – which seems to be an integral physiological part of the fat adaption (that can lead to a problematic situation if the carbohydrate content isn’t kept strictly low). If you’re looking for long-term improvements in insulin sensitivity you should switch after your low carbohydrate (and fat loss) diet to a mixed diet.

Besides the incorporation of high intensive interval training for normal weight people and/or athletes you should predominantly eat complex carbohydrates with a low glycemic index (instead of tons of sugar and “sports beverages”). Just don’t go too low on carbohydrates.

Step #2: Consume More Whey Protein

Raising the protein content while cutting down enhances insulin sensitivity, because it naturally lowers the percentage of carbohydrate and fat content in the diet. However, the intake of ample amounts of whey protein seems to have a direct impact on the insulin sensitivity itself.

For example, Damien, P. Belobradjic, Graeme H. McIntosh and Julie A. Owenes demonstrated in 2004, that a higher amount of whey protein (32 %) improves the insulin sensitivity when compared to a similar given amount of flesh in rats, although both protein types tend to reduce the energy intake and body fat percentage to a significant degree [3].

Effect of whey protein on insulin sensitivity

Take a look at the changes in body composition (left side) and insulin sensitivity (right side; figures in %): Whey protein shows a positive effect in terms of body fat and carbohydrate metabolism, thanks to its amino acid composition and peptide structure (data taken from Belobrajdic (2004)).

If you take a closer look, you should notice that the improvements in insulin sensitivity don’t account for the changes in body fat levels only. Speaking in relative terms, the rats in the (32%) flesh group lost a similar amount of body fat – just like the whey group.

In fact, there are quite a few studies that suggest that whey protein unfolds a very positive effect on insulin sensitivity due to its special amino acid composition and bioactive peptides (more complex proteins), that emerge upon digestion – an effect, that manifests itself in non-overweight and healthy persons, too, upon one time consumption of whey protein. Akhavan et al. showed that the intake of 10 to 20 grams of whey protein before a glucose tolerance test reduces the rise in blood sugar and insulin levels, while stimulation the secretion of the satiety hormone GLP-1 and PYY [1].

Of course, this doesn’t mean that you need to consume a whey shake before a meal. Taking into consideration that the food you’re about to ingest already consists of 30 grams of high quality protein (lots of essential amino acids), it could mean that it would be a good idea to drink a whey shake to your morning slice of bread with butter (instead of, let’s say, your typical coffee).

Step #3: Supplement Alpha Lipoic Acid (ALA)

Once developed as an anti-diabetes medication by BASF, alpha lipoic acid became a common supplement nowadays. Since lipoic acid is a natural substances which occurs in the human body, there is no possibility to get a medical patent on it. It just doesn’t pay off to invest money in research and development for Big Pharma. Therefore it is really astonishing that there is so much scientific material, that validates the usefulness of alpha lipoic acid – especially when it comes down on improving insulin sensitivity in overweight individuals.

But ALAs efficacy isn’t limited to overweight individuals only (besides the fact, that it shows potent anti-oxidative properties and that it is essential for the “recycling process” of vitamin C and E in the human body)

Effect of alpha lipoic acid on insulin sensitivity

Lipoic acid aka alpha lipoic acid works the same way like the diabetes drug Metformin (Glucophage), which itself serves as one of the best treatments for non-insulin dependent diabetics.

As I already mentioned in part one of this series, there is a rising number of lean people that experience insulin intolerance (better known as insulin resistance). According to a study from Konrad et al. (1999) a daily dosage (2x 600 mg) of alpha lipoic acid exerts a positive effect in this population as well [37].

However, there seems to be a caveat in athletes and individuals, who try to cut down body fat levels on a low carbohydrate diet. The level of AMPK (AMP-activated protein kinase), a cellular protein that facilitates the glucose uptake in the cells, isn’t low in this group. If these levels were to rise any further, it could pose a real problem if no glucose is provided, leading to a bottle-neck situation in regards of blood sugar levels and acute hypoglycemia. These symptoms seem to be fairly mild, ranging from nervousness, to fatigue and displeasure to a slightly elevated heart-rate, (cold) sweating, sleeping issues and a low libido.

Maybe you have read my recently published article on the correlation of hypoglycemic episodes in the context of being overweight at Suppversity.com There seems to be an existing link to cravings, too (Moussa (2014)), so maybe you should leave the supplementation of alpha lipoic acid (2x600mg; 20 minutes before a meal) rather to those, that are in need of it: Individuals with a significantly lowered insulin sensitivity on a not-so-low carbohydrate diet.

If you want to stock up on alpha lipoic acid, you should check this product, manufactured by Myprotein.com (one bag should last up to 2-3 months if used thoughtfully).

Step #4: Drink More Green Tea and Coffee

While green tea is considered as a super healthy beverage, coffee is still struggling with a bad reputation (e.g. leading to blood pressure and stomach ulcers) – of course, this turns out to be a wrong assumption as several studies point out [19][24][25].

Quite to the contrary: There is a lot of scientific work, which attests that coffee and green tea tends to reduce the risk of diabetes on a large scale [8][16]. However, in both cases it seems that this effect is not due to its caffeine content.

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Coffee has quite a lot of talents: You probably already know that coffee (due to its caffeine content and the stimulation of thermogensis) has a positive effect on fat metabolism and energy expenditure. Coffee made from coffee beans has anti-oxidative properties and acts immunosuppressive, but it can also interfere with the resorption of iron. It was shown that coffee consumption is able to reduce the risk of developing diabetes [22]. Despite all this it remains a mystery which of these effects is the most important one.
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Practically speaking, studies show that the consumption of caffeine reduces insulin sensitivity in healthy subjects in the short-run [5][26], however, there seems to be an adaption effect, which kicks in after only 5 days and solves the problem [7].

One can assume, that the phytochemicals in the coffee is the driving force behind the acute improvement in insulin sensitivity – in spite of the reduction effect mediated through the caffeine content [9].

Effects of coffee on insulin sensitivity

Coffee (and especially the chlorogenic acid in the coffee) exerts beneficial effects on liver, digestive tract and muscle and thus, improves insulin sensitivity.

So, even though we don’t know which part in the coffee (bean) is responsible for these outcomes, scientists have identified several potential candidates – among them a very interesting substance, a caffeic acid, called Chlorogenic Acid whose consumption leads to an elevated secretion of a hormone named Incretin Hormone GLP-1 (which itself exerts a control on glucose metabolism – just like whey protein) [18]. This hormone also inhibits the uptake of glucose in the digestive tract [22] and promotes the resorption of blood sugar into skeletal muscle cells [23].

Therefore, it shouldn’t come as a big surprise that coffee drinkers seem to show a better insulin sensitivity and beta cell function (those cells that produce the hormone insulin) than their non-drinking counterparts [17].

If you compare the effects of Chlorogenic Acid and Epigallocatechine-3-Gallate (EGCG), a bioactive substance which is found in green tea, you get a quite similar picture. EGCG, too, is a strong antioxidant, reduces the glucose production in the liver (a process known as gluconeogenesis), inhibits the resorption of glucose in the digestive tract and promotes the uptake of glucose into muscle cells.

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Coffee and the Magnesium-Advantage: One of the neglected benefits of coffee in contrast to green tea is its high magnesium content. Even a small cup of espresso contains up to 30 mg of magnesium – a mineral, which seems to improve insulin sensitivity in diabetics and individuals with a compromised insulin sensitivity [13].
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All in all I have to admit that the current evidence on diabetes risk reduction on green tea consumption isn’t as positive as it is for coffee. For example, Wang et al. (2013) concluded just recently, that there is not enough evidence to suggest that regular consumption of (green) tea leads to an improved glucose metabolism [23]. This might come as a surprise for some readers if you take the hype around green tea into consideration. Anyhow – this doesn’t change a thing on the results of a meta-analysis conducted by Huxley et al. (2009), which shows a dose dependent correlation for coffee (but not green tea) in the risk of diabetes by 7 % per cup (which, of course, just applies for the consumption of 1-4 cups per day – not 10-20 cups!) [14].

So what about the practical recommendation? Well, you should get some positive results on improving your insulin sensitivity, if you start consuming 2-4 cups of coffee and green tea per day. If you don’t like to drink such amounts of coffee and tea, you should consider popping some pills: 400-800 mg of chlorogenic acid and EGCG should be enough to get a measurable improvement on insulin sensitivity [4][27]. Again, there might be a caveat for athletes, who already have a good insulin sensitivity. Improvements might be small in this case.

Step #5: Take Some Cinnamon

Granted, not everyone likes cinnamon, but if you have ever tried to take a little bit of lipoic acid in powdered form, you will value the taste of cinnamon pretty fast.

Before we start talking about the effects of cinnamon on absorption and cellular uptake of glucose, I want to clarify, that there is a lot you can do wrong if you decide to go with the cheap cinnamon powder out of the grocery shelve. Should you take this route, I wouldn’t recommend taking more than 3 grams in total per day – not because it taste that bad compared to original Ceylon cinnamon. Overdosage with cheap cinnamon (speak: Cassia cinnamon) contains large amounts of coumarin, a toxic compound (see chart down below).

Scientists from Germany (Institute of Risk Asessment) randomly bought several products manufactured with cinnamon powder in German grocery stores to check their coumarin content. 40 (out of 47) products declared “cinnamon” content on their label (you could translate this term with “cheap cinnamon”) – only 7 products were directly imported from Zeylon.

Cassia (Cinnamon) Powder Cassia Rod Ceylon (Cinnamon) Powder Ceylon Rod
Average Content 4020 3252 64 185
Min. – Max. 1750 – 7670 0-9900 0 – 297 0 – 489

Chart 1: Coumarin content in mg/kg in “Cinnamon”-products in German grocery stores [30]

Taking a closer look on the outcome of this study (cf. chart 1) it should become clear: The maximum allowance of dietary coumarin in the European Union is 50mg coumarin per day for adults. This translates to a daily consumption of approximately 10g cinnamon. However, if you decide to use the Ceylon version of cinnamon you could down 750 grams (!) without taking a risk of damaging kidneys and liver.

Of course, nobody needs to consume such  large amounts of cinnamon in the first place for improvements in insulin sensitivity (and it doesn’t matter if you’re a diabetic or a healthy individual, either). 3 grams of cinnamon per day should be a fair amount already – this is backed up by some very interesting studies, like the one from Solomon and Blannin (2009). These scientists from the University of Birmingham and the Lerner Research Institute in Cleveland demonstrated, that such amounts of cinnamon already lead to a significant reduction in the rise of blood sugar in a standardized glucose tolerance test [31].

Effect of cinnamon on insulin sensitivity

Reduction in rise of blood sugar (glucose) and insulin levels after the intake of 3 grams of cinnamon (in the evening of the day before) [31].

Solomon and Blannin used the cheap cassia cinnamon in their test series, but not with the same protocol Hlebowicz et al. (2007) suggested (20-60 minutes before a meal), but instead on 8:30 p.m. each day – plain and simple [35].

This makes the outcome of the study even more impressive. Well, you could always suggest that this might be a random effect. However there is more evidence (reviews and meta-analyses) that validate this outcome (Qin et al. (2010), Davis et al. (2011) and Akilen et al. (2012)) underscore that 1-6 grams of cinnamon per day is enough to faciliate an effect in regards of blood sugar management [32][33][34], And it turns out that this intervention is especially effective for individuals with an altready compromised insulin sensitivity.

The only caveat: There are no long-term studies (4-6 months) to this point. Therefore it remains inconclusive if these effects persist in the long run (especially in healthy individuals) and if the slower glucose uptake remains (besides the faster – already verified – blood sugar clearance) [36].

Is this assumption justified? It could be, if you take into consideration that the reduction in glucose levels Solomon and Blannin saw in their test series was half as big after day 14 (in contrast to the first days). Though, it might have been the bad timing of consumption that lead to this result. I wouldn’t overemphasize about this-

Let’s face it: We could go on and on like this in terms of supplementation. If you are wondering why I decided to leave fish oil out of the top 5 list, you can rest assured, since it doesn’t really look like it does much in terms of improving insulin sensitivity in healthy [11] and diabetic [10][20] individuals.

If you decide to take the aformentioned 8 steps (from part one and part two) to your heart, you wouldn’t need to consider supplementing alpha lipoic acid or cinnamon to keep your insulin sensitivity in check (or even improving it). However, if you should decide on adding cinnamon to your supplement stack, you should probably go with water soluble cinnamon extract (e.g. Cinnulin PF) or just the plain old Ceylon cinnamon powder. You would just need a bigger dosage of the latter on (3 grams).

Let’s get to the fazit.

Conclusion: What to Keep in Mind

Avoid getting overweight (in terms of body fat, that is), reduce the amount of (unhealthy) visceral fat tissue (around the belly), engage in vigorous exercise, take the stairs (not the lift), sleep well and limit the intake of heavily processed and unhealthy fast food (and food stuff that comes with high fat AND high carb content) to take a first step to improve your insulin sensitivity. Limit stress to a minimum and relax from time to time.

Add a decent whey protein powder to your daily nutrition, drink some cups of coffee and/or tea along the way – this are easy action steps everyone can take.

Decide for yourself if you want to stack up on alpha lipoic acid and cinnamon. Generally speaking, all of the above mentioned (eight) steps should do their share on improving insulin sensitivity (and limit insulin resistance) for ideal weighted iron warriors.

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About the Author

Suppversity by Adel MoussaAddel Moussa (Suppversity): “In the seminars I hold in the faculty of physics at the university, the main point lies in conveying data, facts and techniques to the students, which – although not related to religion – that are as safe as the “gospels truth”. It is hard to find these “buts” (data and facts) on the internet, when it comes down to searching for information on training, nutrition and supplementation. Well, at least it was like that 4 years ago and it was reason enough for me to launch my own blog on this area.

The Name “SuppVersity” – you can already hear the word “University” and “Supplement” out of this name – says it all. At http://www.suppversity.com/ I discuss and scrutinize the latest studies in the area of training, nutrition and health, looking steadily for something that might not even exist: the ideal workout, nutrition and supplement plan for me, you and everyone else.”

References (click to expand)

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[36] Kim, W., et al. (2006): Naphthalenemethyl ester derivative of dihydroxyhydrocinnamic acid, a component of cinnamon, increases glucose disposal by enhancing translocation of glucose transporter 4. In: Diabetologia. URL: http://www.ncbi.nlm.nih.gov/pubmed/16896937.

[37] Konrad, T., et al. (1999): Alpha-Lipoic acid treatment decreases serum lactate and pyruvate concentrations and improves glucose effectiveness in lean and obese patients with type 2 diabetes. In: Diabetes care. URL: http://www.ncbi.nlm.nih.gov/pubmed/10333946.

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2 Comments

  1. Janita Galanga
    28 June 2015, 09:16 Janita Galanga

    I feel that supplements are a great solution to make life easier and healthier

    Reply to this comment

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