Insulin-Resistance Diet – one of the 4 Pillars to balance IR

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What I would like to explain in this post are the basic principles of the diet we use to balance glucose and insulin levels, to improve insulin sensitivity, hormonal status, fertility, etc. We often refer to it as Insulin Resistance Diet or IR-Diet, but it is also known as the “160g carbs diet“, because we focus on carbs and in the beginning (!) we aim for a daily total intake of 160 gramms. Which of course is only a general starting point and needs to be personalized in each case.

This form of the diet was developed in Hungary by a team of endocrinologists and dietitians, and has a history of about 10 years now with follow-up, documentation and statistics. During these years it has helped numerous patients to improve their carbohydrate metabolism, hormonal imbalances – such as PCOS – and has supported hundreds of women on their journey to become a mother. It is also applied with great results in gestational diabetes mellitus – a medical condition women with insulin resistance or PCOS has elevated risk to develop. This diet is actually part of the lifestyle change to which the study A comparative study between myo-inositol and metformin in the treatment of insulin-resistant women – published in 2017 in the European Review for Medical and Pharmacological Sciences – refers.

I myself have been following this diet since 2012, and do not plan to stop.

 

Learning this diet is quite similar to learning a new language (I like to use this metaphor): a lot of new info to remember in the beginning, but with time and practice it just becomes natural, a skill. So it might seem complicated at first, but don’t give up. Once you understand the rules, everything will make sense. 🙂 (Yes it actually does. Yes, it works. Yes, there are studies behind it.)

Points to remember:

  1. This diet is based on the WHO’s recommendations on healthy eating – so it will not harm you even if you do not have insulin-resistance.
  2. Aim is to get a healthy, balanced diet, not to exclude food or have too much of some nutrients
  3. Health comes first. Losing or gaining weight and getting fitt is the “side effect” of a healthy lifestyle. 
  4. Basic rules like aiming for 5 portion veggies/day, drinking enough water, having complex proteins at least for the main meals still apply.
  5. Your body needs carbs. Good carbs. Good carbs are the complex ones, which are elevating the glucose – and so the insulin – levels slowly. (This is not always correlating to the glycemic index!) We are not avoiding, but regulating carbs intake.
  6. We limit the intake of carbs – but also have to eat the given amount, otherwise (if we eat too little of them) our carbohydrate metabolism won’t like our diet. 
  7. Most important factors are to get those carbs from QUALITY sources, REGULARLY, and in the appropriate AMOUNT
  8. Meal time (so, eating) should have a start and then an end. Then pause. Do not snack all day long, your pancreas needs to rest between the meals.
  9. We are timing our meals so that there are min 2 hours and max 4 hours between them. This allows your pancreas to rest, but also ensures that you get energy supply regularly. It will boost your metabolism and will help your body to keep glucose level in a normal range and to keep (only) a healthy reserve. Like a Just-in-Time management system.
  10. Things didn’t go wrong in a day – results will also take some time. Give yourself time.

 

This diet could rather be called “eating healthy“, than a “diet” – for this is not only for a limited period of time, but part of a lifestyle change. This also means that there are no (or very few) strict rules, the diet should become a flexible system which is able to adapt to the changes of life. Life is change itself and there are times when one is travelling, invited for a dinner, training harder, may become sick and can not eat, or one is pregnant, breastfeeding, etc – if the system we build is stable, these situations should not mess up the health results of the lifestyle change.

 

Choose the good carbs, swap ingredients 

Basically, what we avoid (does not mean that one can never ever eat these, but it’s better to have these only once in a while) are:

  • any form of added sugar (also brown sugar, fructose, glucose, syrups, honey, etc..)
  • white flour, white rice
  • most of the premade dishes/fast food/sauces which are containing these

Instead of these we

  • use erythritol, stevia (0g CH, 0 kcal) – or xylitol (we count 60% CH)
  • use 70% wholegrain 30% white flour, go for durum pasta, basmati rice, brown rice, etc
  • can eat a lot of delicious real food 🙂

When building up this system, the main focus is on carbs. Of course we won’t forget about proteins, fats, vitamins or calories, but choosing and timing the carbs you eat is in most cases the game changer. So, remember: 

WHAT you eat and WHEN you eat it is almost more important than HOW MUCH you eat. 

  • What and when is important for balancing glucose and insulin levels throughout the day. 
  • How much is important for having enough (not too little, not to much) energy/nutrients.

 

Let’s see the “what to eat” part

If the diet would be a language you just start to learn, this would be the “vocabulary”. We categorize food into 3 types: 

  1. Slow carbs
  2. Fast carbs
  3. Not counting as carbs 🙂 (Yes, we won’t count every leaf of lettuce. We just want to have a healthy life, not a nervous breakdown.)

 

1. Slow carbs

Foods in this category contain complex carbs to fuel your body, but – since they are high in fibre – it will take some time for your body to get energy from them. So your glucose and insulin levels will react slowly, allowing time for your body to balance – what is good for us since our aim is to keep those levels within a healthy range, without jumping too high or falling too low.

Here we count:

  • wholegrain flour, semolina, bread, pastry, pasta… (70% of the flour should be wholegrain, 30% can be white)
  • durum pasta (wholegrain durum is best, white durum is somewhat faster, but still better than simple wheat)
  • Basmati, brown, wild, red and black rice
  • Bulgur, couscous, buckwheat, millet, quinoa, oat and oat flakes… 
  • flour made of the above
  • veggies containing more than 5g Ch/100g of veggie
  • Potato and sweet potato comes here too 
  • Nuts/seeds that contain higher amount of carbs like chestnut, peanut, cashew, pistachios, and poppyseed 
 

 

2. Fast carbs

Foods in this category contain simple carbs, natural sugars (fructose, lactose). Your body will get energy from them quickly (which is sometimes really needed), but glucose and insulin levels will also react fast. This is true even if the glycemic index (GI) is low (e.g. blueberry) – although the change of glucose level won’t be big (and therefore GI is low), it will be quick and your insulin will (over)react the same way.

Here we count:

  • milk, yoghurt (kefir, buttermilch…) Don’t fall for “lactose free” goods: they also contain sugar only in a different form.
  • Fruits (also juices, jams) – watch out for dried fruits and “healthy snack bars” made from them – they are basically concentrated sugar.
  • smoothies, cream soups, veggie juices, vegetable “milks” made of nuts/seeds that should be counted as slow carbs (rice milk, oat milk, soy milk etc)
  • flakes and crisp breads that were extruded (like Ham-Let, Abonett, Rice flakes, most of the cereals you can buy in a mix), even if they are made of brown rice or whole grains. (But for example crisp breads like Wasa and Finn Crisp are not extruded so they are rather slow.)

 

3. Not counted as carbs

Foods in this category are not counted as carbs as they contain either not much carbs and/or contain so much protein and fats (which will slow down the reaction to the carbs within) that they will not change glucose level significantly. This also means that if you are feeling unwell because your glucose level went too low, these foods will not really help you out. Watch out: they may be rich in calories, so not counting them as carbs does not mean that one can eat a lot of them! (unless your goal is actually to gain weight)

  • Meat (cold cuts, sausage, pate) fish, cheese, eggs…
  • oils, fats, butter, heavy cream (also coffee cream), sour cream…
  • oily seeds (walnut, hazelnut, almonds, chia, sesam etc., except the ones with high amount of carbs, counted as slow)
  • vegetable milks made from above (like almond milk, hazelnut milk, coconut milk)
  • veggies that contain less than 5g carbs/100g of veggie 
  • avocado

So, this was the WHAT to eat part. 

Now let’s see WHEN and HOW MUCH to eat

When deciding which carb type (slow or fast) to eat, we follow the natural rhythm of our body’s insulin sensitivity.  The reaction the insulin receptors give to carb intake varies throughout the day. The worst insulin reaction you will get in the morning hours – therefore it will be one of the cornerstones how you choose your breakfast –  and the best one around lunch time.  Following is the basically recommended schedule for the meals with an approximate timeframe – means: you should start your meal within this timeframe, does not mean you should eat this long -, amount and type of carbs they should contain, and a few examples. If you would learn a language, this would be the grammar part, learning how to apply the vocabulary in a correct way:

 

  • 6:30- 8:00 – Breakfast: 30g CH, slow carbs only, like:
    1. 6dkg (about 2 slices) of wholegrain bread (in case of carbs content of 50g /100g)
    2. 3 slices of wholemeal toast bread (if 1 slice contains 10g of carbs)    
    3. 5dkg of oatmeal (approx. 3 tablespoons) – cooked in water / cream/ sugarfree coconut or almond milk or prepared as an oatcake (eg with cottage cheese / natural cocoa powder / cinnamon) and:
    1. cold cuts / cheese / sausage / egg / cottage cheese / cottage cheese / canned fish / eggplant cream / egg cream
    2. vegetables whose 10dkg contains less than 5g of carbs, eg: paprika, cucumbers, lettuce, radishes. (max. 200g)                       
    3. tea (without sugar, honey)
    4. coffee (without sugar, with coffee cream or sugarfree coconut/almond milk)

 

  • 9:30-11:00 – Morning Snack: 20g CH : 10g slow + 10g fast, like:
  1. Latte without sugar (with 2 dl milk, fast) + 2 Gullon Fibre biscuits (slow) , or
    1.  
    2. 3 pcs Korpovit biscuits or Finn Crisp
    3. 2 pcs Gullon Fibre biscuits
    4. 3dkg cashews / 6.6dkg peanuts and
    1. 2dl milk / kefir / natural yogurt
    2. 20dkg raspberries / blackberries or 
    3. 15dkg apples (ca.1 pc) / strawberry / grapefruit / blueberry or 
    4. 10dkg peach, apricot, nectarine / kiwi / cherry / mandarin or 
    5. 1-2 dl of 100% juice
    1.  
  • 12:00-14:00 – Lunch: 50g CH, rather slow, like:
    1. Broth (1 tablespoon pasta + carrot) (ca 12g CH), Oven/french fries from 20dkg raw potatoes (40g CH)  +  grilled chicken  + Greek salad (up to 200g) (cucumbers, tomatoes, green peppers, olives, feta cheese, olive oil, lemon juice)
    2. 6 dkg steamed basmati rice (50g CH), chicken stew, cucumber salad (without sugar)
    3. Tuna-spinach pasta: Pasta cooked from 7dkg raw durum pasta (50g CH), 40g tuna (canned), 60g spinach (frozen or fresh), 40ml cream, oil, onion, cheese
    4. Tomato soup with oatmeal (17g CH), Casserole (4 dkg raw brown rice) (32g CH)
    5. Green pea vegetable with grilled chicken breast: 250g green peas (35g CH) + 15g flour (10g CH) + 1dl milk (5g CH), grilled chicken breast
    6. Sandwich with vegetables: 8dkg wholemeal bread (50g / 100g carbs) (40g CH) + ingredients that do not count as carbs + 10dkg carrots (8g CH) 

 

  • 15:00-17:00 – Afternoon Snack: 20g CH, can be all fast or part of it slow, like:
    1. Fruits, eg. 40dkg of raspberries / blackberries or
      • 30dkg apple / strawberry / grapefruit / currant or
      • 25dkg orange or 20dkg mandarin / kiwi / cherry / autumn, apricot, nectarine or
      • 15dkg cherries / plums / pears or
      • 8dkg bananas
    2. Smoothie
    3. 2dl milk / natural yoghurt (10g CH) + frutis containing 10g CH 
    4. Cappuccino without sugar (with 1 dl milk, 5g CH) + 3 Gullon Fibre biscuits

 

  • 18:00-20:00 – Dinner: 30g CH, at least 2/3 part slow, like:
    1. Similar to breakfast 
    2. 2 salty pancakes stuffed with green spicy cottage cheese and salad
    3. French salad (5dkg potatoes, 5dkg green peas, 8dkg carrots, 5dkg apples) + sausage
    4. Grilled chicken with potatoes + salad

 

  • 21:00-22:00 – After-dinner snack: 10g CH slow carbs only, like:
    1. 2dkg of wholemeal bread
    2. 3 pcs of Korpovit biscuits or Finn Crisp
    3. 15dkg of carrots

 

So, this is the basic structure of the diet we usually start with. Knowing these rules are essential, but not necessarily enough.

The exact amount of carbs may (and will) vary, the needs of your body will change. Your diet should be revised and tailor-made by a dietitian regularly, following up on the changes in your body. The rules (carb types and timing) can be applied also if you are lactose intolerant, vegan, need to avoid gluten, etc. In these cases it needs to be checked if you get enough protein, vitamins, etc.

And do not forget about the other pillars of a healthy life, diet is only one of them. Training regularly, using your body in a way it was designed to – physical activity is actually why you have your muscles in your body – is essential also for your metabolism, hormones and wellbeing. Most of the insulin receptors are on the surface of your muscle cells, even if they are not functioning fully it is always good to have more of them. Still, sports and diet will not work to its fullest if you do not manage your mental and emotional balance. And there might be also a need for proper medical treatment – even if for a period of time – to support the results of the lifestyle change.

With diet you can come half of the way. It’s like filling up your expensive Porsche with quality fuel. The other half comes when you start to use “your machine”.

 

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