By By Knvul Sheikh, NYT News Service: Studies have confirmed it over and over again, well over a third of adults in the United States are walking around with insulin resistance, a condition in which the body does not respond effectively to insulin and is unable to properly use glucose from the blood for energy.
The consequences to long-term health can be serious. Insulin resistance, which is thought to precede Type 2 diabetes by 10 to 15 years, has also been linked to an increased risk of heart attacks, strokes, nonalcoholic fatty liver disease, certain types of cancer and even an increased risk of depression and dementia.
If you are starting to notice outward signs of insulin resistance or have already tested positive for pre-diabetes, there’s still a good chance you can reverse the condition and prevent Type 2 diabetes by making some lifestyle changes right away.
Move more
Exercise is one of the most effective tools for reversing insulin resistance, said Dr. Gerald I. Shulman, a professor of medicine and co-director of the Yale Diabetes Research Center. In a small study of adults aged 19 to 44, Dr. Shulman and his colleagues found that just one 45-minute session of moderate-intensity exercise could improve insulin sensitivity; six weeks of regular exercise improved sensitivity by 40 percent. Because the benefits dissipate 48 to 72 hours after you stop, it is important to keep exercising regularly.
Making exercise a part of your routine also helps increase muscle mass and reduce body fat, both of which can affect how your body manages glucose and insulin, Dr. Shulman said.
Long-term studies funded by the National Institutes of Health have found that people who exercised and lost 5 to 7 percent of their starting weight significantly reduced their risk of developing diabetes.
Experts recommend aiming for 30 minutes of exercise a day. But that doesn’t have to be limited to going to the gym, lifting weights or running outdoors. Instead, you can add more physical activity into your day by taking two-minute breaks for movement, using stairs or turning your errands into exercise, said Dr. Ruchi Mathur, an endocrinologist at Cedars-Sinai in Los Angeles.
Make small dietary swaps
One of the most well-studied diets that can reduce the risk of developing Type 2 diabetes is the Mediterranean diet, which prioritizes whole grains, fruits, vegetables, legumes, nuts and olive oil. But any low-carb or low-fat diet that is affordable and sustainable for you can help, said Dr. Mary Vouyiouklis Kellis, an endocrinologist at Cleveland Clinic.
“The important thing is to eat more healthy vegetables, have enough fiber and protein in your meals and reduce refined sugar,” Dr. Kellis said. Some of the food you eat may still be carb-heavy, like many common dishes in Latin and South Asian cuisines. But with a few adjustments, like swapping whole wheat for refined flour or eating brown rice instead of white rice, you can continue to enjoy the foods you grew up eating, she said.
Doctors also recommend that you pair fruit with nuts to limit the impact of natural sugars in fruits on your blood glucose levels. And avoid sodas, energy drinks and sweetened teas, Dr. Kellis said.
Some research suggests that limiting snacks and late-night meals or shortening the window of time when you eat, as with intermittent fasting, can also improve your body’s insulin sensitivity.
Troubleshoot your sleep
Some evidence indicates that sleep apnea, changing circadian rhythms during night shift work and not getting enough sleep in general can increase your insulin levels and hunger hormones. Additionally, having poor quality sleep can make you more likely to crave high-carb foods for energy.
Aim for seven or more hours of sleep by making your bedroom a dark, quiet and cool environment. Remove electronic devices from your room and schedule some time to relax without screens before bed. You can also try reducing your caffeine and alcohol intake, which can affect your sleep quality. Read more tips for restful sleep here.
Manage stress
When you’re feeling stressed, your body releases more cortisol. Too much of the hormone can inhibit insulin production as a way of keeping glucose readily available for a “fight or flight” reaction.
While stress can be unavoidable, you can learn skills to help manage it, including by reframing situations and leaning on your loved ones for support. Studies show that breathing exercises, yoga and meditation can also help reduce stress.
Quit smoking
Nicotine and other chemicals in cigarettes can lead to inflammation in the body, increasing oxidative stress and changing cells so they don’t respond as well to insulin. When you stop smoking, your body’s insulin sensitivity eventually improves, though the risk of diabetes can be high for the first two years after quitting. That may partly be because people gain weight after they quit.
Talk to your doctor about managing your weight and remember that smoking cessation may take several attempts. Combining the nicotine patch with either a nicotine gum or lozenge can improve your chances of success.
