A COMBINATION of excessive calorie intake, physical inactivity and excess weight will contribute to insulin resistance. Obesity should be addressed since excess fatty tissue and too much free fatty acids in the blood will result in insulin resistance. The dietary changes for insulin resistance are similar to those for persons with type II diabetes, who are obese.
Controlling obesity requires lifetime changes in eating and exercise habits not just for three months. Since obese persons are sensitive to a diet high in glycaemic load, the concept of the glycaemic index in foods is applicable.
DIETARY CHANGES
The first objective should be to lose excess fat. This requires a diet deficient in calories relative to energy needs along with exercise. For every deficit of 500 calories daily, you will lose one pound of body fat weekly. Fat loss is a much slower process than water loss so that your body's fat content could be monitored along with total weight to see how much of your weight loss is actually due to fat.
Insulin secretion responds best when the carbohydrate intake is distributed more evenly throughout the day and related to exercise output. For this reason, it is advantageous to spread the nutrient load by eating smaller meals more regularly. When taking medication such as metformin, the carbohydrate load should be calculated to match the action of the tablet to avoid the ill feelings that may be experienced. All persons being treated for insulin resistance and/or diabetes should be referred by their doctor to a registered dietitian or nutritionist to ensure that the total meal intake and distribution are compatible with the medical regimen.
Several nutrients are also being tested for their effects on insulin and diabetes control. Some have been found to have positive effects such as chromium picolinate which may be recommended if the diet is deficient. A diet, well- balanced in all nutrients, must be assured.
GLYCAEMIC INDEX
When dietary restrictions on carbohydrate intake in treating diabetes was relaxed, the recommendations favoured foods with complex carbohydrate or starch and those high in dietary fibre such as whole grains, raw fruits and vegetables.
In 1981, a scientist named Jenkins demonstrated that not all starches behave alike and some had a more drastic effect on blood glucose levels (glycaemic effect) than others. Moreover, some foods with added sugars such as ice-cream and some chocolate bars produced lower glycaemic effects than starchy foods that were allowed such as Irish potato and whole-wheat bread.
Further work on glycaemic indices of various single foods suggest that there are several factors that affect the response to the foods including ripeness of fruits, cooking methods and food combinations. A food presented in different forms could have as many different glycaemic responses. While research continues to determine the glycaemic effects of various foods, the practical application is to maintain a consistent pattern of the glycaemic load from day-to-day.
Various patterns of food intake are possible for achieving an overall desirable response and this is best determined on an individual basis. The response of individual foods and combinations must be known and meal planning can be a very complex and time-consuming exercise. Persons should therefore consult a qualified nutrition professional for help.
Patricia Thompson M.Sc.,is a Registered Nutritionist, Nutrition and Diet Services.
