Catherine DeMayo

Should you be tested for insulin resistance?

“I can’t lose weight, no matter what I do."

Over the years, I’ve had numerous clients tell me, often in frustration, of their struggles with weight gain. A common theme is, “I can’t lose weight, no matter what I do. I’ve cut back on food, I’ve increased my exercise, nothing happens.” Worse, they sometimes go on to say that their whole family has changed habits, their spouse has lost 5 kg, and yet – nothing.

If this sounds like you, it may be worth talking to your doctor or consulting a dietician and investigating whether you could have insulin resistance (IR).

The Dieticians’ Association of Australia’s website explains:

If someone has insulin resistance, their body does not respond properly to the hormone insulin.

Insulin is produced by the pancreas. When we eat foods containing carbohydrate they are broken down to glucose (sugar) in the blood. The normal function of the hormone insulin is to transfer glucose from the blood into the liver and muscle cells, to be used as energy, and managing our blood glucose levels.

In people with insulin resistance, the muscles and the liver resist the action of insulin, so the body has to produce higher amounts to keep the blood glucose levels within a normal range.

Left untreated, insulin resistance increases the likelihood of developing Type 2 Diabetes. It can make attempts at losing weight ineffective. The usual, and most reliable, test for insulin resistance is a glucose tolerance test (GTT). In a fasting state, you consume a sugary drink, and your blood is tested regularly over several hours to determine your insulin response to it.

While only a medical test can determine whether you have IR, a common symptom reported is an inability to lose weight, even with restricted eating and/or significantly increased exercise. Other risk factors are, for women, Polycystic Ovary Syndrome (PCOS) and gestation diabetes in pregnancy. Being overweight, especially around the midsection, being sedentary and having a family history of diabetes are also risk factors.

Lifestyle changes (food, exercise) and medication (Metformin etc) may be effective in combating insulin resistance. So if you, or a friend or family member has some of these symptoms, it may be time to ask for a test. Better bones, better balance Rather than seeing bone loss (osteoporosis) and falls as inevitable aspects of ageing, a growing body of research is showing that we can take action to improve both balance and bone density.

While some of the risk factors for osteoporosis can’t be changed (among these risk factors are being female, being post menopausal, being Caucasian and having a close female relative with osteoporosis), there are lifestyle factors that can be modified to improve bone density.

Adequate calcium and Vitamin D have long been recognized as contributing to healthy bones. The role of exercise has recently been recognized, and, more importantly, we now know more and more about the kind of exercise that helps prevent and combat osteoporosis.

Unfortunately for those who love the water, swimming and water exercise aren’t very effective in building bone (they are perfectly good exercises, just not useful for bones). Nor is cycling, though again, it’s a great exercise for cardio vascular health. Neither of these are weight bearing or high impact enough to have a significant effect on bones. Neither is ordinary walking.

Weights, however, done at high enough intensity (that is, heavy enough) has been shown to help bone density, as do higher impact activities like walking on uneven surfaces (bushwalking, for example), running, jumping, playing sports like tennis. And while the latter category may not be safe for some older adults, most older adults, even with some bone loss, can perform weight training safely.

As for maintaining balance, the old saying “use it or lose it” is highly relevant. Simple balance exercises, including many that can be done at home, and strengthening of the muscles in the legs have been shown to improve balance and decrease the likelihood of falls.

Want to know more? Contact me for a copy of my Powerpoint slides from the presentation I gave at Sutherland Library this year.