Category Archives: Science

Maintaining optimal health is a lifelong journey, and when it comes to our metabolic well-being, understanding insulin levels becomes paramount. In particular, women with Polycystic Ovary Syndrome (PCOS) face unique challenges in managing their insulin levels. Thankfully, a revolutionary tool is on the horizon: the Lilli at-home insulin testing kit. In this article, we’ll delve into the importance of testing insulin levels for overall health, shed light on the significance of monitoring insulin in women with PCOS, and explore how the Lilli kit can revolutionize our ability to take charge of our health from the comfort of our own homes.

The Importance of Testing Insulin Levels:

Recognizing the importance of testing insulin levels for our metabolic health, particularly when it comes to identifying early signs of insulin resistance, becomes crucial. Regular monitoring empowers us to gauge our progress and make well-informed decisions regarding our lifestyle choices, especially when adopting a low insulin approach to combat insulin resistance. Tracking changes in insulin levels over time allows us to personalize our dietary and exercise routines, effectively supporting our overall health goals. However, the process of getting insulin levels tested can prove challenging.

Symptoms of high insulin levels, such as fatigue, sugar cravings, frequent hunger, weight gain, and difficulty losing weight, are not always easily noticeable. This presents a significant issue, considering that an estimated 88% of US adults are affected by hyperinsulinemia, making it imperative to have a means of detection. Unfortunately, the task of having insulin tested can be complicated.

Several reasons contribute to healthcare providers’ reluctance to perform regular insulin tests:

• Health Insurance Coverage: Not all health insurance plans cover the cost of testing insulin, making it an obstacle for many individuals seeking to monitor their insulin levels.
• Lack of Awareness: Some healthcare providers may not be fully aware of the importance of testing fasting insulin. Instead, they rely on glucose and A1c tests to detect diabetes. However, these tests often fail to indicate hyperinsulinemia and insulin resistance since individuals with hyperinsulinemia typically exhibit normal blood glucose and A1c levels.
• Convenience: Fasting is necessary for accurate fasting insulin testing, as insulin levels fluctuate throughout the day. However, fasting can be inconvenient for patients due to various reasons, leading to challenges in scheduling the appropriate testing.
• Medications: Apart from metformin, which is only approved for type 2 diabetes, there are no medications available specifically targeting insulin reduction. As a result, healthcare providers may not always see the value in testing fasting insulin levels.

While these hurdles may exist, it is crucial to advocate for our health and find alternative solutions to test insulin levels. We are thrilled to be the solution that helps you conquer those hurdles. Soon, you will have direct access to the Lilli at-home insulin testing kit, available conveniently on our website. This revolutionary kit brings you a hassle-free and accessible option for testing your insulin levels, enabling you to take charge of your metabolic well-being like never before.

Gone are the days of struggling to schedule appointments or dealing with the uncertainty of insurance coverage. With the Lilli kit, you can now embark on a journey of self-empowerment, monitoring your insulin levels from the comfort of your own home.

Our mission is to ensure that you have the tools you need to make informed decisions about your health. By offering a convenient and reliable at-home insulin testing solution, we’re putting the power back into your hands. Remember, your health is your most valuable asset, and we’re here to support you every step of the way.

Conclusion

The importance of testing insulin levels for our metabolic health cannot be overstated. Although obstacles exist in obtaining regular insulin tests, it is crucial to find solutions that allow us to monitor our insulin levels effectively. This is why we decided to launch the Lilli kit to help you monitor your insulin levels.

Symptoms of hyperinsulinemia may not always be evident, making testing even more essential. While traditional healthcare approaches may overlook the significance of fasting insulin tests, advancements like the Lilli kit provide hope and empowerment. By overcoming the challenges associated with insulin testing, we can proactively address insulin resistance, make informed choices about our health, and ultimately lead more vibrant lives.

Insulin and fertility share a fascinating connection, which is essential to understand in order to navigate this aspect of reproductive health successfully. High levels of insulin and insulin resistance, a condition where our body’s cells become less responsive to insulin, have been linked to various fertility-related conditions, with polycystic ovary syndrome (PCOS) being one of them.

Women with PCOS often experience elevated insulin levels, which can disrupt the delicate balance of reproductive hormones like estrogen, progesterone, and testosterone. These imbalances can have repercussions on various aspects of fertility. For instance, high insulin levels have been linked to poor oocyte (egg) development and maturation. This can lead to lower egg quality, which in turn affects fertility and increases the risk of miscarriage. It’s like a domino effect!

But wait, insulin doesn’t stop there. It can also interfere with crucial processes like ovulation, implantation, and placental development. This means that high insulin levels can significantly impact a woman’s ability to get pregnant, maintain a healthy pregnancy, and reduce the risk of recurrent pregnancy loss.

In summary, high levels of insulin can:

• Interfere with the normal release of luteinizing hormone (LH), a key player in triggering ovulation.
• Impair the development and receptivity of the uterine lining, making it less welcoming for the fertilized egg to implant.
• Interfere with the normal development of blood vessels within the placenta, leading to potential pregnancy complications

The good news is that understanding the role of insulin in female infertility opens doors to potential interventions and treatments. By addressing insulin levels and improving insulin sensitivity, we can positively impact fertility outcomes. The bad news is that most women’s healthcare providers only test blood glucose and hemoglobin A1c levels, not insulin. By solely relying on blood glucose and A1c measurements, healthcare providers may miss the underlying insulin-related issues contributing to infertility and recurrent miscarriage. This can lead to missed opportunities for early intervention and tailored treatment plans that address insulin resistance and promote optimal reproductive function, such as a low insulin lifestyle.

Comprehensive insulin testing, which includes fasting insulin levels and HOMA-IR (homeostatic model assessment for insulin resistance), provides a more accurate assessment of a patient’s metabolic and reproductive health. It enables healthcare providers to identify insulin resistance or elevated insulin levels that may be impacting fertility.

In a published case series, infertile patients with PCOS were able to conceive on average 86 days after starting a low insulin lifestyle. That is unbelievable! By simply lowering their insulin levels, they were able to improve the health of their eggs, ovulate more regularly, create an improved environment for implantation, all of which improved their fertility.

References

• Hoeger KM, Dokras A, Piltonen T. Update on PCOS: Consequences, Challenges, and Guiding Treatment. J Clin Endocrinol Metab. 2021;106(3):e1071-e1083. doi:10.1210/clinem/dgaa839
• Marshall JC, Dunaif A. Should all women with PCOS be treated for insulin resistance? Fertil Steril. 2012;97(1):18-22. doi:10.1016/j.fertnstert.2011.11.036
• Craig LB, Ke RW, Kutteh WH. Increased prevalence of insulin resistance in women with a history of recurrent pregnancy loss. Fertil Steril. 2002;78(3):487-490. doi:10.1016/S0015-0282(02)03247-8
• Ispasoiu CA, Chicea R, Stamatian FV, Ispasoiu F. High fasting insulin levels and insulin resistance may be linked to idiopathic recurrent pregnancy loss: A case-control study. Int J Endocrinol. 2013;2013. doi:10.1155/2013/576926
• Sharpe A, Morley LC, Tang T, Norman RJ, Balen AH. Metformin for ovulation induction (excluding gonadotrophins) in women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews. 2019;2019(12). doi:10.1002/14651858.CD013505
• Zhang D, Yang X, Li J, Yu J, Wu X. Effect of hyperinsulinaemia and insulin resistance on endocrine, metabolic and fertility outcomes in women with polycystic ovary syndrome undergoing ovulation induction. Clin Endocrinol (Oxf). 2019;91(3). doi:10.1111/cen.14050
• Balen AH, Morley LC, Misso M, et al. The management of anovulatory infertility in women with polycystic ovary syndrome: An analysis of the evidence to support the development of global WHO guidance. Hum Reprod Update. 2016;22(6). doi:10.1093/humupd/dmw025
• Chen M, Li J, Zhang B, et al. Uterine Insulin Sensitivity Defects Induced Embryo Implantation Loss Associated with Mitochondrial Dysfunction-Triggered Oxidative Stress. Oxid Med Cell Longev. 2021;2021:1-18. doi:10.1155/2021/6655685
• Chang EM, Han JE, Seok HH, Lee DR, Yoon TK, Lee WS. Insulin resistance does not affect early embryo development but lowers implantation rate in in vitro maturation-in vitro fertilization-embryo transfer cycle. Clin Endocrinol (Oxf). 2013;79(1). doi:10.1111/cen.12099
• Araújo J, Cai J, Stevens J. Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016. Metab Syndr Relat Disord. 2019;17(1):46-52. doi:10.1089/met.2018.0105
• Wang H, Zhang Y, Fang X, Kwak-Kim J, Wu L. Insulin Resistance Adversely Affect IVF Outcomes in Lean Women Without PCOS. Front Endocrinol (Lausanne). 2021;12. doi:10.3389/fendo.2021.734638
• Sun YF, Zhang J, Xu YM, et al. High BMI and Insulin Resistance Are Risk Factors for Spontaneous Abortion in Patients With Polycystic Ovary Syndrome Undergoing Assisted Reproductive Treatment: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne). 2020;11. doi:10.3389/fendo.2020.592495
• Kelley AS, Smith YR, Padmanabhan V. A Narrative Review of Placental Contribution to Adverse Pregnancy Outcomes in Women with Polycystic Ovary Syndrome. Journal of Clinical Endocrinology and Metabolism. 2019;104(11). doi:10.1210/jc.2019-00383
• Kayemba-Kay’s S, Peters C, Geary MPP, Hill NR, Mathews DR, Hindmarsh PC. Maternal hyperinsulinism and glycaemic status in the first trimester of pregnancy are associated with the development of pregnancy-induced hypertension and gestational diabetes. Eur J Endocrinol. 2013;168(3):413-418. doi:10.1530/EJE-12-0609
• Riestenberg C, Jagasia A, Markovic D, Buyalos RP, Azziz R. Health Care-Related Economic Burden of Polycystic Ovary Syndrome in the United States: Pregnancy-Related and Long-Term Health Consequences. Journal of Clinical Endocrinology and Metabolism. 2022;107(2). doi:10.1210/clinem/dgab613
• Vega M, Mauro M, Williams Z. Direct toxicity of insulin on the human placenta and protection by metformin. Fertil Steril. 2019;111(3):489-496.e5. doi:10.1016/j.fertnstert.2018.11.032
• Spontaneous Pregnancies in Polycystic Ovary Syndrome (PCOS) Patients with a Low Starch/Low Dairy Diet: A Retrospective Case Series. J Community Med Public Health. 2022;6(2). doi:10.29011/2577-2228.100242

Although the exact cause of PCOS is still not fully understood, research suggests that it actually begins in the womb. To understand this, we have to dive into the fascinating world of epigenetics. Epigenetics is all about how our environment and behaviors can influence our genes, and PCOS is a perfect example of these epigenetic changes being passed from mother to baby.

When a female fetus is exposed to high levels of testosterone or anti-Müllerian hormone (AMH) during development, usually because the mother herself has PCOS, it triggers changes in specific genes associated with PCOS. These changes occur due to the influence of the environment within the womb, and that’s where the journey of PCOS begins.

While there are various genetic changes that have been implicated as being associated with the development of PCOS, one in particular has received the most attention. This significant genetic change is related to an enzyme called P450c17. This enzyme plays a crucial role in regulating testosterone production by controlling 17-hydroxylase and 17,20-lyase activities, two enzymes involved in androgen production.

Picture P450c17 as a traffic control officer for testosterone levels. In women without PCOS, this officer efficiently slows down testosterone production, ensuring it doesn’t go overboard. However, in women with PCOS, it’s like there’s no traffic control officer at all. This enzyme works tirelessly, producing excessive amounts of testosterone round the clock. What’s more, when insulin levels are high, this enzyme goes into overdrive and produces even more testosterone. This genetic change involving P450c17 is one of the key factors that contribute to PCOS, shifting it from regulated traffic to a nonstop green light!

Normal

PCOS

Experts have revealed that the genetic changes associated with PCOS can actually be passed down for multiple generations, with studies showing the genes spanning at least three generations in mice. This means that a mom with PCOS might unknowingly be passing down the condition to her grandchildren or even her great-grandchildren.

This discovery sheds light on why daughters born to mothers with PCOS have a 5-fold increased risk of developing PCOS themselves. In fact, a whopping 70% of daughters born to women with PCOS will also experience this condition. These genetic changes don’t just affect females. Even male children born to women with PCOS have been shown to have poorer metabolic health and hormonal imbalance later in life.

So, what can we do about it? Well, it turns out that maintaining lower insulin levels before and during pregnancy is key. By keeping insulin levels within the normal range (3-8 mIU/mL), we can help regulate testosterone levels and prevent these epigenetic changes from occurring in the offspring. Understanding these genetic changes that lead to PCOS empowers us to explore interventions and lifestyle strategies that can effectively manage the condition. By targeting insulin levels through adopting a low insulin lifestyle, women with PCOS can take charge of their health and the health of future generations.

References

• Zhu Z, Cao F, Li X. Epigenetic Programming and Fetal Metabolic Programming. Front Endocrinol (Lausanne). 2019;10. doi:10.3389/fendo.2019.00764
• Goodarzi MO, Dumesic DA, Chazenbalk G, Azziz R. Polycystic ovary syndrome: Etiology, pathogenesis and diagnosis. Nat Rev Endocrinol. 2011;7(4). doi:10.1038/nrendo.2010.217
• Hoeger KM, Dokras A, Piltonen T. Update on PCOS: Consequences, Challenges, and Guiding Treatment. J Clin Endocrinol Metab. 2021;106(3):e1071-e1083. doi:10.1210/clinem/dgaa839
• Qin K nan, Rosenfield RL. Role of cytochrome P450c17 in polycystic ovary syndrome. Mol Cell Endocrinol. 1998;145(1-2):111-121. doi:10.1016/S0303-7207(98)00177-4
• Bell GA, Sundaram R, Mumford SL, et al. Maternal polycystic ovarian syndrome and early offspring development. Human Reproduction. 2018;33(7):1307-1315. doi:10.1093/humrep/dey087
• Şanlı E, Kabaran S. Maternal Obesity, Maternal Overnutrition and Fetal Programming: Effects of Epigenetic Mechanisms on the Development of Metabolic Disorders. Curr Genomics. 2019;20(6):419-427. doi:10.2174/1389202920666191030092225
• Pohlmeier AM, Phy JL, Watkins P, et al. Effect of a low-starch/low-dairy diet on fat oxidation in overweight and obese women with polycystic ovary syndrome. Applied Physiology, Nutrition and Metabolism. 2014;39(11):1237-1244. doi:10.1139/apnm-2014-0073
• Phy Jennifer L, Pohlmeier AM, Cooper JA, et al. Low Starch/Low Dairy Diet Results in Successful Treatment of Obesity and Co- Morbidities Linked to Polycystic Ovary Syndrome (PCOS). J Obes Weight Loss Ther. 2015;05(02). doi:10.4172/2165-7904.1000259

Infertility is a common issue, affecting approximately 1 in 8 couples worldwide. Surprisingly, in about 50% of infertility cases, the male partner plays a significant role. It’s important to recognize that the causes of male infertility can be multifaceted, and one crucial factor that often goes unnoticed is the impact of insulin resistance and high insulin levels. However, men’s reproductive health encompasses more than just fertility. By adopting a low insulin lifestyle and working towards lowering insulin levels, men can improve various reproductive health conditions that affect them.

Erectile Dysfunction

One significant area where insulin resistance and high insulin levels can impact men’s reproductive health is erectile dysfunction (ED). Insulin resistance can impair blood flow, affecting the ability to achieve and maintain an erection. By addressing insulin resistance and lowering insulin levels, men may experience improvements in their erectile function, leading to enhanced sexual performance and satisfaction.

Sperm Health

Furthermore, insulin resistance and high insulin levels have been associated with sperm health issues. Studies have shown that elevated insulin levels can contribute to reduced sperm quality, including decreased motility, abnormal morphology, and reduced sperm count. By adopting a low insulin lifestyle, men can potentially improve their sperm health, increasing the chances of successful conception.

Prostate Health

Prostate health is another aspect of men’s reproductive well-being that can be influenced by insulin levels. Studies have suggested a link between insulin resistance and an increased risk of prostate enlargement (benign prostatic hyperplasia) and prostate cancer. By managing insulin levels through lifestyle modifications, men may reduce their risk and promote better prostate health.

Low Testosterone

Additionally, insulin resistance and high insulin levels can impact testosterone levels in men. Testosterone is a vital hormone for male reproductive health, influencing libido, energy levels, muscle mass, and overall well-being. Insulin resistance can lead to decreased testosterone production or inefficient utilization of testosterone in the body. By adopting a low insulin lifestyle, men may experience improvements in testosterone levels, promoting better reproductive health and overall vitality.

Low Libido

Low libido, or a decreased sex drive, can also be influenced by insulin resistance and high insulin levels. Addressing these factors through lifestyle modifications can help enhance libido, improving the overall sexual experience and satisfaction for men.

By understanding the broader implications of insulin resistance and high insulin levels on men’s reproductive health, we can emphasize the importance of adopting a low insulin lifestyle. This includes making dietary choices that minimize insulin spikes, engaging in regular physical activity, managing stress levels, and getting adequate sleep. These lifestyle modifications can contribute to improved insulin sensitivity, better metabolic health, and enhanced reproductive well-being.

It’s crucial to promote awareness and open discussions surrounding men’s reproductive health, including the impact of insulin resistance and high insulin levels. Encouraging men to seek comprehensive care that addresses the underlying insulin-related issues can lead to better overall reproductive health outcomes. By prioritizing a low insulin lifestyle, men can take control of their reproductive health, improve fertility, enhance sexual function, promote prostate health, boost testosterone levels, and revitalize their overall well-being. 

If you are experiencing reproductive health issues, it’s important to talk to your healthcare provider and ask to have your fasting insulin tested. An ideal fasting insulin should be between 3-8 mIU/ml. Anything higher than 8 mIU/ml suggests insulin resistance. If your healthcare provider says no, you will soon be able to purchase a Lilli at-home insulin testing kit directly from our website! This will allow you to stay on top of your metabolic and reproductive health from the comfort of your own home.

References

• Mansour R, El-Faissal Y, Kamel A, et al. Increased insulin resistance in men with unexplained infertility. Reprod Biomed Online. 2017;35(5):571-575. doi:10.1016/j.rbmo.2017.08.020
• Pitteloud N, Mootha VK, Dwyer AA, et al. Relationship Between Testosterone Levels, Insulin Sensitivity, and Mitochondrial Function in Men.; 2005.
• Shanik MH, Xu Y, Skrha J, Dankner R, Zick Y, Roth J. Insulin resistance and hyperinsulinemia: is hyperinsulinemia the cart or the horse? Diabetes Care. 2008;31 Suppl 2. doi:10.2337/dc08-s264
• Abdul-Ghani M, DeFronzo RA. Insulin Resistance and Hyperinsulinemia: The Egg and the Chicken. Journal of Clinical Endocrinology and Metabolism. 2021;106(4). doi:10.1210/clinem/dgaa364
• Janssen JAMJL. Hyperinsulinemia and its pivotal role in aging, obesity, type 2 diabetes, cardiovascular disease and cancer. Int J Mol Sci. 2021;22(15). doi:10.3390/ijms22157797
• Pohlmeier AM, Phy JL, Watkins P, et al. Effect of a low-starch/low-dairy diet on fat oxidation in overweight and obese women with polycystic ovary syndrome. Applied Physiology, Nutrition and Metabolism. 2014;39(11):1237-1244. doi:10.1139/apnm-2014-0073
• Phy Jennifer L, Pohlmeier AM, Cooper JA, et al. Low Starch/Low Dairy Diet Results in Successful Treatment of Obesity and Co- Morbidities Linked to Polycystic Ovary Syndrome (PCOS). J Obes Weight Loss Ther. 2015;05(02). doi:10.4172/2165-7904.1000259
• Araújo J, Cai J, Stevens J. Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016. Metab Syndr Relat Disord. 2019;17(1):46-52. doi:10.1089/met.2018.0105
• Leisegang K, Bouic PJ, Menkveld R, Henkel RR. Obesity is associated with increased seminal insulin and leptin alongside reduced fertility parameters in a controlled male cohort. Reproductive Biology and Endocrinology. 2014;12(1):34. doi:10.1186/1477-7827-12-34
• Chen S, Wu R, Huang Y, et al. Insulin Resistance Is an Independent Determinate of ED in Young Adult Men. PLoS One. 2013;8(12):e83951. doi:10.1371/journal.pone.0083951
• Grossmann M, Thomas MC, Panagiotopoulos S, et al. Low Testosterone Levels Are Common and Associated with Insulin Resistance in Men with Diabetes. J Clin Endocrinol Metab. 2008;93(5):1834-1840. doi:10.1210/jc.2007-2177
• Wang L, Lu B, He M, Wang Y, Wang Z, Du L. Prostate Cancer Incidence and Mortality: Global Status and Temporal Trends in 89 Countries From 2000 to 2019. Front Public Health. 2022;10. doi:10.3389/fpubh.2022.811044

In PCOS, the body’s hormonal balance can be disrupted, leading to various symptoms like acne, excessive hair growth, and menstrual irregularities. One of the hormones involved in this condition is DHEA-S (dehydroepiandrosterone sulfate), which is produced by the adrenal glands located above the kidneys. DHEA-S is a precursor to testosterone and estrogen, and its levels are often measured in diagnosing PCOS.

Approximately 20-30% of women with PCOS have elevated levels of DHEA-S. While most excess androgens in PCOS come from the ovaries in response to high insulin levels, the adrenal glands can also contribute by producing excessive DHEA-S. Interestingly, elevated DHEA-S levels may also be associated with insulin resistance, further linking it to the development of PCOS.

Understanding the role of DHEA-S and its connection to insulin resistance provides valuable insights into the mechanisms behind PCOS. By addressing insulin levels and adopting a low insulin lifestyle, individuals with PCOS can work towards restoring hormonal balance and managing their symptoms effectively. It’s empowering to know that lifestyle changes can play a significant role in improving the overall well-being of those with PCOS.

Stress

Stress and anxiety have significant impacts on our hormonal balance and overall well-being. When it comes to stress, the interplay between insulin resistance and cortisol is crucial to understand. Cortisol is produced by the adrenal glands in response to stress, and chronically high cortisol levels can lead to insulin resistance. Furthermore, high cortisol levels can contribute to overeating and weight gain, further worsening insulin resistance.

The increased insulin resistance not only contributes to rising insulin levels but also triggers the adrenal glands to produce excess androgens, such as testosterone. These androgens contribute to the signs and symptoms of PCOS, including acne, excessive hair growth, and menstrual irregularities. Therefore, managing stress is also an important component of a low insulin lifestyle.

Anxiety

In addition to the impact on insulin resistance, research has shown a potential association between insulin resistance and altered dopamine signaling in the brain, particularly in relation to mood disorders like anxiety. Dopamine, a neurotransmitter involved in mood regulation and motivation, may be affected by insulin resistance. Specifically, insulin resistance has been linked to decreased dopamine turnover, which refers to the rate at which dopamine is synthesized and metabolized in the brain. This decreased turnover may lead to decreased dopamine availability, which has been linked to depressive and anxiety symptoms.

Overall, chronic stress and anxiety can lead to overactivity of the adrenal glands, resulting in chronically elevated cortisol levels. This can contribute to a variety of health problems, including anxiety, depression, insomnia, and weight gain.

The good news is that through lifestyle changes and targeted interventions, we can tackle insulin resistance and its impact on adrenal androgen production. By adopting a low insulin lifestyle, including managing our stress, we can work towards improving insulin sensitivity and reducing the production of androgens from the adrenal glands. This comprehensive approach can help alleviate the symptoms of PCOS and promote better hormonal balance.

References

• Hoeger KM, Dokras A, Piltonen T. Update on PCOS: Consequences, Challenges, and Guiding Treatment. J Clin Endocrinol Metab. 2021;106(3):e1071-e1083. doi:10.1210/clinem/dgaa839
• Tsilchorozidou T, Honour JW, Conway GS. Altered Cortisol Metabolism in Polycystic Ovary Syndrome: Insulin Enhances 5α-Reduction But Not the Elevated Adrenal Steroid Production Rates. J Clin Endocrinol Metab. 2003;88(12):5907-5913. doi:10.1210/jc.2003-030240
• Kleinridders A, Cai W, Cappellucci L, et al. Insulin resistance in brain alters dopamine turnover and causes behavioral disorders. Proceedings of the National Academy of Sciences. 2015;112(11):3463-3468. doi:10.1073/pnas.1500877112
• Watson KT, Simard JF, Henderson VW, et al. Incident Major Depressive Disorder Predicted by Three Measures of Insulin Resistance: A Dutch Cohort Study. American Journal of Psychiatry. 2021;178(10):914-920. doi:10.1176/appi.ajp.2021.20101479
• Zou XH, Sun LH, Yang W, Li BJ, Cui RJ. Potential role of insulin on the pathogenesis of depression. Cell Prolif. 2020;53(5). doi:10.1111/cpr.12806
• Watson KT, Simard JF, Henderson VW, et al. Association of Insulin Resistance With Depression Severity and Remission Status. JAMA Psychiatry. 2021;78(4):439. doi:10.1001/jamapsychiatry.2020.3669
• Greenwood EA, Pasch LA, Cedars MI, Legro RS, Eisenberg E, Huddleston HG. Insulin resistance is associated with depression risk in polycystic ovary syndrome. Fertil Steril. 2018;110(1). doi:10.1016/j.fertnstert.2018.03.009
• Lyra e Silva N de M, Lam MP, Soares CN, Munoz DP, Milev R, de Felice FG. Insulin resistance as a shared pathogenic mechanism between depression and type 2 diabetes. Front Psychiatry. 2019;10(FEB). doi:10.3389/fpsyt.2019.00057

The keto diet has gained immense popularity, and it’s no wonder why! Many people have found success with keto, especially those dealing with insulin resistance, which affects the majority of the population. The secret behind keto’s effectiveness lies in its drastic reduction in carbohydrate intake, leading to a significant drop in insulin levels. This not only promotes weight loss but also improves various aspects of health, including energy levels, cognition, inflammation, mental well-being, and symptoms associated with conditions like PCOS.

However, while keto offers impressive results in lowering insulin, it does come with some drawbacks. Its highly restrictive nature can make it challenging to sustain for extended periods. With a total “net” carbohydrate goal of 20-40 carbohydrates per day, it can make eating a variety of fruits and vegetables difficult. It’s for this reason that keto diet often lacks sufficient fruits and vegetables, which are vital for overall health. There is also a potential risk of developing binge eating behaviors due to the strict rules. Many individuals who have followed the keto diet will report that when they fall off the wagon, they fall hard. 

Here’s where the concept of a low insulin lifestyle comes into play. You don’t necessarily have to eliminate all carbs from your diet to lower insulin levels; the key lies in avoiding insulin-spiking foods. Certain foods, such as starches, specific dairy products, and added sugar, tend to cause significant insulin spikes. However, with a low insulin lifestyle, you can enjoy non-starchy vegetables and fruits to your heart’s content. While fruits may contain more sugar, the type of sugar, primarily fructose, elicits a much smaller insulin response compared to starches. It’s all about understanding how different foods impact insulin secretion and making choices that lead to a more sustainable reduction in insulin levels.

Low  Insulin Lifestyle (Lilli)

• Unlimited carbohydrates from non-starchy vegetables and fruits
• Restricts starches, certain types of dairy products, and added sugar
• Does not require counting calories, fat, or carbohydrates

Ketogenic Diet (Keto)

• Restricts carbohydrates to 20g per day (10% or less)
• Restricts most fruit and limits non-starchy vegetables
• Restricts starches, certain types of dairy products, and added sugars
• Does not require counting calories or fat

Look at the graph below. This graph compares a day in the life of someone following a low insulin lifestyle (teal), someone following a keto diet (navy), and someone eating a typical American diet (red). Remember, the pancreas secretes insulin after every meal, but the amount depends on what is eaten. You can see that the person following a keto diet has a minimal rise in insulin after meals because a keto diet includes very few carbohydrates, thus requiring very little insulin. The person following a low insulin lifestyle has a relatively higher rise in insulin after each meal because a low insulin lifestyle does not require carbohydrate restriction. However, insulin levels are still significantly lower than following a typical American diet, high in starches, dairy, and sugar.

What’s truly important about the graph and the two lifestyles depicted is that insulin levels return to baseline between meals and during the overnight fast. This is the most critical factor for improving overall health. When insulin levels return to normal, it promotes metabolic flexibility, enhances fat burning, boosts energy levels, and contributes to better overall health.

It’s not necessarily about achieving “ketosis,” but rather about adopting an eating pattern that allows insulin levels to come back down to normal. You don’t have to strictly avoid carbohydrates altogether to achieve this, but rather focus on preventing excessive spikes in insulin. The key lies in the source of carbohydrates rather than the quantity consumed.

If you look at the red line on the graph, which represents a typical American diet, you can see that insulin levels are elevated all day and night. This continuous elevation is particularly noticeable during the fasting period, resulting in a high fasting insulin level, as depicted in the image.

Fasting insulin levels serve as a valuable indicator of chronically high insulin levels. If a person has a high fasting insulin, it suggests that their insulin levels remain chronically elevated and are unable to return to the normal range. This indicates a state of insulin resistance. Because chronically high insulin levels and insulin resistance are associated with a range of health issues, monitoring fasting insulin levels provides crucial insights into an individual’s metabolic health and can serve as an important marker to identify and address underlying insulin-related concerns.

By adopting a low insulin lifestyle, individuals can take proactive steps to regulate their insulin levels and promote overall health. This includes making mindful dietary choices that avoid insulin-spiking foods. Taking control of insulin levels not only helps in maintaining a healthy weight but also contributes to improved energy, hormonal balance, and long-term well-being.

So, remember that achieving lower insulin levels doesn’t necessarily mean eliminating all carbs. Diets rich in fruits and non-starchy vegetables have long been associated with improved health outcomes. These foods offer fiber, vitamins, minerals, and antioxidants, all of which play a significant role in protecting against heart disease and cancer. With Lilli, the focus is less on quantity and more on the quality of the food you consume, allowing you to embrace and maintain a more sustainable lifestyle.

References

• Paoli A, Mancin L, Giacona MC, Bianco A, Caprio M. Effects of a ketogenic diet in overweight women with polycystic ovary syndrome. J Transl Med. 2020;18(1):104. doi:10.1186/s12967-020-02277-0
• Westman EC, Yancy WS, Mavropoulos JC, Marquart M, McDuffie JR. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutr Metab (Lond). 2008;5(1):36. doi:10.1186/1743-7075-5-36
• Araújo J, Cai J, Stevens J. Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016. Metab Syndr Relat Disord. 2019;17(1):46-52. doi:10.1089/met.2018.0105
• Shanik MH, Xu Y, Skrha J, Dankner R, Zick Y, Roth J. Insulin resistance and hyperinsulinemia: is hyperinsulinemia the cart or the horse? Diabetes Care. 2008;31 Suppl 2. doi:10.2337/dc08-s264
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