Insulin: Truths & Hype – A Comprehensive Guide

If your algorithm is used to showing you videos about well-being, exercise and nutrition, you will surely have already encountered a content creator explaining the thousand reasons why he/she takes care of insulin or glucose spikes, while showing you how, whether on an empty stomach or before any meal, he/she takes a supplement or an ingredient from the basic basket that, until that moment, did not have that function for you.

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“I can’t miss my apple cider vinegar on an empty stomach because it helps me keep my insulin from going up at breakfast”explained a well-known influencer with more than 500,000 followers in a video in which she showed in detail what her day-to-day life was like.

And although much is said about these tools, little is explained about how they work in the body, who should really follow them or what the expected results are. This is the science behind insulin, the trendy hormone.

Insulin is a hormone produced by the pancreas and that regulates glucose levels, that is, blood sugar. This acts as a key that allows glucose to pass from the bloodstream to the cells to produce energy.

“All cells, to function normally, need sugar, that is, glucose. Everything we eat is transformed into glucose and that glucose is what the body converts into energy to perform its functions. So that the glucose that is in the blood can enter the cells and produce energy, it needs to pass through a key, and that key is insulin. That is what happens under normal conditions. When we eat and glucose levels rise, the pancreas responds by producing more insulin, whose function is to allow that glucose to enter the cell and be released. use it as energy. And, clearly, the more glucose there is in the blood, the greater the amount of insulin that the body needs to produce,” explains Sebastián Peláez, internist at the San Vicente Fundación Hospital.

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Technically, the pancreas functions as a small hormone factory. Inside it there are tiny groups of cells called islets of Langerhans, which fulfill different functions. Some of these cells – beta cells – are responsible for producing insulin. Every time we eat, food is transformed into glucose and that glucose passes into the blood. Upon detecting this increase, the beta cells of the pancreas release insulin. Its function is to allow that sugar to enter the cells to be used for energy or, if there is leftovers, to be stored for later.

Before it is ready, insulin is initially manufactured within the pancreas and then activated to do its job in the body. This process occurs several times a day and is essential for the body to maintain a healthy blood sugar balance.

But, as with other hormones, this one can also have failures at the time of its production. It can happen that the pancreas produces little or no insulin, which is known as type 1 diabetes, from which more than 9 million people worldwide suffer.

It may also happen that the problem is not that it is missing, but that the body stops responding well to it. Cells in the liver, muscles, and fat tissue become “resistant” to the insulin signal, as if the key no longer fits properly in the lock. When this occurs, glucose cannot enter the cells to be used or stored as energy. Instead, it stays circulating in the blood, causing sugar levels to rise higher than normal, technically known as hyperglycemia.

By not being able to use glucose efficiently, the body runs out of the fuel it needs, which explains many of the symptoms of type 2 diabetes, such as tiredness, constant hunger, excessive thirst, and increased frequency of urination. More than 500 million people in the world have this disease and it is predicted that by 2040 there will be more than 700 million.

“The problem we have today with diabetes, especially type 2, is directly linked to the population’s bad habits. Habits that have to do, above all, with the quality of food, weight gain, poor rest and the lack of adequate controls to detect risk factors such as high blood pressure or high cholesterol.

Added to this is a worrying aspect: sedentary lifestyle. Exercising has been stopped and these bad habits not only affect adults, but start from childhood. This whole set of situations deteriorates the quality of life and ends up translating into weight gain and multiple diseases associated with obesity,” explains José Luis Torres, president of the Colombian Association of Endocrinology, Diabetes and Metabolism (ACE).

Another common condition that can occur when there are problems with insulin is insulin resistance. Peláez explains that, when the pancreas is constantly forced by high levels of glucose that are not burned as energy, the body changes strategy: instead of taking advantage of that glucose, it begins to store it. Some is stored in the liver and muscles, but the excess ends up becoming fat.

The more glucose you ingest without spending it, the more fat you accumulate. This forces the pancreas to work harder and harder to produce insulin, until it reaches a point of exhaustion. In addition, fat – especially abdominal fat – releases substances that hinder the action of insulin. Over time, this causes the tissues to respond increasingly less well to the hormone, and this is known as insulin resistance.

This is mainly caused by a lack of physical exercise and a high consumption of foods rich in sugars and ultra-processed carbohydrates: boxed cereals, packaged potatoes, sweets and fast food.

Therefore, the best way to maintain proper insulin function is a balanced diet and an active life. Both Peláez and Torres agree that the key is to understand that it is not about following a restrictive diet for a couple of weeks or months, but about a deep and conscious change in lifestyle.

To keep this process at bay and prevent diseases, such as type 2 diabetes, it is recommended to avoid foods high in sugar, stay away from sodas and other artificial drinks, and avoid the aforementioned ultra-processed carbohydrates.

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It is also advisable to say yes to white proteins such as chicken and fish, vegetables, whole grains and avocado. This, along with frequent physical activity and good sleep habits, are basic, but key, recommendations to be healthy.

Although the ideal is to maintain this lifestyle, not only so that sugar levels remain controlled, but to guarantee general well-being, one should not become obsessed with this process, which is ultimately a physiological response of the body. It must be understood that the mere fact of eating and insulin rising due to the body’s normal response does not mean that resistance to this hormone will immediately be created, for example.

“On social media, alarmist discourse has become common that oversimplifies the issue of insulin to attract attention. People are led to believe that eating carbohydrates is automatically bad because ‘insulin rises’, when in reality insulin is a normal physiological response. In fact, there are studies that show that certain protein foods can stimulate insulin as much or even more than some carbohydrates. The problem is that many of these conclusions come from studies done under very controlled conditions. In real life, people do not eat isolated carbohydrates or proteins alone. They eat mixed dishes: protein, carbohydrate, fat and fiber. This mixture makes glucose absorption slower and insulin release much more moderate. Therefore, reducing everything to ‘carbohydrates equal insulin equal problem’ is a mechanistic vision that does not reflect how everyday eating really works,” explains Andrés Zapata, dietitian nutritionist and master in sports and clinical nutrition.

This is when certain advice or types of diet, such as using a supplement or following a specific diet, should be done only at the suggestion and under the supervision of a health professional, since not all patients have the same clinical context. The foods and quantities that a high-performance athlete should consume are not the same as those that a sedentary young person who works more than eight hours at a desk should eat, for example.

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In that sense, healthy people should continue with a lifestyle that continues to be beneficial for their health, but this does not mean they should be overly concerned about their insulin levels or take daily insulin measurements. On the other hand, there are patients with certain conditions that must be kept under constant control: this group clearly includes type 1 and 2 diabetes, obesity, high blood pressure and some autoimmune diseases. They are the ones who must take stricter care in this regard.

Be careful!: at no time does this mean that healthy people should not undergo routine examinations and, as with any warning sign – excessive thirst, blurred vision, a lot of tiredness and constant urge to urinate are some of those that could indicate that sugar is high – consult a professional.

There are recommendations that, thanks to social networks, have become very popular. For example, eating in a certain order, which says that vegetables should be eaten first, then protein, and finally carbohydrates so as not to have significant spikes in blood sugar.

However, studies have shown that the positive effects of this order, also known as nutrient sequencing, are seen by people with type 2 diabetes or insulin resistance. Zapata believes that it is a tip that those who already have a risk disease should follow and Vijaya Surampudi, an endocrinologist at UCLA Health, told The New York Times for an article on that specific topic that healthy people do not usually need to control their blood glucose in this way because “a properly functioning body will normalize blood sugar levels hours after eating.”

Currently, there is also evidence in favor of berberine, which is a plant substance found in plants such as barberry, goldenseal root and turmeric, which comes in a supplement and has been proven to have an effect on improving insulin sensitivity. The same thing happens with cinnamon, of which there are studies that claim that it can reduce resistance to this hormone, although it still needs more evidence on its operation and results.

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This is the case with apple cider vinegar, which thanks to one of its main components, acetic acid, can reduce glucose peaks. “The problem with this recommendation is that it is very difficult to generalize it, because not all vinegars have the same concentration of acetic acid. There is apple cider vinegar, apple cider vinegar and, at least here in Colombia, there are no brands that clearly standardize the acetic acid content. In addition, many people do not know how to read that information on the nutritional label. Added to this is that apple cider vinegar gummies are very fashionable, which actually contain more sugar than acetic acid,” says the nutritionist.

However, what specialists agree on is that, More than using supplements or other types of foods, the most important thing is to know how to choose what we eat. In the end, these decisions depend on what our body needs based on age, gender, occupation and habits. To do this, the best thing will always be – and even more so in times when suggestions on what to eat and how to do it are just around the corner – to consult with professionals who, without demonizing any type of food, guide and educate in the wide world of nutrition and well-being.