Silent Insulin Resistance Increases Your Risk of Depression

What do your blood sugar, cholesterol levels and triglycerides have to do with your mental health? They’re all quite connected, as it turns out. 

Gone are the days of us treating mental health issues as a purely psychological phenomenon. We now know that biological factors like inflammation, hormones and blood sugar greatly influence our state of mind. 

Insulin resistance is common and often ignored until it progresses to diabetes. This is unfortunate because science tells us that insulin resistance can impact our wellbeing even before it leads to diabetes. Research consistently shows a connection between insulin resistance and mental health. A 2021 study by Rasgon et. al. found that those with insulin resistance had an increased risk of developing major depressive disorder over the 9 year follow up period of the study–even for those who never had depression or anxiety in the past.

What is insulin resistance?

Insulin resistance is not a specific disease in the same way that we think about diabetes. Insulin resistance is a state that the body can be stuck in long before diabetes shows up. When the body is in a state of insulin resistance, it means that it’s ignoring (or resisting) the instructions that insulin is trying to give to your body: make use of that sugar! When the body ignores those instructions from insulin, sugar is not used well by various parts of the body so it remains floating in the blood stream leading to elevated blood sugar. 

It can be tricky to measure early stages of insulin resistance because it can fluctuate easily from moment to moment. There are many ways to test it and it’s common for some tests to come back normal and for others to show signs of insulin resistance. 

In the study mentioned above, researchers measured insulin resistance in three validated ways:

• They calculated the ratio of triglycerides to HDL

• They measured abdominal fat 

• They assessed fasting plasma glucose levels 

An increase in the triglyceride-HDL ratio, an increase in abdominal fat and rising plasma glucose levels over the years all suggest insulin resistance and they were all associated with a higher risk of developing major depressive disorder. 

How do we treat insulin resistance?

Causes of insulin resistance include:

• Being sedentary 

• Consuming more calories than your body needs

• Not getting enough sleep

• Poor stress management

So in many cases, the way to manage insulin resistance is the same old, simple advice we’ve all heard over and over: 

• Exercise

• Eat healthy and keep moderation in mind (culturally appropriate Mediterranean Diet principles are a great way to do this)

• Go to bed on time and get help addressing any sleep issues

• Work on stress management

• Some supplements can play a role in managing insulin resistance but they can’t replace lifestyle changes

The thing is, we may all know about these lifestyle changes but the challenge becomes motivating ourselves to do them and dealing with life situations that make it difficult to implement these healthy changes. Depression is serious and devastating, hopefully more awareness about how these lifestyle changes can prevent depression will help keep us all motivated to take care of ourselves in the best way we can. If you need help coming up with a practical plan to manage insulin resistance and your mental health, book an appointment and I would be happy to help.

Why Stress Management Is Important For Diabetes Management

If you have diabetes, you’re probably thinking of ways to manage your diet, exercise more often, and you’re probably working with your doctor to manage your medications. Maybe you’re even trying some herbs and supplements to lower your blood sugar. 

But are you putting in serious effort to manage your stress levels?

Stress can cause spikes in blood sugar. When you’re stressed, your body is flooded with stress chemicals like cortisol and adrenaline. 

Cortisol reduces the ability of your muscles to soak sugar out of the blood stream. It also leads to the production of glucose in organs like the liver and decreases the ability of your pancreas to produce insulin. All of this keeps your blood sugar levels high.

In the short term, this stress-induced spike in blood sugar is beneficial to humans. It provides readily accessible energy for the body to help us survive dangerous situations. This was a survival mechanism that evolved within us and other animals. 

However, chronically high blood sugar leads to insulin resistance. Insulin tells your cells to make use of the sugar in your bloodstream. Insulin resistance is when your cells resist that command from insulin. It’s like insulin is knocking on the door telling your organs, muscles, and other tissues to let the sugar in but nobody’s answering the door. Insulin resistance is the underlying problem in type 2 diabetes.  

There is evidence that stress management can improve blood sugar and reduce HbA1c levels. Most studies use some sort of mindfulness training to help participants manage stress. It’s unfortunate that there are not more diverse studies in this area because people respond so differently to various stress management approaches. Not everyone likes meditation and there are many other ways to calm down your nervous system.

While high stress is certainly not the only important factor to consider for type 2 diabetes, it can make managing the condition more difficult. Whether you’re thinking about preventing diabetes or managing it, stress management should be an important part of your diabetes plan. 

Is Fruit Really Healthy?

Fruit continues to get a bad reputation online due to its sugar content. At least once a month somebody asks me if it’s ok to eat fruit or if it’s bad for weight management, acne, blood sugar control, etc. I love when my patients ask me this question because I get to clear up a lot of fear-mongering myths about fruit.  

For years studies have demonstrated the benefits of fruit intake in all sorts of areas of health - both mental and physical. Yes, fruit contains sugar, however it also contains many wonderful plant chemicals that benefit health. Your favourite sugary candy might have sugar, butter, flour, artificial colour, and not much else going for it. Fruit, on the other hand, has sugar, fibre, antioxidants, and anti-inflammatory chemicals. Many of these ingredients have a potent and positive impact on health. 

A large 2020 systematic review study on the association between fruit and vegetable intake and mental health showed that both fruits and vegetables benefit mood and anxiety levels. This may be especially true for berries and citrus fruit (although we still need more research before deciding if one type of fruit is better than another).

In terms of physical health, fruit has been shown to reduce the risk of cardiovascular disease, cancer, perimenopausal hot flashes, endometriosis and so much more.

Keep in mind, many studies assess fruit and vegetable intake together so it’s not clear whether you would get the same benefit if you only ate fruits alone and no vegetables. Research points to the benefits of consuming both fruits and vegetables. It certainly does not show that fruit should be removed from our diets.

If you’re concerned about the impact that fruit has on blood sugar, you can take comfort in the fact that even reliable organizations such as Diabetes Canada recommend fruit intake as part of a diabetes-friendly diet. Fruit may actually help with blood sugar control and reduce the risk of developing diabetes. Those with concerns about blood sugar control may want to emphasize lower glycemic index fruits such as apples, berries, oranges, pears and cantaloupe. Higher glycemic index fruits that can be minimized include overripe, brown bananas, watermelon and fruit in juice form. Again, this won’t be relevant for everyone - only those who are being advised to control their blood sugar.

Of course, if you notice some sort of negative response to a fruit or to fruit in general, that’s worth taking note of and mentioning to your naturopathic doctor or other healthcare provider. 

Ultimately, fruit is a healthy part of the diet for both mental health and overall health. Nowadays people are being told to eliminate so many different foods from their lives. Sometimes this advice comes from a reliable source and sometimes it doesn’t. Take comfort in knowing that, unless you’ve been clearly told by a healthcare provider to avoid it, fruit is a nutritious and valuable part of the diet for most people. 

Testing For Anxiety - is it Necessary?

Anxiety can involve a whole bunch of confusing and overwhelming symptoms. For some people, all of the symptoms are thought based - overthinking, catastrophizing, constant worrying etc. For others, physical symptoms are associated with the anxiety like heart palpitations, diarrhea, irregular periods, sweating, nausea and so on.

Whether or not you need testing depends on your signs and symptoms. The type of testing you need will be completely individualized to you. Testing can help us figure out potential root causes that could be contributing to your anxiety.

Here are some tests that can be run for certain cases of anxiety:

Thyroid testing - this is sometimes tested when heart palpitations, jitters, constipation or diarrhea, cold or hot flashes, irregular periods, hair issues or skin changes occur.

Iron deficiency testing - this can be considered when symptoms like weakness, fatigue, shortness of breath and heart palpitations are present.

Blood sugar testing - this is sometimes done when symptoms like lightheadedness, weakness and shaking are present.

Other tests like liver testing, triglycerides, reproductive hormones, vitamin d, B12 and many more may also be considered on a case by case basis.

I often get asked if I offer testing as a naturopathic doctor. I have access to many common tests and I often run tests for my anxiety patients when we feel it’s necessary. If you want to talk more about how I can help you with testing, please book a free 15 minute consultation.

How Food Affects Your Mood

This was a food-filled weekend for many of us. I think we all understand that certain foods can leave us feeling bloated, nauseous and groggy. But did you know that food can affect your mood as well? If you’re finding it hard to keep up with the demands of your work and family life because you’re feeling down or stressed it might be time to revamp your diet.  

Inflammation and Your Brain

Many foods can trigger inflammation. This is especially true for processed foods and foods you have an intolerance or sensitivity to. This inflammation can happen in your gut as well as the rest of your body. It has been found that inflammation in your body is able to affect what goes on in your brain – and not in a good way. The inflammation can trigger feelings of anxiety, stress and even depression.

The Gut-Mood Connection

When you eat foods that your body can’t deal with, it damages the health of your gut bacteria. As bizarre as it sounds, the health of your gut bacteria is deeply connected to your mental health. Scientists have associated unhealthy gut bacteria with mood problems. Giving your body the right foods can improve your gut health.

Nutrients and Blood Sugar

Adding the right foods into the diet is just as important as taking the wrong foods out. In order to feel your best, your diet needs to be rich in vitamins, minerals, antioxidants, healthy fats, quality protein and other phytochemicals. These are key nutrients for a healthy brain and happy mood. Your diet also needs to be able to keep blood sugar levels stable as spikes and crashes in blood sugar are a recipe for stress and anxiety.

If you feel like you don’t have time to do all the things that are important for keeping mood troubles at bay, just start with small improvements to your diet. You will notice a difference over time. If you need help fixing your diet or if you’re wondering if you need food sensitivity testing, don’t hesitate to reach out. The connection between diet and mood is often overlooked. The sooner you get your diet right, the sooner you can get back to feeling like yourself so you can tackle your day with enthusiasm and be present and fully engaged with your loved ones.