February 8, 2023

Watch the full episode of this Ask Me Anything podcast #17:

Finally on the nutrition side it seems obvious but it’s amazing how often this is overlooked by definition insulin resistance is a carbohydrate tolerance disorder there are many people who for whatever reason don’t want to understand that is true and they tend to look at other things and say no insulin resistance occurs because there’s fat in the muscle and therefore

It’s a fat problem and i fundamentally don’t agree with that and i think that anybody who’s been on the front lines clinically taking care of patients will say insulin resistant patients generally respond better to carbohydrate restriction than any other form of restriction they respond very well to calorie restriction as well but calorie restriction by definition

Typically includes carbohydrate restriction it doesn’t necessarily need to be that extreme it doesn’t have to be a ketogenic diet and it doesn’t have to be profound caloric restriction but when a person is insulin resistant their carbohydrate tolerance is lower than it should be and we can use tools like cgm to basically figure that out so rather than say oh

Everybody should be eating 100 grams a day or 50 grams a day 150 grams per day the answer is put a cgm on and find out we set the standard which says as long as the average blood glucose stays below this and the standard deviation meaning the fluctuation of glucose stays below this use that as your guide and the most insulin resistant person might only be able to

Consume 50 or 75 grams of carbohydrates while staying in that range while someone else might be able to consume 600 grams of carbohydrates while staying in that range but using that tool then helps you start to course correct that and as that number starts to come down and the insulin starts to come down and all these other things start to go that’s exactly what

Reversibility looks like so let’s quickly go over a case study of a patient we’ll include these numbers in the show notes thank you for listening to today’s sneak peek ama episode of the drive if you’re interested in hearing the complete version of this ama you’ll want to become a member we created a membership program to bring you more in-depth exclusive content

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Transcribed from video
Peter Attia on Mitigating and Reversing Insulin Resistance with Nutrition By Peter Attia MD