Rethinking Prediabetes: It's Not About Carbs

Philip Pape 0:02

you've been told that if you're pre-diabetic or insulin resistant , carbs are the enemy . Cut the bread , ditch the rice , avoid fruit . But what if I told you that's not only wrong , it might be keeping you stuck . 96 million american adults have pre-diabetes and most of them are fighting the wrong battle . They're cutting carbs when they should be building muscle . They're reducing fuel when they should be upgrading their engine . Today we're exposing the real culprit behind insulin resistance and prediabetes , and it's not carbs . You'll discover the research showing how muscle mass directly determines your carb tolerance , why a single strength training session can increase glucose uptake by 40% , and the exact strategy to reverse insulin resistance while still enjoying rice , potatoes and even fruit .

Philip Pape 1:01

Welcome to Wits and Weights , the show that helps you build a strong , healthy physique using evidence , engineering and efficiency . I'm your host certified nutrition coach , philip Pape , and today we're tackling one of the most misunderstood conditions in modern health prediabetes and insulin resistance . Now , if you've been diagnosed with either condition , you've probably been handed a list of foods to avoid . Carbs are demonized . You've been told to eat like you're already diabetic , and even there there's an asterisk on that as to how to manage your blood sugar . On diabetes , but I digress . Here's what they're not telling you . Insulin resistance is not a carbohydrate problem . It is a muscle problem . When you understand the real mechanism behind insulin resistance , everything will change for you . You'll have more power and flexibility and freedom in your life . You'll discover today why building muscle is more powerful far more powerful than cutting carbs , how you can increase your capacity to handle glucose , and why the solution isn't about eating less but becoming metabolically stronger . Now , before we get into the science that will change how you think about prediabetes , I wanna make sure you have the tools to put this into practice , and so I created a free nutrition one-on-one guide that breaks down how to structure your nutrition , including carbs , for optimal health and body composition , based on your goal . It's gonna show you how to structure your nutrition , including carbs , for optimal health and body composition , based on your goal . It's gonna show you how to determine your personal carb tolerance , optimize your macros for insulin sensitivity and create a sustainable approach that works with your body and where you're trying to go , whether it's fat loss , building muscle , even just to maintain your results . So get your free copy at witsandweightscom , slash free , or use the link in my show notes and let's get into the topic today , which is pretty much why everything you've been told about pre-diabetes might be , I'll say , backward from reality

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Philip Pape 2:53

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Philip Pape 2:53

So

How Muscle Mass Determines Insulin Sensitivity

Philip Pape 2:54

let's start with the facts . Pre-diabetes affects 96 million American adults the country I live in and that's one in three people . It's defined as having blood glucose levels that are elevated above normal , but not quite high enough for a type 2 diabetes diagnosis . So we're talking about fasting glucose between 100 and 125 milligrams per deciliter , or HbA1c between 5.7 and 6.4% . Now the standard advice from the medical field is essentially eat like you already have diabetes . Cut your carbs , avoid sugar , be afraid of fruit . But this is like a band-aid . This is treating the symptom . It's not treating the cause , and that's because the issue isn't carbs themselves .

Philip Pape 3:41

Carbs are not inherently bad for you in just about any context . Well , I shouldn't say in just about any context . We're going to talk about how you set your context up so that they're not at all bad for you . In fact , they are beneficial and you're going to want to eat more of them by the time the episode is done , but the real issue is that your body has lost the capacity to handle them efficiently . So it's like you have a small gas tank and you're being told the solution is go ahead and use less gas instead of just upgrading to a bigger , more efficient tank and I don't know about you . I'd rather have more capacity than trying to restrict and deprive myself for the rest of my life .

Philip Pape 4:13

Research from the third national health and nutrition examination survey looked at over 13,000 people and found something remarkable For every 10% increase in relative muscle mass , there was an 11% reduction in insulin resistance and a 12% reduction in prediabetes risk . Your muscle mass was literally determining your metabolic health Very powerful . What's even more wild is that this relationship holds true no matter your age , your ethnicity , your sex , your obesity history . In other words , two people with the same body fat percentage could have completely different insulin sensitivity based solely on how much muscle they carried right . So it's not just about body fat , it's about muscle , it's about overall body composition . So if we want to understand why that is why does muscle matter so much , which we talk about a lot on this show , but it's something I will never fail to repeat because it's powerful , it's central to what we do we have to talk about what insulin resistance is at the cellular level .

Philip Pape 5:17

It is highly misunderstood . Insulin resistance occurs when your cells , especially your muscle , your liver and fat cells don't respond well to insulin , and they can't easily take up the glucose from your blood right . Hence the word resistance . They are resisting that . And muscle tissue muscle mass is your body's largest glucose sink or battery . It's where the majority of the glucose gets stored as glycogen after you eat , and so when you have more muscle mass , you literally have more capacity to absorb and store glucose without it causing blood sugar spikes to the same extent .

Philip Pape 5:53

A study published in the Proceedings of National Academy of Sciences showed that just one 45-minute bout of exercise could completely normalize insulin-stimulated muscle glycogen synthesis in individuals who are insulin-resistant . We're talking

The Cellular Mechanism of Insulin Resistance

Philip Pape 6:10

a single workout . We're not even distinguishing the type literally just getting your butt off the chair and moving , going for a walk , exercising of any kind strength training we're going to get into that . All of it is extremely beneficial because you are now activating your muscle machinery . We did an episode not long ago about how two minute walks every 30 minutes if you tend to sit down all day in a desk job can increase your muscle protein synthesis by 47% , and how sitting for almost eight hours can reduce it by 50% . That's how powerful this whole mechanism is , and I almost fell over while I'm standing here recording this . This whole mechanism is and I almost fell over while I'm standing here recording this that is how powerful muscle is . And then the research gives us even more compelling data to lean into here , because strength training specifically increases what's called glut4 transporter density in your muscle cells , and these are like little glucose doorways where the more that you have , the easier it is for glucose to get into your muscle cells where it belongs right More of them can unlock , rather than the glucose floating around in your bloodstream causing problems , which is when we talk about blood sugar management . That's what we're talking about .

Philip Pape 7:16

Ben Zeal was on the show . He's a type one diabetic . Talks all about that , that specific mechanisms . And it's even more pronounced when we talk about your training right , having strength training in your lifestyle . A 16-week strength training study with older Hispanic adults with type 2 diabetes found not only improved muscle quality and fiber hypertrophy , but also significant improvements in insulin resistance markers . And again , these were not young and fit individuals . These are older adults who had established metabolic dysfunction and strength training still worked . Wow , now I'm not shocked . I say it sarcastically , like what a surprise . But if you're new to this game , if you don't train right now .

Philip Pape 7:58

If you found this episode or this video because you're curious about prediabetes or you've been diagnosed with it , understand that doing what it takes to build muscle strength training is going to be probably the biggest game changer of all , like that's the TLDR of this episode . So if muscle is the solution , then how do we build it strategically to reverse insulin resistance ? And I don't think it takes a lot of skill , is the way I'm going to put it . We talk a lot on the show about how to build strength and muscle and do it efficiently . But even very just basics like going to the gym and just giving it a shot believe it or not can in and of itself be a step change in your health when it comes to insulin . But of course , we want to do it efficiently because a lot of us are busy . We don't have time to just be in the gym all day . So this is where the engineering mindset comes in time to just be in the gym all day . So this is where the engineering mindset comes in right .

Philip Pape 8:44

We're not just going to randomly lift weights . We're going to upgrade your glucose disposal machinery . That is your goal here . If prediabetes is your concern , if blood sugar management is your concern , if carbs are your concern , that is the goal . So first , understand that strength training is a non-negotiable . From now to the time you die , it becomes non-negotiable , of course , you're your health span and your longevity and solve a lot of these things that people are worried about and you're probably worried about related to your diet and nutrition , your health , everything . So what we're talking about here

Strength Training: The Ultimate Blood Sugar Solution

Philip Pape 9:20

is progressive resistance training , probably at least three times a week , focused on the basic fundamental human movement patterns , compound movements that engage the most muscle mass squats , deadlifts , rows , pressing right , the movements that recruit massive amounts of muscle tissue and create the greatest adaptive response .

Philip Pape 9:40

Now , if you want to go check out my episode , strength Versus Hypertrophy , you can get a good deep dive into all of that , and I'm not going to tell you exactly how to train on this episode , just that it's very important . It has to be done systematically so that you get the best out of the effort . Where it gets interesting is that high intensity strength training is probably superior , according to the research , than moderate intensity strength training for improving insulin sensitivity . There was a meta-analysis of resistance training studies in older adults with type 2 diabetes found that higher intensity protocols produced better outcomes for both muscle mass and glycemic control . I don't want to overplay that , though .

Philip Pape 10:20

When we talk about intensity , it gets confounded by the term itself . We have lifting heavy , but that's a wide range as little as 35% of your max all the way up to your max , and if you're focused on strength , it's above 65% . And if you're an older individual and you're worried about bone density as well , I would focus on the slightly heavier type of lifting early on , before you then branch out . But intensity can also mean you're training hard . You're training within a few reps , shy of failure , getting that muscular tension that is required for the stimulus and the adaptation to build muscle . That's all we're talking about . We're not talking about CrossFit or cardio when we talk about intensity in this context , these are a secret weapon .

Philip Pape 11:04

Walking after a meal I've talked to so many experts on this and I've read so much on it and I've seen the research . There's research from Diabetologia hard to say that that showed that just two-minute walks every 30 minutes reduce glucose spikes significantly . And guess what ? We just talked in the other episode not long ago how two-minute walks every 30 minutes has tons of benefits for your muscle , protein synthesis , blood flow , everything else , and so you shouldn't be sedentary is the point . But in addition to that , going for walks , especially after meals , especially when combined with strength training , you get a synergistic effect with all of this . The muscle contractions from your workout , for example , create like a muscle memory that improves your glucose uptake and it lasts for a couple days after your training . So if you're lifting regularly , if you're walking regularly and you're not super sedentary , you are just a walking glucose-sucking machine , which is an amazing thing , especially if you're concerned about this and you want to stop and reverse prediabetes .

Philip Pape 12:11

The third here is we want to address the nutrition piece , but not how you think . Right , the whole premise of the show is you're not going to cut carbs . We actually want to strategically include carbs , and here's why If you never challenge your glucose disposal system , it is not going to adapt and improve . So you've actually got to reintroduce those carbs . It's like you've you know . It's like if you never lift weights , you're not going to get stronger . So if you never eat carbs , you're never going to be able to use those carbs and get used to eating them as well .

Philip Pape 12:38

And the key here is you start with thinking about your training and eating in the context of your training . Peri-workout is what we call it Before and after your workout , around or during your workout , that whole period of your workout . That is when your muscles are most primed to absorb the glucose . This is when the sweet potato or the rice or the fruit becomes the biggest tool for improving insulin sensitivity , rather than just glucose you need to get away with because you're trying to eat some food you think is bad , for example . So training carbs , you know , before your workout to give you glucose and glycogen for your muscles and after your workout for recovery , is a starting point . There are other aspects of carbs we can get into related to how it reduces stress . I've done episodes on that . Uh , related to the sustainability of your diet , obviously Right . But more importantly for this episode , if you are strength training , you can now use that glucose highly effectively and you should and you should consume it , and that gives you the flexibility to enjoy it and include it .

Philip Pape 13:41

The fourth thing here is prioritizing protein . This is always something everyone should do , so it's kind of an easy one , not just for muscle building , but because protein has the highest thermic effect of food . It helps with satiety . It's just going to be great as a part of a balanced diet and having it in every meal . The rule of thumb we always talk about is 0.7 to 1 grams per pound of body weight , and you can distribute that across your meals . It's a good way to manage blood sugar , a good way to practically get it in . You don't have to have it at every meal as long as you get your total protein . That's the most important thing . But I think if , again , your concern is blood sugar management , it's not a bad idea to have balanced macros in all your meals , and this will support this muscle building process that you are now engaging in and , like I said , help with blood sugar control . So I want to be clear , though this whole thing it's not just exercise or movement training and eating more carbs .

Philip Pape 14:32

There are other factors that matter for insulin sensitivity that we can't ignore , and sleep quality is probably the biggest one .

Beyond Exercise: Sleep, Stress and Body Composition

Philip Pape 14:40

Sleep quality Just five days , five days of poor quality sleep , can reduce insulin sensitivity by 20% to 25% . Your muscles literally can't respond to insulin as well when you are deprived of sleep , and the mechanism here is cortisol being elevated and your glucose metabolism is being disrupted at the cellular level . This is an understood mechanism from sleep deprivation , and it also affects other things . When you deprive yourself of sleep , you have greater visceral fat storage , you have more cravings , your hunger hormones are out of whack , all of it . There's nothing good that comes from it . Plus , you don't get recovered from your workouts , so sleep quality is huge .

Philip Pape 15:21

Stress management is probably equally critical . You know , I know you don't want to hear it Sleep and stress , sleep and stress . There , philip goes again , but chronic stress is associated with that elevated cortisol , and that's directly tied to insulin resistance and visceral fat accumulation . Okay , here it is . We're talking about it again over and over , and what's interesting is that strength training itself is one of the most effective stress management tools we have . It provides something . Now , I hardly use this word on the show , but it's called eustress , e-u-s-t-r-e-s-s eustress . This is beneficial stress that improves your stress resilience . I usually just call it acute stressors , but it's called eustress .

Philip Pape 16:02

Body composition matters , again , not necessarily in the way you think , because it's not just about losing weight . I will say , though , that somebody who has excess weight to lose , who then loses weight , is probably going to see a massive improvement in their insulin sensitivity . But really , we want to change your body composition ratio , because you can actually improve insulin sensitivity at the same body weight simply by adding muscle and reducing visceral fat . So again , training , sleep , stress management here's another mind bender . The location of your fat matters more than the total amount of your fat . Right Visceral fat I alluded to it twice already . That's the kind of fat around your organs . It's metabolically active . It releases inflammatory compounds that worsen insulin resistance .

Philip Pape 16:45

We did a whole episode about chronic inflammation being caused by lifestyle , not by what you eat . It's caused by lifestyle . Again , common theme here you guys can eat carbs and we want to eat carbs , we want to use those carbs . But you have to be training and active , getting enough sleep , managing your stress . The subcutaneous fat in your skin is much less problematic than the visceral fat , and strength training preferentially reduces the visceral fat while you build muscle . It's all tied together . So we talked about how muscle is a glucose storage unit . I've mentioned that time and again .

Philip Pape 17:18

But think about the fact that it's also an endocrine organ and when you contract your muscles during training they release signaling molecules called myokines . I talked about this on the inflammation episode . It's all coming together . These myokines communicate directly with your pancreas , with your liver , with your fat tissue to improve insulin sensitivity throughout your entire body . And there's a specific one called erysin and that's released again during contractions of the muscle that it browses the white fat cells , let's say right , it like browses them and it turns them into beige

Myokines: How Muscles Communicate With Your Body

Philip Pape 17:50

fat cells and we think those might burn more calories and improve metabolic function as well .

Philip Pape 17:56

Whatever and by whatever mechanism it occurs , you are changing the behavior of your fat tissue when you lift weights and we've seen time and again I've seen this with clients that your ability to lose fat and preferentially store fat and reduce belly fat improves the more you lift , even when everything else is not perfect . And , yes , you're eating a lot of carbs and there's some interesting things happening underneath the surface . And this you're eating a lot of carbs and there's some interesting things happening underneath the surface . And this happens with every workout , with every training session . Right , because we're not just talking about the muscle itself , we're talking about the act of building muscle , which is another , I guess , incentive to train regularly , consistently and frequently , because all these signals , they persist for several days .

Philip Pape 18:37

And therefore , just by being a lifter , just starting to lift weights , today when you hear this podcast , or tomorrow , and incorporating , let's say , three days of weight training a week , you're going to improve your insulin sensitivity in the moment and then it's going to last even before you start changing the other things , and that's why people can sometimes reverse pre pre-diabetes fairly quickly . Um , I've seen this happen very quickly when they start lifting weights , like within weeks . Right , I can't guarantee anything , of course , um , and it's not like you have to wait for massive growth of muscle . Is the point , like you're , the signaling pathways we talked about today that improve your glucose handling right away have a benefit . And so it's kind of like if you think of software and hardware , the muscle mass is your hardware . It takes a while to build that up and upgrade it , but the software you can upgrade to version 2.0 right away . Just go to the gym and start lifting .

Philip Pape 19:29

Learn today prediabetes and insulin resistance . They are not carbohydrate-related diseases , they are muscle diseases . The solution isn't to eat like you're already sick and have to avoid carbs again , with the caveat that even that isn't totally true . It's to build the metabolic tank right , the gas tank that we talked about , making it bigger , to then make you healthy and mitigate all of these things when you shift your focus , then , from trying to restrict and avoid carbs which , by the way , you're probably under eating in the process to building muscle , eating enough and eating enough carbs . Everything changes . Everything changes the benefits that I hear from individuals who just literally add a piece of fruit before their workout , who might have been fasted training .

Philip Pape 20:17

It's incredible . You're talking about like within a day , right , holy crap , I have so much more energy . Oh , my God , I feel recovered . Oh , I'm not sore from my workout . I was able to get more reps , right . Those kinds of statements , those kinds of wins happen when you do this , and it's because you're training at the same time . So you're building insulin sensitivity to be able to handle those carbs and you're reversing prediabetes in the process , which is awesome . Like you're not just surviving and limping along and feeling like you have to restrict everything . You're now starting to be a very capable , thriving person who can enjoy all these things like everyone else . I think the research in this area is overwhelming because it's such of interest to the population .

Philip Pape 20:55

Muscle mass directly correlates with insulin sensitivity period . Strength training immediately improves glucose uptake period . The ability and the capacity to handle carbs isn't fixed . It's a totally trainable thing . Your pre-diabetes diagnosis or those of you concerned about it . It's not a life sentence . It's an early warning system . It's telling you you're at the brink and now what we need to do is build a stronger , more capable version of yourself .

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Philip Pape 21:20

So immediately , the next session in the gym is gonna start having a benefit . The next walk after a meal , the next protein-rich , balanced meal , the next time you take breaks during the day instead of sitting all day , the next time you get a good night's sleep all of those things separately and especially together

Taking Action: Practical Steps To Reverse Prediabetes

Philip Pape 21:40

, are going to move you in the right direction . All right , if you want to take action at the practical level for everything we discussed today , go ahead and grab my free guide Nutrition 101 Guide link in the show notes , or you can always go to witsandweightscom slash free . It's going to show you the basics on how to structure your nutrition , depending on your goal , so that you can support all these things your muscle building , your insulin sensitivity . I do have other guides that take it to another level for specific goals like muscle building , but this is where you want to start to get a handle on the basics and strategically include carbs in your diet , while you are , of course , strength training and being active . Again . Go to witsandweightscom , slash free or click the link in the show notes . I think it's the perfect next step to implement what you learned today .

Philip Pape 22:19

Remember the goal isn't to manage prediabetes , it's not . You just want to eliminate that sucker , get rid of it , get it out of your life , build the muscle , fix the machinery , reclaim that health , like few people do , but you're going to do it . You are going to do it . Listen to this podcast , follow it . Listen to what we talk about with lifting weights . Yes , it's a skill . Yes , you have to learn it , but you can get there . Until next time , keep using your wits and lifting those weights and remember you're not broken . You just need to build the capacity to handle what life throws at you . I will talk to you next time here on the Wits and Weights podcast .