Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
1 Apr

25 Ways to Improve Your Insulin Sensitivity

Insulin does a lot of important things for us. It pulls glucose from the blood and fritters it away into our cells to be burned for energy or stored as glycogen. It prevents hyperglycemic toxicity to neurons, pancreatic cells, the arterial walls and the generation of excessive levels of reactive oxygen species. It even promotes muscle protein synthesis and helps augment muscular hypertrophy, especially following resistance training. Clearly, we need insulin. Without it, we’d die, as type 1 diabetics readily do without an exogenous source.

But insulin has other effects, like inhibiting the breakdown of body fat into free fatty acids for energy production. Although locking fatty acids into body fat sounds terrible, it isn’t evidence of insulin being malicious. Lipolysis is temporarily blunted so that we can burn or sequester the glucose coming in. Once the glucose is handled, lipolysis resumes. We oscillate between fat burning and glucose burning, seamlessly switching fuel sources when needed. Sure, we’re not burning any fat when insulin is elevated, but once our insulin levels normalize we’ll be back on track. When you’re insulin sensitive, this is pretty much how it works. You secrete enough insulin to get the job done, but not so much that you gain weight and stop burning fat.

What if a person secretes too much insulin in response to a glucose load? What if, for whatever reason (and there are dozens of possible culprits), a person’s cells are resistant to the effects of insulin? What if, to remove the same amount of glucose from the blood, a person secretes twice or thrice the amount of insulin? What happens when insulin stays elevated? Lipolysis is inhibited to an even greater degree. Body fat becomes even harder to burn. Susceptible brain, artery, and pancreatic cells are exposed to higher levels of blood sugar for longer. Muscle protein synthesis falls off a cliff. Glycogen is replenished at a diminished rate. And if cells are already full of glycogen and there’s nowhere else to put the glucose, it converts to fat for storage.

Obviously, we don’t want to be insulin resistant. We want to be insulin sensitive. But how do we do it?

1. Lift weights.

Lifting heavy things, particularly with great intensity, improves insulin sensitivity by an interesting mechanism: non-insulin dependent glucose uptake happens immediately after the workout, which allows your muscles to replenish glycogen without insulin. According to some researchers, “the effect of exercise is similar to the action of insulin on glucose uptake.” I’d say not having to secrete any insulin makes you effectively insulin-sensitive.

2. Run (or bike/swim/row) sprint intervals.

An overloaded, energy-replete cell is an insulin resistant cell. An empty, “starving” cell is an insulin sensitive cell. Any exercise that burns glycogen and leaves your muscles empty and gaping for more will necessarily increase insulin sensitivity. I can’t think of a faster way to burn through your glycogen than with a high intensity interval training session. Hill sprints or rower sprints are sufficiently intense and comprehensive.

3. Do CrossFit or similar full body high-volume, high-intensity training.

Glycogen depletion occurs locally: high rep leg presses will deplete leg muscle glycogen, but they won’t touch glycogen in your arms, chest, and back. To fully deplete all the glycogen, you need to do full-body movements. CrossFit WODs and other similar metcon workouts that have you doing pullups, squats, sprints, pushups, box jumps, and other compound movements — at high volume, in the same workout, and with minimal rest—will drain your glycogen stores and reduce the amount of insulin you need to replenish them.

4. Train at altitude.

A recent study found that altitude hiking at 4500 meters improved glucose tolerance and insulin sensitivity. This isn’t feasible for everyone (4500 meters is really quite high, and not everyone lives near a suitable mountain), and some people just aren’t ready to climb a mountain and hike around (in the study, some participants with low DHEA-S levels didn’t get the benefits), but it’s one way to improve it. Just google around to see if any local hikes reach those heights.

5. Train fasted.

While training of any kind promotes better insulin sensitivity, training in the fasted state enhances this effect. One study found that relatively high-intensity “cardio” performed while fasted increased subjects’ insulin sensitivity beyond the group who did the same training after a carb meal, even in the context of a normally obesogenic high-fat, high-carb diet.

6. Go for a walk.

As you know from reading this blog, a simple walk can be quite powerful, particularly if you string them together to form a daily walking habit. A walk is good for glucose control after meals, but regular walking can have impressive effects on insulin sensitivity. Whether it’s obese Japanese men or obese women, making walking a regular occurrence will help.

7. Never stop exercising.

I don’t mean “take no breaks.” I mean “stay active for life.” In a recent paper, both sprinters (aged 20-90 years) and endurance athletes (20-80 years) had far better insulin sensitivity than sedentary controls. And get this: insulin sensitivity didn’t decrease with age in the two active groups. Even the 90 year-old sprinter retained good insulin sensitivity. The sedentary controls? Not so much.

8. Eat cinnamon.

Although cinnamon isn’t always effective against insulin resistance, it can reliably attenuate the insulin resistance resulting from sleep loss. Plus, cinnamon is delicious, so there’s that.

9. Sprinkle some vinegar on your food.

Next time you plan on eating a high-carb meal, have a salad with a vinegar-based dressing beforehand. Vinegar has been shown to increase insulin sensitivity in response to a carb-rich meal in type 2 diabetics.

10. Get more magnesium.

Magnesium figures into hundreds of physiological processes, many of which concern glucose disposal and insulin sensitivity. My favorite sources are leafy greens like spinach, nuts, seeds, dark chocolate, and halibut. If you hate spinach, nuts, fish, chocolate (what’s wrong with you?), and other magnesium-rich foods, oral supplementation of magnesium also works pretty well.

11. Drink mineral water.

Mineral water—good, high-mineral content water—is rich in minerals commonly associated with insulin sensitivity, like magnesium. So it’s no surprise that high sodium-bicarbonate mineral waters have been shown to increase insulin sensitivity in postmenopausal women and post-surgery breast cancer patients.

12. Drink tea.

Green tea lowers insulin resistance in subjects with type 2 diabetes. Pu-erh tea, a fermented black tea with a distinct and strong taste, also ameliorates insulin resistance. Gallic acid, an antioxidant compound found in tea leaves, also improves insulin sensitivity. Across the board, tea improves insulin sensitivity.

13. Lose weight.

Since insulin resistance is often the body’s response to energy excess (too much energy in), losing weight (increasing energy out) improves insulin sensitivity. Losing abdominal fat is particularly effective for increasing insulin sensitivity.

14. Go low carb, but not too low carb.

Huh? Isn’t low-carb the greatest and most effective path to insulin sensitivity? Partly because it’s often the easiest way to lose weight, low-carb eating can and usually does improve insulin sensitivity. But when you go very low carb, low enough to start relying primarily on ketones and free fatty acids for energy, your peripheral tissues enter an insulin-resistant state to preserve glucose for the parts of the brain that require it. This is normal, and as long as you don’t try to eat a high-fat, high-carb diet, this physiological insulin resistance should pose no harm.

15. Meditate.

Maybe it’s the quieting of the sympathetic nervous system, the “flight or flight” stress pathway. Maybe brief glimpses of bodhi reduce the amount of insulin required to dispose of glucose. Whatever’s going on, meditation improves insulin sensitivity. Well, successful meditation. I’ve never had much luck with it.

16. Go hug someone you love.

Okay, so maybe the researchers didn’t prescribe bear hugs to improve insulin sensitivity in overweight subjects. Maybe they used intranasal oxytocin. But oxytocin is what we secrete in response to positive social interactions like sex, good conversation, dinner parties, breastfeeding, and yes, hugs.

17. Get adequate sleep.

Now, if you’re coming from a place of already-adequate sleep, getting even more adequater sleep isn’t going to help your insulin sensitivity. It is the absence of adequate sleep that destroys insulin sensitivity. By sleeping well, you’re restoring what was lost.

18. Eat colorful and bitter plant foods.

Color and bitterness imply phytonutrients, the intangible plant compounds that don’t show up in standard nutrient databases but play huge roles in human health. Many, perhaps most, rich food sources of phytonutrients improve insulin sensitivity, like blueberries, strawberries, purple sweet potatoes, broccoli sprouts, and dark chocolate (even in healthy folks).

19. Eat pungent fermented food from Asian cuisines.

I’ve been telling you guys to get on this stuff for awhile now. No more messing around, yeah? A natto (sticky stinky fermented soybeans) breakfast improves insulin sensitivity. Long-fermented kimchi also improves it; fresh kimchi does, too, but not as much as the sour stuff.

20. Go paleo (or Primal).

In controlled trials, the paleolithic diet consistently improves insulin sensitivity in human subjects, besting even that critical darling of seemingly every mainstream health expert: the Mediterranean diet.

21. Cook with ginger and garlic.

Cook with ginger and garlic because they’re delicious. Cook with ginger and garlic because many dishes require their inclusion. But also cook with ginger and garlic because both can improve insulin sensitivity. Ginger helped type 2 diabetics regain insulin sensitivity and glucose tolerance. Garlic helped fructose-fed rats do the same.

22. Use turmeric.

I love turmeric for its taste and pharmacoogical profile. I’ve outlined turmeric’s effects in the past, so it should come as no surprise to learn that it is a potent insulin-sensitizer. Be sure to include some black pepper when you cook with it to increase the bioavailability.

23. Get some vitamin K2 through food or supplements.

In a 2011 controlled trial, vitamin K2 supplementation improved insulin sensitivity. Maybe that’s partly why natto improved it in the breakfast study mentioned previously — it’s the richest source of vitamin K2 around. Other likely sources of vitamin K2 include goose and chicken liver, aged cheeses (especially gouda), grass-fed butter, pastured eggs, and fermented milk.

24. Reduce refined sugar intake.

Some would say “reduce all sugar intake.” That’s a mistake, because it eliminates many colorful fruits and berries, most of which either have a neutral or beneficial effect on insulin sensitivity. But by most accounts, eating excessive amounts of refined sugar (and perhaps even moderate amounts) can reduce insulin sensitivity. And “excessive” is relative, of course. Highly active individuals with room to spare in their glycogen compartments have more leeway. I still do sugar in my coffee, and I’ll have a bite or two of dessert if someone else orders it at dinner.

25. Eat liver and oysters once a week.

Ruminant liver and oysters are some of the best sources of copper and zinc, two minerals that play essential roles in maintenance of insulin sensitivity. Serum zinc and copper have inverse relationships to insulin resistance, and increases in zinc status match up well with improvements to insulin sensitivity.  If you absolutely hate these foods, you can certainly find zinc and copper elsewhere. These are just the quickest way to obtain them (plus other important nutrients).

Now, this isn’t an exhaustive list. There are probably other ways to improve insulin sensitivity outlined in the literature, and still others yet to be discovered. But this is a good start that should keep you busy for a good long while.

Now, let’s hear from you guys. What did I miss that should be included? What shouldn’t be included? What’s worked for you? What didn’t that everyone said would?

Thanks for reading!

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  1. Happy that I do about 75% of these regularly.
    My favorite way to get more cinnamon into my diet: cut up the sweetest apple you can find (I really love Gala) and cover it with cinnamon. My go-to snack when I’ve got a sweet tooth at night.

    Erica wrote on April 1st, 2015
    • The cinnamon apple snack sounds great! I put cinnamon in my protein shakes with coconut oil.
      Try the Opal apple, the sweetest apple I’ve tasted

      Mark wrote on April 1st, 2015
  2. I’m by no means an expert on this, but when I climbed Kilimanjaro last Autumn they took three days to take us as high as 4500 m and that was after a couple of acclimitisation days. I’d be pretty careful about doing much at that sort of article straight off the bat even if you could find somewhere that highup in the first place.

    I got a world record for playing cricket at the top though, so it is possible. The porters gave us cheese toasties and sugary tea in the break. between innings. I didn’t complain.

    Mr Ed wrote on April 1st, 2015
    • Yeah I’ve been to Everest base camp and 4500m is well into altitude sickness range and if you were to be flown in at that hight from sea level I’d be absolutely certain you’d probably suffer cerebral edema. I knew one guy at the time that needed to be helicoptered out from 4300m and that was with 5 days spent at a lower altitude to acclimatize, admittedly he had a stomach bug, but there are definitely more prudent ways to go about sensitizing yourself to insulin.

      isenriver wrote on April 1st, 2015
    • I wonder if the 4500m was meant to read 4500 feet? Not super high altitude but hiking a 12,000 ft mountain is a pretty tall order. I live and exercise at about 4000 ft and visitors who come to ski between 6K and 7K ft can find the change uncomfortable. We casually hike at that level as well but we are used to it and I still can get a bit winded.

      kelley c wrote on April 4th, 2015
  3. Press-ups after a chocolate over-indulgence works well for me!

    Anna wrote on April 1st, 2015
  4. Regarding the cinnamon: Make sure you use Ceylon cinnamon, and not the Saigon cinnamon (commonly sold in grocery stores), because Saigon won’t do a thing for your blood sugar. Only Ceylon cinnamon has this ability.

    Wenchypoo wrote on April 1st, 2015
    • Do you have a reference for this. From my reading, most of the research has been done with Saigon not Ceylon. I haven’t seen any proof that Saigon “…won’t do a thing for your blood sugar.”

      Harry Mossman wrote on April 1st, 2015
      • Harry, here is a link to a post you may interest you. References are at the end. And you are correct, the statement that Saigon “…won’t do a thing for your blood sugar” is not correct. There is a concern, however, of the potentially toxic (to your liver) coumarin that is in Saigon/Cassia cinnamon. Ceylon cinnamon contains very little coumarin.

        Joe wrote on April 1st, 2015
        • Thanks, I was aware of that. I buy Ceylon powder but also some cassia sticks. Haven’t found Ceylon sticks but I’m not worried about using a little.

          Harry Mossman wrote on April 1st, 2015
    • Where can I find this particular type of cinnamon?

      Beans wrote on April 1st, 2015
      • for ceylon cinnamon

        suzanne wrote on April 1st, 2015
      • Penzeys spices at

        Melissa wrote on April 4th, 2015
    • Apparently cassia cinamon is more effective in controlling blood sugar than ceylon: A study in that vid shows the lack of blood sugar regularity w/ ceylon

      Drew wrote on April 28th, 2015
    • Not true. Ceylon actually has less of the insulin sensitivity increasing/blood pressure reducing compounds than Saigon. That’s why Saigon smells and tastes bolder. Somewhat similar concept to the hotter the pepper, the more capsaicin.

      Jon wrote on January 24th, 2016
  5. Solid list. I’ve been meaning to incorporate liver back into my weekly routine, but I can’t do oysters. I’ve tried canned and fresh, but just can’t stomach them. Anything I can eat that has a similar nutritional profile to oysters?

    Jacob wrote on April 1st, 2015
    • I don’t know what may have a similar nutritional profile as oysters. Since I love them so, I have never worried about them.

      I will offer a recipe that may change your mind about oysters. Obviously breadcrumbs aren’t paleo and probably not on the menu. But I have used the Primalal Cravings Bread recipe Mark Sisson offered around last Thanksgiving to make breadcrumbs. I will often add Italian herbs and garlic powder to the mix before baking for seasoned breadcrumbs and crumble after baking.

      If you completely abstain from Dairy and don’t do Parmesan cheese, then this won’t work for you. But otherwise it is a taste of heaven on earth. Of course you can use zoodles or spaghetti squash in place of the pasta.

      Oysters Mosca

      2 cups breadcrumbs
      1 Tblsp dried red pepper flakes
      2 lemons, juiced
      ¾ cup olive oil
      1 clove garlic, crushed
      3 Tblsp parsley, chopped
      1 cup parmesan cheese
      Salt to taste
      1 Qt oysters, drained

      Preheat oven to 350 DegF. Combine all ingredients except oysters and mix well. Place oysters in casserole dish. Top with mixture. Bake at 350 DegF until oysters curl. Then place under broiler until slightly browned. Serve over vermicelli or angel hair pasta. Alternatively, place each oyster on a shell and spoon mixture to cover and serve as individual oysters on the half shell like you would Oysters Rockefeller.

      Note: this recipe came from the Cotton Country Collection cookbook and was attributed to Mrs. Louis Kusin. Sharing this may be a violation of copyright laws, but it is sooo good! It has been a family favorite for years. Mosca’s is one of those little Italian restaurants that are so good in New Orleans. Mosca’s is (was?) way out past Westwego on the westbank of New Orleans. It is well worth the drive if you are ever in New Orleans.

      Lou wrote on April 1st, 2015
    • Oysters: Do you not like the taste or texture? If taste, there are many ways to flavor raw oysters. If texture, baking them on the half shell changes the texture. Oysters Rockefeller are a good example of both adding flavor and baking the oyster.

      Paleo Bon Rurgundy wrote on April 1st, 2015
      • Mainly a texture thing. Lou’s idea of breading the oysters sounds like a good idea since it should help dry out the oyster a bit. I’ll look into oysters Rockafeller too. Thanks to you both for the suggestions.

        Jacob wrote on April 1st, 2015
  6. I recently learned about the importance of insulin sensitivity, so this list comes at the perfect time!

    From the list above I’m currently doing cardio sprints, going on daily walks, maintaining an active-for-life approach, meditating and eating Paleo (for the most part). Oh, and hugs too!

    In the past month and a half I’m down 7 pounds and only have 7 to go to reach my goal. I’m only 2 lbs away from my high school basketball weight! I think all of these things have contributed to my success. Now I’ve got a few more things to try. Thanks!

    Ernie Parsons wrote on April 1st, 2015
  7. I have started taking oral magnesium and it has helped me to sleep much better. I have a triple magnesium complex, oxide, citrate, and aspartate. I know Mg is very difficult to get from food.

    Shirley wrote on April 1st, 2015
  8. Tara Grant in The Hidden Plague says that “Vitamin D3 is critical in managing insulin resistance and autoimmunity.”

    Industrious Warrior Maiden wrote on April 1st, 2015
  9. I do have one question though. How much glycogen is being stored or rather how much HIT must i do to deplete my reserves and at what time do i start using my body reserves (in my liver, as i understand). So if i sprint for less than 4 minutes (this tabata style), then i probably did not even deplete my stores in legs,let alone the ones in liver. Or did i?
    And relative to that question, if i deplete, say 100% of my stores in (both) leg muscles, how much carbs do i have to eat to again fill my stores.
    I know this is very individual, but can someone give me an aproximation, so i can at least shoot close by?

    Igor wrote on April 1st, 2015
    • My understanding of this in a conversation with or a blog entry form Peter Attia was that a rough measure would be two Fuji apples. in other words, two Fuji apples could replace the glycogen if it were completely depleted. I asked in reference to a cheat meal and could I cheat if I did some serious HIT. the answer was yes you can but it wont work!

      Tom A wrote on April 1st, 2015
      • Yes, i remember something about 2 Fuji apples, but can’t find the answer. Thanks.

        Igor wrote on April 3rd, 2015
    • I think that our glycogen stores for the muscles are about 300g (1200 kcal) and the liver is about 120g(480 kcal).

      Myles wrote on April 2nd, 2015
      • You know, i do remember now something about our stores being some 400g all together, so you are right. Thank you. It’s just so darn tough finding the answer you want in that particular moment you want it. Darn search engines, very good for finding the things you don’t need…

        Igor wrote on April 3rd, 2015
  10. Question: Does a hot soak with epsom salts provide magnesium in a form that impacts insulin sensitivity

    Sam wrote on April 1st, 2015
    • Yes, from what I’ve read, Magnesium is actually easier to absorb through your skin than through diet.

      Jessica wrote on April 2nd, 2015
  11. When I started walking in the local mountains five mornings a week for an hour (early!) shortly after I went Primal, the weight fell off and my energy soared. The combination has been a winner for me.

    Jessica wrote on April 1st, 2015
  12. So sensitive!

    I was happy to see that some of my “normal routine” includes quite a bit of these. Fwew!

    2Rae wrote on April 1st, 2015
  13. That’s about the best advice one can offer!

    Groktimus Primal wrote on April 1st, 2015
  14. What to you know about berberine for improving insulin sensitivty?

    Joe Saldarelli wrote on April 1st, 2015
    • In my ongoing one person experiment, I tried barberry root tea which is a berberine source. I couldn’t see a difference. There may be one but it’s not that large. Or perhaps my dose wasn’t large enough. It is really good for diarrhea in my experience, YMMV. Intermittent fasting every other day or two days a week is quite effective for me in decreasing morning ‘fasting’ glucose readings. Further, also I run 3 or 4 miles on my semi-fast days (500 calories). I am starting on the weights and upper body exercises and hoping further response towards the ideal.

      Dan Hepler wrote on April 26th, 2016
  15. Fresh shucked oysters topped with Apple cider vinegar and dusted with grated cinnamon and shaved 85% chocolate is the perfect insulin regulating snack food.

    Jack Lea Mason wrote on April 1st, 2015
    • You forgot the ginger, garlic, and turmeric that should be sprinkled on top…and it’d probably be best that you’re sprinting at a high altitude while eating them. 😀

      Jacob wrote on April 1st, 2015
      • Good point! The best oysters are harvested above 4500 meters might as well eat them up there.

        Jack Lea Mason wrote on April 1st, 2015
    • LOL!!! (….and Blech!)

      Terez wrote on April 1st, 2015
  16. Love me some cinnamon in my smoothies, but as Wenchypoo said, get the right kind.

    Nocona wrote on April 1st, 2015
  17. I really want to find a good liver braunschweiger pate. I lived the Oscar Myer stuff as a kid, but i’m wanting to make some. any one have a tried and true recipe?

    Meg94 wrote on April 1st, 2015
    • US Wellness Meats has braunschweiger sausage (beef or chicken) that’s quite tasty; also liverwurst (my fave). Check it out at

      Their minimum order is $75 & 7lb (to be sure frozen food will still be frozen on delivery), and there’s a $7.50 handling fee. If you sign up for their newsletter, they offer a 15% off deal every other week.


      Miz Pat wrote on April 1st, 2015
      • I agree with wellness meats braunschweiger, love it. I get 3 everytime I order from them and keep in freezer. they also have liverwurst, but I prefer the other and get the beef one

        terry wrote on April 2nd, 2015
  18. Love oysters with a mignonette. Yummers.

    Paleo Bon Rurgundy wrote on April 1st, 2015
  19. Good list but . . . I have been doing all those things plus taking lots of Metformin. (Well, I don’t drink much tea but everything else on the list I do a lot of.) And my glucose was still way too high. A1C of 11. So I reluctantly started taking Glipizide, which has brought my glucose down to an “OK” level.

    I’m surprised that the list doesn’t include “avoid prolonged sitting.” I am working on that. I do get up at least hourly but right now earning a living to supplement my Social Security and retirement involves lots of sitting. No, a standing desk isn’t happening. No, doing different work isn’t happening.

    Harry Mossman wrote on April 1st, 2015
    • I feel you, Harry. I’m trying my best to get up from sitting down more often at work. I wish I could get a standing desk, but that’s not happening where I work (ironically health care!). I also take a 45 min-1 hour walk after eating my lunch every day. When I do get up, I try to do a couple of squats or lunges if I remember.

      Curtis wrote on April 1st, 2015
    • Harry, I don’t know if you eat things like chocolate and honey, but fructose in all concentrated and added forms is something to avoid, especially for metabolic issue management. Even fruit may be too much fructose for you and your liver to manage.

      Debbie wrote on April 1st, 2015
      • Thanks. Rarely honey. Some ultra-dark chocolate. Barely ripe enough to eat, i.e. still green, bananas or plantains when I can get them.

        Made a big effort to be active than usual today. Just took glucose reading and got 102, which is the lowest I’ve gotten in about 6 months.

        I am working on learning to do the Chinese linking rings, which a stand up routine unless you use the tiny rings. I mostly use large ones.

        Harry Mossman wrote on April 1st, 2015
  20. Crossfit plus paleo diet worked wonders for me. Add walking the dog before breakfast,and all body fat just melted away whilst muscle mass increased.
    Plus 2 extras to mention: chromium (in picolinate form) is often mentioned as improving insulin sensitivity, and good old fish oils also have a relevant effect.

    Graham Fletcher wrote on April 1st, 2015
    • I second the chromium picolinate!

      Jennifer L. wrote on April 1st, 2015
  21. I can’t seem to lose weight no matter what I do. So this article was an interesting read for me. I’ve been doing 5 out of the 25 points, will try to do more. It’s just so discouraging for me. I’ve turned 50, have bad knees, which makes many things I should do, impossible.
    I was a couch potato, and started exercising mid December last year, fell down the chronic cardio hole. I thought it would show results since I was going from 0 – daily exercise up to an hour a day. But no.

    Monika wrote on April 1st, 2015
    • 1hr of cardio is not chronic cardio. If you were not losing weight, it’s because you were not creating a calorie deficit. You were either eating too much or not exercising enough. Or exercising enough but eating your calories back.

      Rachel wrote on April 1st, 2015
      • I’m going to have to politely disagree with your comment. There are many conditions that even in light of caloric deficits, will keep you from losing weight. From personal experience and tracking everything (even OCD measuring in grams to be as accurate as possible) and having 800-1200 daily caloric deficits for three months running with zero weight loss, it is just not that simple. Hormones, stress, sleep, and a number of health conditions can stymie weight loss completely. After months of trying everything including fat fasts and zero carb days I finally bit the bullet and found a doctor who practices Functional Medicine.

        What have I learned? The biggest key to all of this is adequate quality sleep. It is the first thing you have to address and fix before anything else will start to improve.

        Hormonal balance (even in men) is tantamount. Not just estrogen, testosterone and progesterone. T3, T4, insulin, leptin, ghrellin etc (the list is quite long) also need to be modulated and whether you are a woman or a man, all of these hormones are important and necessary. There is also a huge difference between “normal” and “optimal” levels. That is why seeing a doc who specializes in Functional Medicine is so important.

        Thirdly, gut health is the next Holy Grail. Healing your gut and making sure all of those creepy crawlies in there are in balance and fed properly goes a long way towards healing off kilter hormonal processes and increasing immunity. Also, discovering and eliminating food intolerances will improve gut health, sleep and hormonal balance.

        After numerous tests I found out that my hormones were all over the place, I had developed hypothyroidism and had Intestinal Permeability (Leaky Gut) along with Adrenal Insufficiency (Adrenal Fatigue).

        Many of these things go hand in hand, so when you fix one then the others will begin to improve. You have to view your body holistically as one complete system.

        My treatment plan includes a Primal diet, four different bioidentical hormones, thyroid meds (Armour), supplements for gut health (prebiotics, probiotics,soil based organisms and resistant starch), supplements for general function (Magnesium glycinate, fish oil, Vitamin D, B12-methylcobalmin …) and stress reduction.

        My weight is beginning to drop, body and joint pain are decreasing, sleep is increasing and my fatigue has been cut in half. So you see, it is so much more than just creating a calorie deficit.

        If you have been diligently trying to lose weight and are getting nowhere fast, I encourage you to find a Functional Medicine specialist and get a check up. The “American Dream” life style of eating right (FDA Food Pyramid), exercising (Chronic Cardio), and working hard (High Stress and No Play), causes a lot of damage. Going Primal is a start but it is just one piece, albeit a large piece, of the puzzle.

        Wishing you all the best!

        Anna wrote on April 5th, 2015
        • I second Anna’s comment. I was unable to lose weight for years, despite a low carb, grain/sugar free diet and regular exercise. The scale wouldn’t even budge during a “fat fast” (ie. 80% fat diet), Atkins, you name it. I was the Queen of calorie counting too.

          Like Anna, I also found a functional MD; she tested my hormone levels and they were almost non-existent. I am now on thyroid meds, testosterone, progesterone and a couple of other goodies. My inability to make hormones appears to be linked to an old head injury where I likely damaged my hypothalamus.

          The good news – the weight is starting to come off and I do feel much better. The bad news – it’s still work :). I gained 80 pounds over the course of a few years (after hitting my head). I’m now down 40, and it will probably take me another year or two to get back to where I was.

          If you can look yourself in the mirror and honestly tell yourself that you have been a) eating a clean diet, b) truly exercising and c) not cheating – and you still aren’t able to lose, please find a doctor that will listen! I know that it’s not common to have these problems but it does happen. Good luck!

          JustJen wrote on April 7th, 2015
    • I’m starting to think that once you turn 50 you might as well forget trying to lose weight. Nothing seems to work. If it weren’t for all the other health benefits, I would just chuck it all and have a bowl of cereal!!

      Vicki wrote on April 1st, 2015
      • :o)
        I went Primal the first time in 2009, and lost 25lbs in three month just by changing my eating habits. This time around I try to be more active, AND eat right (Primal) and I’ve only lost 10lbs in three month. I do feel better etc. but since I have to lose ~ 100lbs I thought the first few month would show a faster weight loss. I know I’ve gained some muscle, but still.
        What keeps me going is, that I don’t want to have to take medicine because of my lifestyle. I hope to stay motivated, but it’s hard. ;o)

        Monika wrote on April 1st, 2015
        • Have a look at your gut health, the biome etc, get tested if you can. A ton of evidence coming on stream now that shows if your gut flora is off no amount of great weight-loss protocols will help.

          Kelda wrote on April 1st, 2015
        • Monika, Vicki too, please don’t give up. As a thriving 51 year old, I promise you your goals are attainable. An observation (based on limited info of course), don’t be so hard on yourselves, focus on living in the present and release yourself from the stress of feeling incapable. That’s the kind of stress that can sabotage your efforts; remember stress = excessive cortisol production = inflammation = physiological dysfunction so give yourselves a break. Monika, given the load your knees are carrying at your current weight, just walk for now (note, I’m not a doctor – just applying reason & common sense) and add upper body and core strength training (if you aren’t already/Mark’s primal movements work great). In my experience, after eating primally, there is nothing like strength training to jump start the fat burning beast within. You are both AWESOME for challenging yourselves to thrive and I know you can succeed!

          Beth wrote on April 1st, 2015
        • I had been stuggling with many of the issues decribed throughout the comments. I’d been adding the supplements, changes in food habits, meditation, etc. However, it wasn’t until I began reading “Wheat Belly” by William Davis that I decided to remove all grains from my diet. I have lost 17 lbs in a few months and still eat other things I enjoy. It was a struggle at first, but now I’m finding fruits and veggies that I love. I’m making better choices and feel amazing.

          michell wrote on April 15th, 2015
      • Don’t get discouraged! There are lots of success stories on here by people 50 and older – I remember one in particular where I believe the man was something like 70. I know it isn’t easy for everyone, but whatever you’re doing now is most likely so much better than what you probably did in the past. Just keep putting one foot in front of the other and congratulate yourself on your progress so far. Eventually, the weight will come off. Take care!

        KariVery wrote on April 1st, 2015
        • Thanks, for your encouraging words!

          Monika wrote on April 1st, 2015
        • Mine may be the story you are referring to. I was 71 last year when I wrote it. Primal Living at Any Age: One Stubborn Senior’s Testimonial
          September 26, 2014.

          It took me a couple years to make much progress. Now I am in even better shape than when I wrote the story.

          Harry Mossman wrote on April 1st, 2015
      • Hi Vicki, My sister is 60 years old and is diabetic. I got her interested in primal eating after I started it a year ago. I lost several pounds effortlessly, and she has lost 35 pounds in 3 months, and is still losing. I feel for you, truly if nothing is working for you, but please trust me, it is very individual. My sister never thought she would ever be able to lose weight, and here she is at 60, losing and doing great! I will send positive energy your way and hope your luck turns soon.

        Viola wrote on April 1st, 2015
      • I’m 58 and I lost almost forty pounds over the last two years with exercise and an increasingly Paleo diet.

        IthacaNancy wrote on April 2nd, 2015
      • Hang in there Vicky. I’m 67 and went Paleo 8 months ago. So far I’ve lost 35 lbs, my joints are now pain free, my sinus and hay fever has disappeared and I feel 100% better than I have done in years.
        I’ve stopped eating all grains and any packaged or processed food. I eat single ingredient foods only and check very carefully any nutrition information on anything else I want to buy to eat including herbs and spices.
        I like to walk a lot and will be incorporating some weight training and yoga into my day.
        Don’t give up, if you are doing everything right there could be another issue that is stopping you from losing weight and feeling much fitter. Are you taking any medication for any existing medical condition you may have? Some medications can stop you losing weight so you need to have a look at that.
        Good luck.

        Pauline wrote on April 2nd, 2015
    • I have struggled with plantar fasciitis, which has made exercise a challenge. I found that the Bellicose rebounder made it possible to enjoy exercise more – make a rebounder would help cushion your joints enough to make the kind of exercise you want to do possible again? I also found that exercise video games, like EA Sports Active 2 for Nintendo gave a pretty good mix of encouragement, accountability, and enough variety in exercises (strength, cardio, stretching) that I wasn’t stressing my body in the way I had with too much dancey cardio. The WiiFit U is another game that I’ve enjoyed. It has fun games as well as yoga, cardio and some body weight exercises and you have more control over the choice of exercises. Good luck.

      IthacaNancy wrote on April 2nd, 2015
    • Decide on 3 times where you go, every week. And, even if it feels urgent, allow yourself a longterm focus. And think more about what you LIKE doing than whether it instantly produces 100% the thing you think you need.
      Would love see I can help you make that havit a reality; I happen to know a lot about forming habits in the easiest way possible and about making health less a necessary evil and more something you’ll actually look forward to doing.

      Simon wrote on April 3rd, 2015
    • I have a similar problem, and intermittent fast seems to do the trick. I have just started, so I don’t have much to brag about yet.

      monica wrote on April 7th, 2015
  22. Rubbing a spray-on magnesium oil into your skin is a great way to increase magnesium intake if you suffer from low tolerance to oral magnesium ( diarrhoea can be a problem for instance). There is also the added benefit of direct absorption into the cells. On initial use the spray may sting the skin- this is simply an indicator of low magnesium levels and will correct itself with regular and sufficient usage.

    Susie wrote on April 1st, 2015
  23. And what about fasting and its effect to insulin sensitivity?

    Ondrej wrote on April 1st, 2015
  24. Does 24 include honey, molasses, and maple syrup?

    Zach wrote on April 1st, 2015
  25. reduce iron overload ( if you have it , of course)

    I had ferritin levels in the 500s (confirmed 3 different blood draws over 3 months) and with therapeutic phebotomy it’s down below 200…

    I’m definitely less carb sensitive… in the past any change in blood sugar over 60 would cause uneasiness.

    mccollums wrote on April 1st, 2015
    • Hi, are your Irons level within norm? My FER are about 400 but I am on the anemic side (low hemoglobin), in spit of eating plenty or red meat and liver, so my specialist ruled out phlebotomy. Any one else here who share the profile?

      Time Traveler wrote on April 1st, 2015
    • 2nd try……Hi, I’m a little carious…. Are your Iron levels over the top or normal? My ferritin levels hover around 400ish since around 2009 but since I am also anemic (my hemoglobin levels are at the minimum range or right below it), my specialist ruled out phlebotomy. Everything else aside from my thyroid checks ok. I eat plenty of red meat and organs so go figure. Any one else here in a similar situation?

      Time Traveler wrote on April 1st, 2015
  26. Fascinating… bitter sweet chocolate (85% or with hot chile) and Oysters? Bring them on (;

    Time Traveler wrote on April 1st, 2015
  27. There are 21 mountains in the world that are over 4500 meters high. I’d be interested to see a study about the effects of lower high-altitude exercise, since most of us don’t have access to exercising at that altitude without making a special trip.

    aliceaitch wrote on April 1st, 2015
  28. I have been paleo’ing (100 net carbs or less daily) & IF’ing (skipping breakfast) for three years now. Cholesterol has gotten better each year. My fasting blood glucose – not so much! results:
    1st year 99
    2nd year 106
    3rd year 124

    I’m guessing I have physiological insulin resistance – I’m basically highly adapted to burning fat for fuel. Maybe it’s not so healthy? My concern is the high levels of sugar coursing through my bloodstream – isn’t this what causes AGE (Advanced Glycation End Products) and premature aging? Basically part of what happens to diabetics – proteins or lipids that become glycated after exposure to sugars.

    Jer wrote on April 1st, 2015
  29. Jer, can’t answer your question.. but check out this article, might give you a new perspective that could possibly help solve your riddle…

    This was one of the most interesting parts of the article….

    To develop a more complete approach to controlling insulin, it is important to look beyond the common belief that insulin resistance is always systemic. Tissue specific insulin resistance is a more accurate description of what may be occurring in some people with insulin resistance. The liver, muscle, adipose tissue, and even the brain and pancreas can all develop dysfunction regarding insulin signaling.

    mccollums wrote on April 1st, 2015
    • Thanks, that’s a very interesting take – something I’ve kind of suspected about extremely low carb diets. I know I can “fool” the test by doing 150+ carbs per day for three days. I’m going to try increasing my carbs to 150-200 per day and see how that works out.

      Jer wrote on April 2nd, 2015
  30. Vicki, I was one of those people who didn’t really think the exercise rule applied to ME, so I didn’t start my weight loss story until I woke up from that delusion on the cusp of 50. It’s continuing with flying colors that I’m about to hit 51 @ almost 40# lighter. I figure each person’s solution is different .. for me, it was a combo of Crossfit-style full body workouts that include a lot of weightlifting, running, and eating Primal that turned the train around–(and it sure needed turning around lol)

    I still try and self-talk myself out of exercise nearly every day :) but have gotten better at ignoring that inner self-defeating stuff–most people I confess that to share that they have the same struggle. If that helps. :) Good luck, I’m sure you’ll find what works best for you!!!!

    wildgarden wrote on April 1st, 2015
    • Hi WildGarden,
      check out
      I think you’ll like her. She’s a kick. Such a refreshing voice for women, in particular.

      Alison wrote on April 5th, 2015
  31. Sounds like just about everything that helps you lose weight, reduce inflammation, etc, is the same thing that helps you with insulin sensitivity. Once again pointing to carbohydrates and sugar spikes generally being wack and the cause of obesity.

    If you’ll excuse me, I need a taco.

    Dante McPfffft wrote on April 1st, 2015
    • Carbs and sugar don’t cause obesity or insulin resistance or diabetes. Some of us eat plenty of carbs and even sugar on a daily basis and are in shape and healthy. Overeating and sedentary living is the problem.

      Rachel wrote on April 1st, 2015
      • Rachel, see my comment below. I just hope that you never get sick the way I was; slim and fit on the outside, but falling to bits on the inside.

        Debbie wrote on April 1st, 2015
  32. If it helps anyone I have an interesting story related to physiological insulin sensitivity. I have been a long term VHFLC kind of guy and been very successful at that and heart rate training to burn fat. Maybe too successful. 😉 I got tested to donate a kidney and failed the Oral Glucose Tolerance Test (OGTT) in a big way. No insulin response whatsoever. They told me I was a T1 diabetic at the age of 50 and kicked me out of the donor program! BTW, I had literally finished a half Ironman two weeks before the test so I am not out of shape. I literally laughed and told a panel of doctors it was a physiological response and there was no issue. I mean my a1c was 5.0 so come on) These are doctors, BTW, who work at a transplant clinic so they see a lot of people but they were adamant that I was a huge health risk. Long story short, I got advice form a few well known people to eat 200 gm of carbs a day for 3-4 days and retest. I did so and retested and the results were amazing. It was like I had taken no glucose at all an hour later. Goes to show you they don’t know everything as good as they are.

    BTW, they accepted my OGTT results and I donated a kidney to my brother on Jan 20 with the promise (fingers crossed) that I never go on that crazy diet again. Yeah right.

    Tom A wrote on April 1st, 2015
    • That was a very generous thing to do for your brother. :)

      Chris wrote on April 1st, 2015
  33. Soaking your feet in an Epsom Salt bath, at least once a week, can help with magnesium uptake with the side-effect of relaxation.

    Chris wrote on April 1st, 2015
  34. I have always been slim and active, but still had multiple health issues due to sugar intake. Overweight is just a symptom like hypertension. Added and concentrated fructose, whether in sucrose, maple syrup, honey , agave, dried fruit, juices or chocolate (70% cocoa chocolate is still 30 % sugar, and 85 % chocolate is still 14% sugar) all stresses and overloads your liver. Fructose consumption via the various forms of added and concentrated sugar is the most common cause of non-alcoholic fatty liver disease, Alzheimers, PCOS, hypertension, type 2 diabetes, and many other ailments.

    Debbie wrote on April 1st, 2015
  35. I think one of the most important factors here is sleep. People really need to prioritise sleep in order for a whole range of physical process to function including insulin sensitivity.
    Sleep is a casualty of modern society and no matter how much exercise you dial in, it can all be undone by lack of sleep.
    One other thing, weight gain or lack of weight loss is really complex. It’s not calories in verses calories out. I have been recently diagnosed with Hashimotos, it’s probably been around for decades, but I am now the lightest I have been since high school, by addressing diet (strict paleo, and autoimmune protocol for the moment), sleep, stress, and activity. Due to pain my exercise is limited, yet I have still lost weight, and this points to the importance of so many othe axis in the body, like digestion, leaky gut, and hormone imbalance. In my mid 50’s I am finally finding a way forward, for all that expressed their struggle, keep researching and ignore the conventional energy balance fantasy.

    Heather wrote on April 1st, 2015
  36. So glad you mentioned vinegar, Mark!
    Vinegar has some really interesting effects when it comes to blood sugar regulation — and also mood regulation!

    Amy wrote on April 1st, 2015
  37. I have been eating Primal/paleo for a year and a half. In the first six weeks I lost 26 lbs (still over 100 to go) and not a pound since. I am sedentary! I am at a desk job for 9 hours a day and come home to help the kidlets with homework. I have 0 energy when I get home. Due to severe shin splints I have been unable to walk for exercise. I am thinking that I should join our local Crossfit box and go straight after work (before I go home and get hijacked by life and kids). I think it would help with accountability and I tend to not have what it takes to push myself physically. I have a question, should I plan to go daily to get into the habit? Or only 3 days a week. My concern, with 3 days a week, is my severe procrastination would always be the voice in my mind telling me to ‘skip today, go tomorrow’…but I don’t want to burn out by going everyday. Thoughts and opinions please.

    sarahfino wrote on April 1st, 2015
    • Sara, find a C2 rower and get a log card. The machine is great for those with walking difficulty. The log card will allow you to record your progress. Start slow and set goals. I have metabolic arthritis and some days it takes me a few minutes to get down the stairs. The rower allows me to bust through the pain threshold without injuring myself and actually reach a max heart rate. Something I don’t ever expect to do on foot. In my opinion cross fit is for people who are already fit. C2Rowing is easy and suitable for an overweight octogenarian recovering from triple bypass as well as Olympic oarsmen and women training to compete. If you get one at home you can still help the kiddos with homework. You just have to talk over the whoosh. Unless you are doing sprints of course. 26 lbs is a great start! The next 100 will come off easier with a full body excercise.

      Jack Lea Mason wrote on April 1st, 2015
    • Decide on 3 times where you go, every week. And, even if it feels urgent, allow yourself a longterm focus. And think more about what you LIKE doing than whether it instantly produces 100% the thing you think you need.
      Would love see I can help you make that havit a reality; I happen to know a lot about forming habits in the easiest way possible and about making health less a necessary evil and more something you’ll actually look forward to doing.

      Simon wrote on April 3rd, 2015
  38. My takeaway: I need to breastfeed more. It’s just so difficult finding a compliant, lactating person to accommodate me. They act like my healthquest is weird.

    mattoomba wrote on April 2nd, 2015
  39. Hi,

    Can anyone give me some advise regarding whey protein and it’s insulin effects?.

    I have pcos and wanted to introduce organic, whey protein in a smoothie as a breakfast option. Would this cause me massive issues with spiking insulin levels or will it be ok?.

    I have just read the paleo approach book and it’s advising against whey protein yet i’ve come across this info after reading loads of info advising it can be healpful for pcs and insulin levels.

    Please send me your advise this is driving me nuts!!!!!

    gemma wrote on April 2nd, 2015
    • Gemma, blood glucose meters are really inexpensive these days. Why not buy one and see what the whey protein does for you. Test before and then a couple of times after to see how high it rises and stays risen. Personally I wouldn’t eat whey protein, as I find dairy is a contributor to my autoimmune flares. Consider autoimmune issues as PCOS and metabolic syndrome and Hashimotos are often found together. I have the trifecta, and have to be really strict at the moment, while I calm my immune system down. Good luck.

      Heather wrote on April 2nd, 2015
  40. I’d like to share a couple of great tips that I have stored over the years.
    1) From Robert Atkins, in the Atkins diet book, I learned that if you have been avoiding sugar & carbs, and are at least part of the way toward ketogenic, if you are going to fall off the wagon and eat something with a lot of sugar or simple starch, try to keep it to a single binge session of less than an hour. If you do that, your insulin levels will not have time to respond.
    2) From Grant Petersen, in Just Ride (a great book), I learned that a great way to increase your insulin sensitivity is to exercise muscle groups to exhaustion (weightlifting) on an empty stomach, and wait about an hour afterward before eating. He suggests doing this maybe once a week.

    But the most important thing anyone can do to keep their insulin sensitivity OK is to exercise. In any way at all.

    Marge wrote on April 2nd, 2015

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