Beat Insulin Resistance, The Best Diet and Nutritional Supplements

By Dr. J.E. Williams | | Reading Time: 4 minutes

How to beat insulin resistance with astaxanthin and berberine, and krill oil. Doctors have advised us to eat less and move more for decades, but Americans are fatter. Doctors admonished us to lower LDL cholesterol with diet and atorvastatin (Lipitor) to prevent heart disease. Still, cardiovascular diseases remain the #1 cause of death in the United States. What’s wrong with this paradigm? 

Ben Bikman, Ph.D., who researches metabolic disease at Brigham Young University, advises an insulin-based approach. His book, Why We Get Sick, provides evidence that insulin resistance (IR) is the common denominator of most modern diseases. I agree that insulin resistance is insidious and goes underdiagnosed. 

Insulin is a hormone in the pancreas that regulates blood sugar by controlling the amount of glucose your cells use. Disruption of this safeguarding process leads to insulin resistance, a step toward type II diabetes. 

Conditions and Lab Markers Associated with Insulin Resistance Syndrome:

  • A waist circumference of over 35 inches for men and 40 inches for women
  • Triglyceride (TG) levels of great than 150 mg/dL 
  • HDL-C levels of less than 40 mg/dL in men or less than 50 mg/dL in women
  • Blood pressure of 130/85 mm Hg or higher
  • Fasting glucose over 126 mg/dL
  • Fasting insulin of more than 20 μIU/mL
  • C-Peptide over 3.85 ng/mL
  • Hemoglobin A1c greater than 5.7%
  • High uric acid levels greater than 7.2 mg/dL
  • High C-reactive protein, cardiac or highly sensitive (hs), over 3.0 mg/L
  • Fatty liver disease with high ALT above 33 U/L; and an AST:ALT ratio greater than 1.5

I also calculate the triglyceride to high-density lipoprotein (TG/HDL) ratio on all my new patients. It’s a reliable marker for fatty liver. Divide your fasting TG by HDL. High TG indicates that more fat and sugar are stored in the liver. Eventually, if your TG/HDL ratio stays high, you’ll develop fatty liver disease. Aim for a TG/HDL of less than 2.0. 

Medical conditions associated with insulin resistance include obesity, prediabetes, type II diabetes, fatty liver disease (FLD), and polycystic ovarian syndrome (PCOS). Erectile dysfunction in men is often caused by insulin resistance. And lower mitochondrial function occurs with IR, leading to loss of muscle mass. Non-medical problems include fatigue, muscle loss, and increased belly fat with a greater waist-to-hip ratio. 

I do not doubt that Type II Diabetes is a lifestyle disease of excess. Overeating refined carbohydrates and consuming French fries, GMO potatoes, and sweets increase the risk of insulin resistance. But so do other things like your salt sensitivity. Type II diabetes and IR are usually associated with being overweight. But I also see this condition in lean patients with high blood pressure. 

Recommended Screening Tests

In my clinical experience, some are more prone to glucose imbalances and insulin resistance than others. I’m sure genetics play a role. However, metabolic conditions are so common in modern people that I recommend everyone gets screening blood tests for insulin along with glucose and hemoglobin A1c levels every year. 

Get Tested: Order lab tests without a doctor’s requisition from Ulta Lab Tests or Quest

  • Cardio IQ Insulin Resistance Panel with Score
  • Cardio IQ Hemoglobin A1c
  • Fasting glucose

Get an email everytime there's a new Dr. Williams post!

The Best Diet to Control Insulin Resistance and Glucose

There are several practical nutritional approaches to managing insulin resistance. The basic rule is that a low animal fat, plant-based diet with enough fiber is a successful dietary change, plus exercise and strength training is a lifestyle plan that works. A ketogenic diet is also effective in improving insulin resistance. Dr. Bikman’s dietary approach is research-based and works.  But whatever healthy diet you choose, you’ll have to limit natural sugar sources like fruit juices, agave syrup, and even organic raw honey. 

Nutritional Supplements to Beat Insulin Resistance 

For some, diet isn’t enough because they have stubborn insulin resistance. They lose weight but plateau. Their fasting glucose goes down but not to normal. Their C-Peptide, another blood test for type II diabetes, improves but not enough. And their serum insulin may improve but remains high. 

If you’re one of those who need an extra metabolic edge despite dieting and exercise, take astaxanthin and berberine. Studies show that astaxanthin plus berberine have similar effects as metformin. 

Lipotoxicity, a term used to describe the unhealthy biological effects of body fat accumulation on glucose metabolism, is an often-overlooked piece of the IR puzzle. If your blood triglycerides are high, add krill oil. Studies found that krill oil is better than omega-3 fish oil for lowering triglycerides. 

Dr. Williams’ Recommended Supplements: 

  • Krill Oil 1000 mg – Take one twice daily with food. 
  • Astaxanthin 6 mg – Take one twice daily with food. 
  • Berberine 500 mg – Take one twice daily with or without food. 
  • Chromium Picolinate 500 mcg – Take one twice daily with or without food. 
Insulin Resistance recommended supplements

I know it’s difficult to lose weight and trim belly fat. But you can do it. The key is to lower glucose and insulin levels and create a healthy lipid profile. Start by improving your food choices, stick to an exercise plan, and add my supplement recommendations. To mark your progress, measure your insulin, glucose, and A1c every three months for one year. 

Further Reading: 

DiNicolantonio JJ, McCarty M, OKeefe J

Astaxanthin plus berberine: a nutraceutical strategy for replicating the benefits of a metformin/fibrate regimen in metabolic syndrome

Open Heart 2019;6:e000977. doi: 10.1136/openhrt-2018-000977

Meex, RCR, Blaak, EE, van Loon, LJC. Lipotoxicity plays a key role in the development of both insulin resistance and muscle atrophy in patients with type 2 diabetes. Obesity Reviews. 2019; 20: 1205– 1217.

Ertuglu LA, Elijovich F, Laffer CL, Kirabo A. Salt-Sensitivity of Blood Pressure and Insulin Resistance. Front Physiol. 2021 Dec 13;12:793924. doi: 10.3389/fphys.2021.793924. PMID: 34966295; PMCID: PMC8711096.

Meex, RCR, Blaak, EE, van Loon, LJC. Lipotoxicity plays a key role in the development of both insulin resistance and muscle atrophy in patients with type 2 diabetes. Obesity Reviews. 2019; 20: 1205– 1217.

Skow SL, Jha RK. A Ketogenic Diet is Effective in Improving Insulin Sensitivity in Individuals with Type 2 Diabetes. Curr Diabetes Rev. 2022 Apr 25. doi: 10.2174/1573399818666220425093535. Epub ahead of print. PMID: 35469570.