Insulin Resistance with Dr. Ritamarie Loscalzo: Rational Wellness Podcast 74
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Dr. Ritamarie Loscalzo talks about insulin resistance with Dr. Ben Weitz.
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Podcast Highlights
0:53 The topic of this episode is insulin resistance. When you ingest sugar or carbohydrates, this raises your blood sugar levels. The body reacts to elevated blood sugar by having the pancreas secrete insulin, which signals the muscle cells to take in the sugar, thus lowering blood sugar levels. High glucose levels are inflammatory in the blood stream. If you regularly consume sugar and high glycemic carbs (carbs that cause a large spike in blood sugar levels) and thus your pancreas is secreting a lot of insulin, the cells will become resistant to insulin, which we refer to as insulin resistance. This requires the pancreas to secrete more insulin to have the same blood sugar lowering effect. Eventually, the pancreas will burn out and not be able to produce ever increasing amounts of insulin, which is what we diagnose as type II diabetes.
3:00 Dr. Loscalzo explained that as her chiropractic practice was developing, she realized that some of her patients had blood sugar dysregulation. She had her patients buy glucose meters and test their own blood sugar every 15 minutes after a meal and they found out that they were having blood sugar and insulin problems. She feels that when you eat, your blood sugar should go up, but not to more than 110. But many of her patients were on high carb diets, even though some of them were eating whole wheat bread and brown rice, and their blood sugar would peak at 140 or 170. Dr. Loscalzo had one client who was putting raisins on her salad, who’s blood sugar would go up to 220 after eating that. She feels that ideally after a meal, the blood sugar should not go up to more than 110 at the peak, which is usually 45 minutes to an hour after the meal. This patient may have normal fasting sugar levels, even though their sugar level after a meal shoots up too high. She finds that insulin levels will start to rise before fasting blood sugar levels go up, which is an early sign of blood sugar problems. Insulin damages blood vessels, so Dr. Loscalzo likes to test levels of insulin and Hemoglobin A1c, which will go up before fasting blood sugar levels go up.
7:21 Dr. Loscalzo said that rather than ask her patients to do a standard glucose challenge test by going to a lab and getting their blood sugar tested and then having them drink a 100 gm of glucose and then get their blood drawn every 30 minutes for six hours, she has them do a home version of this test. She has them purchase a home glucose meter to test their glucose and then eat their highest carb meal and then monitor their blood sugar after regularly for 5 or 6 hours. Some patients discover that their blood sugar drops 20 points or so below their normal fasting level, which indicates hyperinsulinemia.
10:17 Stress causes cortisol to rise, which raises blood sugar levels for your muscles to use. Our stress response is to help us run away from a lion on the savannah, so a spike in sugar provides fuel for our muscles. If you were going to be running away from a lion, we would burn that glucose, but if you’re sitting at your desk and worrying about the stock market or about your kids grades, then it’s raising your blood sugar, your blood pressure, your heart rate, your breathing rate and it’s happening consistently day after day, hour after hour, this has negative impacts on our health and results in insulin resistance and heart disease. Dr. Loscalzo likes to use a target fasting glucose level of 75-85 with 75 being ideal. For hemoglobin A1c, she likes to see it a bit below 5, because at 4.5-4.8 it means your average glucose is in the 80s. At 5 it means your average glucose is in the 90s. At 5.6, where MDs consider it normal, it means your average glucose is around 117, which is way too high.
16:26 Dr. Loscalzo prefers her clients with pre-diabetes or diabetes to be on a whole foods, plant based diet that is rich in plant based fats, like avocados, olives, nuts, seeds, and coconut. They should be consuming a lot of fiber. She personally is vegetarian, but she is ok with a small amount of organic, grassfed meat. But 75% of your plate should be vegetables. She pointed out that a cup of spinach has 5 grams of protein and she advocates eating 10 cups of green leafy vegetables per day. As far as legumes, they don’t work for some people, but she has her clients test them out and see if they raise their sugar levels too high.
20:33 The negative effects of high blood sugar and insulin resistance include peripheral neuropathy, which is damage to the peripheral nerves. Dr. Loscalzo said that studies show that when blood sugar goes above 120, you start to damage those nerves. The nerves get glycosylated, they essentially get a sugar coating and they can function. You get retinopathy, which is one of the leading causes of blindness in the US. The endothelium of the blood vessel walls become thickened and damaged and less elastic.
21:58 Dr. Loscalzo doesn’t like the idea of patients eating every 2 to 3 hours to balance their blood sugar and thinks that this is the worst advice anybody could give. She recommends going at least 4 hours between meals, preferably 6 hours. She likes them fasting overnight for at least 12 hours and preferably 16 hours. Healing happens during fasting and not feeding. She is a big fan of water only fasting.
25:58 Rita-Marie likes using certain supplements to help her patients combat insulin resistance, including chromium, magnesium, and omega 3s, esp. DHA, which she calls her craving crusher supplements. She also has used cinnamon, berberine, olive leaf extract, and lipoic acid.
28:43 Exercise is also very important for balancing blood sugar and Dr. Loscalzo likes burst training, where you do some exercise very intensely for 30 seconds. Some weight training is also helpful to increase your muscle mass and trained muscles are more resistant to insulin resistance than untrained muscle.
30:15 Sleep is important, since a ton of studies show that even one night of bad sleep in an otherwise healthy person will induce a temporary insulin resistance.
30:34 For stress reduction Dr. Loscalzo likes meditation using a device called The Muse, which measure your brain waves. She also likes Heart Math, which is this breathing appreciation combo that you do throughout the day for 30 seconds at a time.
Dr. Ritamarie Loscalzo is Dr. Ritamarie is a licensed Doctor of Chiropractic and the founder of the Institute of Nutritional Endocrinology. She can be contacted through her website http://www.drritamarie.com/ where she offers online courses, including her program for blood sugar balancing, The Sweet Spot Solution as well as a program for health care practitioners on helping patients to improve insulin resistance, Insulin Resistance Solution Practitioner Training.
Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.
Podcast Transcripts
Dr. Weitz: This is Dr. Ben Weitz with The Rational Wellness Podcast bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to The Rational Wellness Podcast at iTunes and YouTube. And sign up for my free e-book on my website by going to drweitz.com. Let’s get started on your road to better health. Hello, Rational Wellness podcasters. Dr. Ben Weitz here. Thank you so much for joining me again today. For those of you who enjoy the Rational Wellness Podcast, please go to iTunes and leave us a ratings and reviews so more people can find out about the Rational Wellness Podcast.
Our topic for today is insulin resistance. When you ingest sugar or carbohydrate foods that are turned into sugar in your body, your pancreas secretes insulin, which is a hormone that stimulates the muscle cells and liver to take in the sugar. The body doesn’t like having high sugar levels. And as the cells take in the sugar, that lowers the sugar levels in the bloodstream. And if you regularly consume a lot of sugar and carbohydrates that cause your blood sugar to spike, what we call high-glycemic carbohydrates, over time, your cells will become resistant or less sensitive to insulin. This is what we refer to as insulin resistance. And this will slowly become more severe. And this is the process that eventually leads to type 2 diabetes.
Today we have Dr. Ritamarie Loscalzo who’s a licensed doctor of chiropractic and the founder of The Institute of Nutritional Endocrinology. She specializes in using the wisdom of nature to restore balance to hormones with a special emphasis on thyroid, adrenal, and insulin imbalances. She’s a best-selling offer. Her latest book is Unstoppable Health. She’s a speaker and internationally recognized nutrition and women’s health authority with over 25 years clinical experience. Dr. Ritamarie, thank you so much for joining me today.
Dr. Loscalzo: Thank you so much. I’m very excited to be here. This is one of my favorite topics to talk about, so.
Dr. Weitz: Good. So how did you, personally, become interested in insulin resistance as an area of focus for your practice?
Dr. Loscalzo: Well, it just kind of found me. It’s like I started practicing back in back in, I don’t know, 19 whatever it was ’92, when functional medicine wasn’t as well known as it is now, and nutrition. And there’s wasn’t an internet. And there weren’t summits. And there weren’t podcasts. And there wasn’t any of this. So I started out. And I just started out getting people in, and some people came to see me because they had back pain. But I would quickly educate them to what their various aches, and pains, and other things … you know, you do a comprehensive health history, find out they don’t just have back pain, they have irritable bowel, and fatigue, and brain fog, and all this. And so as I worked with people more, I just used the common logic of knowing how the body works and what it could be going on that’s causing their symptoms because we’re all about root cause, not about, “Well, what herb is good to treat this symptom?” Or “What nutrient treats that symptom?” It’s more about going to the underlying cause.
And the more and more I found it, I just got that these people had blood sugar dysregulation. It wasn’t at the point where it could be clinically diagnosed yet as insulin resistance. So I started to actually have them buy glucose meters and test their own blood sugar because I suspected that even though they’re fasting glucose was low, that they were having big spikes based on what they were telling me the were eating and based on other things in their life. And so I just started doing that, and watching, and going, “Oh, my gosh.” And I had the, what’s the word? It’s not ammunition. I had the influence of being able to have these numbers and say to them, “Hey, you don’t have diabetes. You don’t even have clinically diagnosable insulin resistance. But you have something that comes before that that is eating away at your body for 30 years before all those complications of that stuff comes up. Would you like to address that?” And they’re like, “Well, I’m looking at these numbers, and yeah.”
So I just started, more and more, doing it with a clinical practice and seeing great results. Like when people shifted and they kept their blood sugars in a manageable level, I personally think their highest peak of blood sugar, the 45 minutes to an hour after you eat where the blood sugar actually peaks before the insulin brings it back down, should not be any more than 110. And most people who were on these high carb diets, typical, even the ones that are educated and just doing whole wheat bread, and brown rice, and all this, were actually having these peaks that were 140, 150, 170. And even one lady who put raisins no her salad. She’d been eating her salad and she’d been testing and everything looked good. She put raisins on her salad and her sugar shot up to 220.
And then they started telling me that when they found their blood sugar is the highest is when they felt like they had low blood sugar. You know, people will say, “I’m hypoglycemic. I can’t go more than two hours.” What I was finding was in any of those, their blood sugar was actually high, not low. So this just got me into really doing the research. And the more I thought about it and looked back, I really felt like this was the straw that broke the camel’s back, so to speak, for my parents who died very young of heart disease. That the heart and the vessel stuff was happening for decades before they even realized it, and they actually died of heart attacks before it was even clinically recognizable.
Dr. Weitz: Why is it important to focus on insulin resistance rather than just looking at blood sugar levels?
Dr. Loscalzo: Yeah. So the typical way that they test is, right, fasting blood sugar. That’s actually the last thing to shift. It’s usually … there’s a lot of other signs beforehand that there’s something problematic. And insulin actually goes up … I actually look at it as a spectrum. And I think high insulin is actually the very first step. It’s like, but most people are adapting to it. And there they go. The insulin works, and it brings it down, and it brings it down. But those high levels of insulin are what’s causing problems. And insulin damages blood vessels. Insulin causes restriction of arterials. Insulin causes all kind of damage in the body that nobody’s seeing or attributing to it. So I think testing insulin levels early on, not waiting for somebody to be diabetic to see what their … or to see if their pancreas is failing. But no. Check it real early on to see if they’re over-producing. So that and hemoglobin A1C, I think, should be routine blood work that’s done on people with any kind of history, with any kind of brain fog, fatigue, belly fat, all those sorts of symptoms that indicate that there’s probably a blood sugar imbalance going on. They should be tested for insulin and hemoglobin A1C because those are going to shift way before the fasting glucose does.
Dr. Weitz: Do you do a glucose challenge test or an insulin challenge test?
Dr. Loscalzo: What I do is I teach people how to measure their own glucose. And I have them do a kind of a variation of a glucose tolerance test, but at home. I dare not send these folks off to a lab to be taking 100 gram solution of pure sugar and watch them feel miserable for the next couple of days, and flair up, and whatever else. Because most of them are educated, and then you been bringing you down. So I have them do it at home. And I have them get their own glucose meter. And they measure. They measure their fasting right before their meal. And then they measure every 15 minutes to catch the spot, the peak, so we know when they catch the peak. Because some people peak at a half an hour, some people 45 minutes, some people an hour, some people an hour and a half. So it does vary, although the average is somewhere around 45 minutes.
So I help them to figure out what their peak is. So when we’re doing this challenge, I just have them eat a meal that’s the highest carbohydrate meal that they would typically eat. So for some people, that might be popcorn and orange juice. Right? For other people it might be toast and orange juice. For other people it might be a piece of pizza. For other people it might be a salad with a bunch of raisins on it. Right? So wherever they are in their evolution of diet, I want to see how their diet is impacting them so they can clean up their own diet. And so we have them do this challenge over the course of six hours, and we’re measuring it. The one meal over the course of six hours to see where did they peak, how high did they go, and how low did they go. Now, do they just go back down to baseline and stay steady out to five or six hours? Or do they drop down below 20 points or so, indicating that the hyperinsulinenemia probably caused a hypoglycemia.
So that’s how I do it. And I teach people to do it at home. And people love the fact that they can do it at home, and they don’t have to go sit in a doctor’s office, spend several hundred dollars, or fight the insurance company to get it paid for, feel miserable. Like I did a glucose tolerance test, and I got cold, and I got shaky, and my blood sugar went down real low. And I was like, “Oh, I don’t want to put people through that. I can tell if they have a problem, and they need to know that they have a problem.”
But further, I teach them how to do that kind of testing on an ongoing basis. Not with a challenge meal, but more with their own meals. And they go, “Wow. I had this salad today and it just was this beautiful salad with all kinds of veggies, and coconut, and whatever else, and my sugar stayed nice and steady.” And, “Oh, today I had that with a bowl of brown rice, and my sugar shot up.” So I try to teach them how to identify the foods in their diet that are causing them to go up. But it’s more than food, too. So, as you know, it’s a lot more than food. It’s the food, but it’s also the stress, the kind of exercise they’re doing, how much sleep they’re having. So I have them map all these things out. And it empowers them to know what behaviors they’re doing that’s throwing their blood sugar out of balance.
Dr. Weitz: Can you explain how stress impacts blood sugar?
Dr. Loscalzo: Sure. While stress causes an increase in a hormone called cortisol. Cortisol’s job is to help you get away from those tigers, and the lions, and anything else physical that’s chasing you that’s creating this fear. And in order to do that, you need to use your muscles. You need to be able to fight, and run, and jump, and all that. And it basically breaks down stored glucose into blood sugar so that you can use that to get away from tigers. So that’s how it impacts it. And when you do this once in a while to get away from a tiger, no big deal. Right? Because you’re actually running, and you’re burning that sugar. But if you’re sitting at your desk, like worrying about the stock market, or your kids grades, or your aging parents, and you’re getting all stressed out, that same cortisol response is happening. And in addition to raising your blood sugar, it’s raising your blood pressure, it’s constricting your heart, it’s increasing the rate of your heart, and it’s increasing your breathing. So if that happens once in a while like in the olden days of tigers chasing us, didn’t matter. Right? But if it’s happening consistently, day after day, hour after hour, those levels just, they stay high and they create an insulin resistance.
Dr. Weitz: What kind of target level do you shoot for for fasting glucose and also hemoglobin A1C-
Dr. Loscalzo: Great question.
Dr. Weitz: … that are ideal?
Dr. Loscalzo: I consider ideal, I like 75 to 85 as the range. I really like to see it at the 75 because I think that that’s a healthier long term. But it’s different from person to person and all. For hemoglobin A1C, I like to see it at 5. 5 or a little bit below 5 because at 4.5, 4.8, it means your average glucose is in the 80s. At 5 it means your average glucose is in the 90s, which accounts for the after the eating and then the all night fast, which is a good level. But at 5.6, where the medical puts it, that means your average glucose is around a 117. That’s not good. That’s way too high.
Dr. Weitz: From testing a bunch of people, do you see a lot of people under 5? I don’t think it’s that common.
Dr. Loscalzo: It’s not that common. But I do see after they’ve gone through the program I see them get down to 5.2, 5.1, 5, 4.8. Now, if it’s below 5 and they have not followed the diet, then I’m suspicious that what’s happening is a lot of periods of hypoglycemia. And I’m suspicious of hyperinsulinenemia. So I’m also testing their insulin. Because what will happen is that they may be waking up in the morning with 75, 80 as their fasting glucose. And then they’ll eat a meal and it goes up. Maybe it goes up to 180, and then it drops back down to 50. And then they get the shaky and irritable and all that. So I’m a little suspicious if somebody comes in off the street without having been through the education and the program with that 4.8 to 5. I’m suspicious that they’ve got this other situation going on, and I check for it. But after they’ve been on the program? Yeah, they’re good.
Dr. Weitz: Now, what about target ranges when you’re dealing, say, with type 2 diabetic who’s on, say, oral medication? And maybe you could address the same issue with a type 1 diabetic.
Dr. Loscalzo: Yeah. So you can’t really create a target range. You have to see where they’re at, right? So they’re on the medication and they’re maintaining at this. With a type 2 diabetic, if they go on and they change their diet like we recommend, then what you see is that it starts to drop. And if they’re on medication, then I’m much more careful. If it drops below 80, I’m careful because they can overshoot because they’re on medication, especially if they’re on insulin. So I’m more likely to want to keep that fasting 80 or above. And the after meal, well, as low as they can get it. Right? Because if they’re at a fasting glucose of 120, and they’re diagnosed, and then they’re put on medication, and they get it down to 90, then it’s harder to keep them in that range of 90 to 110.
So it may be higher. But we’re always looking at like what does this meal or this activity do to your sugar levels? Does it raise it more than 25 points? It’s probably something to consider that you don’t want to be having something that’s raising you more than 25 points. So whereas I try to keep my regular people that are new to the program and I’m just working with below 110. With a diabetic I’m telling them, “I want you to watch your meals, and anything that causes your sugar to go up more than 25 points after that meal, it’s in the suspect column.” And we write lists. Right? Good stuff, absolutely bad, and then the suspicious ones in the middle. So that’s how I do it with them.
With a type 1 diabetic, much more careful. But with a type 1 diabetic, the chance of getting them completely off of insulin is probably slim unless they’re very young. If they’ve been type 1 and on insulin for many years, there’s a lot of damage done and you probably won’t. But I also do, with them, because they’re on insulin, much more careful about the low. Right? And so I’m watching that really carefully, that they don’t go too low. But we can control it and we can control the amount of insulin. And the goal with a type 1 diabetic is to get them down to the minimum amount of insulin possible because insulin has its downsides. Insulin causes weight gain, although, in type 1, it generally doesn’t because they’re not making any of their own. But it also, like I said, stiffens those arterial walls and creates a breeding ground for cardiovascular and stroke. So I’m real careful with type 1s, but I’ve seen that it goes way down. Type 1s, they need the exercise. And they need consistency because they’re on insulin. Right? So consistency in exercise, and daily rigorous exercise is important. And if they miss a couple of days, they’re going to need more insulin. Right? So it’s good information to take back to type 2s or pre-insulin resistance folks as well.
Dr. Weitz: So what kind of dietary regimen do you find to be most effective for patients either with pre-diabetes or diabetes, for managing their blood sugar?
Dr. Loscalzo: Well, it depends on the person. But I find that a whole foods diet is mandatory. So no processed food. I find that a lower carb, for most people. And I, personally, find that the best results I get for myself and for others is a whole foods, plant-based diet that is good and rich in whole food fats, whole food fat, plant-based fat. So yeah. If they want to do meat or chicken or whatever, it’s a small amount of their diet. And the majority is vegetables and plant-based fats like avocados, and olives, and nuts, and seeds, and coconut, and I said avocado. I’ll say it twice because it’s my favorite. So those sorts of things are super important. And a lot of green leafy vegetables, and a lot of vegetables. The fiber tends to slow down the absorption of sugar. And if they are going to eat fruits, then I have them do it with a big plate of greens or with a green smoothie where they’re having a bit of fruit, a bunch of the greens, and then a couple of bites of fruit. And I find that people who on like a mango by itself will shoot their sugar through the roof. When they do it with this bed of greens, it slows it down enough that they can deal with it and not raise their glucose too much.
Dr. Weitz: So when you say plant-based diet, people usually think of vegetarian. But you’re talking about a plant-based diet with meat?
Dr. Loscalzo: Well, it depends on the person. Personally, I don’t do meat. Haven’t done it for 35 years.
Dr. Weitz: Oh, okay.
Dr. Loscalzo: But some people do a small amount of organic, grass-fed, et cetera. But when I say plant-based, I mean plant strong, the majority of the diet. Like 75% of your plate should be vegetables. Right? And that’s where I get the most results. And then on top of that, there’s the whatever, the nuts, the seeds, the avocado, all of the … the whole food fats. I’m not a big fan of oil. I just don’t think it’s a good food. It’s kind of empty calories, and it’s kind of filler. And some people need it because they have high metabolic rate, and they’re real thin, and you have to give them something that they can not take up too much room in their stomach that they can tolerate. But yeah, that’s how I work it.
Dr. Weitz: And how do you get your protein as a vegetarian?
Dr. Loscalzo: From my foods. From all my foods. Right? I mean, spinach. A cup of spinach has about 5 grams of protein. And that’s just representative of any green leafy vegetable. I probably eat 10 cups of green leafy vegetables in the course of a day. That’s 50 grams of protein. Now you add that hemp seeds, and pumpkin seeds, and chia seeds, and all the seeds, which have a little bit more protein per calorie, well, not even per calorie. I think there’s more protein per calorie in the greens. But more protein per unit that you’re willing to eat. Yeah. That’s where it comes from. Right? The protein is, it’s just this crazy myth that people don’t get enough protein. People don’t absorb their protein. That’s more of a problem. Low stomach acid and digestive incapability, that they can’t actually absorb their protein, and so they require higher amounts. And so they move to meats or fish or whatever.
Dr. Weitz: Do you recommend eating legumes?
Dr. Loscalzo: Depends on the person. Like they don’t work for me. They work for some people. I think if you’re going to do them, they’re better off that you soak them really well. Maybe start to germinate or sprout them and then lightly cook them. And mix them with tons of vegetables. So yeah. Yeah. I mean, it depends on the person. That’s why we do the testing. Some people try the legumes, and some people, it shoots their sugars up too high.
Dr. Weitz: And then, so people with gut problems with legumes, it-
Dr. Loscalzo: Exactly. Exactly. It could be lectin sensitivity. There’s a lot of things, leaky gut, that would create problems with that. And they get gas and bloating.
Dr. Weitz: Can you talk about what is some of the negative affects of having high blood sugar insulin resistance?
Dr. Loscalzo: Absolutely. Well, high blood sugar, we know that the end range complication of diabetes are peripheral neuropathy. Right? So it’s damage to the peripheral nerves. So studies I’ve found show that when the sugar goes above 120, you start to damage those nerves.
Dr. Weitz: How do those nerves get damaged?
Dr. Loscalzo: They get damaged by the sugar. They get glycosylated. They get coated with the sugar and then they can’t function. The red blood cells get coated. And that’s what hemoglobin A1C is a glycosylation or a sugar coating, and they can’t function properly. So the nerves get damaged by the high sugar. The retina, retinopathy, one of the leading causes of blindness in this country is diabetic retinopathy. But people think, “Well, I’m not diabetic. I’m not diabetic.” They think that the damage starts to happen when they cross the line and become diagnosed as diabetic. But, seriously, its been happening for decades with these sugar highs and lows, and the insulin highs and lows. And insulin causes an increase in C-reactive protein. It, like I said, thickens the cell, the walls of the endothelium of the blood vessels, so it makes them less elastic. So instead of them flowing and, “Oh, yeah.” You need a sudden burst of energy, more blood flow. They can’t go. And that’s part of the cause of ischemic attacks.
Dr. Weitz: What do you think about the timing of meals? Should we be eating every two or three hours to keep an even blood sugar? What do you think about intermittent fasting, which, essentially, is like skipping breakfast, or a fasting mimicking diet, which a lot of people are doing now for anti-aging purposes?
Dr. Loscalzo: Yeah. So I think eating every two hours is the worst advice anybody could ever get. There are exceptions to it. There are times when a person needs to be weaned and the meals slowly separated as you’re rebuilding and restoring their system. When you eat every two hours, you have insulin in your system every minute of the day. Insulin is a catabolic hormone. Insulin causes the lay down of fat. Insulin is damaging blood vessel linings. Insulin interferes with growth hormone which we need for growth and repair and laying down of lean tissue. So eating every two hours is, I think it’s a nutritional nightmare, time bomb. I love the fact of having longer periods. I recommend people do at least four hours between meals, preferably six. And then I also recommend a long overnight fast. So at least 12 hours, but 16 hours is even better, so the intermittent fasting concept.
I don’t equate intermittent fasting with skipping breakfast because it doesn’t have to be that way. For some people, they do really well with having breakfast. And they have breakfast and lunch, a later lunch, and then they don’t eat again until breakfast again. And some people do better by skipping the breakfast and eating later. And some people just eat moderately early, like a breakfast at maybe 10:00 AM, and then skip 8 hours and eat a dinner at 4:00, and then that’s it. So intermittent fasting is just giving the body a rest, a real rest in between. And healing happens during fasting and not feeding. Feeding is when we’re doing all this metabolic stuff, generating metabolic waste. But healing happens during fasting. So I’m a big fan of that.
I’m a big fan of fasting. Like I look at intermittent as that’s one method of intermittent fasting. Another method is the 24-hour fast where you have one meal in a day. You pick dinner or breakfast or lunch, it doesn’t matter which, and then you go all the way around to that meal. And the studies who that that elevates level of growth hormone, decreases levels of insulin without decreasing metabolic rate. Now, if you do multiple days, more than five days or so, it could decrease the metabolic rate, which counteracts the whole process of weight loss.
But if you just do it for 24 hours or these longer periods, it actually has been shown to work better than long-term caloric restriction because caloric restriction, over time, will definitely lower the metabolic rate. “Oh, you’re only going to give me 1,000 calories? I’m only going to burn 1,000 calories. Thank you very much.” And then its like, “Okay. Now I got to decrease it further, and further, and further.” Whereas, fasting is very healing. And so the fasting mimicking diet is very low calorie diet over the course of four or five days once a month where you’re actually getting the benefits of fasting without actually having to fast. Personally, I’d rather fast. I just fast four or five days a month. And it’s easy for me because I’ve done it many times. And if you can, get amazing healing benefits when you do a fast.
Dr. Weitz: And do you consume anything during your fast?
Dr. Loscalzo: Water. Yeah.
Dr. Weitz: That’s it?
Dr. Loscalzo: Yep.
Dr. Weitz: Yeah.
Dr. Loscalzo: That’s what fasting means. People think that fasting is juice cleansing, or drinking sauerkraut juice, or drinking coffee with butter in it. That’s not fasting. Right? Let’s find a different name for that. That’s fasting mimicking maybe. But that’s not fasting. Fasting is water. And dry-fasting is without it, but I haven’t seen any benefit. I haven’t studied it much, but the whole idea of that turns me off, so I don’t do that.
Dr. Weitz: Do you ever use nutritional supplements to help patients balance their blood sugar?
Dr. Loscalzo: Absolutely. Yeah. Absolutely. In fact-
Dr. Weitz: What are your favorite supplements for that?
Dr. Loscalzo: Sometimes what I do is before I even tell them to start doing the diet stuff because that’s real hard and they’re having cravings that are related to their insulin imbalances, so what I’ll do is I’ll put them on chromium, and magnesium, and some omega 3s, a DHA. Especially DHA because that has the most profound, the DHA-EPA is very helpful. And I’ll start with those three. And I call them my craving crusher supplements. You go, “Oh, I’ll take the craving crusher supplements.” Because people say that after a week or two, they’re like, “Oh, I don’t have my sugar cravings as much anymore.” Then, I can start with the diet. But because if I start with the diet, which I used to do, they’re like, “Oh, but I need. And I need.” And they’re always falling off. But this way, they feel really good. I use cinnamon. I’ve used berberine, olive leaf extract, lipoic acid. But my main core three that I start with are those, the magnesium, chromium, and DHA.
Dr. Weitz: What do you think about some of the resistant starch products on the market? You know, there’s powders with resistant starch, medical foods?
Dr. Loscalzo: I’m not a big fan of powders and potions. That said, I haven’t really tested them much. I mean, the research looks like if you take potatoes, which are very high glycemic, and you cook them, and then you put them in the refrigerator, that it’s better. I haven’t actually tested it on myself just because I haven’t eaten potato in like six or seven years. And I really have no interest. But I could do an experiment with some of my clients. A lot of my clients find is that if they do that and then they ferment that, like take a sweet potato, and cook it, and then put it in the fridge. And then they take that sweet potato, and they blend it up, and they put in probiotic organisms, and they let it ferment, like make a yogurt, make a sweet potato yogurt, that that lowers the glycemic-
Dr. Weitz: Sweet potato yogurt?
Dr. Loscalzo: Yep. I have a friend how makes lentil yogurt.
Dr. Weitz: Really?
Dr. Loscalzo: I haven’t tried these things. I’ve tasted them, but I haven’t really tried making them. I stick to coconut yogurt. I do cashew yogurt. I do a combination of hemp, and brazil nut, and cashew. I do all kind of nuts and seed type yogurts and kefirs, but I haven’t tried those yet. It’s just I have to stay away from the starchy foods, personally, for me.
Dr. Weitz: Yeah. The grains and beans et cetera. Okay. So I think that’s all the questions I have. I think that was … You gave us some good information. Any other topic, any other final thoughts you want to give us about improving insulin resistance?
Dr. Loscalzo: Yeah. I would say it’s not just about the food. So you really have to look at these five lifestyle factors that I teach. You have to be moving. We have to move. It’s so-
Dr. Weitz: Oh, yeah. We didn’t really talk about exercise. What kind of exercise you think is most effective for blood sugar balancing?
Dr. Loscalzo: I like burst training. I think that’s the most effective-
Dr. Weitz: Burst training?
Dr. Loscalzo: Burst training.
Dr. Weitz: Explode, you know?
Dr. Loscalzo: Where you just explode 30 seconds of really intense exercise. And then you stop. And you could either do that as part of an aerobic routine where you’re running along, and then you go way on, and then you run back to normal speed. You can do stair, up and down the stairs. You can do jumping jacks. I have a little stair-climber thing that I get on there and I just go, “Err,” as fast as I can. And that helps to really burn. It’s been shown that that increases growth hormone as much as a half an hour of aerobics in 30 seconds. So it’s very effective. And I know people who have … They eat something, you go, “Oh, my God. My sugar just went up.” And they’ll just go do some bursts and bring it back down.
Dr. Weitz: Is that part of your exercise program? Do you also do steady state aerobic?
Dr. Loscalzo: Oh, yeah. I do. Yeah. I do. I run or I swim. I do weights. I mean, it’s part of it. But that’s something to add to. Yeah. And then, for some people who are not that fit, walking. Just get out there and walking in 10 minutes at a time, plus the burst training. And you can really reverse things dramatically. Trained muscle is much less resistant to insulin than untrained muscle.
Dr. Weitz: Right. I think doing some weight training probably helps stimulate muscle in the body.
Dr. Loscalzo: And weight training is great.
Dr. Weitz: Yeah.
Dr. Loscalzo: Because you increase muscle. Right.
Dr. Weitz: Yeah.
Dr. Loscalzo: And yes. You increase the metabolic rate by increasing the muscle. Right. And sleep is super important. Tons of studies that show that even one night of bad sleep in an otherwise healthy person will induce a temporary insulin resistance. So I find that on days when I haven’t gotten enough sleep, I’ve stayed up, I’ve flown, whatever the reason, that I’m ultra careful the next day with my food. Yeah.
Dr. Weitz: For stress relief?
Dr. Loscalzo: Stress release. My favorite is Heart Math. And I also mediate using a device called The Muse, which kind of measures my brain waves. You wear a little band around your head and it measures your brain waves. It’ll give you like “Tweet, tweet, tweet,” on the birds if you’re in calm state. And it’ll do these like, “Whish, whish, whish,” to show you that your mind’s just gone off and come on back.
Dr. Weitz: What’s that called, The Muse?
Dr. Loscalzo: Muse. M-U-S-E.
Dr. Weitz: Oh, okay.
Dr. Loscalzo: Yeah. Yeah. It’s really cool.
Dr. Weitz: You wear this thing on your head?
Dr. Loscalzo: Yeah. I do it for 20 minutes a day in the morning. And it’s my meditation. I’ve always had a hard time meditating because it’s like, “Am I done yet. Am I done yet? Am I done yet? How’s the timer?” And then I do Heart Math, which is this breathing appreciation combo that you can do throughout the day in 30 seconds at a time. So I’m into quick-fix stress relief. And it’s helped me dramatically from that.
Dr. Weitz: Right. Great.
Dr. Loscalzo: Yeah.
Dr. Weitz: Good. Okay.
Dr. Loscalzo: Yeah.
Dr. Weitz: Okay.
Dr. Loscalzo: Yeah.
Dr. Weitz: So how can listeners and viewers get a hold of you?
Dr. Loscalzo: Yeah. So my main website is drritamarie.com. I have a couple of free things I could tell you about that they can get that are related to this. One is called hormonehackingbreakfastmenus.com. For those of you who don’t want to skip breakfast or want that really balancing, hormonehackingbreakfastmenus.com, and it’s just little 20-page booklet that has 5 different menus, and, I don’t know,, 12 different recipes, and guidelines for how to put together a breakfast that’s going to keep you steady throughout the day.
Dr. Weitz: Okay. And I understand you have some courses for-
Dr. Loscalzo: Yes.
Dr. Weitz: … for both patients and practitioners, for blood sugar insulin balance.
Dr. Loscalzo: I do. I do. I have a program called The Sweet Spot Solution. It’s thesweetspotsolution.com, and that’s where people who want to get their own blood sugar under balance do. It’s like a three-month program. And we guide people through. And we have a Facebook group. And they really get to learn the process and go through the steps. And we guide them and we coach them. And then we have for practitioners, we have the Insulin Resistance Practitioner training which is at insulinresitancepractitioner.com. And we take them through, and they get a free seat in our individual programs. They can actually go through themselves or take a client through. And we teach them all the ins and the outs and the tracking. And we have coaching calls where they get on and ask questions so they can bring their client cases and that sort of thing. And that’s a certification program.
Dr. Weitz: Okay. Cool. That’s great. Thank you for spending the time with us. And I’ll talk to you soon.
Dr. Loscalzo: Thank you very much. Bye.
