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This question is important to me and I plan on giving it a bounty after the necessary waiting time passes (48 hrs), please tell me what you think.

Have I found the ultimate Health Hack? When this question is through I hope to convince you that becoming insulin sensitive might be the most important thing that most people can do for themselves. I also hope to make the case for the most efficient way to increase insulin sensitivity.

First I'll make the case for how being Insulin Resistant can be BAD for your health:

  1. Hair loss and Insulin Resistance in Women.
  2. Insulin Resistance and Alzheimer: Reuters, Penn Med and Washington.
  3. Insulin Resistance and All Cause Mortality NCBI1 and NCBI2.
  4. Insulin Resistance and Acne.
  5. Insulin Resistance and Hard-gainers (Bodybuilding).
  6. Insulin Resistance has an inverse correlation with Serum Testosterone and Mitochondrial Function: Diabetes Journal, Doc Guide and NCBI. Tied to this is low testosterone predicts all cause mortality in women and men.
  7. Hair loss and Insulin Resistance in Men.
  8. Insulin Resistance and cancer: 1, 2, 3 and 4.
  9. Insulin Resistance and PCOS.
  10. Insulin Resistance and the Metabolic Syndrome Natural Choices inc, Pubmed.
  11. Insulin Resistance and Diabetes.
  12. Insulin Resistance and Obesity.
  13. Insulin Resistance and Depression / Mood Disorders: British Medical Journal, Diabetes Journal (ADA) and Women's Health.
  14. Insulin Resistance and living proximity to wealthy areas (This one is a bit of a reach for sure, but the fact that poorer people are more insulin resistant on a linear regression is quite interesting imo).

So if you want to keep your hair as a man or a woman, have sound cognitive function, lower your all cause mortality risk, get rid of acne, build muscle, increase mitochondrial function, increase sex hormones like testosterone, decrease risk of glandular cancers especially, not be obese, not be diabetic (type 2), not have metabolic syndrome, not have pcos, not be depressed or generally have ideal physical and mental health then becoming more insulin sensitive is probably a good idea.

Some things that might Cause Insulin Resistance:

  1. Grains - NCBI.
  2. Sedentary Lifestyle NCBI 1, NCBI 2 and Diabetes Journal.

Some things that might Improve Insulin Sensitivity:

  1. Vitamin A - NCBI
  2. Calcium, magnesium, chromium, vanadium and zinc - Well Cited Thorne pdf Article.
  3. HIIT - British Journal of Sports Medicine , The Journal of Psyiology , BioMed Journal.
  4. Resistance Training - Diabetes Journals (ADA) , NCBI 1, NCBI 2.
  5. Vitamin K2 - Diabetes Journal.
  6. Cold Showers / Ice baths - Tim Ferris, Jack Kruse and others.

I've shown that Insulin Resistance is correlated with Testosterone, Mitochondrial Function, Leptin and a host of other processes in the body. If the master hack is to become more insulin sensitive, then obviously these other processes which correlate with insulin sensitivity would be included also. So, my question to you then is:

Is Increasing Insulin Sensitivity THE Ultimate Hack?

I have 42 citations from over 10 recognized clinical journals. If you answer this question with a NO, I fully expect at least a descent rebuttal with appropriate citations. TY. I'd also like to note that this is assuming you're already getting adequate micro/macro nutrients in your diet.

The discussion on this hack has been going on for some time now and we have had a lot of valuable input. I recommend strongly for anyone interested in this idea to read through the whole thing. I'm copying one particular entry by Mike T because I'd HATE for anyone to walk away without reading this. After much discussion I've come to the conclusion that this is probably an essential puzzle piece of this hack.

You allude to this in your comment to August above, but perhaps the hack is actually to make your muscle cells insulin sensitive relative to your fat cells. I think increasing the insulin sensitivity of muscle and fat cells together, has much less benefit (if any) relative to increasing muscle cell insulin sensitivity while maintaining fat cell insulin sensitivity or even maintaining muscle cell insulin sensitivity while decreasing fat cell insulin sensitivity. -Mike T

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Does becoming insulin sensitive mean eating low carb or ketogenic? How many carbs do you propose to be ideal? I am confused by the Perfect Health Diet's recommendation of 150 g/day of starch versus the numerous others (Kruse, Ferris) advocating lower carb consumption. Can a ketogenic diet be healthy long term? – Andrew Dec 9 at 19:27
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 I hope I'm capturing the essence of your comment by paraphrasing it as "What would a long term healthy insulin sensitive promoting diet's macro-nutrient ratio be?" And if that was your question I would say that the ball is still in the air on that one as far as I can see. jacn.org/content/23/2/177.abstract and ncbi.nlm.nih.gov/pubmed/15650564 both contradict each other. I think the reason for these discrepancies is that there are so many other things, other than the amount of carbs/fat you eat that can influence Insulin Sensitivity dramatically. – Stephen Ross Dec 9 at 19:49
Grains, sugar, fruit, honey and starchy tubers all effect your body differently. I personally believe and tend to practice a simple idea, which is, would I easily be able to get this food or something similar 3,000 years ago. That narrows what I eat down to meat, vegetables and tubers with seasonal fruits. I find I function well on this and with the high intensity short duration activities that I perform, I can usually feel when my body needs some starches/carbs and I eat them accordingly. – Stephen Ross Dec 9 at 19:57
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 Does becoming insulin sensitive mean eating low carb or ketogenic? (Not necessarily). How many carbs do you propose to be ideal? (From my research I'm not convinced there is a one-size-fits-all amount of carbs that are ideal for everyone). I am confused by the Perfect Health Diet's recommendation of 150 g/day of starch versus the numerous others (Kruse, Ferris) advocating lower carb consumption. Can a ketogenic diet be healthy long term? (For Some People probably). – Stephen Ross Dec 9 at 20:00
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 Stephan recently wrote about this: wholehealthsource.blogspot.com/2012/12/… and something I took from that is if you become more insulin sensitive, your body will then produce less insulin to achieve the same level of signaling and the net effect might be inconsequential (assuming you were metabolically healthy to begin with). – Mike T Dec 10 at 4:03
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8 Answers

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Yes it is, and I have been saying this since the first day I signed up here. It is why I am adamantly opposed to high fat, ketogenic diets as they do not increase insulin sensitivity. Aside from probably exacerbating insulin resistance, they don't treat type 2 diabetes. Being healed means being symptom free (normal blood sugar) upon agitation (carbs), not being symptom free (normal blood sugar) in the absence of agitation (no carbs). Diet and exercise is still the best way to get lean and hot and look good naked. High fat ketogenic diets are for fat people who binge and eat crap food and then blame carbs generally. Carbs generally are their scape goat. High fat, VLC diets do not attack the root of the problem (insulin resistance) they just avoid carbs and don't actually heal (restore pancreatic beta cell function). The latest research shows that 2 months is all you need to restore that beta cell function and all it takes is severely reduced calorie diet (800 cals/day) that is low in fat and moderate in carbs. Problem is, fat diabetic people don't like restricting calories (which is why they also love paleo, where you can eat all the fat you want and never get fat.LMFAO). (It is no consequence that this site usually feels like it should be renamed binge-eaters anonymous).

That was a bit of a rant, but it's nothing new as I've been saying this in so many words on this site. Glad you at least get it.

...this is also why many fitness models say the combination of HIIT, weight training and a clean diet (not a high fat zero carb diet) is the fountain of youth. it is because this is a potent combination for increasing insulin sensitivity as evidenced by looking down right f***able with or without clothes on.

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 Totally agree with you! And upvoted! Would the downvoters like to say why they would downvote this answer, it had one downvote when I saw it, it will probably have more, although you speak the truth. Maybe the downvoters are just bitter "paleophatties" who like to think down the HAES route? I find it extremely entertaining how the still sick overweight fateaters give advise to others on how to be "healthy, and lose fat" while never succeeding to do so themselves. This is " the emperors new clothes" situation going on here, and elsewhere too. – mM Dec 9 at 22:20
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 Haha, good. I'm glad I'm not crazy and that there are other people who understand this too Ty for your comment it is very well received. +1. – Stephen Ross Dec 9 at 22:20
Foreveryoung, you have a question from September 10th at 20:18 titled Low carb dieters are ego depleted (paleohacks.com/questions/148431/…). Now I some of the reasons I think activities like HIIT and weight lifting are intrinsically healthy (other than insulin sensitivity) is because of Todd Becker's blog www.gettingstronger.org , specifically his article on the opponent process theory of emotion. I have some qualms with some of his arguments but I really latch onto the idea of acute stressors causing sustained happiness and vice versa. – Stephen Ross Dec 10 at 3:34
His blog post I'm referring to is gettingstronger.org/2010/05/… and the reason I'm brining this up is because your low carb ego depletion question got me reconsidering the fact that making choices and tough decisions and deciding to act actually depletes glucose/glycogen? supplies to the brain. My theory is that in the same way that doing HIIT increases sensitivity to glucose, so would doing short bouts of overcomming tough mental obstacles (such as cold approaches, job interviews or doing cal, lol) increase your brains sensitivity, which ultimately would result – Stephen Ross Dec 10 at 3:38
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 ...before both would have been simultaneously impossible. Also, it makes sense on another level. Mental stress releases cortisol and cortisol is suppressed by carbohydrate consumption. There are so many reasons carbs are beneficial for us, and many paleo-minded people are either too ignorant and/or in a great deal of denial of it. – foreveryoung Dec 10 at 12:58
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Since these seem to be mostly epidemiological studies I do think there's likely to be some confused causation. IR is probably linked casually to some of those conditions (like diabetes), but in others like obesity there is likely a number of underlying factors which cause them both, two examples of this in the case of obesity being chronically over consuming calories and leptin resistance.

I think Stephan Guyenet makes a pretty good case in this post for the idea that over consuming calories and gaining fat increases insulin resistance, suggesting IR could very well be secondary to calorie over consumption.

Furthermore, it could be pointed out that in studies in which subjects are fed large doses of fructose leptin resistance precedes insulin resistance. In fact, leptin resistance is increasingly being recognized as a potential factor in insulin resistance (7, 8).

Leptin resistance also appears linked to increased body weight and obesity (3, 4, 5, 6) and animal studies have also noted that leptin sensitivity plays a key role in regulation of body weight (look up the "Zucker Rat").

Thus, one could reasonably postulate that at least part of explanation for the correlation between insulin resistance and obesity is either due to a reversed causation (obesity –> IR) and/or leptin resistance playing a casual role in both.

So I guess what I'm saying is I don't think improving insulin resistance is inherently the ultimate hack. I think if you improve insulin sensitivity you're almost always doing something right, but I think you have to make sure the treatment is hitting at the true underlying cause of disease so you don't end up focusing on a mostly downstream biomarker, sort of like what a lot of people have done with high cholesterol (which is not to say that both don't potentially pose problems themselves though, I think both can be, just not in every situation).

Edit: This was one of the better constructed hacks I've seen here on PH, so I really tried to offer well supported explanation of why I don't entirely agree. I think there's a lot of good information here and I don't want to seem like I'm trying to throw the baby out with the bath water.

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I agree that 1-13 are epidemiological and correlation is not causation. Part 2 and 3 include generous amounts of Clinical trials though, specifically sedentary lifestyle ncbi 1, HIIT and Resistance training. I encourage you to consider that while sedentary life, HIIT and Resistance training all have significant impacts on insulin resistance they also effect many many other hormones and functions in your body, from HGH to mitochondrial function to testosterone. So maybe it should be more accurate to consider my suggested hack a general good direction and insulin sensitivity as a good goal/ – Stephen Ross Dec 9 at 23:44
/starting point because of it's strong correlation to many other healthy hormone levels and body functions. You talk a good bit about leptin and obesity and it just reminds me of the close relationship between insulin and leptin: nature.com/ijo/journal/v22/n2/abs/0800559a.html , smj.org.sa/PDFFiles/Jun08/… , ncbi.nlm.nih.gov/pubmed/18075970 and ncbi.nlm.nih.gov/pubmed/8666154 . So maybe I cited too many epidemiological studies and I can agree that maybe insulin resistance as a lone target is too simplistic if you can agree – Stephen Ross Dec 9 at 23:44
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 Yeah I pretty much agree with everything you just said. – Mscott Dec 10 at 0:04
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 I think the main caveat I can think of to all this is the adaptive increase/decrease in insulin sensitivity when increasing/decreasing carbohydrate intake is probably not (IMO) via a mechanism suggestive of increased disease risk. – Mscott Dec 10 at 0:06
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 If the person who downvoted my answer would like to explain why they thought my answer was unhelpful I would gladly listen to your reasoning. Feel free to come in from the shadows on anonymity. – Mscott Dec 10 at 0:24
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You propose to evaluate a "hack" described as cause and solution, but you provide no method or diagnostic, which is what all biohacks rely on. A symptomatology of "insulin resistance" is vague until it reaches pathological levels (ie diabetes) as well, so, while good insulin sensitivity is, as you prove, certainly desirable, i don't see a hack being proposed here. If it was, i'd say the ultimate hack is being healthy.

An actual hack would be a way to get excellent insulin sensitivity with a very high degree of success and in a predetermined amount of time by following a clear method, with a diagnostic tool to tell us when we have or haven't achieved that.

Even then, there are multiple factors affecting the health of Paleohacks users: gut flora balance, inflammation, fatty acid metabolism, bad epigenetic profile, pollutant toxicity... and i doubt fixing insulin sensitivity alone would solve all of them.

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I'm sorry you appear to have missed my header titled "Some things that might Improve Insulin Sensitivity:". The hack is improving insulin sensitivity and this is the section where I detail 6 techniques to improve insulin sensitivity / decrease insulin resistance. (ie. the 'hack). Many of these studies were done in non diabetics and I Do list causes and solutions. Everyone has varying degrees of insulin sensitivity and maybe I didn't make that clear enough. Ty for your comment none the less. – Stephen Ross Dec 9 at 22:28
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Oh hell no. Listen to Robb Wolf and Kiefer talk about carb backloading and the implications. Seriously- I listened to this one three times.

Insulin resistance in response to the Standard American High Carb diet is very different from insulin resistance because of eating low carb. Insulin is suppose to shuttle the blood sugar into the cells, but in the case of low carb, the brain wants it sequestered for itself- this is a natural process. It is an unnatural- i.e. weird neolithic crisis mode- situation when your cells just can't take it anymore. The insulin sensitizing agents are not going to fix the situation; they will just break the cells.

This is at least as bad as the people who assume ketosis and keto-acidosis are pretty much the same thing.

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Thanks for the link, Kiefer is the man. – Stephen Ross Dec 14 at 0:16
I'm not advocating high or low carb here though man, and you're going to be hard pressed convincing me cold showers, working out, HIIT and vit a d3 k2 are going to "just break my cells", lol.. – Stephen Ross Dec 14 at 0:17
Also, at 50:00 in the link you gave me he mentions that while insulin sensitivity might not generally help, insulin sensitivity in the muscles and not the fat is excellent and what you want. – Stephen Ross Dec 14 at 1:04
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 You can see why it isn't the ultimate hack though. Extreme insulin sensitivity would mean your cells were fast to store- and the muscles can only store a little. So, you'd be ravenously hungry under conditons of extrreme insulin sensitivity, because your brain wouldn't like how low your blood sugar was, but also ridiculously fat- until those fat cells did pretty much break. This is why they become insulin resistant under SAD conditions- they are trying to stay alive. It might make sense to improve insulin sensitivity under specific conditions, but it isn't a catch-all. – August Dec 14 at 14:55
Would increasing muscular insulin sensitivity while decreasing or sustaining fat insulin sensitivity be the ultimate hack then? Assuming no drugs or gene manipulation, but rather using the techniques listed above like HIIT and weight lifting? – Stephen Ross Dec 16 at 21:32
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The Ultimate Hack is out there...The Potato Diet. www.freetheanimal.com is showing you how and has all the links, musings, science to back it up.

The "Potato Diet" is this: Eat potatoes for 7-14 days, or eat potatoes periodically. When 'eating potatoes', that's all you eat...potatoes. Some have been adding a miniscule amount of fat to cook with, but no other veggies, fruits, or meats allowed.

Eating a predominately (90%+) diet of white potato causes almost unlimited insulin sensititivity by necessity.

Potatoes are a highly resistance starch with a supply of all essential amiono acids. They are lacking in certain vitamins and minerals, which is why this is not done long-term. The sodium and potassium content of potatoes, and the effect on gut flora make the potato diet the perfect storm for insulin sensitivity.

Here is a thought experiment: How can a 'high carb, low fat, low protein' diet make one both insulin sensitive and insulin resistant while allowing rapid fat-loss and ketosis?

The "Potato Diet" does all this...

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 This is super interesting to me and TY for posting this. I've included more mashed potatoes in my diet these last 2 weeks and have been feeling really good overall and I wasn't sure why. After the 1-2 weeks on the exclusively potato diet, can you then include other meats and vegetables and still benefit from it's health promoting properties? – Stephen Ross Dec 11 at 18:39
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 Yes, in fact most people feel pretty silly for demonizing potatoes. They are not in the same boat as sugar as a carb source. Potatoes are a real, whole food, full of antioxidants. Paleo man would have surely been stuck eating only starchy tubers in times of famine. Most who have done this report better glucose control and long-lasting weightloss. marksdailyapple.com/forum/thread72366.html dozens of MDA readers did an experiment last week and posted results... – akman Dec 11 at 19:27
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I thought add some information you might find worthwhile:

http://paleohacks.com/questions/184290/selenium-and-diabetes-insulin-resistance/184329#184329

This is a question I asked today about 2 controlled trials where 200 ug/d selenium supplements increased diabetes rates in men. When breaking down subjects by in one of those studies by blood selenium, only men with higher blood selenium levels saw their diabetes risk increase:

In the comments of MarkES's answer I posted what was actually the same study, but looking at cancer rates. The graph below is hard to see, but it found that broken down by the same selenium levels, selenium supplementation lowered cancer risk in the lower level and raised risk in the higher level:

So with that data, here's a simple chart I made comparing the risk of diabetes with the risk of cancer in each of the three tertiles:

Certainly a decent correlation between trends there. I do wish there were more data points to look at, but oh well. Anyway, sorry for such a spacious answer but I just wanted to post this since I've been looking at it and it fits in with your ultimate hack theory. What the casual connection is between cancer and insulin resistance in all this is who knows (selenium toxicity?), but this seems to lend a small amount of support to looking at preventing or alleviating insulin resistance for cancer prevention.

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Yea dude, I'm still pretty confident that this is basically the ultimate hack. I've come up with a system of short duration intense exercises spread throughout the day, 30 seconds of pushups or sprinting up the stairs or jumping squats spread periodically over 12 ish hours. I'm basically trying to make my muscle cells bigger so they can sponge up the glucose and lower insulin and balance my hormone panel in general. Did you see my 14th study that insulin resistant people live in poorer neighborhoods? Fuck that, I won't stop trying this new shit till I drop stone cold dead, lol. – Stephen Ross Mar 10 at 3:31
Haha I like your enthusiasm. I'm trying out some HIIT once finals are over this week since guys like yourself sing its praises. We'll see how it goes. BTW do you ever get your insulin sensitivity measured clinically or just like with a home bg moniter? – Mscott Mar 10 at 5:59
Actually, idk if it's better or worse of a measurement but when I was 15-16 I started to get mild acne (when I started sitting in front of the computer for hours playing wow/runescape). I had mild-moderate acne up till the time I started doing HIIT (in the last year or so). I've since learned that there is a significant correlation between insulin resistance and acne in men(study 4 from above). So I can't specifically say that HIIT has necessarily improved my insulin sensitivity, but being a computer science major I sit in front of a computer a lot (sedentary behavior) and if I go a week – Stephen Ross Mar 10 at 13:20
Of that without doing any HIIT I'll get 1-2 whiteheads, which will literally go away within 1-2 days of some HIIT (and stay away for months if I'm consistent with HIIT, and not necessarily the sprint 8 protocol, protocols with less sets work too, usually 4-6 sets at 20 seconds). So it's very easy for me to accept that HIIT is basically essential for me, I'm technically assuming that it's specifically because of insulin resistance but in truth it could be either other things or a combination of several things. My only advice, which is critical from myperspective is to – Stephen Ross Mar 10 at 13:27
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 Well thanks dude I appreciate the info. I think I might try incorporating something when I'm riding my bike to and from school or wherever, like 20 seconds hardcore peddling then an easy pace then repeat. I'll hit you up if I have more questions. – Mscott Mar 10 at 19:38
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Maybe I'm reading your question too literally, but to me paleo is the ultimate hack. Guiding our food, exercise, sleep, etc. decisions by the environment in which our bodies evolved. Everything is else is details and application. To me, this likely encompasses your hack above.

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Paleo as a lifestyle could encompass this, but it doesn't necessarily. One could live 20,000 years ago AND be insulin resistant necessarily. While Insulin Resistance / being healthier would most likely have lead to higher reproduction rates it doesn't necessarily follow that living paleolithically (not a real word, lol) would include insulin sensitivity. Paleo as a diet most definitely does not encompass this, as you could eat ideal foods and have sporadic sleep schedules and/or a sedentary lifestyle. – Stephen Ross Dec 9 at 23:51
If that's the case, then I would choose living "paleolithically" as a more "ultimate" hack than increasing insulin sensitivity, though I'm not sure how valuable of a debate it is... – Mike T Dec 10 at 4:00
Lol, insulin sensitivity is something that's actually do-able is the thing, having access to foods that don't exist anymore, living outside where you can get vitamin d all day, running from predators, killing your prey, living in small close knit groups starving when you don't get enough food, being exposed constantly to the elements.. This isn't as realistic of a hack as just doing HIIT and weight lifting. That hack might in theory be more ultimate, but if it can't be reproduced for most people and still doesn't necessarily work then I consider it an inferior hack... – Stephen Ross Dec 10 at 12:50
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You allude to this in your comment to August above, but perhaps the hack is actually to make your muscle cells insulin sensitive relative to your fat cells. I think increasing the insulin sensitivity of muscle and fat cells together, has much less benefit (if any) relative to increasing muscle cell insulin sensitivity while maintaining fat cell insulin sensitivity or even maintaining muscle cell insulin sensitivity while decreasing fat cell insulin sensitivity.

If this is the case, then much of the hack you list above, may actually not be helpful in this regard? I'm not sure. Perhaps resistance training? Or maybe the relative insulin sensitivity between muscle and fat is largely genetic? E.g., a mesomorph has high muscle cell sensitivity relative to fat cell sensitivity, while an endomorph has the opposite.

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This is an astute observation. If an individual walked away from this thread and only decided to incorporate HIIT and weight lifting into their everyday routine, then I would consider this thread a success. I +1'ed this. I do however take offense that much of my hack "may not be helpful" because HIIT and resistance training should definitely help in this regard. And the consequences of becoming insulin resistant in muscles and fat still exist in the epidemiological studies listed above. sedentary lifestyle will also likely lead to insulin resistance in these unused muscles. – Stephen Ross Dec 16 at 21:21
2 
 Thanks. Definitely didn't mean to offend you. I was just trying to say if you agree that the real goal is change the relative sensitivity between muscle and fat and IF any of 1-6 you listed above improves sensitivity in both muscle and fat together, then those specific ones wouldn't help with the goal of changing the relative sensitivity. Right? That may only apply to 1,2,5,6 or maybe not to any of them or maybe to all. I don't know. – Mike T Dec 16 at 21:27
Okay, that's valid. I think I'll update my above post with these conclusions as this is a valid distinction that should be noted. I think this rightfully helps tie in both the critics and the supporters of this thread by stressing the correlation between IR and a host of diseases while still noting the difference between IR in muscles and IR in fat. Really though, I think It might be better to re-research this topic, and make a part two that uses these conclusions to come up with a better explanation and a more accurate hack. Possibly tying in sex hormones and maybe muscle mass. – Stephen Ross Dec 16 at 21:44

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