Reverse Insulin Resistance: Health Tips for Women Over 40

00:00Real quick, the only ask I could ever have of you guys is to help spread the word so we can help more women lose body fat, build muscle, reach their goals, and feel insanely confident. And the only way we can do that is if you rate, review, and share this podcast. So the single thing I ask for you to do is if you could leave a review. It will take you 10 seconds, and it will mean the absolute world to me and may change the world of someone else. That is why my heart is in preventative medicine so much so that I can help people in midlife, maybe their 60s, early 70s, get their health back so that they can be there for their family because, heck, kids need their parents. Grandkids need their grandparents. And I think that the society is just a better place with people of good health.

00:44We save so much money, so much energy, so much time, and have a greater quality of life if we can get and stay healthy now versus waiting until like you're 70 or 80 hoping that your doctor can fix it. What is going on, everybody? Welcome back to The WarriorBabe Show. Today, we are so honored to have and host Dr. Morgan Nolte, a board-certified clinical specialist in geriatric physical therapy and the founder of Zivli.

01:21Dr. Nolte's pioneering work, you guys, focuses on reversing insulin resistance and sustainable weight loss and disease prevention. So I'm super excited for her to be here today because I know there's so many of you guys that listen to this podcast that have or are dealing with these types of diseases, and we're here to pick her brain. So stay tuned, and let's dive into some amazing insights with Morgan. Welcome to the show. Yeah, thanks, Nikki. I'm excited to be here.

01:52Awesome. So first and foremost, what is insulin resistance? Let's just dive right into that. Okay, so insulin resistance is essentially a condition that can happen throughout the body when your cells become resistant to the hormone insulin. And insulin is a hormone made in your pancreas that has a lot of different roles in the body, but the primary role that I focus on is its ability to regulate blood sugars. So for example, after you eat a high-carbohydrate meal, your blood glucose will spike up, especially if it's not during exercise or right after exercise.

02:28And that's going to require insulin to come up to push the glucose back into the cells to maintain a normal low blood sugar level. And what happens is over time, if you repeatedly eat a diet high in refined carbohydrates, and I know your crowd is a bit different because they may be eating those but also exercising to match that, but I'm talking about people who are over-consuming carbohydrates compared to their exercise level, or perhaps they're chronically stressed or sleep-deprived.

02:58There's a lot of things that can contribute to insulin resistance, but a diet high in processed foods and refined carbohydrates is usually part of the equation for most people. And what happens is over the years, their glucose has spiked and their insulin has spiked, and their cells just kind of start to tune out insulin and become less sensitive to its blood sugar lowering effects. And what you'll see then is a rise in blood sugar levels. But the thing that I think is so important for people to realize is that you can see elevated fasting insulin levels 10 to 20 years

03:34before you would see the downstream effect of a rise in blood sugar or hemoglobin A1C, which is a three-month estimate of your blood sugar. And so many doctors aren't checking fasting insulin levels, and they are waiting until somebody is diabetic to do something about it. But there's 10 to 20 years of intervention that we can use to prevent diabetes in the first place, and that's what I'm so passionate about. Thank you so much for that explanation. And thank you also for the differentiator there from the majority of people that are going through this

04:08and the people that are listening to this podcast who carbohydrates are a great fuel source for exercising. So with insulin resistance, how does that affect weight loss and overall health? Yeah, so it's interesting. So let's start with overall health first of all. High levels of insulin is very inflammatory. And inflammation in general can raise insulin levels. So inflammation and high levels of insulin really fuel each other. And our program, our approach is to keep both levels low,

04:39keep inflammation low and keep insulin low. And that's really how we prevent disease. But if you're looking at root causes of disease, you're going to find insulin resistance in so many. I like to think of a picture of like a tree with a root system and a lot of different branches. Insulin resistance is at that root system. And whether or not it manifests into type 2 diabetes, cardiovascular disease, such as a heart attack or stroke, Alzheimer's dementia, vascular dementia, osteoarthritis, sarcopenia or muscle wasting,

05:10there are so many things that can be traced back to insulin resistance. But your lifestyle and your genetics will depend on how that manifests for you personally. And obesity is also something. So insulin is not just your blood sugar regulating or stabilizing hormone. It's also your fat creation and storage hormone. So another really important job of insulin, it's almost like the master regulator of how your nutrients are assimilated in the body.

05:40So if you're eating a lot of protein, for example, that will stimulate a moderate insulin response. And what that does is your insulin will essentially tell the cells what to do with that protein. Okay, go build bone, go build muscle mass, go build more skin or hair. So insulin also tells your body what to do with the nutrients that you eat. And when you're eating a diet that is high in refined and processed carbohydrates and sugar, I'm not going to use the caveat anymore.

06:12This is the last time that I'm going to use that caveat on carbs. If you're not balancing that out with some high intensity exercise. So just know there's always that caveat. I understand your audience is very much into muscle building, which can require intense exercise, which is better performed with some carbohydrates. However, when that happens and you spike your insulin, that puts you in a fat storage mode. And so high levels of insulin will drive fat storage. Low levels of insulin will facilitate fat burning.

06:46And that's not to mean that calories don't matter. Low insulin calories are still calories. And if your goal is to lose body fat, you will have to be in an energy deficit. But from my experience in coaching and personal experience, that's going to be easier to do on a lower insulin diet. So low insulin doesn't necessarily mean low carb if you're doing a ton of exercise and stuff like that. But usually it does. So insulin resistance does contribute to obesity, but it's not always accompanied by obesity.

07:23And there's some really interesting statistics out there on TOFI. So thin on the outside, fat on the inside. And I think this is another benefit of insulin testing, because if your physician is just looking at your waist circumference or your body weight, you may be in the normal range. You may look thin on the outside, but actually have fat around your organs on the inside. And when we test for insulin, we can catch that more effectively than if we're just looking at body weight or waist circumference.

07:55And actually the same goes for metabolic healthy obesity. So if we're looking at symptoms of metabolic syndrome, for example, low HDL cholesterol, high blood pressure, high blood sugar, high triglycerides, high waist circumference. When you only look at those factors, I think the statistic was like 50% of people with obesity are considered metabolically healthy. So in order to have metabolic syndrome, you have to have, I believe, like three or more of those criteria.

08:33And so when you check fasting insulin, that number reduces down to about 7%. So only 7% or so of people with obesity have healthy insulin levels. And so we're giving people a false sense of confidence in their health if we are not checking insulin, which again has been shown to predict type 2 diabetes 10 to 20 years before glucose and A1C. So I like to say glucose and A1C are the last dominoes to fall here.

09:04We have got to be more informed about our insulin. And I think one barrier to this is physician education, physician knowledge. And, you know, it takes a long time for evidence to make it into mainstream practice. And I hear people all the time saying, I asked my doctor for an insulin test and they looked at me like I had two heads. Or they said, well, we only do that for people with type 2 diabetics. And that's not used. I'm not ordering one. But you don't have to have your doctor order you one. You can order one from testing.com. We sell them on our website for like an at-home test.

09:36So if your doctor's not on board, there's a couple other great options to check your insulin. Awesome. So I was actually going to lead into my next question there. Like, you know, individuals are listening to this and maybe want to go and do this. How does someone determine if they are insulin resistant? Like, or insulin resistant? So they have the test or fasting. Yeah. So there's a few different ways. The gold standard really in research is going to be a HOMA IR score. If you Google HOMA, H-O-M-A dash IR, a calculator, that's going to come up.

10:11And in order to calculate that, you're going to need your fasting glucose and your fasting insulin. And I say Google it because it depends on if you're in like the EU or the US, depending on like what equation it is. So it's just easier to type the numbers into a calculator. That's going to be the gold standard that you're going to see in most research. I think there's some simpler things that you can do. Just look at your fasting insulin level. Ideally, that's going to be less than six. And if you don't have access to a fasting insulin, there's even more markers of insulin resistance.

10:43I've already covered some. So if you have a large waist circumference, if you have elevated fasting blood sugar, like that's the telltale sign, high blood pressure, high blood sugar. Even if it's mildly high, that's a telltale sign that you have some degree of insulin resistance, high triglycerides, low HDL. Just some more symptomatic things too would be like frequent carb and sugar cravings is often a sign of insulin resistance. Because when your cells are insulin resistant, they have a harder time letting nutrients into the cell.

11:18So it's like kind of like a type one diabetic situation where they don't make any insulin really. So their blood sugar is chronically high and it can't get into the cell. There's no key to unlock the cell to let the glucose in. So there's plenty of available energy, but their cells are actually starving. So a type one diabetic, before they start taking insulin, they're starving. They're ravenous. They're so thirsty all the time and they can't gain any weight. Why?

11:48Because they don't have any insulin. And if you don't have any insulin, you can't gain weight. So I think that that's really important to recognize that insulin is a vital hormone in our body. We need some of it. We just don't want too much of it. We just don't want too much of it. We just don't want too much of it. We just don't want too much of it. We just don't want too much of it. We just don't want too much of it. We just don't want too much of it. Please. Are you feeling frustrated with body changes you're experiencing during menopause? It's time to take control. If you're between 45 and 65 years old and tired of struggling with body fat and muscle loss,

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12:54That's WarriorBabe.com forward slash apply. All right. Let's get back to the show. Okay. We're like 11 minutes into this podcast right now. And like you've just been dumping so many knowledge bombs. Like I think of all the guests I've had on the, this, uh, The WarriorBabe Show, like we've, you know, been able to get through an entire episode with tons and tons of knowledge bombs. I'm like, we're only 11 minutes in.

13:25We got like at least like 40 more to go. This is going to be a very, very, very valuable podcast for some, for many of the people listening. So I just want to thank you before we even continue diving forward, because, um, you know, just in those three questions that were asked, it's very, you're, it's, you're, uh, you're sharing in a way that's very understandable, but not too scientific, right? Where you have to kind of bring it down. Yeah. You're amazing. Thank you. Yeah. So you mentioned that. Yeah. You mentioned a couple of minutes ago about doctors, right?

13:57And like, and, and I totally agree with this coming from the medical space that, um, they try and treat, uh, symptoms rather than root causes. And, you know, it takes a lot of time for the studies like you just shared to, you know, show evidence and show value and show that maybe there's some things that, you know, some people need to start questioning how things are being done and, and, and, uh, in healthcare space. So why do you personally think it's important to shift from just treating symptoms, um, to preventing like health issues?

14:30I've seen it. I've seen it. You know, Nikki, I was a geriatric physical therapist. And the reason that I stopped doing that was my heart broke. Like I saw so many people who had devastatingly low qualities of life. There was one lady who was morbidly obese, who I went to her home that was on the home care record, knocked on the door for her home care evaluation. The neighbors are like, Oh, she had to move, you know, months ago. I'm like, Oh, great. You know how that goes. I'm like someone in admin didn't do their job. What's this lady's address?

15:01Had to track her down. She was living in like this mobile home and in a bed in her living room and terrible. She hadn't been out of bed in 10 months. She had to move because of the medical bills draining her bank account. She never did from when I was working with her, get out of bed. And when the, uh, when the squad had to carry her in on a stretcher and turn her new home, they had to turn her sideways because she didn't fit through the door and she fell out on the door. And it's like, that is one story that will stay with me forever.

15:35Another one is this sweet, sweet, sweet man who we worked together for nine months in rehab. We got so close and he had had a fall in his apartment. He lived alone and he had rhabdomyelosis, which for those who aren't in the medical field means severe muscle wasting. He had, um, very uncontrolled type two diabetes. He was not overweight. He was actually probably underweight somewhat. Uh, one of those TOFI people then on the outside fat on the inside, he had developed a huge ulcer on his ankle because he wasn't strong enough to get up from the floor and a huge old ulcer on his bottom from being bed bound.

16:15And in nine months, we got him from being bed bound Hoyer lift, which means a mechanical lift, um, to get in and out of bed because he was on the ground for three days till a neighbor found him to walking independently with a walker, even though he couldn't feel his legs from the knees down because of the diabetic peripheral neuropathy. And then I found out later that Medicare came back and took back payments for months, six through nine of his stay in a skilled nursing facility.

16:46And I thought, what the heck, how many thousands of dollars were spent during these nine months on resources for a preventable condition. And then I was like, what the heck caused them to take their money back? Turns out somebody in billing miscoded and they put muscle muscle like weakness as the primary diagnosis instead of rhabdomyelosis. And I was just like, because of a coding error, this, this lovely business that I, I really, I liked that company a lot, you know, lost thousands and thousands of dollars.

17:22And all the work that I did for three months rehabbing this person, like was not reimbursed. And it was just story after heartbreaking story like that made me want to do something about it. And it made me want to help people prevent diabetes. And then I saw it hit home. So my dad's a type two diabetic and I saw he was way too young. You know, he, I'm like, but I saw the signs, you know, sure. Candy bar every day after work, ton of sugar, obesity, his doctors didn't do anything about it besides prescribe him medications.

17:57And I thought, man, if only he would have known better. And he was really starting to experience some symptoms of like brain fog. I was really worried about his cognitive health. His mobility was really declining. I didn't want him watching my children alone. I didn't want him carrying my babies around the house. And, you know, he got a double hip replacement, which helped, but he also got his blood sugars under control. And I trust him with my children now. And, you know, his quality of life has greatly improved. His energy levels have improved.

18:28And I have seen firsthand how many people slip through the cracks in traditional healthcare. Just this week, Nikki, I was doing a lab review for one of our sibling members and office hours. And on it, I was looking at her glucose levels, which were like 99. So very, very borderline pre-diabetic. And the normal value was like 64 to 126. There was, there wasn't even like a middle zone of pre-diabetes. And I'm like, what is happening here? So her doctor probably wouldn't say anything about her blood sugar until she was diabetic.

19:03And then it would be like, oh, here's some metformin. And so many doctors are like that. They're ignoring pre-diabetes. I had a client who had pre-diabetes for over a decade. And when she finally started to look at her own lab work and interpret it for herself, instead of like believe the little excellent that the doctor wrote at the top of the lab work every year, she's like, I have been pre-diabetic for 10 years. Oh my gosh. And my doctor didn't even tell me. And so this happens all the time. And I think that's why I'm so passionate about disease prevention, Nikki, is because

19:35I've seen firsthand how it affects my patients. But then here's the other thing that I like to say. I eight out of nine of our grandparents were present at our wedding. Eight out of nine of our grandparents were at our wedding. And we I'm like, man, we have great grandparents. And they influenced my life so much. They taught me values of hard work and loyalty and faithfulness and faith and love. And I saw them age well. And I saw them enjoy a healthy, happy retirement. And then so I saw my 80 year old grandparents acting like 60 year olds.

20:08And then I saw my 60 year old patients acting like 80 year olds. And I'm like, what's the difference here? And I just really that's why I went into geriatrics was to really pay it forward to my grandparents. And I realized that we were doing way too little, way too late in health care, especially for geriatrics. And that is why my heart is in preventative medicine so much so that I can help people in midlife, maybe their 60s, early 70s, get their health back so that they can be there for their family.

20:39Because heck, like kids need their parents. Grandkids need their grandparents. And I think that the society is just a better place with people of good health. We save so much money, so much energy, so much time and have a greater quality of life if we can get and stay healthy now versus waiting until like you're 70 or 80, hoping that your doctor can fix it. Because it's never too late, but the earlier you start improving your health, the longer you will have to reap those benefits and you won't have like decades of unhealthy habits to undo.

21:14So that opened up a can of worms, that one right there. That's why I'm so passionate. Amen. Men. I also just learned, and I don't know if we talked about this on your podcast, but we have very, very similar startings. I started in geriatric. I was in long-term healthcare. We didn't talk about that. Yeah. So I worked out of the gate, right out of right while I was going through college. I was a CNA. And I took care of the geriatrics in the nursing home in the skilled unit.

21:48So the, you know, the ones with dementia, the ones that were a little combative, the ones that are also very, very sweet. And I had full on chills when you were sharing those stories because I can totally resonate with that. Like I'm so close to some of these members that their families trusted me to take them out for lunch on one of the shifts like that. So that's so cool. I didn't know that you, you know, that that was your extensive background too, as well. That's, that's amazing. Yeah, very much. And I worked with a lot of people with dementia, Nikki, and insulin resistance is directly tied to Alzheimer's disease.

22:23Um, I just interviewed Dr. Georgia Ede, E-D-E, and she wrote the book, uh, Change Your Diet, Change Your Mind. And she does such a beautiful job. It's very scientific, but such a beautiful job of explaining when your blood sugar goes up, your brain sugar goes up. And that is very inflammatory. Um, it's, it's a cause of oxidative stress and you can get insulin resistance in the brain. And Alzheimer's disease has been coined type three diabetes.

22:54And I mean, I, you know, how heartbreaking that condition is for people to have their loved ones come in and you don't, they don't know their daughter's name. Uh, I can't even, there's one time when I was a student, physical therapy student, maybe a resident. And I was in a long-term care, um, home, probably similar to where you worked. And one of the residents was like, where's my husband? Or like, where's my husband? Where's my husband? Where's my husband? And I went to the CNA and I'm like, or the nurse, I'm like, where's her husband?

23:24I'm like, oh honey, he died a really long time ago. And I'm like, oh my gosh, I have to go break it to this woman. But you don't, you know, you just enter into the, I don't know. He's not here right now. Um, and so once I, like my passion really started from a diabetes prevention standpoint, but then once you dig down the insulin resistance rabbit hole, you realize when you live a low insulin and inflammation lifestyle, you kill the most birds with one stone. You reduce your risk for dementia, heart disease, obesity, osteoporosis, um, osteoarthritis, diabetes, the gamut.

23:57And so that is my passion. I'm a very efficient person. And I'm like, if I can focus on one thing, what should I be focusing on for my long-term health and to help other people get healthy and prevent these heartbreaking things that I saw? Yeah. I love that so much. That was, uh, what you were saying a little bit earlier. And even right there, like going in and seeing, um, when it's almost too late and healthcare is trying to fix something when it's too late. That's how I felt working in the long-term healthcare and looking at these older women and men and being like, wow, these guys probably never really exercise a day in their life or, you know, some other things, um, that I,

24:31just was very intrigued by when seeing their bodies. And then also when I went to the ER and worked in ER for four years and I was like, man, there's a lot of preventative situations that could come from eating right. And from exercise that are just not being taught. Um, so yeah, I love that. And then when seeing that is what made me transition into, um, wanting to be in the fitness space and wanting to help and serve more women and, and, and, and men too, but, uh, predominantly women. But anyway, like our stories are very, we're passionate in that sense because we've experienced it and you've experienced it with the clients that you worked with there.

25:06Then you experienced it with your dad, um, which is incredible to hear that outcome of what you just shared. And you touched a little bit on like, well, there's some other, how the underlying risk factors can, you know, enhance once you, you understand them can lead to better health outcomes. Can you touch a little bit again on that? Like when you address these, these risk factors with insulin resistance, how can that lead to better health? Hey, Hey, just want to drop a huge appreciation to you guys listening to the show. It means a lot.

25:38I hope you guys are enjoying it and there's so much more to come with it. If you are enjoying it, hit the subscribe button. I'd appreciate that tons. And also it would help this podcast reach others who need to hear these messages too. Thanks so much guys. Let's get back to the show. Yeah. Well, I think first off, I just also wanted to highlight one of the reasons I went in here with the kids of the patients that I was treating. And so I saw family members following in their footsteps and like, who is helping you? Like you don't need a physical therapist right now, but you are not well. And so I think that people in the gray zone is who I'm really passionate about.

26:11And, you know, other risk factors for insulin resistance that are completely controllable. I always like to start with sleep and stress management because when you're not sleeping seven to eight hours a night, maybe up to nine, but not past nine, not less than seven. When you're not sleeping like that, that does a couple of things. Number one is it increases your stress in your body. It increases a stress hormone called cortisol and cortisol will naturally cause your blood sugars to go up.

26:42And if you're not moving your body to utilize that blood sugar in your muscles, well, guess what? Your insulin is going to go up. So over time, poor sleep is definitely an underlying contributor contributing factor to insulin resistance. The other thing there too, is when we are sleep deprived, we are way more likely to overeat and we are far more likely to crave carbohydrate foods. And that's because cortisol increases a substance in your body called NPY, which preferentially makes you want to eat carbohydrates.

27:13So it is not just you after a poor night of sleep, or if you're super stressed out at work and you're going to the candy jar, like that is your hormones. There are things that we can do to change your environment. So sleep is really crucial for good hormone health. As you know, that's where we really build our muscle. So it's important for so many things. The other thing is stress management. And I had a very long coaching call today with somebody for mindset and, you know, the action items that we came up with were creating boundaries. I went around her work.

27:43She's working 60 hours a week and creating more joyful activities in her life because I had her reflect on the question. When I think about planning my meals, I feel, and she had a whole paragraph full of how like the external was affecting the internal. But one thing that she said was, I feel like my, my spontaneity is taken away when I plan my meals and then my fun is taken away and I need more fun. And I said, wow, like that's a great line.

28:16You need more fun. How are we going to create boundaries around your work time to create more intense, intentional rest and more fun so that food is not your only source of restful fun spontaneity. And so getting into the underlying factors that are leading to people, like leading people to be stressed out is very important. And then helping them create better thought habits and activity management habits. I like to say, you can't manage your time. We all have 24 hours in a day, but we can manage our activities.

28:47So that's important to stress, sleep, physical activity, as you know, is so important. The more physically active we are, the more likely you are to prevent insulin resistance because your muscles act as a sponge to soak up that glucose after a meal. And it reduces the insulin response to whatever you're eating essentially. And I like to say a balance of activities is best. The cornerstone has got to be strength training for long-term health at least twice a week of moderate to high intensity strength training for all major muscle groups is my baseline recommendation.

29:24And then different forms of cardio. I don't know how specific you want to get there is important, but flexibility too, I think is often overlooked. So just a nice comprehensive activity program. There's some other factors too, especially menopause. So I think that's important to address for insulin resistance. Many women go through perimenopause and they're like, oh my gosh, I gained 30 pounds overnight and I'm not changing how I'm eating and I'm not changing how I'm exercising. And now I have all this belly fat and I'm not doing anything differently.

29:57What's happening to my body. And I like to explain to them that when you go through menopause, your ovaries stop producing estrogen. And estrogen is not just a reproductive hormone. It's a hormone that's important for your nails and your skin and your hair and your muscle and your bone. Like we need estrogen, our mood, our mental health. And so what happens, your body is very intelligent and it has backup mechanisms to produce estrogen. And those are your adrenal glands and your adipose or your fat tissue.

30:28And so as we transition through menopause, your fat tissue starts picking up some of the slack that your ovaries used to do for producing estrogen and your adrenal glands do the same. But if you are chronically stressed out and your adrenal glands are just pumping out a bunch of cortisol because they also produce the stress hormone cortisol, there's not going to be enough like bandwidth in the kidneys to produce more estrogen. So then your body relies even more on your fat tissue to produce that estrogen. And that's one reason why stress management is so critical, especially in midlife to really calm those adrenals and calm the stress response so that they can produce some more estrogen.

31:08And your body feels like it's a safe environment to release some more of that fat tissue. So that's kind of hormonally what happens. Your estrogen levels are going to drop anyways, but estrogen is an insulin sensitizing hormone, meaning when we have higher levels of estrogen, we have lower levels of insulin and lower levels of cortisol. And so a cycling woman will experience that where when estrogen is highest around day 14, like when we're ovulating, I believe is when it is, we're going to feel naturally slimmer.

31:46And then as our estrogen levels fall about the week before our period, insulin levels will naturally rise and we're going to feel more bloating. It happens in pregnancy. If you're looking at like a woman who's pregnant, insulin will just, man, it'll skyrocket. You can look at a type one, look up type one diabetic insulin needs during pregnancy. And you'll see that direct correlation between insulin and weight gain. So that is so pivotal to understand that women going through menopause, it is hormone.

32:18It's hormones, but it's not necessarily estrogen. It's insulin, insulin that's really driving the weight gain, the prediabetes, the high blood pressure that you're seeing in midlife. And the couple of things that we can do is to recognize, yeah, what worked in your 30s and 40s is not going to work anymore. So we need to pivot our strategy to one that focuses on keeping cortisol and insulin and inflammation low to one that supports healthy muscle mass. And really a more comprehensive approach.

32:48So I don't prescribe any medications, but I think looking into hormone replacement therapy is a wise decision on a person to person basis, because there's kind of a golden window around menopause where if you're taking some hormone replacement therapy, that can help preserve your muscle mass and your cardiovascular health and your mental health for a bit longer as you age. So those would be the other things. Yeah, I love that you touched on menopause there. We're going to dive into it. So with the HRT, what you just mentioned, like HRT used to get a really bad rep.

33:19And now it's kind of being resurfaced as something that is, you know, very beneficial for women that are, like you just said, like before the years of menopause, it's too late though, if you're like 65, right? To do HRT? Yeah, that's my understanding. So Dr. Jamie Seaman, she also goes by Dr. Fit and Fabulous. She's come on my show to talk about HRT before. And I believe that it was her, it could have been a different guest that said it's about like 10 years. That's the 10 year window after you go through menopause, which means you don't have a period for a full year.

33:50That's kind of that golden window when we want to optimize hormone replacement therapy. And then the benefits really reduce after those years, after the 10 years after menopause, there's not as great benefits from taking it. Yeah, man, our bodies are incredible. Incredible. You know, like, I know. Yeah. Even just like you, we have, if there's menopause and like, you know, being insulin resistant, there, there's ways to fix it outside of just being, you know, turning to any type of medication.

34:20It's really, which I want to ask you a question, like working with individuals like you do in, in Zivli, what are some of the dietary like changes that are effective for you helping your, your clients and combating insulin resistance? So, you know, we have a little bit of a different approach. We have like a, we call it a Zivli habit hierarchy. We start with mindset and sleep. And then we start with, cause that's like the foundation. If you're not sleeping well, if you don't have a strong mindset and system of accountability for yourself, you're probably not going to follow through on anything else.

34:53And then we talk about water intake, at least half your body weight in ounces of water a day. And very important, especially during fat loss, um, fat actually holds onto water. And so if you're dehydrated, your body's not going to want to release that fat because that's your water reserve as well as your energy reserve. So being well hydrated electrolytes, I think are important to supplement during fat loss, especially if you're using fasting. Um, really we focus on protein next. So sleep, if you're, if you're sleeping well, if you're hydrating, if you're eating your protein, your carbohydrate cravings are naturally going to be lower.

35:29So a lot of people we work with have very intense sweets, carbohydrate cravings. They feel like they're addicted to sugar. So they just start cutting their carbs and sugar. And I'm like, well, you don't have the foundation in place to really help reduce your cravings in the first place. So for protein, I recommend about one gram per pound of ideal body weight. That's not maybe what some people feel like is realistic. So if someone's like 250 pounds and they think it's a realistic goal to get down to 170, that may even be above your ideal body weight.

36:00Your ideal body weight may be closer to like 140. So it'd be like 140 grams of protein. Um, a great starting goal there is at least 30 grams of high quality protein per meal to support muscle health. So that's usually where we start from a nutrition standpoint is water and protein. We also really recommend healthy fats. So we're not afraid of fat. Fat is the macronutrient that keeps the insulin response the lowest comparatively to protein or to, you know, starches or sugars or those kinds of things.

36:35So fat is good. We usually take, we recommend bias your fat intake towards the monounsaturated fats, especially. So avocados, olives, and their oils, unprocessed polyunsaturated fats like nuts and seeds. You want to avoid the processed seed oils like canola oil, corn oil, soybean oil, et cetera. Those are very inflammatory. And even though they won't raise your insulin level, you won't see a blood sugar response. They're inflammatory for your cells.

37:06And ultimately they will drive insulin resistance. Um, we're not afraid of saturated fats. I think it depends on the source and it depends on the person and their specific, um, genetic risk factors for cardiovascular disease. Whether or not we're recommending like eat as much as you want or bias your fat intakes, you know, towards the ones that I just mentioned. We really recommend reducing the processed fats as, as much as possible. And they're kind of everywhere, like especially salad dressings. Many people eat, think that they're eating healthy because they're eating like this huge salad with this little bit of protein.

37:39And then they're putting this dressing on top. That's like loaded with added sugar and refined oils. And that's just not the way that we want to go. And then lastly, I think it's important too, to mention gut health. I see a lot of people who are pretty dogmatic, dogmatic about like keto or carnivore, and they're forgetting about fibers and gut health in general. And there's a bunch of bacteria in your gut, long story short, and those bacteria eat fiber. And so even though we can't digest the fiber, our bacteria can, and we do get some benefits.

38:12So we recommend 20 to 30 grams of fiber a day as well. And then for carbohydrates, it's really person specific. The more insulin resistant you are, the fewer carbohydrates you're probably going to be able to tolerate. And so I think a really nice starting place is like around 30 grams of net carbs per meal or less, which is, you know, that's a pretty good amount of carbohydrates still. Definitely lower than like your typical processed American food diet, but very doable.

38:45And then depending on your levels of activity, we can strategically time some carbohydrates like before or after a workout to improve performance, but also reduce the insulin response of those carbohydrates. I think it's really interesting to note that about, I say that 30 minutes after a workout is like the golden window for eating carbohydrates without secreting insulin. So you're still going to see a blood sugar spike, but the receptor, it's called a GLUT4 transporter.

39:18It's on the cell membrane of muscle, and it's like a tube slide that glucose slides down from the bloodstream into the cell. That GLUT4 transporter gets to the cell membrane via exercise or insulin, and they stay on the muscle cell membrane for about 30 minutes after exercise. So your glucose can just slide right down without the added insulin after exercise. So just to kind of sum that up again, we want to focus on water. You want to get one gram of protein per pound of ideal body weight spread out ideally throughout the day in doses of at least 30 grams.

39:55And then we want 20 to 30 grams of fiber and then fill in the rest of your calories with healthy fats and then carbohydrates, depending on your level of insulin resistance and activity, kind of as tolerated. So we also, I think it's important to note when I make those recommendations, people also like, they're like, oh, what if my cholesterol goes up? If I'm eating a bunch of meat and a bunch of fat and there's, there's just so much really, really good information out there right now, proving that your total cholesterol and your LDL cholesterol have no indication whatsoever of your risk of cardiovascular disease.

40:33We must go deeper. We must go deeper. There's so many great resources out there that explain this further. One of my favorites is an interview with Dr. Robert Lustig and Casey Means from Levels Health, where Dr. Lustig is explaining how to properly interpret your cholesterol panel. If people want to check out that resource, I think it's a really good one. But, you know, long story short, it's very, very commonly misconstrued that total cholesterol and LDL have any indicator whatsoever of your risk for cardiovascular disease.

41:08And here's the problem. Doctors will see high LDL or high total cholesterol and be like, here's a statin. Oh, your cholesterol is high. You need to take a statin. And they don't look any deeper into like LDL particle number or LDL particle size, which are the two factors that are more important for cardiovascular risk and statins directly like increase insulin resistance. Yeah. So that's another factor. We talked about stress, sleep, movement, diet, but your medications that you're taking, there's actually a lot of medications that contribute to elevated levels of insulin resistance.

41:45So some blood pressure medications like beta blockers, statins, and then a lot of antipsychotic medications or like antidepressive or anxiety medications can also contribute to insulin resistance. So when we get to the root cause, which is diet and lifestyle, you're going to reduce your need for these medications in the first place. Sometimes the ones that are like confounding the problem. Amen. Thank you again. That was a lot. I want to unpack that a little bit. I know that was a lot. Yeah.

42:15It's all good. It was a great stuff. And I love that we align on the, we talked about that on your podcast with the protein. And that's great that, you know, you share the same value in getting the protein, the one body, one gram per body weight of protein. And then dosing it out in 30 grams throughout the day. I love that. There was one question that I wanted to ask. I wanted to circle back to sleep. I love the foundational mindset, sleep, hydration. Like that's, that's golden right there.

42:46Because like you said earlier in the podcast, man, managing your stress can totally help with insulin resistance and making that better. And then at the end, you had mentioned something about fiber and carbs. I want to circle back to that first because there was somebody that was on the podcast recently that I had. We talked about fiber and carbs, but I couldn't pull this out enough the way that I wanted to. So do you, would you recommend people to like, like fiber and carbs are the same? What do you think? No. I agree. Okay. No.

43:17Why? So, you know, technically there, I like to explain there's three types of carbohydrates. And this is a little bit misleading, but I think it's easiest to understand. Starches, sugars, and fibers are like the three big categories of carbohydrates. The caveat there is that starch is just a type of sugar. So if we're breaking sugars down, I think this is really helpful. There's like three main simple sugars. There's glucose, fructose, and galactose.

43:50Those simple sugars combine and make different kinds of sugars. So the lactose found in dairy products, for example, is the galactose bonded with a glucose and table sugar, like the white stuff that people might put on their cereal or in their tea is one molecule of glucose bonded with one molecule of fructose. Whereas starchy foods like bread, rice, pasta, et cetera. Those are many molecules of glucose just bonded together.

44:23And that's why you might hear starch is just sugar. Starch is just many molecules of a type of sugar glucose bonded together. Fiber is none of those. Fiber is a completely different plant compound that acts totally differently in the body. And there's different types of fibers that have various benefits. Um, but in general, I think that's why I can't ever tell someone like don't eat fiber because I know what it does to the gut. I know how beneficial it is to the gut microbiome.

44:56And there's just, I'm, I'm reading a book right now called super gut by Dr. William Davis. And his episode airs on my podcast next week at the time of this recording. I learned so much from him. And if you're looking, if you're a nerd, like I am, and you're going down the rabbit holes, you will find there is no required carbohydrate. Like there's just not, there's, um, essential proteins, like essential amino acids. There's essential fatty acids, but thus far there have not been declared essential carbohydrates.

45:28So I think some people say, Oh, your body can make all the glucose that it needs. And, and, and keto and like, yes, that's totally true. But if we're only focused on energy needs for like the brain and whatever, yeah, your body can make glucose from fat and protein, but we're forgetting about the gut health. And so I do not agree with, I don't know if that's what that person said, but no fiber is in its own category fiber. When you eat fiber with your food, that's going to cause a slower and lower blood sugar.

45:58And insulin response. It's going to feed your microbiome. It's going to help you feel full. It adds volume to the food. So it triggers satiety mechanisms from like the gastric stretching. Whereas carbs and sugar, sugar has a completely different hormonal effect in the body. So it has a different hormonal effect. It has a different physiological effect. It has a different effect on your gut health. So I don't think that we can say that fiber and starches and sugars, fiber and sugars to simplify it are the same.

46:29Beautiful. Thank you so much for sharing that and elaborating on that. Cause I agree with you a thousand percent. One of the main reasons, like it was, it felt like it was like carbs was getting a bad hit and that fiber was more important than the carbs. Um, and to that point, like you mentioned like carbs with all the molecules that are involved, they're straight glucose, which is why I love talking about like why carbs are good in terms of building muscle and going into performing exercises because that glucose is going to help them get through, um, you know, uh, a workout with sustained energy, but twofold to the strength

47:03training. I want to you to elaborate why strength training and muscle is good when you, when you're dealing with patients that are insulin resistant. Yeah. So, well, muscle, I, maybe, you know, the stat too. I thought it was like 80% of the glucose that we eat is deposited in muscle. Have you heard of that one? No, I haven't, but I firmly agree with that. I think it's something around there. So muscle acts as the reservoir for glucose that you eat after a meal. Well, the more muscle you have, it's almost like the bigger your garage, the more cars you

47:34can park in your garage before you have to have spillover onto the driveway. So the more muscle mass we have, the more glucose can be stored in the muscle mass in the form of muscle glycogen before it's shuffled off to the driveway, i.e. adipose stores or fat tissue. And so that's the primary reason that muscle is so important when we're talking about insulin resistance is we want to reduce how much glucose spills over into the fat tissue. And ideally we can pair our eating with some form of movement to reduce the insulin response

48:11after a meal. Beautiful. Love that. That's why I love carbs so much. I just can eat as much as I want because I have new muscles essentially, you know? It's true. It's totally true. And I think that's another reason why people's carbohydrate tolerance tends to decrease with age and why they're like, ah, I can't eat what I used to. Well, your muscle mass isn't what it used to be either. And so if we focus on muscle mass, we can definitely eat more. And I do believe that we are in a movement maybe that is prioritizing strength training

48:42more. But I know when I was growing up, it was all about calories in, calories out. Cardio is king. You can see how many calories you're burning on the treadmill or the elliptical. You can't see the calories when you're lifting the weight. I know. I know the temptation is like to get that instant gratification of a calorie burn. And that recognize that you're still burning calories. I think I don't remember what the study said for sure. 24 hours after a strength training session. Do you know that one? For sure. 110%. It's like that epoch. It's what Orange Theory got really big on with their marketing.

49:16But it's, you know, it's with any, it's with strength training in general. Yeah. So like the effects of cardio last, you know, a little bit after the workout, but not near as long as after strength training. So we can't just focus on the immediate gratification of seeing the calorie burn, but we also have to emphasize protein and diet because in order to build muscle, we must have great strength training programming and we must have good protein. So both are important. Love this. Speak in your language. I know. You are speaking.

49:47It's music to my ears. I had just a second ago when you were talking about it, because I know that it's going to all of this and all of this valuable information is going to resonate with the audience. But I know specifically, like there's been people saying that in our community a lot of the time that they're insulin resistant. Yes, we understand. And they don't want to do strength training. And we just, yeah. So it's a very small amount of people, but it's always, it's nice to hear, have, you know, me who preaches a lot of the things.

50:19And then you have somebody else that comes on the podcast to reach in the same way. Same thing happens with my members. They're like, oh, you had so-and-so on. And they said it like this, and that made way more sense to me than how you say it. And I'm like, I don't care how you, I don't care how it gets in your head. I just want it to get in your head, whether it's from you or someone else. So yeah, this has been great. I even learned so much from you today, Morgan. So thank you for sharing your, your insights are invaluable and the lives that you're helping. It's, it's, you can feel your passion as you're sharing what you love so much about.

50:51So talk a little about it, about Zivli and then where people can find you. Um, I'll have all the descriptions in the link below, but where people can find you a little bit about your program. Yeah. So we open enrollment for a program a couple of times a year and next is in September. It's a 12 week online course. I developed a curriculum that teaches people in depth, all the things that we covered today. We cover macronutrients in depth, micronutrients, different forms of exercise, stress, sleep, mindset, habit change. Uh, we develop systems to help them implement these lifestyle changes.

51:26It's lifetime access. So when people join their member for life with ongoing support, we're just starting accountability pods, which we're really excited about. Um, because we know that behavior change takes time and it takes a consistent focused effort. And so we wanted to develop, um, a program, you know, that people can join and get that ongoing support and get the information that they need. Like everything that I wanted to tell my patients and their children and geriatric PT is in this course so that they can empower themselves with the knowledge required to reverse insulin

51:58resistance. Because sometimes there's some unlearning to do as we've kind of alluded to today on cardio and what about dietary fats? And, um, many people are under eating protein and overlooking sugars and so many things. The mindset stuff is my personal favorite and passion because you can have all the strategy in the world, but if you don't have the right mindset, it's going to fall on deaf ears. You're not going to follow through. You're not going to be consistent and you're going to keep beating yourself up. So we really like to pair the strategy with the mindset.

52:29And if people will kind of want to learn more about insulin resistance right away, we have a starter course they can take. They can go to zivli.com, which is Z-I-V-L-I.com and learn more about macros and insulin resistance. That way I have a YouTube channel podcast. You're gracious enough to come on mine. It's the reshape your health podcast. And I'm also on Instagram at Dr. Morgan Nolte. Amazing. Well, Morgan, thank you so much for being here and sharing your, your insights with the audience. Guys, go check her out. And again, thank you for being here. Thank you, Nikki.

53:00I appreciate it. Hey guys, real quick. If you're interested in taking your body to the next level, lose body fat, build more muscle, feel more confident. Do it alongside one of our 30 plus professional coaches. Work one-on-one with her to eliminate all of the guesswork that you may have. And all you need to do is just do the work that she tells you to do to get to those goals of yours. And to learn more, click the link below this podcast and apply to our VIP program right

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