Dr Ritamarie

They're doing everything right. So why aren't they getting better? They're limiting carbs, they're eating clean, they're avoiding sugar, their blood sugar even looks pretty good. So why are they still dealing with cravings, low energy and stubborn belly fat?

Here's what most practitioners overlook. Some foods can spike insulin without raising blood sugar at all, and that hidden response may be blocking their progress. That disconnect can make or break metabolic recovery.

Let's start with talking about the myth that we were all taught. Let's face it, most of your clients are metabolically unwell. 93% of the population is metabolically unwell. And it's whether they know it or not. Insulin resistance often shows up long before fasting glucose, or hemoglobin A1C, even budge. So if you've ever had a client who eats clean, keeps their carbs low and still struggles with belly fat, fatigue, cravings and blood pressure problems, this episode will give you one of the missing pieces.

We're taught that insulin goes up when blood sugar goes up. And for the most part, that's true, right? It's simple, yet the truth is really more nuanced than that. It's a common misconception that only carbs raise insulin.

Dr Ritamarie (01:40)

Yes, carbohydrates, especially refined, are a major trigger. But here's what's often missed. Protein, dairy, and even non-caloric sweeteners can raise insulin without a significant blood sugar rise. So insulin is not just a clearing hormone for glucose, it also responds to protein, amino acids, and sensory signals like taste and smell, even the anticipation of food.

That's called the cephalic phase insulin response. And it happens before food even hits the bloodstream.

Dr Ritamarie (02:16)

So yes, insulin can go up without any significant change in blood glucose. And that can quietly drive fat storage, inflammation, and metabolic inflexibility without triggering alarms and standard blood tests. That's why some clients can be eating low glycemic meals and still be stuck in a state of chronically elevated insulin, which impairs fat burning. It increases inflammation and contributes to metabolic dysfunction.

Dr Ritamarie (02:48)

So let's look at some of these sneaky insulin triggers. Let's break down the main foods and the ingredients that raise insulin without raising blood sugar.

Dairy products, especially low-fat, which a lot of people are focusing on, even unsweetened yogurt or milk can be highly insulinogenic due to the whey protein. Whey protein prompts a significant insulin response, primarily due to the high content of branched chain amino acids like leucine, isoleucine, and valine.

These amino acids stimulate insulin secretion both directly and through incretin hormones such as GIP and GLP-1. We hear a lot about that these days. For instance, a study observed that adding whey to meals increased insulin response by 31% after breakfast and 57% after lunch in type 2 diabetic subjects, while it reduced the postprandial glucose by 21%, reduced sugar, high insulin. How's a person to know?

And low fat milk has been shown to be even more of an insulin trigger than white bread in some studies. And I'll link to some of those studies down below.

Whey protein isolate is used in lots of studies, because it has such a strong insulin response. So that confirms that whey will raise insulin in most people.

So some other things are lean animal proteins like chicken breast, eggs, and fish. They can raise insulin, especially in isolation without other foods to change it, without changing glucose very much. So isolated plant proteins and branched-chain amino acids like soy protein isolate, pea protein, and high leucine blends, it's very common for people to supplement BCAAs. Even though leucine is important for most muscle building, and it's getting a lot of press lately, those with elevated insulin and stubborn extra weight need to be careful about adding too much leucine.

Another surprising one is artificial and even some natural sweeteners. Sucralose, aspartame, and possibly even stevia can provoke insulin through taste receptor signaling, even with no calories. Although most studies show stevia, monk fruit, and allulose not to contribute to increased insulin.

Dr Ritamarie (05:04)

Here's another one I see people doing all the time. They're grazing, and they're eating combinations of macros at their meals. So when they're eating frequently, even on low carb foods, this can keep insulin levels persistently high. And then a fat plus protein combo and a fat plus glucose, or carb combo, if eaten too often can provoke a mild but chronic insulin load, because the fat keeps the glucose from going up, and we don't realize that this might be a problem.

What's a solution? Test insulin, please, test insulin. Fasting and postprandial. These foods delay glucose absorption but still require insulin, especially if snacking is frequent and these combo meals are frequent.

So low glycemic or keto clients can still be flooding their body with insulin multiple times a day, even though they're eating low keto, low glycemic, even though they're eating low glycemic or keto.

So why does this all matter for clinical practice? We see a lot of people, and we want to help them. And yet, if they seem like they're doing it right, what's the problem? How do we help them?

Well, high insulin, even with normal blood sugar, can block fat burning. It can also increase inflammation. And we have so many autoimmune conditions. We have so many people with chronic inflammation, which contributes to every disease known to mankind.

It's hormone disruptive to have high insulin. In fact, insulin resistance can be concurrent with thyroid resistance. The insulin can damage the thyroid receptors on the cells and also disrupt thyroid hormone production and other hormones as well, sex hormones and such.

What happens is we get resistance that standard labs don't catch, right? Because most labs can't test for resistance. You'll see it in symptoms, before you see it in the labs, though. So keep an eye out for these. Cravings, fatigue, extra belly weight, PCOS symptoms like infertility, and acne, and other things like that. Elevated blood pressure and even mood swings.

Dr Ritamarie (07:00)

And this is why people can follow the perfect plan and still feel awful. So what can we do? And why does it matter?

Clients may appear metabolically healthy on the surface, but elevated fasting, insulin, HOMA-IR, or even waist circumference tell a different story. Elevated insulin suppresses fat burning, as we said before. It also promotes inflammation, drives PCOS, drives hypertension, and it drives fatigue.

So if you're not measuring insulin or educating about the hidden food triggers, you're missing key pieces of the metabolic puzzle.

So let's take a few examples. What about the low carb dieter who's stuck? They're stuck. They can't lose weight. Test their fasting insulin and even check their postprandial. PCOS patient with normal blood sugar. We don't expect that with PCOS. Look at the insulin index of the meals.

The fatigued client is drinking whey protein shakes daily. Maybe it's time for a protein rethink. They might be sensitive to the whey. And when you explain this to your clients, you'll empower them to stop chasing diet trends and start making choices that truly affect and truly support metabolic healing.

Dr Ritamarie (08:15)

So let's take a look at some action steps. Here are some of the things you can do in your practice, and help to detect this, and help people to reverse this.

Start testing insulin regularly. Don't just test fasting glucose and hemoglobin A1C. Unfortunately, there's no good home test for this, because that would be awesome, and they could test it on their own. Calculate the HOMA-IR ratio, the triglyceride HDL ratio and the hip waist or waist-hip ratio.

That'll give you a fuller picture of how severe their insulin resistance might be.

Educate clients on the insulin index, not just the glycemic index. Check out the chart, we'll give you a link to it down below.

Encourage protein rotation. Don't rely solely on isolated powders or dairy products for them to get their protein. Look into whole plant foods. Look into whole plant foods, because they contain a lot of fiber, and that's going to help the situation.

Coach your clients to avoid snacking and frequent grazing. And focus on insulin-friendly meal timing, like four to six hours apart. Even low-carb snacks can keep insulin elevated throughout the day and contribute to their stuckness, their extra belly fat, their high blood pressure, et cetera. Evaluate their sweetener use. What's truly sugar-free might still be insulin spiking.

Use tools like continuous glucose meters alongside symptom tracking to get a really good sense of what's going on. And again, just because the glucose doesn't go up, doesn't mean the insulin isn't going up. So check those trackings, check the insulin levels, compare the waist-hip ratio, and look at the HOMA-IR. And above all, help your clients to connect their symptoms like fatigue, cravings, and brain fog to their metabolic pattern, not just the macronutrient math.

A lot of people are teaching macronutrient math. Just this much protein, and this much carb, and this much fat, and that's going to get you there. No. Help them and teach them to connect their symptoms. Keep a symptom tracker. And if a food, a specific set of foods, or type of meals, continuously leaves them craving after the meal or brain foggy, then suspect that maybe the insulin is going up, and that's creating that problem.

Dr Ritamarie (10:31)

So again, if your clients are doing everything right, but they're still stuck, look deeper than their sugar and their carb content. Look at insulin. Insulin resistance starts long before blood sugar changes show up. It's an early warning sign. I think people should be getting their insulin checked when they're teenagers and in their twenties early on, but that's not typically what's done in Western medicine. This is what it means to practice root cause functional healthcare.

And if you found this episode to be helpful, like, subscribe, and share it with your practitioner network. And be sure to grab the free Insulin Index Sheet I created to go with this episode. The link should be in the show notes and or the description. And as practitioners committed to root cause healing, we have to dig deeper. We have to keep digging, until we hit the cause.

When we understand these subtle patterns, when we understand how the body works, when we understand the biochemistry and the hidden insulin triggers, we can help our clients break through their plateaus, restore their energy, get rid of their belly fat and reclaim true metabolic health.

So if this sparked some ideas for how to work differently with your clients, I invite you to leave a review and check other resources that we have on the podcast at reinventhealthcare.com.

And if you want to dive deeper into interpreting labs and customizing foods and fasting protocols, check out our practitioner trainings at INEmethod.com.

Let's keep asking better questions. Let's keep digging deeper and staying committed to helping people to get to their root cause metabolic imbalance. We are the future of healthcare. We have the ability to put health and care back into our current system, which is really a disease management system.

And until next time, shine on.