Articles

Evidence based

Evidence Based

This article is based on scientific evidence, written by experts and fact checked by experts.

Our team of licensed nutritionists and dietitians strive to be objective, unbiased, honest and to present both sides of the argument.

This article contains scientific references. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.

Insulin Resistance Dieting—What to Eat & What to Limit

Written by Dr. Michael Ruscio, DC on May 16, 2025

Written by Dr. Michael Ruscio, DC on May 16, 2025 — Reviewed by Hannah Wright

• Insulin Resistance Diet|
• Insulin Resistance|
• Health Impact|
• Diagnosis|
• Treatment|
• Lifestyle|

By the time we see many of our clients in the clinic, they’ve been on a blood sugar roller coaster ride. Blood sugar highs and lows can cause fatigue after meals, intense food cravings, and unwanted weight gain. These are all warning signs that we need to address.  

Insulin is an important hormone that helps us regulate our blood sugar. When our body’s cells become less responsive to it, we’re insulin resistant. Over time, this can lead to high blood sugar levels, weight gain, and an increased risk of chronic health conditions such as type 2 diabetes.

Following an insulin resistance diet, losing weight, and leading a healthy lifestyle can help the body respond normally to insulin again. 

What Is The Best Diet for Insulin Resistance?

As I discuss in my book, Healthy Gut, Healthy You, diet is unquestionably the most impactful way to improve overall health. It’s also one of the key ways to correct insulin resistance. If you’re wondering what to eat to shift insulin resistance to insulin sensitivity, there isn’t one specific insulin resistance diet that works for everyone. 

General insulin resistance diet guidelines look similar to other healthy eating patterns, in that it’s important to 1 2: 

• Choose whole foods over ultra-processed foods
• Focus on nonstarchy vegetables and fiber-rich foods
• Minimize added and simple sugars (soda, sweets, fruit juice) and refined grains (white bread, pasta, and rice)
• Reduce overall carbohydrate intake to about 40% of total calories
• Eat protein at every meal
• Avoid too much saturated fat (fatty meat, butter, cheese)
• Increase healthy fats (monounsaturated fats and omega-3 polyunsaturated fats) 
• Limit alcohol

And since insulin resistance is often linked to excess weight, anyone who needs to lose weight while improving their insulin sensitivity should try to reduce their daily calories by 500–600.

If you like “eat this, not that” lists, the following table provides a snapshot of some foods to enjoy and foods to limit or avoid on an insulin resistance diet 2:

A variety of dietary patterns including the Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets can help manage insulin resistance. Low-carb diets may also be helpful, but more research is needed 1 2. The good news is, you’ve got options.

In the clinic, we often recommend the Paleo diet as a great starting point because it reduces refined and total carbohydrate intake and can:

• Help to balance blood sugar levels 3 4
• Help reduce body weight, body fat, waist size, and BMI 5 6 7
• Reduce insulin resistance 8
• Reduce blood pressure 8
• Improve cholesterol and triglyceride levels 8

It may be best to work with a registered dietitian or other health provider who can help personalize a plan for you, and we offer this service in our clinic.

In addition to a balanced insulin resistance diet that promotes healthy weight loss, your meal timing and eating habits matter. 

Eating more calories earlier in the day, especially as a larger, balanced breakfast with complex carbs, protein, and healthy fat, may improve insulin sensitivity 2. And eating mindfully and slowly can help improve digestion and absorption, reduce overeating, and foster a healthier relationship with food 2.

What Is Insulin Resistance? 

First of all, insulin is a hormone the pancreas makes to help regulate how we use and store energy from the foods we eat 9.   

The beta cells of the pancreas monitor the following substances in our blood to determine how much insulin the body needs to metabolize (use) them 9: 

• Glucose (sugar)
• Amino acids (building blocks of proteins)
• Keto acids (byproducts of the body breaking down amino acids)
• Fatty acids (building blocks of fats)  

The beta cells then make whatever insulin is required for each metabolic task. The main metabolic functions of insulin include 9:

When we eat carbohydrates (from grains, dairy, fruits, vegetables, beans, and legumes), our bodies break them down into glucose—a simple sugar—which gets absorbed into the bloodstream. 

But glucose isn’t helpful if it just stays in the blood—we need to get it into our cells so the body can use it for energy. That’s where insulin comes in: Its main job is to tell our cells—especially muscle cells—to take up the glucose in the bloodstream and use it as fuel.

In metabolically healthy people, this system works efficiently to keep blood sugar levels balanced both after meals and while fasting 9. After eating, more than 80% of the sugar from food goes from the bloodstream to skeletal muscle 10. Muscles can either burn that glucose for energy (like during exercise) or store it as glycogen for later use.

But in people with insulin resistance—typically as a result of excess body fat, but sometimes as a result of genetics—muscle, liver, and fat cells stop responding properly to insulin 10. As a result, glucose stays in the blood instead of being taken up and used or stored 11. 

Because skeletal muscle is responsible for the majority of glucose uptake, insulin resistance in muscle seriously disrupts the body’s ability to manage blood sugar. To compensate, the pancreas pumps out even more insulin. This condition of chronically high insulin is called hyperinsulinemia. 

When muscles are insulin resistant, they can’t store much more glucose. So the excess sugar gets redirected to the liver, where it’s converted into fat. That fat can contribute to weight gain, which worsens insulin resistance—creating a vicious cycle that leads to both short-and long-term health problems 11. 

How Does Insulin Resistance Affect Your Health?

In the short term, insulin resistance can cause metabolic issues such as 11: 

• High blood sugar (hyperglycemia)
• High blood pressure (hypertension)
• Abnormal cholesterol levels 
• Inflammation 
• Higher risk of blood clots 

When left untreated for 10–15 years, insulin resistance can lead to 11: 

• Metabolic syndrome 
• Metabolic-associated fatty liver disease 
• Type 2 diabetes mellitus  

Besides causing type 2 diabetes, insulin resistance is also linked to 11: 

• Obesity 
• Heart disease 
• Polycystic ovary syndrome (PCOS) 
• Increased risk of nerve damage 

How Do You Know If You Have Insulin Resistance?

The best way to measure insulin sensitivity is with a research technique called the hyperinsulinemic-euglycemic clamp. But in a healthcare provider’s office, there are simpler, less risky options for identifying insulin resistance, including these measurements from blood tests 11: 

• HOMA-IR (homeostatic model assessment for insulin resistance), most common 
• HOMA2 (homeostatic model assessment 2) 
• GIR (glucose-to-insulin ratio) 
• QUICKI (quantitative insulin sensitivity index) 
• TyG index (triglyceride-glucose index), a newer option 12

Your provider may also recommend that you wear a continuous glucose monitor (CGM) to track your glucose measurements for 24-hours. 

People with type 1 or 2 diabetes mellitus often wear CGM devices to help improve blood sugar management. But CGMs are also used by people without diabetes to catch and address insulin resistance early.

Outside of these measurements, your physician should also look for signs and symptoms of insulin resistance syndrome and metabolic syndrome, and check to see whether you have risk factors for insulin resistance 11. 

Signs and Symptoms of Insulin Resistance

Common signs and symptoms of insulin resistance include 11: 

• High blood pressure 
• High cholesterol levels (hyperlipidemia) 
• Increased waist size 
• PCOS symptoms (irregular periods, unusual hair growth, acne, and hair thinning) 
• Dark, velvety patches of the skin in folded areas like the neck, armpits, and groin (acanthosis nigricans) 
• Signs of inherited disorders that affect how the body responds to insulin 
• Rare, extreme resistance to insulin (type A or type B insulin resistance syndromes) 

Signs of Metabolic Syndrome

Metabolic syndrome (MetS) refers to a cluster of conditions that increase your risk for chronic medical issues such as type 2 diabetes, heart disease, and stroke.  

MetS is diagnosed when you have three or more of the following 11: 

• Increased waist size (35” for women, 40” for men) 
• Triglyceride level of 150 mg/dL or higher (or you take medication for high triglycerides) 
• LDL cholesterol level below 40 mg/dL for men, or below 50mg/dL for women 
• Blood pressure of 130/85 mm Hg or higher (or you take medication for blood pressure) 
• Fasting blood sugar of 100 mg/dL or higher (or you take medication for high blood sugar) 

Insulin Resistance Risk Factors

In addition to metabolic syndrome, many factors increase the risk of insulin resistance, including 11: 

• High blood glucose levels 
• High uric acid levels 
• Abnormal lipid levels (high LDL cholesterol, low HDL cholesterol, and high triglycerides) 
• High blood pressure 
• Poor blood vessel function (endothelial dysfunction) 
• Body mass index (BMI) greater than 25 
• Existing conditions such as heart disease, PCOS, fatty liver, or dark skin patches 
• Inactive lifestyle 
• Non-white ethnicity 
• Being over age 40 

How Do You Treat Insulin Resistance?

Leaving insulin resistance untreated can contribute to poor health and difficulty losing weight. But there’s a silver lining—it’s often possible to completely reverse insulin resistance with cost-effective diet and lifestyle changes 11.  

For people who need additional measures, medications (such as metformin, GLP-1 agonists, and SGLT2 inhibitors) and bariatric surgery (weight loss surgery) are options—but these aren’t where I would start for most 11.

I would start with following an insulin resistance diet and building certain lifestyle habits.

Beyond Diet: Lifestyle Changes for Insulin Resistance

Eating a healthy diet is a very effective way to reverse insulin resistance. But lifestyle factors, including low physical activity 13, not sleeping well 14, and having too much stress 15, can also seriously affect how much insulin the body makes and how we respond to it. 

The following table provides simple ways to implement healthy lifestyle behaviors to help you overcome insulin resistance:  

I want to specifically plug resistance training here. One major reason to build and maintain muscle mass is that muscle acts as a key storage site for glucose—in the form of glycogen. The more muscle you have, the more room your body has to store glucose, which helps improve insulin sensitivity 18. 

In other words, with more muscle, your body can keep more glucose out of the bloodstream and store it where it’s needed, instead of converting that excess sugar into fat. This lowers your risk of insulin resistance 10.

Unlike irreversible damage that can happen to insulin-producing cells in the pancreas, insulin resistance in muscle can be reversed 10. In fact, improving insulin sensitivity in muscle alone can often be enough to restore healthy blood sugar levels.

Reverse Insulin Resistance With Diet and Lifestyle

Insulin is the hormone made by the pancreas that helps move glucose from the bloodstream into our cells, where it can be used for energy. When our cells become less sensitive to insulin—a condition called insulin resistance—blood sugar levels remain high. In response, the body produces more insulin, and the excess glucose eventually gets converted into fat. 

Fortunately, we can break this cycle by following an insulin resistance diet (such as a Paleo meal plan) and adopting healthy lifestyle habits—like walking after meals, lifting weights, getting restful sleep, and managing stress. 

I know it can be intimidating to change your diet and lifestyle. We’re accepting new clients in our clinic and would be honored to partner with you on your journey to reverse insulin resistance.

The Ruscio Institute has developed a range of high-quality formulations to help our clients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you. The information on DrRuscio.com is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.