Kim (00:01.802)
Hi, Shanna, thank you so much for joining me. I'm, this is.
One of the episodes I've been probably most excited about of late because I've had a bit of an obsession with insulin resistance and learning all about blood sugar. I love learning all things health and have been following you for a long time and love the information that you share. So I'm really excited to see and get your I guess advice and information and education about
Kim (00:35.708)
it could influence the pelvic floor. So if we can start out with you giving us a little bit of information about yourself, like how did you become somebody who is specializing in nutrition and insulin resistance?
Shana Hussin (00:39.996)
Yeah.
Shana Hussin (00:50.026)
Yes, yes, I live and breathe blood sugar issues and insulin resistance. So we'll have plenty to talk about in that arena. But I'm a conventionally trained dietician, registered dietician. I've been in the nutrition space for almost 24 years. So a really long time. But the first 15 to 20 years of that, I did not teach the methods and strategies that I teach now.
And quite honestly, what I was teaching in my early years was probably making people a lot more sick than what it was actually helping them just because of the guidelines that are out.
right now that tend to make people feel more sick than they do well. But fast forward about 15 years into my career, I was having my own health issues and health struggles. I was bloated all the time. Even though I've never had a huge weight issue, I was having a hard time managing my weight and keeping my weight where it was. Even though I was a big runner and I'm a dietitian and I thought I
guidelines. We have three children. So I thought, oh, it's just, you know, this is what we do as we age. We start to get, you know, thicker and it gets harder to keep our weight and check.
Kim (02:09.713)
Sorry, you just froze there, we lost you for a second.
Shana Hussin (02:13.147)
Oh, okay, my back.
Kim (02:15.17)
your back. Yeah. Sorry, you said you have three, we can say children. Okay.
Shana Hussin (02:16.547)
Okay.
Shana Hussin (02:19.926)
Yes, we have three children and.
I was never overweight. That was not a big struggle of mine, but it just got harder and harder to manage my weight despite all the things that I was doing. I was one of these people, I'm an early morning person, so I would start eating around five or 6 a.m. before my morning run or before my morning workout. And even though I was eating really healthy foods, I would take a handful of nuts here. I would eat a piece of fruit there. And I was just basically eating all throughout the day. And as I alluded to,
I was having some really a lot of difficulty with bloating as well.
So in 2016, my middle son got really ill and we were projected into the conventional medical system where we had never hung out before. Like we were a really healthy family and I started asking questions about healing him and his digestive disease that no one could answer for me. And every time I would ask about nutrition and digestion, it was never linked together and that
Shana Hussin (03:28.9)
research, my own deep dives into holistic nutrition and natural methods of healing. And what I came across kind of boggled my mind. Like I was pretty close minded to a lot of the natural approaches. And I remember when people would talk about intermittent fasting, you know, a specialist and health providers that I would listen to, I would just kind of tune it out and be like there's no way intermittent fasting can be helpful. We all need to eat as soon as we get up. We need to eat multiple times a day to keep our energy.
up and I was I was not a believer at all.
And fortunately, I started to open my mind to that. And as I learned more and more about his disease and how to heal it, I actually stepped out of conventional nutrition completely because as a registered dietician, if you're in an institution or a hospital or working anywhere for the government, you have to teach the methods and the education that they tell you to teach.
By that point, I knew that it was not what I wanted to be teaching people anymore. I left, I didn't think I was going to ever come back. Then a couple of years later, I was working at a digestive health clinic very part-time, where my son had been receiving some therapies, and they asked me to do a weight loss program. I'm like, no, I've been there, I've done that. No, I don't want to do that. I actually, I started to,
Maybe I'm missing something. It's been such a long time since I've done weight management. Maybe there's something I'm missing. So I read the obesity code and I was mind boggled. I'm like, oh my gosh, I've been lied to all these years as a registered dietician. I've been teaching people the exact opposite of what I should be teaching them. My jaw was dropped. I started implementing things that Jason Fung, who wrote the obesity code, talked about.
Shana Hussin (05:29.114)
and my own health turned around. Like I am healthier now in my late 40s and I was in my 20s and 30s. My metabolic health is really great and.
a couple years into implementing strategies to reverse insulin resistance, I did my own testing on my fasting insulin and I'm probably getting a little bit ahead of where you want to be. But I found out that I had insulin resistance myself and so many light bulbs went off in my head. I was like, Oh,
This is why I'm always hungry and thinking about food. And this is why even though I run 20 miles a week and do strength training twice a week, I'm still struggling with.
managing my weight and this is why I have some skin issues and skin tags and all of these things and so once I actually it took me a while to reverse my insulin resistance actually over the course of a couple of years. All of that went away and again I'm right now at the time of this recording I'm 48.
and feel better than I did in my 20s and 30s because I no longer have insulin resistance and I resolved that. So
Shana Hussin (06:45.754)
Then I decided, okay, well, I started like a little subset of people like to implement the things that I was learning in like a little pilot study, my own little pilot study. And the results that I was seeing were crazy. I'm like, oh my gosh. And all different age groups, men, women, just working on blood sugar stabilization and metabolic health and reversing insulin resistance. And so I started to write some handouts for those people, which turned into a book
to. And now it's just blown up into courses and a podcast and Instagram following because 93% of adult Americans have some some degree of insulin resistance, there's all different varying degrees, it runs on a spectrum. But if I add a stable weight at a healthy weight as a registered
Shana Hussin (07:45.722)
insulin resistance I thought oh my gosh I have to teach people how to reverse this if they do have it or how to you know prevent it from happening in the first place and you and I well know we just need to look around and see we're in a metabolic crisis it's a complete metabolic mess and so I went back into the nutrition field and now I teach how to reverse insulin resistance and how to
Kim (08:03.574)
Yep.
Shana Hussin (08:15.676)
healthy. So it was a long journey, but I love what I do now. And I know that I actually I actually help people at the base root cause of why they are ill.
Kim (08:21.449)
Yeah.
Kim (08:27.218)
Yeah, it's interesting as you're talking, I keep and I've had that sort of same thing where the more I read, I'm thinking, oh, that's why this, oh, that's why this and I
I'm pretty sure I probably still have a little bit of it. I'm doing pretty well, but just thinking about, I remember becoming a vegetarian because I thought that would be better for me in university. And instead of eating meat, I ate loads and loads and loads of processed carbohydrate. And I was very active, so I was able to manage that. But then as you get older and you have kids and I'm not as active, and now I'm snacking all the time because I'm feeding my kids and I snack on what they have.
know that whole perpetual snacking and so everything that I've learned I know you're going to be talking about today and but I just want to say it was very similar to my experience as well and why I've become so fascinated with it but so start out what is insulin resistance?
Shana Hussin (09:23.578)
Yeah, insulin resistance in the simplest terms is when you've had high levels of insulin over the course of many months or years and your body just kind of becomes immune to it. And insulin is a hormone that's secreted by the pancreas in response to rises in blood sugar. So just want to keep it as simple. I mean, we can get really, really complicated with insulin resistance, but in the simplest terms, when your blood sugar starts to rise,
your body, insulin is basically like a defense mechanism for your body because if your blood sugar rises too much, you basically will blackout, go into a coma. And we definitely don't want that. So insulin.
the pink race will push out as much as it can to stabilize blood sugar and it will stabilize your body will stabilize blood sugar in a really you know set range at all costs so that it protects you so over the course of time if we're eating all day long from the time we get up to the time we go to bed even if it's healthy food healthy carbohydrates every time we are having rises in blood sugar our insulin levels are rising as well in response to our blood sugar and of
there are foods, food groups, and certain macronutrients that drive our blood sugar up way more than others. And in the processed food world that we live in, processed, ultra-processed foods being the worst, sugar being the worst, foods without protein or natural fats are the worst drivers of high blood sugar and insulin. And that's what we're eating right now, unfortunately. So you compile two things, eating all the time and then eating.
foods that are high stimulators of blood sugar and insulin response and all of a sudden insulin's very natural. I don't want to make insulin sound like a villain in this hormone because it's essential to life. Like we would die without insulin and type 1 diabetics don't produce insulin so way back when before we had insulin, exogenous insulin for type 1 diabetics, usually they died at
Shana Hussin (11:33.628)
overstimulated by the pancreas. Our pancreas gets really tired and then what happens every cell in your body has an insulin receptor because you're all your cells need energy and so the insulin is directing the blood sugar into the cell but what happens is when we have real high insulin levels over the course of many months to years which is what's happening when you eat too often and you eat foods that are high stimulators your your cells just start to become immune
and it doesn't work efficiently. It's kind of like, oh gosh, there's insulin again. Like, I don't need you. I have plenty of energy in my cells. Like, see, my cells are packed full of energy already. Just kind of go away. And so this insulin intolerance builds up, and that's problematic because then your blood sugars start to be higher. And so it's this Kitch 22.
Your energy's not getting into the cells because you have insulin resistance and your body's not responding to insulin as often and as well as it should. But now you have high blood sugars because the energy's not getting into the cell. And then your pancreas says, oh crap, the blood sugar still is too high and it starts pumping out more insulin. And so it's just this vicious cycle.
And if you keep doing the, you know, the, the timing of your food and what foods you're eating over the course of many months and years, this just brews. And a lot of times you don't know you have insulin resistance because
It's not tested for and even if you went and asked your provider to test for it, he or she might say, no, we don't need that. We don't need to test for it. You know, I don't know why you're asking for fasting insulin. Your blood sugar is fine. And so providers are always testing for blood sugar. Probably almost every person listening to this knows what their fasting blood sugar is. And if it's in the normal range, they'll just say, well, your your blood sugars are normal.
Shana Hussin (13:34.522)
That was me. I've always had very normal blood sugars, very normal lipid panels. And so when I actually figured out I needed to test my insulin, my fasting insulin, it was elevated. And I was like, huh, well, that makes a lot of sense.
And insulin, fasting insulin levels, which we can talk about what levels are normal, fasting insulin can be elevated for years to decades. And a lot of times it is.
before those high blood sugar readings will catch up. So by the time you have high blood sugar readings, pre-diabetes and type two diabetes, you've had insulin resistance for a very long time because remember your body will just keep putting out more insulin to deal with the high blood sugar. And so you're not shown on your lab tests that your blood sugars are irregular because you'll just keep pumping out more insulin.
of these symptoms start to occur of high insulin. And again, insulin is not a bad thing. We just need to keep it in balance. But when you have high levels of insulin running, you know, over the course of many months and years, all of a sudden you're hungry all the time. Because think about it, the energy is not getting into the cell, right? It's kind of floating around in the bloodstream. Hungry all the time, food cravings, because your body's thinking, oh this energy is not getting
hydrates especially. So you're hungry all the time, you have cravings, you're preoccupied with food, weight loss resistance is very very common with insulin resistance because another thing of what insulin does it's a storage hormone, it's directing energy into the cell. So if your insulin levels are high you can't, you're not burning body fat. Like you can't do both at once, you can't have high insulin and burn body fat at the same time. And so this is where
Shana Hussin (15:34.588)
problematic. And then as it starts to escalate, you get more and more symptoms. And that's usually on down the road where the blood sugars start to become problematic. And then all of a sudden you're pre-diabetic and type 2 diabetic. And it's a lot harder to reverse those disease states than it is to reverse starting insulin resistance. So yeah, it's just this huge problem that
Shana Hussin (16:04.508)
Most of us, about, I think it's like 50% of people with prediabetes have no idea that they have it. And like I said, by the time you get to the prediabetes phase, you're a metabolic mess already.
Kim (16:16.81)
Yep, yep. So talk a little bit about, I guess you said sometimes providers won't test for it, but what test would we, is there just one test, fasting insulin, or are there other tests that we would look for, and what are the optimal ranges that we would be, that we'd be wanting to see?
Shana Hussin (16:35.706)
Yeah, it's really frustrating because in the conventional medical world.
if you ask for fasting insulin, most likely your provider's going to look at you like, why do you want that? Like that's an inpatient test because they will test fasting insulin for inpatients typically, but as an outpatient, not so much. It's just not standard. And so like I said, almost everybody has a lipid panel and a fasting glucose, but fasting insulin is indicative of
Shana Hussin (17:11.196)
insulin tested. One, because doctors don't know how to interpret it and if it comes back abnormal they're on the hook to do something about it. So if they don't, if insulin resistance is a problem they know nothing about and I'm not dogging conventional providers. They just weren't trained for it. I'm a registered dietitian. I wasn't trained how to deal with this, look for it,
Shana Hussin (17:41.116)
are trained to diagnose and treat with a pharmaceutical. And so if they don't know how to even test for something, they're really not gonna know how to identify it and then not gonna know how to treat it either. And so there's three tests that you can ask for, that you can then kind of put into a calculation for your overall insulin resistance score. And those would be fasting insulin, fasting glucose,
which you likely have, and hemoglobin A1C. So those three blood sugar, well, two blood sugar and the fasting insulin, those will tell you a lot. And so I have a whole training on this that we could possibly link, but it walks you through all of the lab tests and what the normal ranges are and how to put that all together. Because like I said, insulin resistance is on a spectrum. Some people have a little bit of insulin resistance that's just starting. And then others who are at the top
type two diabetes, insulin, you know, needing exogenous insulin and dosing insulin, that is the extreme of really severe insulin resistance. And so for fasting insulin in the United States, it's in millimoles per deciliter, it's going to be different if you're outside of the United States, but a reading of two to six is normal.
And again, this is problematic because in the conventional system, it will not flag you until you have a fasting insulin over 23.9. I think it is. It's crazy. Yes. And again, that's because it's designed for inpatient, which when you're in a really stressful state and your blood sugars are wonky, your insulin is going to be a little bit higher. But for those of us who aren't hospitalized
Kim (19:16.544)
Wow.
Shana Hussin (19:35.74)
6 to 12 is more like starting to moderate insulin resistance, a level of 6 to 12. And then levels of 12 are over.
are more long-standing and severe. So you can see how that 23.9 is just, that's really high insulin resistance if it's to that point. And so when I first had my test, I was two years into intermittent fasting and low carb eating, because those are the two things that really help to reverse insulin resistance, because they're, it's going to pull your insulin levels down. My level was 10.7. So I was still in the
you know, the starting to moderate range. This was two years after, so I didn't know to test for it because I'd never heard of this test. When I first started all of this lifestyle, but I would be willing to guess I was probably in the 20s, which was probably was more severe. I don't know for sure. But then another year later, it was 7.5 and really close to normal range, but it takes a while
Shana Hussin (20:45.148)
Again, conventional system is going to tell you under 100. I like to see it under 90 as a fasting. Glucose is more metabolically.
metabolically, you know, I don't want to say perfect, optimal. Yeah. 100 to 120 is going to flag you as pre-diabetic. And then over 120 is going to flag you as type 2 diabetic. But remember, by the time you get to blood sugar issues, you're pretty severe. And then the hemoglobin A1c is an average of the blood sugars over the last three months or so. That's helpful to look at for an average. There are definitely some things to watch out for with that. But under 5.7,
Kim (20:56.626)
more optimal.
Kim (21:07.842)
Hehehe
Shana Hussin (21:23.996)
is going to be normal and conventional methods. I like to see it closer to under like 5.3 to 5.4%. So if you have a fasting insulin and a fasting glucose, I know that this is getting a little bit technical, but you can multiply those two numbers together and then divide by 405. So your fasting insulin times your fasting glucose divide by 405 and that will give you
Shana Hussin (21:53.916)
homeostatic assessment for insulin resistance. And it's the best calculation we have right now for insulin resistance. And if you happen to have those two, under 1.6 is optimal.
anything over like 1.6 to 2.6 is kind of beginning to moderate insulin resistance and over 2.6 is more severe. And then kind of like we like to call it in the insulin resistant metabolic world. We like to call it like the poor man's. It's not really a poor man's, but the poor man's calculation for insulin resistance. If you don't have any of those almost everybody has a lipid panel.
So you can also look at your triglyceride to HDL ratio. So if you take your total triglycerides, divide by your HDL cholesterol, that number you want less than 1.5.
because high triglycerides are also very indicative of insulin resistance issues because although we're not looking at glucose in the bloodstream, we're looking at fatty acids and triglyceride in the bloodstream. And if those are high, that means extra energy is being converted into fat.
and that is indicative of insulin resistance as well. So you can look at the blood sugar test with the fasting insulin, or you can look at the triglyceride to HDL ratio. And then another really easy thing that you can do is just take your waist circumference, and if it's over 35 inches for a woman, that's a pretty good indicator. You have some insulin resistance, and if it's over 45, or sorry, 40 inches for a man,
Shana Hussin (23:34.46)
that that is indicative because if your waist is bigger than 35 as a female or 40 for a male you probably have more than
more than what is optimal for visceral fat around your organs. That's the most harmful type. And usually when you have insulin resistance, it's going to be stored around the organs as visceral fat. So those are some quick calculations that you might just have sitting around that you can kind of see where you would fall on the metabolic disease or insulin resistance spectrum.
Kim (24:05.323)
Yeah.
Kim (24:10.834)
Yeah, yeah, that's super helpful. Thank you very much. And we'd love to link to the sheet that you have or the calculator that you have there as well. So one thing before we move on kind of to the pre diabetes path and urination and that type of thing. But one other comment you made was if you've been in a high stress situation. So it's not just.
Shana Hussin (24:17.818)
Yeah.
Kim (24:34.73)
food or a problem with insulin that could lead to insulin resistance. It could be stress, as you said, poor sleep. What are some of the other contributors to why somebody would develop insulin resistance?
Shana Hussin (24:48.986)
Yeah, so you want to just keep in mind anything that's driving your blood sugar up is going to be problematic for insulin resistance. So food is our biggest thing to look at, right? It's like, that's going to be our biggest pull when it when we're looking at what's causing a blood sugar spike and the type of food and, you know, sugar and grains and carbohydrate, those types of things. But beyond that, there are some things because there's there's people who I've worked with who like their nutrition is dialed in, and they're, they're active.
Stress is a big player because stress is going to cause you to release cortisol. And when you're elevating your cortisol, that is going to tell your body to release some glucose into the bloodstream. And that rising glucose, even without eating anything, that's going to cause an insulin response as well. So that can be a factor. Same with sleep deprivation. People do not
put those two together a lot of times, but sleep deprivation, chronic sleep deprivation, or lack of sleep quality that can also drive blood sugars up for the same reason, it elevates your cortisol. And there are studies that show that one poor night's sleep can elevate your cortisol up to by the next night, it's still elevated by like 50%. So it's a substantial amount. So sleep deprivation is going to bump up.
um the cortisol which bumps up the blood sugar so those are problematic with insulin resistance and then um just how all of the hormones are synchronizing together if your thyroid hormone is not optimized that exacerbates insulin resistance um as your female sex hormones start to fall that makes you you know just being in your 40s and 50s and have you seen a decline in your female sex
Shana Hussin (26:44.508)
can combat this. But it's just important to know that, you know, and I would imagine a lot of your listeners are people, you know, women in their 30s, 40s, 50s, like...
things are changing metabolically, things are changing hormonally, and you can't always get away with, like you were saying before, with eating the same way, doing the same things as you did in your 20s and 30s. Your resilience isn't the same, your body composition isn't the same, and that's another thing that can really play a huge role with insulin resistance is lack of muscle mass. And even if you lose weight,
you know if you're the same body composition like say you start at 40% body fat you lose 20-30 pounds but you're still 40% body fat, metabolically you're not all that much better off and so lack of muscle mass and lack of movement can also definitely intensify insulin resistance.
Kim (27:49.162)
Yeah. So what's coming to mind is you're talking and knowing that there's a link between diabetes and, well, specific to diabetes, I wanna ask you about insulin resistance and urinary incontinence and frequently waking at night. I'm thinking of the people who, it's like what came first, the chicken and the egg. Are they waking multiple times a night to pee?
that then they have poor sleep and then it's contributing to the insulin resistant or are they insulin resistant and that's contributing to them waking more frequently at night to pee because I've seen the correlation of that. So what is it about pee and diabetes? Why do people who have diabetes urinate more often and have more urinary incontinence symptoms?
Shana Hussin (28:37.05)
Yeah, and I think it comes down to how well their type 2 diabetes or type 1 doesn't matter, how well it's managed and in this day of this day and age for the most part unless you come with some to somebody like me who's actually trying to reverse the disease state and put you into remission, diabetes is just kind of a disease that's managed. You're told that it's going to progress and get worse over time and that you just have to manage it and manage the symptoms where
that is false. It can be not type one so much, but type two diabetes and pre diabetes can be reversed. You just have to undo what you did and do the opposite of what got you ill in the first place. But when you're to the point of pre diabetes and type two diabetes, and your blood sugars are pretty high, as I was saying before, your body will do anything and everything to get those blood sugars under control. And so when you're to the point of pre diabetes, type two diabetes and really high
and your body's pumping out insulin. And sometimes with type 2 diabetes, your pancreas has been so tired for so long that it just doesn't even want to produce the insulin anymore. There's nowhere for it to go and it's just downright.
tired. So in those circumstances then your body hormonally all these things happen and your blood is just trying to flush the extra blood sugar and it's going to do that by causing frequent thirst like you're really thirsty and you're going to pee a lot because the blood sugars are so high. So that's the main mechanism that's happening. Like I said usually your blood sugars are pretty
Shana Hussin (30:22.748)
are having really increased thirst and increased urination. And as insulin, what's interesting too, is as insulin levels fall, you naturally, there's a couple of things that happen. Your body's gonna break down more carbohydrate as your insulin levels fall, because you're not taking food in. So then your body's like, oh, well, I have to use my stored energy. And so it starts to break down stored carbohydrate that's stored in the form of glycogen in your muscle and your liver.
And for each carbohydrate molecule that's broken down, there's two molecules of water attached. So then you're flushing that extra water. And so you're naturally just kind of getting rid of excessive water weight.
But for the most part, people with type 2 diabetes or type 1 diabetes that have blood sugars that are uncontrolled, the reason for the constant urination, the increased urination, is the body's just trying to get that blood sugar out of the system. And so that's why when you go in and, you know, your medical professional might think you have type 2 diabetes or you haven't been diagnosed, the blood sugar will show up in the urine. Because it's not normal to have sugar.
in the urine. Like that's not a normal thing. It's just a process that happens when your body's trying to flush out extra.
Kim (31:45.174)
Yeah. And I'm thinking of all the women who are going through maybe the perimenopause transition, maybe they have some thyroid challenges, they're maybe starting to experience changes in the like GSM, so genitourinary syndrome of menopause.
And many people will self diagnose, they hear the term overactive bladder. And because they go to the bathroom all the time, they're like, oh, I must have an overactive bladder and they go to their, their care provider. They tell them their symptoms. And so often again, the medical, the conventional medical system is like, oh, overactive bladder, here's a medication for that. And there's no, I don't know, I can't think of anybody who's ever talked to me about overactive bladder, who has said, and then we did an investigation into my blood sugar.
and if I have diabetes, right? So if I think about how many people are thinking they have overactive bladder or maybe even diagnosed with overactive bladder, and really it is a blood sugar or insulin resistance issue.
Shana Hussin (32:46.266)
Yeah, it certainly could be. And like you said, it's worth investigating and it's just simple blood tests. And even if a provider won't test for fasting insulin, which is very, very frustrating, it's a very cheap test. It's like six to $12 to run it. And you can run it right with your fasting glucose, but you give them some pushback on it and say, I have somebody who will interpret these tests for me.
know, you know what it is because I'm, you know, I'm thinking this disease process is developing and a lot of times when they hear you say that it's just not the norm for them. And let's face it, a lot of you know, some doctors are egocentric and they don't want somebody saying, you know, knowing more than them about about a certain subject, not all of them are like that, but there are certainly are some so giving them some pushback saying like, I really need to know what this is. And this is why.
Kim (33:36.031)
Yeah.
Shana Hussin (33:46.14)
have, I'm working with another professional who will help me interpret this and help me treat it accordingly. A lot of times and they're like, okay, like it's $6 to add this test on. Yeah.
Kim (33:54.273)
Yeah.
Kim (33:58.142)
Yeah, yeah. And that's typically how I manage my health. My primary care provider is an antipathetic physician and I will use, I'm in Canada, so I will use as much as I can with what's covered and I can get paid for.
Shana Hussin (34:13.978)
Mm-hmm.
Kim (34:15.162)
ask my medical doctor for those tests and take them back to my not to have them interpreted. And there are also lots of tests that they simply won't do that I will have to pay privately for, which is also very frustrating. But anyway, we digress. So I shared a study with you that showed that people with insulin resistance showed lower pelvic floor muscle activity. So they had probes and they weren't looking at EMG activity of the pelvic floor.
Shana Hussin (34:24.762)
Wow.
Shana Hussin (34:28.729)
Yeah.
Kim (34:44.976)
particular study. There wasn't really...
In my research, it wasn't really a lot that looks at a link between insulin resistance or diabetes. There are some for diabetes, sorry, but specific to insulin resistance in the pelvic floor. So I thought that was kind of interesting. What could you speculate or some of the reasons why people with insulin resistance may have, and I suspect it would be through the whole body, but we're talking about pelvic floor, why could they potentially have lower activity in their muscles?
Shana Hussin (35:15.258)
Yeah, and I, you know, I don't know a whole lot about this particular study either or the very, the exact mechanism or the exact link, but it's fascinating when people start to reverse their insulin resistance and blood sugar issues. You have blood sugar receptors and insulin receptors on every single cell. So they'll come and say, oh my gosh, you know, usually people are coming me, coming to me for weight loss or they want to reverse fatty liver or diabetes.
but primarily weight loss. And I always tell them like, we are working on your metabolic health. And once we get that into a healthy place, your body just lets go of that extra weight because it's a symptom of something further going on. And so if we think about, you know, how reversing insulin resistance is going to...
just help every single system in the body, it does make sense. Like I've had people say like, oh my gosh, like my skin rashes went away or, you know, all of a sudden I sleep so much better and my energy is more stable. And all of these things that they might not even notice right away. But all of a sudden, like, you know, two months after, you know, starting to work on blood sugar, all of a sudden, like you said, like there's changes in the
pelvic floor, the muscle tone is different. And of course, you're the expert on all of that. But when we look at where the energy is, the receptors and how
insulin and blood sugar play a role in every single cell, every single cell system, every single organ system, we can only say, well, it's going to be helpful in that area as well. And again, I don't know the exact mechanism, but it is just really interesting how
Kim (37:09.624)
Uh huh.
Kim (37:12.877)
Yep.
Shana Hussin (37:17.402)
you know, and even things with myself. I'm like, oh, well, I used to feel like my face was, you know, more bloated than it is now. And just...
you know, little things like I used to have tons of canker sores in my mouth all the time and, and struggle with that. And all of a sudden I don't. And so I think it's just, you can, you can see relief. It kind of depends on where your body's weak spot is. And, you know, and, and it's interesting. Of course, I talk a lot of it, a lot about time dating and, and time restricted eating, intermittent fasting and fasting strategies. But, you know, people who have done
Kim (37:42.144)
Yeah.
Shana Hussin (37:56.668)
fast can heal some really amazing thing like amazing healing goes on in the body. So if we're just if we're getting out of our own way.
and improving our blood sugar levels. And think about too how, you know, the blood sugar issues create vascular issues. So you have the really, you know, when people have struggled with type 2 diabetes for a long time, they've had real, they have really poor blood sugar management and they have really bad insulin resistance. And so all of a sudden they can't see well, all of a sudden, you know, their kidneys are working overtime and you're pain all the time. Your kidneys,
of that really small vessels and the periphery is getting clogged up. You know, we all have heard about how diabetics get their toes amputated and limbs amputated. It's because that vascular chur just gets clogged up and placked up with blood sugar. And so the same thing is happening in the bladder and the pelvic floor. You know, all of the little small vessels are what are affected first by poor blood sugar management and insulin resistance. So when you clear that up and you take
Kim (39:05.6)
Yeah.
Shana Hussin (39:08.924)
equation, there's just there's better blood flow, there's better healing capabilities. And that's probably what it comes down to if I hadn't speculated.
Kim (39:16.87)
Yep. Yeah. Yeah, I know. Yeah, I appreciate your I appreciate that. And there was another
Another study, actually it was in the same study in the discussion portion, and they shared that the risk of urinary incontinence is between 50 and 200% higher in people with diabetes. And so as you're talking, there's the, is it overactive bladder? Is it because they're peeing so frequently and now they're afraid of peeing so frequently so now they're developing tension to try to hold it on? It can go in this vicious circle of chicken and the egg. But...
We're not saying that, oh, cure your, you know, get your blood sugar and your insulin optimized and your incontinence is 100% going to go away. It's not as simple as that. However, it's an element that we need to consider that could potentially be contributing to it developing, worsening. And also now as we're going to get into, what do we do about it? So if people are now curious thinking, oh my gosh, maybe this is something that I'm been dealing with and I haven't, didn't even know about it. What can we do? We talked about testing. We've given
some optimal ranges and if somebody does the testing, they say, yes, I am insulin resistance, where do they do?
Shana Hussin (40:28.986)
Yeah, and that's like the, that's just it. That's what everybody's wondering, right? And there are so many diets out there. There's so many nutrition professionals pulling you in any one direction. But when we think about insulin resistance and diseases that manifest as...
from insulin resistance, I should say, namely fatty liver disease or non-alcoholic fatty liver disease, diabetes, I should say type two diabetes, pre-diabetes, PCOS is another one, polycystic ovary syndrome. We're even linking it to cancer, we're linking it to Alzheimer's disease. And really it's about getting that insulin level back in balance, right? So like I was saying, when we look at the drivers of what causes blood sugar spikes
high levels of insulin, we need to undo that. And not everybody's willing to invest in this and make the lifestyle choices that need to happen in order to reverse this. But if you are in that boat and you're like, holy cow, I have insulin resistance, there are so many things that you can do to reverse it and things that will start to move the needle within a couple of days, in a couple of weeks. So number one, you wanna look at the timing of your food for sure. Timing of your food and how
often you're eating. I used to, you know, I only eat twice a day now. Almost every day I eat twice a day. I'm not saying that's for everybody, but I usually eat it like between 10 and 11 and I eat in a way that keeps me full and nursed for five to six hours and then I eat again at like four or five and then I'm done. I don't snack. I don't eat at night. Of course there's exceptions to everything. Yes, but for the most part that's what my food intake looks like. I don't eat
high blood sugar, high insulin stimulating foods. I very rarely eat processed food. I make my own foods. They call me the ingredient mom, where at my house we have ingredients to make meals. We don't have packaged, I mean, of course we have some, but not very, very few. And so you just have to start slowly bringing that insulin level down. So the timing of your food, how often you're eating is huge. And so I have lots of courses
Shana Hussin (42:48.828)
with thousands of students at this point. I have a book, you know, just starting with, like I always tell people, you start with time-restricted eating and what does that mean? And people like don't like to hear the word restriction. So you can call it what you want. You can say, I'm just a meal eater and leave it at that. Like I'm just going to eat two to three meals every single day without snacks, without eating at night, without sugary drinks in between.
Kim (43:02.485)
Mm-hmm.
Shana Hussin (43:16.282)
Just that one thing alone, you'll be so far ahead.
of 90% of the population because you're only stimulating insulin a couple times a day. And when I look back at 10 years ago, yeah, I ate healthy food. I ate healthy whole grains. I, you know, I followed what I was, what they, I was told to eat and I developed an insulin resistance, but I probably put food in my mouth 10 times a day. And there's, there's studies that show that people put food in their mouth, even if it's healthy food, 18 to 23 times over the course of the day. That's normal.
hour you're stimulating your insulin. And so you want to eat a meal, let your insulin levels come back down into balance before you eat again. And then having a nice long overnight fast, the minimum everybody should be fasting at night is 12 hours. I call that gut rest. Like we should not have, there should not be any issue going 12 hours with sleeping aid of it with you not having
Shana Hussin (44:19.996)
can't even I can't think about going 12 hours you probably have insulin resistance for sure. So looking at the timing of your eating, looking at the frequency of your eating, and then of course looking at the actual food that you're eating. And so I teach a higher protein natural fat approach. We do restrict our carbohydrate intake because and people don't like to hear that oh I don't take my carbs away but
metabolic issues and insulin resistance is a problem with metabolizing carbohydrate. And people don't like to hear this. I'm a registered dietitian. I'm not just pulling this out of my butt.
Kim (44:56.738)
Hehehe
Shana Hussin (44:58.97)
But we do not need carbohydrates as humans to survive. It's just basic physiology. Do I eat carbohydrates? Yes, I eat them every single day. Do I overeat them? No, I don't overeat them in a way that's gonna cause me to have metabolic disease. I'm strategic about them. I eat non-starchy vegetables, mostly as my carbohydrate. I eat fruit on occasion. Every once in a while, I'll have like potatoes or sweet potatoes. I eat lots of salad, but I don't overdo sugar.
and grains and alcohol and those types of things. And again, if you want to continue to eat those things, that's your prerogative, but you're probably going to struggle with blood sugar and insulin resistance issues at some point in time. And so scaling back on carbohydrate intake, and I want to say too, a lot of times people are like, oh, like I don't want to restrict carbohydrate intake. It's usually, we pull back on carbohydrate and in my courses and
Kim (45:44.299)
Yep.
Shana Hussin (45:58.844)
I have other materials that help you kind of find where you should be for carbohydrates right now Depending on your goals and your disease state and your past medical history But
where you are to reverse a disease process is different than where you're going to be to maintain optimal health. So for a while I was under 50 grams of carbohydrate most days because I was insulin resistant so it didn't make sense for me to eat a lot of carbohydrate. Now I'm a little more liberal probably 50 to 100 somewhere in there is where I fall just if people are wondering well what is low carb? It's really hard to define low carb. There's not a clear cut
So that's why I help people find where they should be for disease reversal process, where they should be for maintenance, because it's different. So you don't have to stay that low forever. But it is imperative to do that when you want to reverse insulin resistance because you're not burning carbohydrates efficiently. And so those are the two main strategies. The meal timing.
looking at carbohydrate intake, focusing more on protein, natural foods, natural fat. And then the third thing is really just making sure we're metabolically active and building muscle, if at all possible, because muscle is like a sponge that soaks up blood sugar. We can store a certain amount of carbohydrate in our muscle, so the more muscle mass we have,
the better we are at controlling our blood sugar. And of course, when we're moving and we're more active, we're burning up that extra blood sugar. So it's not problematic. So if you like after meals, like one thing I always teach my students, like if you can go for a 10 or 15 minute walk or any kind of, even if you're just doing some air squats right after you eat.
Shana Hussin (47:59.13)
that's gonna pull the energy out of the bloodstream and burn it up before your body ever has to release insulin. And so you don't have to release as much insulin. And so that helps your insulin resistance. So those are the main things. Then of course, there's all these little nuances that come into play that we already talked about, like stress management and sleep quality and...
A lot of things, you know, like we could do a whole deep dive on carb, or just on nutrition. But those are the things that I teach in my course and my podcast so that you can, you can bring insulin back down into normal levels. And when insulin is really high, it's hard to think about going five, six hours in between eating because you're hungry all the time. But as that insulin level starts to bounce out, it gets easier and easier to do that. All of a
Kim (48:27.703)
Yep.
Shana Hussin (48:52.572)
your blood sugar is stabilized and you know, I have all these hacks to stabilize blood sugar too, but those are the main things to start reversing it and it's all naturally done. There's no pill to pop.
to reverse insulin resistance. It's done through lifestyle and that's why, that's one of the huge reasons that the conventional medical people aren't educated on it because there's no pill for it.
Kim (49:07.754)
Yeah, yeah.
Kim (49:22.486)
Yep.
Shana Hussin (49:23.034)
So there's not pharmaceutical people coming in saying, hey, this is what you do for insulin resistance. It's like, no, it's lifestyle. And yeah, there are some pharmaceuticals that can help with blood sugar management, but it's a lifestyle that really moves the needle with reversing insulin resistance.
Kim (49:39.966)
Yeah, yeah, really our primary care physician should be nutritionists and naturopaths and that you know, that's what we should really all be going to seek help for. And then if we can't with all of that being changed, address it, then we have the allopathic medicine to help us. But unfortunately, it's flipped right now. But a couple things just before we tell people where to find you. When the thing that scares a lot of people with
Shana Hussin (49:45.082)
I'm sorry.
Kim (50:09.31)
with either intermittent fasting or avoiding like low carbohydrate is where do I get my fiber? And especially even the pelvic health population people are really concerned about pooping and fiber so what do you recommend from what are the best sources of fiber that could still keep us in that place where we're still managing our blood sugar well?
Shana Hussin (50:30.554)
Yeah. And, and like I said, I don't advocate for no fiber. I eat, I don't even know how many grams. I don't really track it, but I eat a lot of non-starchy vegetables. And that's my main fiber intake. I eat probably a piece of fruit most days, but the other thing, so yeah, we want to stay hydrated. We want to, we want to eat some fiber. But the other thing that go along with constipation and, um, regular bowel movements that people just don't ever think about are electrolytes. So not even.
even just drinking water, but getting electrolytes, especially magnesium, magnesium helps you to relax. And with that relaxation comes regular bowel movements. So if you're someone who's all stressed out all the time and you're never relaxed, it's hard to poop. I mean, it just is. And so that, so enough electrolytes and sometimes just taking magnesium regularly or taking up some salt baths with magnesium that absorbs through your skin is enough to get you pooping regularly. And then the other factor
play is having enough fat. People do not ever think about that, but eating enough natural fats, I'm not talking about inflammatory, crappy fats that are in processed foods, but natural fats like butter and ghee and coconut oil and extra virgin olive oil, and even fat that is found naturally on meats, eggs, those types of things. If you tolerate dairy, not everybody tolerates it, but higher fat dairy, once you start to eat more fats,
people poop better and they'd never put that together. And so when you look at processed foods, even if it's a food, like say like a bar that has like fiber, that's high fiber added food, there's nothing natural in there. It doesn't have electrolytes. It doesn't have, you know, there's usually no water content in there. There's not healthy fats. So those are some other things to think about. And sometimes people get freaked out with intermittent fasting too.
because they're not pooping as often and that's really normal because you're not eating as often and sometimes when you're when you start eating like whole real food your body absorbs it better and actually uses it and if you're eating a lot of processed garbage food and you're eating it often your body doesn't need you know it has a lot more waste and so unless you're like feeling really constipated sometimes people don't poop as much and they get all excited about that but
Shana Hussin (53:00.188)
either. And you know, as long as you're pooping every day and you don't feel constipated, that's kind of what you go with. But the electrolytes can be a huge part of it and natural fats too.
Kim (53:13.514)
Yeah, amazing. This was so interesting as I knew it would be. I knew it would be a long one. Thank you for sticking with us. And where can people find you? You've mentioned a podcast and book and courses. Where can people find you and work with you or take your courses and learn more?
Shana Hussin (53:19.994)
No.
Shana Hussin (53:29.85)
Yeah, I'm most active on Instagram as a social platform. I post there pretty much every day and on my stories, I try to post what I'm eating. A lot of time people are always very interested in what I'm eating, how I'm achieving my protein intake and how to put meals together. So I'm on Instagram. It's just my name, shanna.hassen.rdn. So the RDN is Registered Dietitian Nutritionist. And I have a podcast called Fast to Heal.
insulin resistance and metabolic disease. And I'm in the 180s for episodes now. So there's hours and hours of education there. And then all my courses and more about me can be found on my website, which is fast to heal.info. I have lots of different courses, lots of different levels. My book is also called Fast to Heal, which can be found on paperback on Amazon.
Kim (54:26.978)
Amazing. And I'll have all those links in the show notes below. But Shanna, thank you so much for sharing your wisdom. This was super, super interesting. And and I just feel like there's so much more to explore with the links to pelvic health. And so this is just starting me down a whole new path. Thank you very much.
Shana Hussin (54:47.642)
Thanks for having me.
