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"I have been eating clean/keto/paleo/low carb/etc for months now and my blood sugar/insulin/weight is still not where I want it to be.......WHY?"
You still have an insulin issue.....even with "normal" blood sugar......But HOW?
It very well could be due to your very well-intentioned health efforts to lose weight or get fit in the gym over the years.
If you have ever followed a diet, of any kind be it weight loss, diabetes management, or a fitness model, that eats several small meals and snacks per day.....then we may have the answer.
Insulin is secreted with all meals/foods that have carbohydrates, as in sugars, greens, processed carbs, fruits, and vegetables. It is also secreted (at 43% the potency of carbs) by whole food protein like meat, chicken, fish, and is secreted at the same level as sugar with processed protein (powders and BCAAs).
Like the graph shows your insulin goes up each time you eat and doesn't come down as fast as your blood sugar so you go through the day with a high insulin exposure and end the day with an ever-increasing high insulin level that rolls into the next day slightly higher than the previous to start the process over.
As the insulin (test fasting insulin) goes up over time it will magnify each time you eat through the next day. It can actually go up 7 fold.
Medical references say a healthy fasting insulin level is below 25 with type 2 diabetes diagnosed at 30.
I say I want my fasting insulin level at 2-5. That is a huge difference between metabolically healthy and medically sick....hence where "Metabolic Syndrome" develops and does its damage.
If each time we eat that insulin secretion can do up 7x's then at 5 (my high end) it will peak at 35 after a meal then start to come down before the next.
If our number is 20 (medically "acceptable") then it can peak at 140....each time you eat......which in the old model can be 6-9 times a day! This will guarantee a high insulin exposure for that day and that you start the next day with your insulin odds against you.....only to do it again and compound the problem.....even while doing "all the right things".
SOOOO.... now that you have shifted your diet, you changed WHAT you eat, which is great, you need to fix that insulin (metabolic) mechanism that is holding you back keeping the weight on, insulin high, ketones low, and blood sugar high.
Now that you are eating well it is time to eat less often. Time to change WHEN you eat.
Step One: Move from the 6-9 times a day to 2-3 times. With NO snacking.
Step Two: Create rotational fasting (You can start with what is called Intermittent Fasting, then water fasting) calendar 3 days a week spaced by a normal eating day. (M-W-F)
Step Three: High-intensity exercise as much as possible. This means heavy weights, intervals, bursts or peak training.
THAT over time will start to heal the liver and begin to restore the metabolism and shift those numbers, including your weight on the scale and quality of life.
We can do better!
I hope it helps. Dr. Hugh