Ep. 320 Mastering Lifestyle: Guide to Overcoming Insulin Resistance with Shana Hussin, RD

I am thrilled to have my dear friend and colleague, Shana Hussin, joining me on the podcast today. Shana is a registered dietitian and host of the Fast to Heal podcast, where she passionately pursues her mission to empower women in reversing obesity, diabetes, PCOS, and fatty liver. 

In our discussion today, we dive into the main contributors to poor metabolic health, also looking at other factors that may have roles to play. We identify signs of compromised blood glucose metabolism, discuss satiety, and explore ways of reversing insulin resistance and diabetes. Shana also shares her insights on labs to monitor and offers valuable strategies for addressing sleep and constipation issues. 

Join us as we navigate several health topics, all aimed at fostering a healthier and more vibrant lifestyle.

“When you’re insulin resistant, you’re just not utilizing energy very well. So you’re eating but your cells are not utilizing the energy.”

– Shana Hussin, RD

IN THIS EPISODE YOU WILL LEARN:

• How Shana stepped back and re-evaluated her approach after her son got sick
• How Shana’s experience with intermittent fasting and whole foods led her to a renewed understanding of why people are unhealthy 
• How the culture of ultra-processed foods with artificial sweeteners and unhealthy fats started coming into play in the 1970s
• Why your genetics are not your destiny
• Why should seed oils be avoided?
• How sugar is an addictive substance that could lead to insulin resistance and metabolic dysfunction
• What are the symptoms of insulin resistance?
• The benefits of intermittent fasting
• Why women must support their metabolic health during perimenopause and menopause
• Some natural remedies for improving sleep quality

Connect with Cynthia Thurlow

• Follow on Twitter, Instagram & LinkedIn
• Check out Cynthia’s website
• Submit your questions to support@cynthiathurlow.com

Connect with Shana Hussin

• On her website
• On Instagram

Transcript:

Cynthia Thurlow: [00:00:02] Welcome to Everyday Wellness podcast. I’m your host, Nurse Practitioner, Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent, is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.

[00:00:29] Today, I had the honor of connecting with my friend and colleague Shana Hussin. She is a registered dietitian. She is the host of the Fast to Heal podcast and is on a mission to help women reverse obesity, diabetes, PCOS, and fatty liver. Today, we dove into the chief contributors to poor metabolic health, signs of poor blood glucose metabolism, the impact of satiety, labs to look for, how we can help reverse insulin resistance and diabetes, strategies for sleep and constipation, amongst many other topics. I know you will enjoy this conversation as much as I did recording it. 

[00:01:12] It’s so nice to have you on the podcast. We’re kind of reversing roles here. I know that I’ve been fortunate to have been a guest on your podcast several times, so it’s nice to have you on the podcast. 

Shana Hussin: [00:01:21] It’s a real honor. It’s always fun to chat and collaborate with you and we’re very like-minded and have so much in common. So, so happy to be here. 

Cynthia Thurlow: [00:01:30] Absolutely. So, I know we’ve featured other registered dietitians who, much like myself, were allopathic trained and then kind of evolved into being, shall I say, a little more open minded about the complexities of metabolic health. And for you, was there one particular situation or patient that really shifted your perspective? Because I know I dove down a rabbit hole while I was preparing for this podcast about all the complexities related to registered dietitians, what your certifying board is, what roles are played in terms of, what influences the board and the certifying regulatory agencies. And it’s not much different than nursing and medicine. And so, I just start to realize that there is so much to the way that our healthcare clinicians are trained that is heavily influenced by pharmaceuticals, the processed food industry, the USDA, the FDA, worse yet, the lobbyists. And so, for you, was there a defining moment that caused you to kind of shift out of your traditional allopathic mindset into a more open minded one?

Shana Hussin: [00:02:42] Yeah. I wish that it would have been much sooner than it. [laughter] [crosstalk] bit squirmy.

Cynthia Thurlow: [00:02:45] No wait. Don’t we all?

Shana Hussin: [00:02:48] I mean, I was a good decade in before I ever thought to myself, like, “My patients aren’t healing. Their blood sugars continue to get worse. They’re on more insulin.” And it was about 15 years in where my son got very ill, and all of a sudden, we were in the throngs of the conventional medical system where we never had been there before. I mean, I took my kids to their annual visits. Maybe they’d have a fever here and there, but we’re never in the conventional system. And he got very, very ill and I had to take him to many doctor appointments and I was not being listened to at all. And I did not like the therapies they were suggesting and the medications and he was only 11 years old at the time. They wanted him on infusion treatments and things that were classified as chemotherapies. And I thought, “No freaking way. This is crazy.” And so, the mom in me with the alarm bells were definitely going off. 

[00:03:49] And so, I kind of did a deep dive into what could be causing his symptoms and his illness. And of course, I thought, I knew it all about nutrition, and here I am, a registered dietitian, we’re the experts, and you’re told that over and over in the dietetics field. And so, I started to second guess myself. I had been struggling with bloating for so many years myself, and I never had a big weight issue, but I had to fight really hard to maintain my weight where it was at. And I was nearing 40 at the time and I was running marathons and half marathons and strength training and eating my whole grains and my complex carbs and all of these things. And I’m like, “Why is this so hard? [chuckles] Is this way too difficult?” And then everything that happened with him, I just started to take a step back and I thought, “There’s got to be something that I’m teaching that isn’t I don’t even want to say correct, there’s got to be a better way, there might be other possibilities out there.” And that’s hard. And I’m sure you are the same way. It’s hard to take a step back and say, “Holy cow, I’m 15 years into this and I don’t think my message was the greatest.” And I might have contributed to metabolic illness rather than helping people heal from it. 

[00:05:08] And so, after that whole exposure and that whole experience, I had taken a step out of the dietetics field because I just didn’t know if what I was teaching was what was actually helpful for people. And I had just kind of had it with the nutrition field. So, I went into substitute teaching for like five years just to refine myself. And I was exposed to things in the school district that were very jaw dropping and eye opening as far as nutrition goes. But I also decided I wanted to go back and kind of test the waters with digestive health because my son had a lot of digestive issues. And at that time, the owner of the clinic asked me if I would look into running a weight management program. And that’s what I had done most– I was in some way, shape or form, either as a dietitian or a health coach or employee health, I was helping people with weight loss. 

[00:06:02] I mean, everybody comes into your office and they want to lose weight. And at first, I said, I’m like, “I just don’t think I can go there.” I have tried for 15 years to help people get metabolically well and lose weight, and it’s just not happening, like, they’re getting worse.” And so, I decided to okay, this is years later from my original training. I picked up The Obesity Code by Dr. Jason Fung, which a lot of us, that kind of our first exposure to improving metabolic health. So, it wasn’t a patient per se, but I read that book and I was ticked. I was like, “Are you kidding me?” Like, this is so much simpler and makes so much more sense. No wonder all the people who have come to see me haven’t been healing. They are not metabolically well. And the concepts that I’m teaching, while some of them had merit, a lot of them were making them more metabolically ill.

[00:07:02] So, I felt really ticked off at the system and ticked off at the nutrition field. And people ask me, like, “Where’s the disconnect?” I’ve gotten that question a lot because I look back at the curriculum, like, my undergrad curriculum, and granted, it’s been 23 years, so I don’t remember all the specifics, but we learned the biochemistry and the human physiology and the anatomy and all of that is still legit. Like, you look at that, you’re like, “Oh yeah, the Krebs cycle, how to make ATP and all of that.” Where the disconnect comes, I think, is when you then go into the field and into your internship, and all of a sudden, you’re not thinking about that physiology anymore. You’re just doing what the other dietitians are teaching you and what the conventional system is teaching patients. And if you’re in the conventional system, you have to teach the conventional guidelines, which is why I left there. 

[00:07:58] So, to answer your question, it wasn’t per se one person, but it was that book. And then I did like, a really small pilot study at the clinic I was at because I decided to try intermittent fasting on myself. And mind you, I’m one of these people who would eat at like, 05:00 in the morning, 06:00 in the morning before I went for my run. I’d be like, “I have to have a banana on string cheese to fuel myself. [Cynthia laughs] Go to 09:00 AM was a stretch for me. And so, people who did my pilot study, I just kind of threw it together by myself. There’re 20 people in there. And I couldn’t believe the results that I had with just implementing intermittent fasting and eating whole food. And so that just reenergized me. And I thought, “Okay, now I get it.” [laughs] 20 years later, I get it. I get why people are so unhealthy. And so that’s when I went back into the field and of course, went off on my own because I couldn’t teach what I wanted to teach in the conventional system. 

Cynthia Thurlow: [00:09:00] Yeah. I find it really fascinating when I bring experts on and I learn a little bit about their journey. At the time it may not make sense to us, but retrospectively, it’s like all these little steps that made no sense at the time now make complete sense. And so, I know that Dr. Jason Fung’s work has influenced so many of us in this space and I always openly share that. It was Robyn O’Brien’s book The Unhealthy Truth, that changed my life. I read that book and I was so angry when I started to understand the role of the processed food industry and lobbyists and how that so heavily influences policy, health policy, nutrition policy, etc. And so, it’s this full circle moment. Something that I think is really interesting is many individuals don’t understand the role of food subsidies.

[00:09:47] Why is there so much junk that proliferates in the processed food industry? Why is there so much dairy? Now, let me be clear. There’s good dairy and there’s junkie dairy, but dairy, why is there so much soy? Why is there so much sugar? And a lot of it has to do with foods that are subsidized by the federal government that was initially designed to help farmers. But I think in many ways it ultimately hinders them. And I’m sure you could speak to this as well, is that we have this kind of instant gratification culture. We want everything right away. I know for myself still to this day, because we have conditioned patients that a pill will take away all of their illness or will fix whatever is wrong with them. We really have devalued the role of lifestyle changes. And I think that’s a place that we all kind of speak from is that the power of lifestyle change largely surmounts anything else that’s out there. Like a pill may get you their part of the way, but it’s not going to per se fix the problem. Whereas if you prioritize the types of foods you eat and you get more rest and you strength train and you manage your stress, that is going to be far more impactful. 

[00:10:55] And I’m curious for you, you probably lived through the whole phentermine craze and you probably lived through Fen-Phen and things that I think of now. And ironically enough, there was a woman in a program that I’m teaching that on her intake form, she had phentermine down. And I was like, “Wow, I haven’t seen that drug in a long time.” But do you still get a lot of patients into your programs that are still in that mindset that you have to kind of reprogram them to understand it should be lifestyle over medications? Obviously, there’s a place for medications, but that shouldn’t be the first step. 

Shana Hussin: [00:11:26] Yeah, so many. My population, the vast majority of my population is aged 35 to 65. So, these women have been thrown into the diet culture calorie restriction for basically their whole lives or as long as they can remember. And you mentioned Fen-Phen and phentermine, my mom struggled with her weight as long as I can remember. She was going to diet clubs, she was going to WeightWatchers, she took Fen-Phen. And I remember it was around, I think I was in high school and college when she took Fen-Phen. And it was both of them, it wasn’t just the phentermine, it was when both of them were prescribed and that’s the most weight she’s ever lost and she was so excited. And I don’t think she had much for side effects, but when it became that it could no longer be prescribed for her, I remember how sad she was. She’s like, “This is the only thing that has worked for me.” And my younger sister has taken phentermine.

[00:12:25] So just a little sidebar. I’m not one of those people who has all of these significant awesome genes. Like my parents, my sisters, they’re both overweight, obese. My younger sister was actually on the list for bariatric surgery at one time. So, I will back this all day, every day. I do not have the genetic predisposition to be one of those tall, lean, fit people without having to do anything or try anything. But yes, it’s so sad. But I will say this. I would say women, especially in their 60s and 70s, because it’s really the 1970s where the whole culture and so many ultra-processed foods started to come into play, and we just went from healthy natural fats to really crappy fats and started to just, all of the artificial sweeteners became really apparent. And we just had this huge transition from family farm foods to ultra-processed foods. And those women live through that, all of it.

[00:13:31] That’s basically their whole lives. And I remember my mom buying the Brummel and Brown. I always thought like, “Oh, that’s the good stuff,” because it’s got yogurt in it, and I would dip salty crackers in it. [Cynthia laughs] And they are the ones that are really metabolically messed up because it’s just been so long, and they didn’t have the information other than let’s do caloric restriction in some way, shape or form to lose weight. And normally that’s get rid of fat, really keep your protein down. Let’s just really focus on carbohydrates that are supposed to give you energy that really just mess up your blood sugar. But I do find a lot of optimism in it because I feel like I have more and more women in their 60s and 70s, even into their 80s, who are just like, their eyes are opening, they’re getting healthier, they’re losing weight, they’re getting more metabolically fit.

[00:14:30] They’re just thinking, “I’m in my 70s, there’s no hope for me.” And I feel like that population just is ecstatic about this, because finally something resonates with them and it works, and they can go back to feeling full and satisfied rather than always hankering for something because they just haven’t been nourished in so long. And it just makes me sad that they’ve gone so long without proper nourishment and feeling like they are always having to count calories and always having to watch what they eat and not living life to its fullest. So, I have seen that. A lot of my population is perimenopausal and menopausal just like yours, but I do feel like they’re optimistic because they are finally finding something that they can resonate with and feel better with.

Cynthia Thurlow: [00:15:23] Yeah. And I have to give you credit that genetics are not our destiny. So, bravo to you for figuring out a lifestyle that really affirms for you a sustainable strategy. And I think that’s really what both of us embrace and certainly speak to from our platforms. You bring up such a good point that 50 years ago, this is really the start of, I think, about this yoyo dieting craze. Like my mom was doing the Scarsdale diet and every diet you can imagine because she grew up in a toxic food culture. I think her dad actually kind of impressed upon her that “If you’re not thin, you’re not anything.” And so that can be very, very damaging to a young woman’s psyche. My mom’s Italian, but I recall being a kid and sitting underneath the dining room table with a big thing of butter. Like, I loved butter as a kid and I would just stick my– I mean, of course I was like two or three. So, let’s be clear, I wasn’t older doing this, but I would just eat butter by itself. And so, we acquiesced from eating real fats. 

[00:16:26] And I remember my mom would cook bacon and there would be a glass jar that she would collect the bacon grease in and we would use that to fry vegetables in. And so, like, all these things that slowly made their way out as we started to move as a culture from appreciating healthy real fats to adulterated fats and then ultimately seed oils and Brummel and Brown and Smart Balance and all this junk that I used to tell my cardiology patients to eat in lieu of eating butter and ghee and like, real fats. Sorry for that. I always say I will forever be apologizing, know better, do better, but helping people understand that eating a nutrient dense whole foods diet is always going to be superior than the ultra-processed. I think it was Shawn Stevenson last week who said that, “Most food consumed in the United States now, I think it’s 60% to 70% is ultra-processed food.” So, we’re not talking about maybe something that has three ingredients. We’re talking about stuff that vaguely looks similar to what it originally was derived from.

[00:17:23] And this is incredibly troubling and I really think a great deal about what food ingredients are the most toxic. I always think about seed oils as a really great starting point. Do you find for a lot of your patients that seed oils are, A, confusing because we’re told vegetable oils are healthy and vegetable oils are safe. And how do you help them kind of navigate transitioning from these highly processed, rancid fats to healthier ones? Because it’s so much of this social conditioning that we have taught our patients and taught all of these hundreds, if not thousands of patients the wrong information. And now we’re trying to turn the tide and help them understand that we want things that are a little bit less processed, not exposed to solvents and heat and denaturing. So, what is a common strategy used when you’re talking around the fat piece? 

Shana Hussin: [00:18:18] Well, I was right there with you [Cynthia laughs] with patients, and I remember the first weight management program I taught classes. It was eight weeks of classes and there were three dietitians who taught the classes. But one of my classes was “focus on fat.” So, I taught this over and over and over. And of course, we would say saturated fat, keep that less than 10% to 15% because those are the conventional guidelines. And then we’d say polyunsaturated fats are good, so eat canola oil and sunflower and safflower, and all the ones that we know now are highly processed and inflammatory to the body. And at least I can say that I tried to get people to eat olive oil. [laughs] I’m like, I can feel good about that at least. But, yeah, the polyunsaturated fat, I feel like seed oils is the next kind of hot topic with the nutrition field and people just getting more knowledge around them, because we know, people know sugar is not our friend, and that sugar wreaks havoc with the body. It makes us metabolically ill. That’s kind of a no brainer. And they know that processed foods in general aren’t healthy for their body. But you mentioned seed oils to most people and they have no idea what you’re talking about. They’re just like, “Well, what is a seed oil?” And then they get super confused about seed oils and seeds. 

[00:19:40] So, well, if I can’t have sunflower oil, then I can’t have sunflower seeds or I can’t have flaxseeds or whatever it is. So, it’s very, very confusing. And the reason why it’s confusing because these seed oils have been promoted for so long, for decades, and they’re in just about every ultra-processed food. And I never blinked an eye at seed oils until about five years ago because I didn’t know. Here I am, a nutrition professional. I had no idea. And the thing that makes it really, really confusing is the American Diabetes Association will promote foods and recipes on their website with canola oil, with I don’t know that soybean oil, but I know canola oil’s on there for sure. And you just look and you’re like, “Oh, this is the American Diabetes Association.” And many, many dietitians still promote polyunsaturated oils that have been highly processed. So, it’s just so confusing. 

[00:20:37] So I think the main message I teach about fats in my courses now, of course, it’s a totally different message than what I used to teach, but the big message is to cook your own food more and more as often as possible. And I know that this isn’t always going to be applicable to every family, to every person. I mean, we’re just all about convenience and we have three kids, I get it. Sometimes you have so much going on, it’s so much easier to go through a drive through or pick up food from somewhere else. But that’s where these seed oils are lurking, are restaurant foods and ultra-processed foods that you don’t make. Like when you don’t make your own food, you just are out of control with what you’re putting in your body. 

[00:21:23] And so I like to keep it that simple for my students. I’m like, “Okay, for a while at least, just to start with, let’s cook your own food more often than you’re going out.” And I’m not one of these people. I’m getting there because I live in just south of Green Bay in Wisconsin, so it’s not the most progressive area as far as restaurants knowing about seed oils and going out and say, “Can I have my food cooked in butter?” They just kind of look at you like you’re an alien. So, I haven’t gotten that far where I’m always comfortable with asking the restaurant owner how they’re cooking food, can they cook it in butter? But at least I eat out very rarely at this point. I used to eat out more than we do now because I just didn’t think too much about it. But if you can just start to eat at home, prepare your own food, get rid of the ultra-processed foods as much as possible.

[00:22:23] There are some processed foods that will use olive oil or coconut oil that aren’t ultra-processed and will use some cleaning ingredients, but they’re hard to find, and it’s very difficult to go to a restaurant with any seed oil exposure. So those are the two things. Like, if people can just take a step back from ultra-processed foods and take a step back from eating at restaurants. And like I said, “I get it.” I’m a mom of three. I’m just like you, I own my own business. My husband works a lot. Like, I don’t want to be that person. I don’t want to spend all my time in the kitchen either. But for me, that is just a really important focus is to learn how to– and to take the seed oils out of your home too. Get rid of the vegetable oil, get rid of the canola oil. It’s easy enough to just replace it with extra virgin olive oil or coconut oil, and at least that’s a start. But I do think it’s really hard just in this day and age, to 100% eliminate them, especially at first, if you’re just getting used [chuckles] to the whole idea of seed oils. 

Cynthia Thurlow: [00:23:26] Absolutely. And I think it’s kind of like this concept of good, better, best, that when you’re at home, you can likely control what’s in your food versus when you go to a friend’s house or you go to a restaurant. And in fact, last time I was in LA. My Uber driver said, “Oh, just so you know, those pricey steak dinners that you’re eating when you’re here, they’re guaranteed to be cooked in seed oils.” And I was like, “Don’t ruin my day.” But the point is, is that if you’re eating in restaurants and the only city that I’ve been in in the United States where they’re very proactive about eliminating seed oils right now is Austin. Anytime I travel in Austin, they proudly put it on their know, seed oil free. They talk about what oils they do cook with or use. And so, it’s the good, better, best. Like, if you can cook from home, you can control what’s in your food. Be a prodigious label reader. I think that’s also very, very helpful. And then just asking, when you’re in restaurants, if it says olive oil blend, you can be guaranteed it’s probably 99.9% soybean oil and 0.1% olive oil for sure. 

Shana Hussin: [00:24:28] Yeah.

Cynthia Thurlow: [00:24:29] That’s certainly a good point. And if you look at the research, because I’ve presented a couple of papers at different events over the last year, and it’s interesting to me if you look at the animal-based research. So, animal models, what makes seed oils toxic? They’re bad enough when they’re not heated. If they’re heated once, it increases the inflammation, oxidative stress it can create in the animal model. And then if they’re reheated over and over again like a fryer, like when you go to some fast-food places, that’s where they become the most toxic. So, understanding there’s this good, better, best, and that there’re lots of options, and we’re all a work in progress. No one is certainly not exposed them unless they’re living in a bubble. And sometimes people will ask, “What do you do when you go to a restaurant?” And I generally try to have things simply prepared, but I also, if I get exposure, I don’t want to then perseverate over it because I’m then diminishing the experience of being out with loved ones or my husband or friends, etc.

[00:25:24] So just keeping things in kind of perspective. What I find is interesting is we kind of touched on the sugar piece. And if you look at the statistics on sugar, Americans consume 100 pounds of sugar a year. That’s average. So, I can guarantee you there maybe not our listeners, but there are people out there that are consuming way more than that. So, understanding the net impact of sugar and it’s the insidious nature of it, when we find it in condiments and we find it in a sauce or just things that you wouldn’t even– maybe a salad dressing. And I think both you and I are in agreement that I do buy some prepared stuff because I don’t have all the time in the world. But you can find clean salad dressings. You can find like, chosen brands is a one that we’ve used several times or Primal Kitchen Ketchup. It’s just even in mustard, I mean, you find it everywhere. 

[00:26:17] So cumulatively over time, do you find that you tend to have women, and I’m saying women because we both predominantly have women as patients and clients that have a sugar problem. I always say this is that sugar beast. When I ask women, “Do you crave sugary foods? Do you crave salty foods?” And you can generally see some patterns that emerge about sugar. It’s just so highly addictive and so dopaminergic like it just lights up your brain and people want more and more and more. And I always say that typically doesn’t happen with nutrient dense whole food. It’s the highly processed stuff that will light up our brains. But do you feel like sugar is a problem for most of your clients too? 

Shana Hussin: [00:26:56] Absolutely. And most of the clients that I work with, just like yours, are insulin resistant and have pretty severe metabolic dysfunction and metabolic issues. So, this just compounds the issue so much, just kind of backs them into a corner. It’s like when you have insulin resistance, you’re just craving sugar all the time. It’s just really tough to control your appetite. You’re resistant to fat burning, you’re hungry all the time, you eat even just a little bit of sugar. And I found this. I used to be insulin resistant, full disclosure, and I don’t even know to what point, because the first time I tested my insulin, about two years ago, I was at 10. And this is after I had been intermittent fasting for three years and had been on a low carb. I eat around 100 carbs. I’m not like super low carb by any means, but I definitely monitor my carb intake and I eat mostly whole food. And I was one of those people. I’m like, “I don’t understand this intermittent fasting stuff where people can just skip meals.” I just can’t. I don’t feel good when I do that. And it was because I was insulin resistant. 

[00:28:07] A year later, my fasting insulin was 7.5. So, it was a work in progress. It took me a couple of years to really reverse that. And my weight was always normal, my blood sugars were always normal, my hemoglobin A1c was always normal. So, you and I both know that fasting insulin is elevated years to decades before the blood sugar issues arise. So, I find that, yeah, sugar is very problematic. And for me, it was one of those things where if I ate, I could moderate it, but it would still be triggering for me. And I’m not going to say I’m always sugar free, because I’m not. I eat very little sugar. I mean, when you say 100 pounds, you and I probably eat maybe a pound a year.

[00:28:52] We’re really bringing down. We’re on the low end of that. But yeah, it’s like when you’re insulin resistant, you think there’s something wrong with you. You think why can’t I control my appetite? But if that insulin is high and you don’t know it, I mean, you’re just kind of spinning your wheels with trying to control sugar and trying to control carbohydrate intake until you can—you know do some testing for it and see, “Okay, this isn’t all in my head.” And I have so many students who just like, they’re so happy when their fasting insulin comes back elevated, not because they want insulin resistance, but because it explains so much. And they’re just feeling like, “Why can’t I implement the same things? Why can’t I lose weight?” But yeah, sugar is one of those things that just especially depending on the time of the day that you’re eating it and if you’re eating it by itself, if you’re eating it the first thing in your meal, all of those things contribute to how you’re going to respond to that sugar, what your blood sugar is going to do. 

[00:30:00] I know your listeners are very savvy about these topics, but I don’t teach my students to go no sugar forever because I just don’t think it’s attainable for most of them. But if we can teach people, okay, this is why you crave sugar, let’s try to balance some of these hormones out to get you feeling better. If you do want a little bit of sugar, let’s eat some protein and fat first and then eat it later. Let’s not have it by itself to cause a big blood sugar rush because then you’re setting yourself up for more cravings and more sugar. But yeah, I do like sugar is a demon. I mean, it’s very, very problematic. But I don’t think to tell people to 100% remove it, is attainable for– there is a small subset that will totally do that and be completely fine with it. But I think we both work with students, busy women who are around the same age as us with kids and work, and they just need a lifestyle that is sustainable for the long haul.

Cynthia Thurlow: [00:31:05] I think it’s such a good point. Kind of my methodology is if you can’t moderate, you eliminate. And I definitely have patients and clients that will say, “I can’t eat X food because it’s like my kryptonite. However, I can moderate a little bit of dark chocolate or whatever else it is that someone feels like is something they enjoy as a treat. And I think that message is an important one of moderation, finding what it is that makes your body feel good. How to start your day. For most of our listeners, many of them intermittent fast, and I always say we are more insulin sensitive earlier in the day. We know that’s very in line with our chronobiologic rhythms, helping them understand. If you sit down and have a piece of chicken and broccoli, that’s going to set your day up very differently than if you sit down and have a bowl of ice cream. I’m sure there’re lots of people that are like, “I’d love to have that bowl of ice cream,” but I know what it’s going to do to my blood glucose for the rest of the day. You kind of alluded to the fact of some of the signs that can give us a sense of whether or not we are insulin resistant. And you mentioned and kind of touched on the cravings piece, I think a lot about weight loss resistance and you mentioned the fasting insulin and you said before I started intermittent fasting, who knows what my numbers were. This is last time I checked, they were 10, then they were 7. So, you’re heading in the right direction. 

[00:32:19] What are some of the other signs that you find commonly when people are dealing with a degree of insulin resistance? And remember, listeners, this is not typically picked up on normal blood work. If you’re drawing a fasting insulin, you may see it, or if you do a two-hour oral glucose tolerance test, or if you’re looking at a two-hour postprandial, so after a meal, you might start seeing some subtle changes. And this is why as you are moving from being a little bit insulin resistant to becoming more insulin sensitive, it takes time. You’re not going to go from a fasting insulin of 15 to 2. That is not going to happen overnight. That takes time for those cells to get resensitized. What are some of the common symptoms you see? 

Shana Hussin: [00:32:59] Yeah, definitely the cravings. And just not feeling full after meals, that can be another warning sign because really what’s happening? You’re insulin resistant, you’re just not utilizing I mean, to keep it really simple, you’re just not utilizing energy very well. So, you’re eating, but your cells aren’t utilizing the energy. So, a lot of people just think they eat, [chuckles] their cells do what they’re supposed to do and then they eliminate. There’s so much that has to happen at the cellular level and I’m not going to pretend to be an expert on all of those happenings, but I do know when you’re insulin resistant, you’re just not utilizing fuel well, especially carbohydrates. So, if you’re eating a high-carbohydrate diet, your cells just aren’t utilizing that fuel. It’s getting stuck in the bloodstream. You’re just not doing metabolically what your body’s intended to do. 

[00:33:49] So cravings, being hungry even after eating a pretty substantial meal, not being able to go long periods of time without eating, that was me. It was like every 2 to 3 hours I needed to eat something where it’s now sometimes I’m 6 hours after a meal, I’m like, “Oh, I’m still not that hungry or I’m just starting to get hungry.” So that’s a sign of metabolic flexibility and being able to burn your own body fat or burn the fat that you are eating. And that’s a really, really great sign. So those are the big ones, weight loss resistance being another one. If you’re just like, “I don’t know, I don’t eat a lot of calories.” And again, that can go back to being calorically restricted and metabolic issues, but that’s definitely another warning sign, just being lethargic or feeling like you need to take a nap in the afternoon, not being able to make it through your day. And some of this can go back to sleep issues or iron deficiency or thyroid issues. Those can all come into play. But insulin resistance is a huge part of it too. 

[00:34:49] So that kind of afternoon dip, especially if you’re eating a lot of carbohydrates, that’s all– signs of insulin resistance and metabolic inflexibility. And like you said, you can turn this around. It does take some time, depending on how long it’s been going on. But definitely that’s my main message to my students. Like, we can reverse this. We can make this more insulin sensitive. So, yeah, I teach about the testing for it as well as you alluded to with the fasting glucose and the fasting insulin and the hemoglobin A1c are all helpful to look at. Most conventional practitioners will miss the fasting insulin, like you said. But another one that I point people to is blood pressure. I mean, the blood pressure being off, that can be a significant sign not always, but can be a significant sign of metabolic illness. And then people can’t get that testing done. Almost everybody has a cholesterol panel. So, I say, get your last cholesterol panel or your most recent one, and let’s look at your triglycerides, if those are elevated, you probably have some metabolic issues, but if your triglycerides elevated and you have a low HDL, you have some metabolic illness there.

[00:36:04] So I tell them to look at their triglycerides, divide by their HDL, and hope shoot for a ratio less than 1.5. And if it’s 3 or over, you have some pretty long-standing metabolic illness. So that’s just another way to look at it, because a lot of people just don’t have these labs. Like I said, you ask a conventional practitioner, and they won’t order this $15 test. [chuckles] It’s mind boggling. So, when I work with students, I do have home kits that are available, but that’s another way. Almost everybody has a cholesterol panel that they can look at, and that will tip you off as to, if you have some metabolic dysfunction as well. 

Cynthia Thurlow: [00:36:48] I think those are really helpful and it’s interesting, my husband was seeing a new primary care provider first and last, and towards the end of the conversation, I was kind of coaching him on, okay, these are the labs you want to ask for and fasting insulin came up, and this physician looked at my husband and was like, “I’ll be happy to refer you to endocrinology.” And I looked at the guy and I was like, “Oh, my, you’re young and you’re not even open minded.” So, if people are listening and talk to your internist, talk to your primary care provider, I find 90% of the time they’re open to ordering a fasting insulin. It should ideally be between 2 to 5 mg/dL. Obviously, we have plenty of people. I know you this as well, it’s 10, it’s 20. And someone says, I’m struggling to lose weight. And you’re like, “Okay, your fasting glucose is between 75 and 85 and it looks good. And your A1c is within a normal range, normal according to the lab, like, less than 5.7.” 

[00:37:43] I could make the argument that we start watching this slow creep, but also understanding that in as many labs as we can get done through conventional ways are always going to be ideal but a fasting insulin, like, if you go to a place, like, Own Your Labs, who I have no affiliation with, but this is Dave Feldman’s company and oftentimes it beats LabCorp and Quest. I think it’s like $10. So, everyone can be the master of their domain. They can have that information. It can help them guide recommendations and suggestions. And thank you for the tip about the lipids, because I think that’s, like, a poor man’s– I say “poor man’s.” It’s like a way to work around, like, if your healthcare practitioner is not willing to do an NMR looking at particle size or an ApoB or an Lp(a), if your triglycerides are greater than 100,150, you got some work to do. And I used to say to my cardiology patients, this is a sign you’re eating too much processed carbs. If we have to be clear, like the candies, the cookies, alcohol, etc., sometimes that alone will get people thinking, because I’m like, “I don’t want to add another medication.” 

[00:38:45] We can add another medication, but I prefer not to. And so, when we’re kind of looking at ways to effectively kind of become more knowledgeable about different types of fuel substrates so we talk about intermittent fasting. And as you’re transitioning from predominantly using glucose as a fuel source, and then you’re becoming more metabolically healthy, and you can use fats as a stored fuel source. What are some of the other benefits that you see in your patients? Like, some of the things that they’re probably surprised by. Like I always say, people come to intermittent fasting because they want to lose weight, they want to change body composition. But there’re always other side effects that sometimes are even more compelling or more interesting to them than the initial physicality changes that they’re seeing.

Shana Hussin: [00:39:29] Absolutely. And I saw this with myself. I couldn’t believe how much better I felt. Like within a week or two, my bloating was down, like, 80%. It was mind boggling. And some of that had to do with what I was eating, but a lot of it had to do with the frequency of what I was eating. So, I definitely see better digestive function and a lot of those issues being alleviated, better sleep for sure. And I know both of us teach try not to eat at least 3 to 4 hours before going to bed, just so you don’t have all that food in your system to digest. But going back to that pilot study that I did before, we’ve had a whole lot of intermittent fasting under my belt. This one lady, she was in her 70s, she’s like, “I’m a grandma.” She’s like, “I just want to thank you for breaking my binge eating at night.” I’m like, “Oh, I didn’t know you were a binge eater, because you’d never told me that. You didn’t disclose that.” She’s like, “Oh, I was way too embarrassed.” [laughs] I can’t help you if you don’t tell me.

[00:40:34] But anyway, she’s like, “Yeah, every night after my husband went to bed, I’d go and raid the pantry, every night.” And then I’d basically go into a food coma and go to bed. But she’s like, “I just needed some boundaries.” And me setting these boundaries, “I’m no longer binging at night.” And so, she’s like, “It’s helped my mental health.” And I think a lot of people have no idea how important it is for mental health also and what the connection is from the gut to our mental health. And in a perfect world, I wish I could get more messaging out about that because most of my messaging is just on reversing insulin resistance and metabolic dysfunction and helping people with prediabetes and fatty liver and type 2 diabetes reverse their disease processes. But oftentimes people have no idea that a lot of the metabolic insufficiencies or imbalances are stemming from gut health and insulin resistance as well. 

[00:41:37] So, I think people are very surprised with that just energy overall. And I feel like it’s almost for people who have been eating all day every day, from the moment they get up to the moment they go to bed, no matter if it’s healthy food or not, it’s just like reverse aging. I felt like since I’ve started intermittent fasting, I feel healthier. I’m 47, I’m nearing 50, and I feel like I’m healthier in my late 40s than I was in my early 20s. And a lot of that is I’ve eliminated alcohol and I eat more protein than I used to. So, there’re a lot of things that go along with that. But I just feel like it just gives your body such a chance to rejuvenate and clear out all of the toxic sludge that we are exposed to every single day. So, the aging process, I don’t think there’s anything better other than intermittent fasting and the metabolic health aspect. 

[00:42:39] So again, I was somebody who was completely normal weight people, I’m sure, looked at me and thought, “She’s completely healthy,” but no I was on the road to prediabetes and type 2 diabetes. It’s very, very strong in my dad’s family. Pretty much everybody has type 2 diabetes or has died from complications of type 2 diabetes. There’s no doubt in my mind if I weren’t prediabetic already, I would be soon, and I’m still in perimenopause. But it’d be interesting to see how I would go through the whole menopause years, that transition time with the lifestyle I used to lead. Not that I want to go back there.

[laughter] 

[00:43:20] It’d be interesting to– it’s N of 1. It’s like you could duplicate yourself and just see one versus the other with knowing what I know now versus I’m just glad that I figured it out when I did. And like you said, it’d be so nice to be able to go back in time and reteach all of the things that I taught people earlier, but it’s almost like an endless I know a lot of people who have cleared a lot of skin issues with intermittent fasting and just better blood sugar regulation. And like, I teach intermittent fasting, but blood sugar regulation is a huge, huge part of what I teach now. And I was on a blood sugar roller coaster pretty much every day until I found this lifestyle and figured out what is really important to correct metabolic dysfunction and focus on metabolic health for sure.

Cynthia Thurlow: [00:44:12] Yeah. It’s so important. And if you look at the research on perimenopause and menopause, typically the people with the most symptoms, the most severe vasomotor, hot flashes, poor sleep, are the people that have the worst metabolic health. So, the people that are more insulin resistant or diabetic, that are being treated for hypertension, as well as a myriad of other metabolic diseases. And so, I think that the best way to navigate that shift from perimenopause to menopause is to do as much as you can to ensure that you’re supporting metabolic health, like physically moving, make sure your sleep is really dialed in, making sure you’re making good nutritional choices, managing your stress. Like I tell everyone, it’s not five minutes of meditation once a week. You genuinely have to be proactive at it. 

[00:44:59] Now, I got a couple of questions, and people were curious. How do you personally like to address sleep issues? So, if you have someone working with you, maybe their blood sugar is becoming better balanced, they’re losing weight, but their sleep is still terrible. What are some of the common things you like to work through with them? 

Shana Hussin: [00:45:17] Yeah. I know for me, I sleep very well unless I’m stressed or I’m thinking about something stressful. I have two kids leaving for college this week, and sometimes it’s like I wake up in the middle of night, I’m like, “Oh, it’s that week.” So, I think mitigating stress, like you said, is sleep and stress go hand in hand. But other things that I’ve really been focusing on and I just added a lesson into my course about this is really just getting back to natural circadian rhythms. And so many people are so far off of that, that that is disturbing their sleep more so than anything else. So, getting out into sunlight first thing in the morning with natural sunlight, wearing the blue blockers at night to block that blue light. You teach all of these things as well, going out again in the middle of the day, not all of us can watch a sunset, but if you can like, I read a book, I think it was– oh, she teaches all about PCOS, Felice Gersh.

Cynthia Thurlow: [00:46:17] Yeah. She’s going to get– we love Dr. Gersh. 

Shana Hussin: [00:46:19] Yeah. And she said, like, “Go camping.” Like if you want to restore your circadian rhythm go camping for a week, get some grounding in, get up with the sun, go to bed with the sun. So those are all things to think about, blocking out light and not looking at screens. And we’re moms of teenagers, that is tough. I am telling my boys all the time, no, we’re not playing video games at 9 o’clock at night. That’s just not happening. You’re putting your phone down. They think we’re so ridiculous because we make them put their phones down at 09:00 and leave them in the kitchen. They can’t take them in their rooms with them, “Oh, we are the only parents who do this.” I’m like, “I’m protecting you,” [chuckles] is what I always say. 

[00:46:58] So just little things like that to start with and that’s not always going to correct everything, but then we can look at are you eating something that’s inflammatory before bed? Have you cut your carbohydrates so low that sleep is compromised? So maybe introducing a little bit more. I mean, I teach low carb, but sometimes we just take it to the extreme. What are your female sex hormones doing? We need to look at those. You need some progesterone replacement. I’m not the expert in that, but I do know that it can come into play and sometimes even just like one little thing that can make a huge deal with a lot of the people I’ve worked with is to taking up some salt bath at night and just get some magnesium into your system. Get that heat at night, absorb it through your skin rather than your gut, and it just works that much better. 

[00:47:53] So those are some good starting points, but sleep issues can sometimes be complicated and complex. But we at least start there. But yes, there’s nothing worse than not getting a good night’s sleep. And then alcohol, of course too, for women, especially, perimenopause and menopausal years, it can be a disaster. Even I have found with my Oura Ring, I don’t drink anymore, but I used to drink like one or two seltzers in the afternoon and it would still show up interfering with my deep sleep. I’m like, “Okay, this is not worth it to me anymore.” So, all of those things can definitely interfere with heat and even just the temperature of your room. All of those little things can be helpful. 

Cynthia Thurlow: [00:48:40] Yeah, those are all really super helpful tips. I love that you kind of touched on the alcohol piece because we know that for a lot of women it can really erode REM sleep. It erodes deep sleep, completely disrupts sleep architecture. If you’re on HRT, this is something that I think is terrifying. It can raise your estrogen levels for, I think, 6 hours after the alcohol. So, it’s like you’re really keeping yourself in this estrogen-dominant state. Last question was about constipation. This always cracks me up, the questions that we get prerecording a lot of questions about constipation, which I think if this is never something I’ve suffered from, but from what patients and clients have described to me can be very debilitating. What are some of your favorite food-based solutions for constipation? 

Shana Hussin: [00:49:24] Yeah. And sometimes people are surprised because from almost every health professional you’ll hear, make sure you’re hydrated and make sure you’re getting enough fiber. Well, that doesn’t work with everybody. So, what I found is that some people are lacking natural fats, you need fat in order to into the colon to have normal bowel movements as well. So, I always say look at your fat, but then maybe it can go back to digestion too. And do you have a gallbladder? Is your liver detoxifying? There are some more complicated things that can come into play here rather than just water and fiber. And sometimes people add fiber in and it makes the problem even worse or they’re putting in something, gosh, I can’t even remember what they’re called, but some kind of pharmaceutical or over-the-counter type of stool softener and it exacerbates the problem even worse. 

[00:50:23] So, I would say look at fat, but then make sure you’re looking at electrolytes too with the water. And I know you’ve talked about this over and over. Like electrolytes are key when it comes to constipation. And then same with the magnesium. Sometimes people just are very magnesium deficient and then you’re not going to have regular bowel movements either. So, there’re so many different types of magnesium. But again, going back to the Epsom salt bath, like I’ve had people just like, wow, within two days I was having regular bowel movements because my magnesium levels were where they were supposed to be. So certainly, fiber might play a role, but I feel like that’s not the main thing that’s coming into play when people are constipated. And I’ve even had a couple of people who have started to correct their insulin resistance and their blood sugars and that triggers natural bowel movements. What the exact mechanism is, I’m not really sure, but I can’t tell you how many people– and maybe it has more to do with they’re just getting the ultra-processed food out and they’re regulating blood sugar and all of these other intricacies. 

[00:51:29] But I do find too, that there’s not like one end all, be all for every single person. It can be very individualized. And sometimes I do see people the issue gets complicated when they’re taking iron supplements or a multivitamin or something that’s just making them more constipated that you think would be helpful, but just kind of backfires on the system. So, I would start there, like, make sure you’re getting enough natural fats, make sure you’re getting enough electrolytes, hydration, and then trying some just real home remedies the Epsom salt baths, the magnesium, and getting the ultra-processed foods out. Because you just don’t know if there’s something in those ultra-processed foods that’s just not allowing you to have a regular bowel movement.

[00:52:18] And for you personally, it might cause a problem, but the next person, not so much. So just getting back to healthy fats, enough protein, some carbohydrates, some roughage, it can just go a long way. So, it’s probably not the answer everybody was hoping [laughs] just do this one supplement. But I just found that with over the two decades I’ve worked with people with constipation, it just can be variable from person to person. 

Cynthia Thurlow: [00:52:45] No, and I agree with you. You definitely brought up some really good points. And I always feel like magnesium, because I worked in cardiology, is something that I got so savvy, so magnesium glycinate, bisglycinate have great bowel tolerance. Mag oxide does nothing. It’s like the one magnesium we always prescribed in the hospital and it has about 11% absorption. I always say magnesium L-threonate to cross the blood-brain barrier is a great one, but doesn’t per se have any bowel effects. I also think about silly things, like it could just be the position in which you’re going to the bathroom. So squatty potties can be helpful. I think about like when my kids were young, I’m sure you probably had this problem too. My kids were young, they’d be like banging on the door when I was trying to go to the bathroom.

Shana Hussin: [00:53:27] Okay

Cynthia Thurlow: [00:53:28] So I started to get up earlier so I could actually go. But sometimes if your body thinks you’re in fight or flight or you’re stressed, I mean, literally, you’re in the wrong frame of mind to go to the bathroom. I love that you brought up the fat piece. I think a lot of it has, like, the fiber is so bio-individual as you said. If I were to do resistant starch, if I were to put a scoop of it in something, it’ll blow me up like a balloon. But I can eat vegetables just fine. So, I think it’s very, very bio-individual, but I think like raw vegetables, things that are bio-supportive, like bitter greens. [unintelligible 00:54:01] means bitter, dandelion greens, radicchio, arugula, those kinds of things are going to be very, very helpful and just physical activity.

[00:54:11] This is something like we are a culture that is conditioned not to move. And I’m like, “We have to move our bodies.” Like, physical activity is one of the best ways. And I’m not even saying to go do CrossFit. I’m just saying physically move your body is one of the best ways to help regulate your blood glucose. Well, Shana, this has been an amazing conversation that I know my clients and my listeners are going to find invaluable. Please let everyone know how to connect with you on social media, how to listen to your amazing podcast, etc.

Shana Hussin: [00:54:41] Yes, thanks for having me. It’s always a fun hour to spend with you, but my podcast is called Fast to Heal Stories. We talk a lot about intermittent fasting and metabolic health and I do have a several courses available for people if they’re having metabolic issues. My website is fasttoheal.info. All my courses are there and I’m most active on Instagram. I try to be on a lot of other social platforms, but they’re just not my favorite. [laughs] 

Cynthia Thurlow: [00:55:13] It’s hard to be everywhere.

Shana Hussin: [00:55:14] I know, I know. And I feel like I mastered one. I’m just going to hang out there, so you can find me at shana.hussin.rdn on Instagram as well. 

Cynthia Thurlow: [00:55:24] Awesome. Thank you so much.

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