Insulin resistance and the backpacker’s diet

Ryan,

The bars and salmon you mention in the article are they homemade or commercially available. If  homemade care to share the recipe? If commercial the brand (s)?

Just finished a thru hike of The Long Trail (they left out HARD when naming this trail) in Vermont.  I am sure better choices in nutrition would have benefitted me on that journey. Thanks Steve

I’ve been thinking a lot about electrolytes for exercise and daily intake. Morning walks, at home or on the trail are of particular interest because I think it’s an opportunity to set my body up for success, but I often want to get moving before eating and digesting a fully nutritional meal

I’m diabetic taking meds and am conscious of carbs. I used to give myself a break when I was more active, but my typical hiking/BPing choices probably limit protein and some electrolytes.  I think the morning hydration with electrolytes is key. I’ve tried LMNT but would like to try others that are available at retail too. Any suggestions or further feedback on the morning intake ritual?

The bars are homemade, but I’m not super happy with the recipe still, because the nut oils seep out when the temps are warm. They’re fine when it’s cool. Process almonds in a food processor to make the nut butter, then add a 50/50 mix of (pre-cooked, and then baked dry) cracked oats and quinoa until the mix is pretty dry. Press into a baking sheet, refrigerate, cut into serving-sized squares.

I eat different types of salmon but my favorite is Seabear smoked sockeye in foil packets.

rollercoaster of bonks and brain fog

I am insulin resistant and have never experienced that problem ( Type II diabetic). About 1 1/2 year ago I started Ozempic and that has given me more issues to deal with.  I tend eat less as my body is telling me that I am not hungry.  If I don’t eat enough, I feel cold.  I cook my own meals so that they are not carb heavy and make sure that I have enough protein in the menu.  In all of my years of backpacking, I have not experienced brain fog or bonks as you call it.  My 2 cents.

Not all insulin-resistant hikers will inevitably struggle with bonks or cognitive dips, but insulin resistance helps explain why it can happen and how dietary composition can influence it. It sounds like you are already doing what you need to do to regulate your glucose metabolism enough to avoid it.

I’m Type 2 diabetic. Since being diagnosed, I’ve shied away from high carb snacks, simply because they drive up my glucose. But I started to feel like I had a “clogged fuel filter” while backpacking. I simply felt like I was running out of gas all the time. I finally bought three Dexcom 7 glucose monitors. They go on your arm, last 10 days, sample your glucose every five minutes and send it to your phone. I planned a 4-5 day backpack trip in the middle of each 10 day monitor. I found was I was indeed running out of gas. Over the course of those three monitors I experimented with different strategies and the one that worked was popping about 10 grams of carbs in my mouth every 10-20 minutes, depending on the terrain. This smoothed out my glucose but kept supplying my body with the fuel it needed to keep going. I too found if you mixed up the carbs with proteins or fats, it made for a smoother hike. But I now longer hike, then stop for a break and eat a bunch of food — I now slowly add fuel in a consistent manner. I also found I had a much lower weight loss at the end of the season. Previously I would start the season at 165-170 lbs, but end it around 151, way too low for my body type. Now I start at 165 and end at 162.  I do inject fast acting insulin just prior to eating dinner (some freeze dried dinners can be 75 gms of carbs!), but during the day I simply rely upon a small, constant stream of carbs while exercising and it works.

As a Type II, my Dr was more interested in A1c results rather than glucose levels.  Since A1c is an average of 80-120 days, it gives a longer term perspective.  When backpacking, your average calorie consumption goes quite a bit higher than when not being as active.  After eating carbs, there tends to be a glucose spike in the next 2 hours or so.  So, in the morning and a lunch, eating higher carbs can be offset by your energy expenditure.  Grazing small amount while hiking will also help.  Eating lower carbs in the evening works for me.  On a 5-10 day backpacking trip, increasing carbs c” loading will not have a big impact on A1c levels.  My 2 cents.

Ryan, thanks for the helpful post on a neglected topic. I’ve found that eating more fiber rich foods like kidney beans is a big aid in managing glucose levels, especially from food sources rather than just supplements. I charted the fiber/gram concentration of different foods and chia seeds came out on top. And because chia seeds are also about as protein/gram dense as salmon and peanuts, and as calorie/gram dense as dark chocolate, chia has become my new favorite trail food. Chia can be cold soaked in a bot or other container to make the protein and oil inside the seed more accessible in 20 minutes to 2 hours depending on how you like your chia pudding. And they can be mixed with anything from trail mix if you want something sweet to sardines if you’re leaning savory. Sometimes in the morning I’ll even cold soak them with coffee or chocolate or both. But avoid cooking them or exposing them to boiling water if you want to preserve the health benefits of their omega 3 oil which breaks down under high heat.

They say that you can eat up to 1/3 cup of dry chia seeds per day, but you’ll have to work up to that amount over a few weeks of experimentation if your daily fiber intake is as low as most people. But moving that direction is also really good for our health and I’ve found many sources suggesting that people could improve their blood sugar, cholesterol and more by aiming for as much as 50 grams of fiber/day, which is about twice the current recommended daily fiber intake. Just 1/3 cup chia seeds will give you about 20 grams of fiber, so it’s a very effective way to boost your fiber without fiber supplements that don’t have as many health benefits as fiber in food.

In addition to having a steadier flow of energy, we’ve also found that eating healthier on the trail with more real and less processed food also feels better.

On a related topic, this video by Dr. Greger suggests that anti-inflammatory greens and fruits may increase performance and recovery for endurance athletes, especially over multiple days of fatiguing exercise. That sounds a lot like backpacking, so I wonder if anyone has experimented with eating anti-inflammatory foods right before and during a trip. https://nutritionfacts.org/video/foods-to-improve-athletic-performance-and-recovery/

A1c and glucose levels (e.g., via CGM) tell you about sugar in the blood. Insulin levels tell you how hard your body is working to keep those numbers in range. Managing insulin resistance isn’t just about lowering glucose – it’s about lowering the insulin required to lower glucose.

We now know that (in an everyday, low-activity, frontcountry context) that frequent, small dosing of carbs may help us manage glucose (by keeping insulin elevated) – but those elevated levels of insulin may not improve insulin resistance.

Backpacking is a little bit different here, because the physical activity (fat burning HR ranges) can help keep insulin in check in response to frequent carb feeding.

Both CGM responses and A1c can miss insulin resistance. Two people with the same A1c may have very different insulin sensitivity. And two people who show the same glucose spike and time-to-return-to-baseline on a CGM may still differ dramatically in how much insulin their bodies had to produce to make that happen.

That’s why focusing only on glucose seems to be inadequate to me, and possibly give us a false sense of security. Insulin resistance (not glucose) may actually be the underlying driver of both the acute issues backpackers care about (bonking, mental fog). In addition, the past decade of insulin resistance research has pretty much implicated insulin and not glucose as the driver of chronic issues that affect long-term health (inflammation, visceral fat accumulation, cardiovascular disease, etc.).

It’s a fascinating set of metabolic dynamics and complex. But managing T2D (or anywhere on the spectrum of insulin resistance) via A1c or acute blood glucose or CGM feels inadequate to me – especially if we want to send insulin resistance into true remission.

Another type 2 diabetic on Ozempic, Metformin and Jardiance.  I mention the meds because they address insulin resistance. I’m not aware of short term diet choices that can have the same effect. Long term food and activity choices can help, as would be measured by A1C or spot glucose testing.  I’ve been part of a CGM trial and it was fascinating to see the effects of food and exercise minute by minute, but I only used it for 10 days. The feedback loop likely changes eating habits and other choices positively. If it’s warranted for everyday use then definitely helpful while backpacking.  Diabetes  must be the most self tested and self treated condition ever.  My guess is my data would look better backpacking than at home.

As someone who lived most of my adult life feeling horrible after meals of mostly carbs, switching to low carb high fat and doing intermittent fasting changed my world. I made this switch in 2017 after I was diagnosed with ‘metabolic syndrome’. I went from having massive blood sugar swings to having none. Lost 65lbs(over 2 years) and every health metric improved-blood pressure, cholesterol, triglycerides, etc. This isn’t some fad that I tried, I fully committed and have eaten this way for 8 years. I don’t do ‘cheat days’. The thought of sugary or high carb foods makes me sick now. I just remember how bad I felt and have zero desire for them. I built up my fasted/low carb endurance during the first couple of years and can hike 20+ miles fasted. I just feel so much better without food in my stomach while hiking. On high exertion days I eat a couple of hard boiled eggs, a little bit after I start and maybe some small low carb snacks during.  Strangely I feel most energetic when I am hungry. And without the low blood sugar levels, feeling hungry doesn’t mean feeling bad-foggy, bonking, tingly, etc.  Doing lots of long cardio I believe has helped insulin resistance as well. I do cardio every day and make sure I do 3-12 hour long hikes every week.

Electrolytes are very important when doing big days. I have tried most of commercially available products and for me, Hammer Nutrition Fizz Tabs are the best. No mega salt doses and a decent spectrum. If I forget to take them or run out on a trip, cramping can be bad.

No recommending this way to anyone, it’s not easy. Just stating that it truly was freeing and has changed my life.