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Insulin response to sugar and longevity: the hidden factor that should not be overlooked
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Insulin response to sugar and longevity: the hidden factor that should not be overlooked

Insulin resistance is a condition in which normal amounts of insulin in the muscles, liver and fat tissue do not elicit the expected response, leaving the cells unable to effectively take up glucose from the blood, leading to elevated blood sugar levels. It has been linked to a number of health problems, including type 2 diabetes, high blood pressure, cardiovascular disease, stroke, peripheral arterial disease, heart failure, non-alcoholic fatty liver disease, dyslipidaemia (low HDL cholesterol and high triglycerides), and even some types of cancer.

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Although obesity is a well-known risk factor for insulin resistance, other factors such as gender, race, physical activity and genetics also play an important role. But what impact does insulin resistance have on longevity in people who are not diabetic? A recent study investigated this question by looking at the association between insulin resistance – as measured by HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) – and mortality in adults without diabetes.

Association between insulin resistance, body weight and mortality

The study included data from 5,511 adults without diabetes who were followed for an average of 8.5 years. During this period, 643 deaths were recorded, of which 237 were due to cardiovascular disease and 170 to cancer. The researchers found that HOMA-IR, an indicator of insulin resistance, was independently associated with a higher risk of death, even after controlling for other factors such as body mass index (BMI), waist-to-hip ratio and other common predictors of mortality.

Interestingly, the association between insulin resistance and mortality was strongest in individuals with BMI below the median (25.2 kg/m²). In contrast, the association was not statistically significant in those with BMI above 25.2 kg/m². This suggests that insulin resistance is an important risk factor for mortality in those individuals who are not defined as overweight or obese according to standard BMI measurements.

The association between insulin resistance and mortality is strongest in individuals with BMI below 25.2 kg/m². This means that insulin resistance is a significant risk factor for mortality in those individuals who are not defined as overweight or obese according to standard BMI measurements (turquoise and green in the figure).

Insulin resistance contributes to cardiovascular diseases such as hypertension and atherosclerosis, which can lead to fatal cardiovascular complications.

The role of insulin and the risk of cardiovascular disease

Additional analyses showed that the association between HOMA-IR and mortality was mainly dependent on serum insulin levels, not fasting glucose levels. This highlights the role of elevated insulin as a potential risk factor for premature death, even in individuals without diabetes.

Another important finding was that HOMA-IR was statistically significantly associated with cardiovascular mortality, but not with cancer mortality. This confirms that insulin resistance contributes to cardiovascular diseases such as hypertension and atherosclerosis, which can lead to fatal cardiovascular complications.

What does this mean for longevity?

  • The study provides compelling evidence that insulin resistance is an independent predictor of mortality in adults without diabetes, especially those with lower BMI. These findings challenge the notion that insulin resistance is only a concern in overweight people and instead highlight the fact that maintaining insulin sensitivity is crucial for longevity, regardless of body weight.

Insulin resistance is linked to high blood pressure, type 2 diabetes, cardiovascular disease, stroke, peripheral arterial disease, heart failure, etc.

Although this study does not offer specific recommendations for reducing insulin resistance, other research suggests that regular physical activity, a balanced diet, weight control and sufficient sleep can contribute to better insulin sensitivity, which all contribute to a healthy lifestyle. Given the strong association between insulin resistance and cardiovascular mortality, strategies to manage insulin levels may play a key role in preventing disease and prolonging life.

Identifying insulin resistance is therefore key to maintaining long-term health and longevity, as it is an important risk factor for mortality even in people without diabetes and elevated body weight.

Literature:

  1. Ausk, K. J., Boyko, E. J., & Ioannou, G. N. (2010). Insulin resistance predicts mortality in nondiabetic individuals in the U.S.. Diabetes care, 33(6), 1179-1185. https://doi.org/10.2337/dc09-2110
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