Insulin Resistance and NASH: Understanding the Metabolic Connection and Actionable Steps

Most people find out about insulin resistance when they get a type 2 diabetes (T2D) diagnosis. However, it is also linked to many other health conditions, including nonalcoholic steatohepatitis (NASH). Read on to learn more about the link between insulin resistance and nash, and what it means for someone living with this condition.¹

What is insulin resistance?

Let’s start with insulin. Insulin is a hormone our bodies make to help us turn food into energy. Think of insulin as a key that opens the doors to your body’s cells so glucose (sugar) can enter. Your cells need this sugar to work.^2,3

In fact, without insulin, your cells cannot get the energy they need to function, which is life-threatening. Insulin resistance happens when your cells stop responding well to insulin.^2,3

How do you develop insulin resistance?

Insulin resistance is linked to metabolic syndrome. This is a group of conditions that cause issues like high blood pressure, high cholesterol, and diabetes. It happens more often to people with larger bodies, especially those who carry weight around their belly.^2,3

Your risk for metabolic syndrome also increases with:^2,3

• Getting older
• Lack of exercise
• Poor sleep
• Eating unhealthy foods
• Smoking or drinking alcohol
• Certain medical conditions

A doctor diagnoses metabolic syndrome if you have 3 or more of these factors:²

• Fasting blood glucose over 100 mg/dl (pre-diabetes or diabetes)
• Blood pressure over 135/85
• Triglycerides over 150 mg/dl
• HDL (good cholesterol) below 40 mg/dl for men or 50 mg/dl for women
• Large waist size

Insulin resistance and nash

Many studies show that insulin resistance and metabolic syndrome are connected to liver conditions. These include non-alcoholic fatty liver disease (NAFLD) and NASH.⁴

In fact, NASH was recently renamed MASH (metabolic dysfunction-associated steatohepatitis) for that reason. One study found that more liver fat and scarring (fibrosis) meant higher insulin resistance. Other factors—like cholesterol levels, body size, and inflammation—were worse too. This means metabolic syndrome can get worse as liver disease moves from NAFLD to the advanced stage of insulin resistance and nash.³

Managing this issue is crucial for treating NASH/MASH. It also lowers your risk for other related conditions like T2D.¹

3 ways to reduce insulin resistance

Doctors often recommend weight loss for people with NASH. The steps to reduce insulin resistance below can help with that goal.

However, losing weight and keeping it off is hard. Remember that healthy habits improve insulin resistance and NASH symptoms. They also help combat metabolic syndrome for people of all body shapes and sizes. Consider tracking your success by looking at your habits instead of just the scale.

For example, track how many fruits and veggies you eat, how often you are active, or how much you sleep each night. Let’s explore different ways you can lower your insulin resistance.

Exercise

Studies show your body becomes more sensitive to insulin with exercise. Being active for 30 minutes a day, most days of the week, is the standard goal for adults. Your routine should include:^5,6

• Resistance training (lifting weights or using resistance bands)
• Cardio (activities that raise your heart rate)
• Balance and flexibility (yoga or tai chi)

Always talk to your doctor before starting a new exercise. Some people have safety limits on the types of activity they can do.

Healthy eating

What we eat impacts our health. For example, eating a lot of saturated fat (like beef, pork, butter, and heavy cream) is linked to higher insulin resistance.⁷ Instead, experts recommend eating whole grains, fruits, vegetables, nuts, seeds, lean proteins, and healthy fats.^6,7

Remember, small changes make a BIG difference. You can add a fruit or veggie to each meal, or mix nuts, seeds, and dried fruit for a snack. Explore new foods and recipes. Ask your insurance if they cover visits with a registered dietitian for extra guidance.

Sleep

Sleep is frequently overlooked. Many studies connect a lack of sleep with higher insulin resistance. Work schedules, stress, medical conditions (like sleep apnea), and poor sleep habits can all cause problems. Don’t ignore this vital part of your health. Talk with your doctor if you struggle in this area.⁸

Additional tips for improving insulin resistance and liver health

There are many other self-care habits to consider beyond these 3. Avoiding nicotine, reducing stress, and staying connected with friends all help improve insulin resistance and liver health. When focusing on your health, consider all aspects of your mental, physical, and emotional well-being. You can do this!