Reversing Insulin Resistance in Skeletal Muscle: A Science-Backed Guide

Insulin resistance in skeletal muscle is one of the most common and significant metabolic issues, contributing to high blood sugar, weight gain, and decreased performance.

Fortunately, skeletal muscle is highly adaptable, meaning insulin resistance is reversible with the right strategies.

In this article, we’ll break down the most effective ways to restore insulin sensitivity and optimize metabolic health.

Why Skeletal Muscle Insulin Resistance Matters

Skeletal muscle is responsible for 70–80% of glucose uptake after a meal. When muscle cells become insulin resistant, they fail to absorb glucose efficiently, leading to elevated blood sugar levels and increased fat storage.

Over time, this can lead to metabolic disorders such as type 2 diabetes, obesity, and cardiovascular disease.

The good news? By implementing specific lifestyle changes, you can restore insulin sensitivity and enhance your overall performance and longevity.

How to Reverse Insulin Resistance in Skeletal Muscle

1. Exercise: The Most Powerful Intervention

Movement is the most effective way to increase insulin sensitivity, primarily through the upregulation of GLUT4 transporters, which help shuttle glucose into muscle cells.

Resistance Training – Lifting weights and building muscle increases glucose storage capacity and insulin sensitivity.

High-Intensity Interval Training (HIIT) – Short bursts of intense activity improve mitochondrial function and glucose uptake.

Steady-State Cardio – Walking after meals can lower post-meal blood sugar and improve metabolic flexibility.

Action Step: Aim for a combination of strength training 3-5x per week and daily movement (like walking) for best results.

2. Optimize Your Nutrition

What you eat directly impacts your insulin response. 

Here’s how to fuel your body for better insulin sensitivity:

Reduce Processed Carbs & Sugar – Minimize large insulin spikes and metabolic stress by avoiding refined carbs and added sugars.

Prioritize Protein – Supports muscle growth and metabolic efficiency, keeping blood sugar stable.

Healthy Fats (Omega-3s, Monounsaturated Fats) – Reduce inflammation and improve cellular function.

Manage Carb Intake Based on Activity – Consuming most of your carbs around workouts can enhance insulin efficiency and glycogen storage.

Action Step: Focus on whole, nutrient-dense foods and structure carb intake around training sessions.

3. Increase Muscle Mass

Muscle acts as a metabolic sink for glucose. The more muscle you have, the more glucose storage capacity you create, reducing excess glucose in the bloodstream.

Lifting heavy promotes muscle growth and enhances insulin sensitivity.

Progressive overload (gradually increasing weight or reps) ensures continuous adaptation.

Action Step: Strength train at least 3x per week with a focus on compound movements (squats, deadlifts, presses) to maximize muscle gains.

4. Improve Sleep & Manage Stress

Both poor sleep and chronic stress elevate cortisol, which interferes with insulin signaling and promotes fat storage.

Prioritize High-Quality Sleep – Aim for 7-9 hours per night, maintain a consistent sleep schedule, and reduce blue light exposure before bed.

Lower Stress Levels – Practices like deep breathing, movement meditation, and even spending a couple minutes in nature can help lower cortisol.

Action Step: Establish a relaxing evening routine and incorporate stress management techniques into your daily life.

5. Use Cold & Heat Exposure

Exposure to extreme temperatures can activate metabolic pathways that boost insulin sensitivity.

Cold Therapy (Cold showers, ice baths) – Can increase glucose uptake and metabolic efficiency.

Sauna Use – Improves circulation, reduces inflammation, and enhances insulin function.

Action Step: Try cold showers or an ice bath 2-3x per week and consider regular sauna sessions for added benefits.

6. Targeted Supplementation

Certain supplements can enhance insulin sensitivity and support metabolic function:

Magnesium – Essential for insulin signaling and glucose metabolism.

Berberine – Works similarly to metformin in improving glucose uptake.

Alpha-Lipoic Acid (ALA) – Enhances mitochondrial function and insulin sensitivity.

Action Step: Consider getting bloodwork to assess HOMA-IR to see if adding these supplements to your routine would be helpful.

Final Thoughts

Insulin resistance in skeletal muscle is not a life sentence—it’s a condition that can be reversed with strategic lifestyle interventions.

By focusing on exercise, proper nutrition, muscle growth, stress management, heat/cold exposure, and supplementation, you can restore insulin sensitivity, optimize performance, and prevent long-term metabolic issues.

5 Warning Signs You’re Losing Muscle—and How to Prevent It

Losing muscle doesn’t just affect how you look—it impacts your energy, metabolism, blood sugar control, and overall mobility. For men, muscle loss can happen faster than you think.

Here are five warning signs to watch out for and how to prevent muscle loss.

1. You Feel Weaker

Struggling with grip strength, lifting objects, or completing familiar workouts? Weakness is often caused by sarcopenia (age-related muscle loss) combined with a lack of strength training. Starting in your mid-30s, you can lose 1–3% of muscle mass per year. Resistance training can reverse this trend, helping you maintain strength as you age.

2. Slower Metabolism

Muscle is a metabolic powerhouse. Losing it reduces the calories you burn at rest, making it easier to gain fat and harder to maintain blood sugar control. If your diet stops working, check your muscle mass—it might be the missing link.

3. Fatigue or Low Stamina

Constant exhaustion, even after light activity, can indicate low muscle mass. Muscle fuels daily tasks and workouts, so losing it saps your energy. If you’re winded from carrying a suitcase upstairs, it’s time to build back your strength.

4. Unexplained Weight Loss

If you’re losing weight but your waistline stays the same, you might be losing muscle, not fat. This often happens due to insufficient protein intake, lack of strength training, or even medications like Ozempic.

5. Slower Recovery

Lingering soreness or injuries that take longer to heal can signal muscle loss. While low testosterone might play a role, being under-muscled is often the bigger issue.

How to Prevent Muscle Loss

• Strength Train Regularly: Prioritize compound movements like squats, deadlifts, and push-ups 2–3 times per week.

• Eat Enough Protein: Aim for 0.8–1 gram per pound of ideal body weight daily.

• Manage Blood Sugar: Stable glucose helps prevent muscle breakdown.

• Stay Active: Incorporate daily movement, even short walks.

• Prioritize Recovery: Sleep 7–8 hours per night and focus on quality rest.

The Bottom Line

Muscle loss from aging is preventable. No matter your age or fitness level, rebuilding muscle is possible—and essential for long-term health and vitality. Start with small steps, track your progress, and build strength to support your overall health.

The Truth About the Dad Bod

The obvious solution to avoid a dad bod is to continue exercising while avoiding processed food. The obvious obstacle, however, is less time (and energy and motivation, chores and work).

This is why most American men gain weight and lose muscle after becoming a dad. But this isn't the whole story. Let me explain.

Poverty of the flesh

The average age for a new dad is 30, which is inconvenient because it's about the time of peak strength in men. After that there's a steady decline in lean mass until you die. This is referred to as sarcopenia, which is derived from the Greek words 'sarx' and 'penia' and translates to “poverty of the flesh." Wonderful.

Not only is there less time (and energy and motivation) to move more and eat homemade salads, but dads are also up against a biological decline in fitness.

The average American man

The "dad bod" is the result.

6 years ago I shared this graphic of the average American male. At the time, I blamed the high BMI on a lack of exercise and a poor diet, but I've since learned how nuanced weight-gain is. I shared a study last week in my newsletter, for example, that showed how we gain weight discreetly at about a pound a year.

Now, when I look at this image I'm equally concerned about muscle loss because frailty increases your risk of pretty much all negative health issues, including early death.

Movement determines diet

The best solution I've found for myself and for my clients is to focus on movement first, and your diet will follow.

Trust me, you will seek out a Buddha bowl over a burrito if you know you're waking up at 6am to go on a ride. And you definitely won't eat an entire pizza for dinner if you're going to a yoga class in the morning–few things motivate me more than not wanting to fart in a yoga class.

On movement with limited time

Capitalize on any 15- to 20-minute window of free time for resistance training. This requires more discipline and more desire than before, but it's effective.

A recent study found that improvement in muscle strength and muscle endurance were similar regardless if participants performed one or three sets per session. One set per major muscle group equates to just 13-minutes of resistance training per session, or 39 total minutes per week. There goes the excuse about time.

Hare are the major muscle groups to prioritize: chest, back, arms, abdominals, legs, and shoulders. Notice how it's more than arms and abs.

Additional tips

• Find the healthiest fast-food possible. Rural Montana is known for having few restaurants, but almost every bar in this state has a salad with chicken. If you're going to drive through the DQ then create the habit of ordering the healthiest thing on the menu and skip the Dilly bar. Ask yourself, "What would a healthy person order?"

• Nothing ruins your progress like "a few beers." Hops and barley contain phytoestrogens and calories that lead to fat accumulation around the waist. One way to limit the number of beers you drink is to chase each drink with a glass of water. If nothing else, you will pee so much that a 3rd beer will sound like a chore.

Takeaway

Transitioning into a dad bod isn't the end of the world because the fat can be shed and the muscle can come back. The trick is to prioritize your physical health as close to 30 as you can because it's harder to get fit in your 40s due to sarcopenia.

I listened to an interview this week on the Rich Roll podcast with Mark Wardian who has a world record, can run a 2:17 marathon, AND has a family and a full-time job. How? What's the secret? (Please tell me it's genetics.)

"You have to want it."

That's it, that's Mark's secret sauce.

Do you want to stay in shape? It's doable, you just have to want it more than you you did before because it's harder now to find the time (and energy and motivation).

Minimum effective dose of exercise

What is the smallest amount of exercise that will give you the results you want?

It’s probably not as much time as you think.

For walking it’s only 8k steps per day, which is about 4 miles, and takes a little over an hour.

And for resistance training it’s 30 minutes, 3 days per week.

To find this dose, I started with this study, which shows that testosterone was significantly elevated after just 30 minutes of resistance training. Also, a meta-analysis published last year found that 30-90 minutes of resistance training per week was associated with 10–17% lower risk of heart disease, cancer, diabetes, and death from all causes.

Another guideline to build strength and muscle mass is to train on non-consecutive days (IE Monday, Wednesday and Friday), which limits you to 3-4 days per week.

Most of the men I work with are high-performers at work (CEOs, doctors, dentists, business owners), as well dads and husbands--they have a lot of responsibilities, so the last thing I want them to do is add 10 hours of exercise to their schedule every week.

Instead, we start with three days per week of resistance training, and then we build-up to 4 days per week as part of our progressive overload strategy.

Why do the specifics matter?

The hardest thing about exercise is starting. And the best way to get started is to make your workouts pre-planned, and structured. Then make it repetitive.

Overall, you want to aim for a minimum of 150 minutes per week of moderate intensity movement where your heart rate is elevated, yet you can still hold a conversation.

The beauty of my plan is that you're most of the way to that weekly goal if all you’re doing is walking 8k steps per day, and strength training 3 days per week. 

Then repeat.