: What diet/foods decrease IGF-1 and increase IGFBP-1? And also, what happens to these markers when non-fibrous carbohydrates are substantially reduced? Thanks a lot for any comments.

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My son's pediatric endocriniologist recommended a low-carb diet for increasing his insulin sensitivity (=reducing his insulin resistance). This is apparently not totally mainstream (yet), though, because his pediatrician, who was otherwise very up on recent developments and research, did not know about the low carb diet, and had trouble understanding it.

I personally have not read much scientific literature about this -- my personal focus was more on implementing the specialist's recommendations at my house -- but here are a couple of references that might get you started if you are interested in following up:
www.nejm.org/doi/full/10.1056/NEJMoa022637#t=article
Bray, G. A. (2005). Is there something special about low-carbohydrate diets? Annals of Internal Medicine, 142(6), 469-70.

We found that a low carb diet, paired with metformin treatment and attention to regular, moderate exercise, has helped my insulin resistant son increase his IGFBP-1 lab results, lose weight in a slow, sustainable way, and then keep his BMI for age out of the obese zone. It has also helped him experience less

cravings
headaches
nausea
problems with energy level and concentration

The rest of the family, who are not genetically related and have no insulin resistance, benefited mildly from the low carb diet as well, especially in terms of better concentration in the afternoon.

Note about my son's experience with exercise: He has always been a boy who got a lot of enjoyment from both organized sports as well as just plain running around, riding his bike, and showing off his strength by carrying around heavy things. I was surprised how much it helped in the early months of his treatment to avoid exercise that involved short, intense spurts, and religiously walk 20-30 minutes every day (as recommended by the specialist).

He was 9 when we were given the diagnosis and he is now 13.

Since there is not just one approach to "low carb diet", I will share what we have worked out. The specific approach to a low carb diet we use:

no high fructose corn syrup
no candy
no sweet baked goods (except for birthdays, and then we use special flours, such as almond meal)
high fiber bread, maximum one slice per meal
100% whole grain pasta (I buy the kind that tastes like cardboard, hence one doesn't want to eat very much of it)
complex carbohydrates such as brown rice and potatoes in small servings
fruit limited to two servings per day; fresh and whole (requires chewing)
offer salads several times per week
we don't limit fats or protein
we aim for a good proportion of protein to carb ratio at each meal or snack
we all follow the same diet with the child
no fruit juices -- beverages are water, whole milk, and homemade, flavored bubble water (examples of flavorings: lime juice or pure cranberry juice)
raw baby carrots or large carrots often used as a snack, sometimes with hummus

When he hit a plateau after about three months, we temporarily substituted pizza sauce for catsup. That did the trick. He got unstuck, lost a couple more pounds over the next month, and hit his target. We were eventually able to go back to catsup (no high fructose corn syrup) in moderation.