Every year, various diet theories make their way into popular view on the internet. “Everyone should eat less fat”…. “Everyone should eat low carb”…. “Everyone should go Keto”….. it’s enough to make your head spin! The truth is that we are all biologically and genetically unique, and there is no One Diet that is an ideal match for everyone. That said there are some general principles that hold true across various diet types, and one of those is the importance of maintaining balanced blood sugar
Keeping blood sugar levels stable is critical for hormone balance, lowering inflammation, and optimizing energy levels throughout the day.
Why Balanced Blood Sugar Matters
When we eat carbohydrates, the body breaks them down into simple sugars called glucose. Glucose crosses from the small intestine into the bloodstream where it can be taken up by the mitochondria – the “powerhouses”of our cells – and converted into energy. This energy is called adenosine triphosphate (ATP). However, mitochondria have a limited capacity to convert glucose into ATP: they can only convert as much glucose into ATP as they can use. When more glucose is present than can be used by the mitochondria, it causes “glucose spikes” – also known as elevated blood sugar. To prevent glucose spikes, one of two things happens to extra glucose circulating in the bloodstream: it is either converted by the hormone insulin into fat for storage, or into free radicals.
Free radicals are small, unstable molecules that set off a chain reaction of oxidative stress, inflammation, and aging. Free radicals have the potential to create mutations in our DNA, “turning on” harmful genes and even leading to cancerous cell changes. Oxidative stress caused by free radicals is the main trigger for all types of chronic disease, such as heart disease, dementia and cognitive decline, type 2 diabetes, and accelerated aging of all tissues, including your skin. Free radical damage to mitochondria leads to a loss of endurance for exercise and handling situational stress. A diet that prevents free-radical-creating glucose spikes lowers oxidative stress and the resulting inflammation, thereby reducing the risk of any of these inflammation- based diseases.
Insulin is the hormone that stashes away glucose that our mitochondria can’t make use of at the moment. Insulin is released when blood sugar levels rise. First, insulin pushes extra glucose into the cells of our muscles and liver to be stored as glycogen. But then, when it runs out of “closet space,” it turns excess glucose into fat and stores it in our fat reserves. When the muscles and liver run out of glycogen, they should be able to tap into fat stores to replenish themselves, causing weight loss. However, if insulin is present, our body is prevented from tapping into these reserves. If levels of glucose are kept stable, insulin levels stay steady, allowing the body to burn fat for energy, thereby decreasing weight.
Excess levels of insulin contribute to adrenal stress, including hypoglycemia, by clearing glucose out of circulation and into fat cells to be stored for later use, causing blood glucose levels to drop. In order to normalize blood sugar, the adrenals have to produce increased levels of cortisol and epinephrine. This often leads to long-term cortisol depletion and ultimately adrenal hormone dysfunction.
The decline of a glucose spike back to normal levels also triggers cravings. Studies show that a decrease in glucose levels, even just a decrease of 1.1 mmol/L, leads to increased cravings for high calorie foods. This can lead to overeating.
Short & Long-term Effects of Glucose Spikes
- Cravings
- Fatigue/chronic fatigue
- Poor sleep (waking during the night)
- Suppressed immune response/more vulnerability to viruses and bacterial infections
- Exacerbation of hormonal hot flashes and night sweats (worse flashes = high levels of glucose and insulin in studies)
- Increased likelihood of migraines
- Memory and cognitive issues
- Increased risk of Alzheimer’s and dementia
- Acne and other inflammatory skin conditions
- Arthritis and other inflammatory diseases
- Increased cancer risk
- Heart disease
- Infertility and PCOS
- Insulin resistance and Type 2 diabetes
- Non-Alcoholic Fatty Liver Disease
- More depressive episodes
- Digestive symptoms like leaky gut, heartburn, acid reflux
- Accelerated aging and more rapid formation of wrinkles
Normal Blood Sugar Levels
According to the American Diabetes Association (ADA), normal fasting blood sugar is below 100 mg/dL. Levels between 100-125 indicate pre-diabetes, and anything over 126 when fasting is considered diabetic. After eating (postprandial), the ADA considers 70-140 mg/dL to be normal.
But, what’s “normal” isn’t necessarily optimal. Fasting glucose can be “normal,” but you may still experience glucose spikes over 140 mg/dL throughout the day. Instead, I prefer to look for these signs of optimal blood glucose levels:
- Fasting: 70-90 mg/dL
- Postprandial: Below 120 with a return to pre-meal glucose levels within 2 hours (ideally below 100)
However, a single blood sugar reading taken alone is not the best way to gauge overall blood sugar health. Instead, I suggest continuous glucose monitoring.
Continuous Glucose Monitoring
A Continuous Glucose Monitor (CGM) is a small device that you wear on the back of your arm for two weeks. They are painless to insert, and once placed, monitor the amount of glucose in your tissues 24 hours a day, sending the data to an app on your smartphone. Though they were originally developed for people with diabetes who need multiple blood glucose readings a day, almost anyone can benefit from the convenience and multiple data points a CGM can provide. A CGM is the best way to understand how specific foods affect your body, and the impact that glucose shifts have on your mood, energy, sleep, inflammation, and more.
Those interested in continuous glucose monitoring may be able to obtain one by prescription from your general practitioner, especially if you’ve had a history of elevated HBA1c, fasting glucose levels, or labs that suggest diabetes, gestational diabetes, or pre-diabetes. Alternatively, you can request a prescription to be filled at a pharmacy of your choosing through the concierge service at www.pushhealth.com. Request the Abbott Freestyle Libre unless you have an actual diagnosis of Diabetes, in which case you should qualify for insurance coverage of the Dexcom G6 CGM, which is more accurate, but more expensive out of pocket.
There are many subscription platforms using CGM, as well. These services come with app interfaces with more bells and whistles, food tracking built in, and generally some type of interactive coaching service available through in-app messaging. January.ai, Nutrisense, and Levels are a few of the better known platforms offering this service.
For more information on how CGMs work and directions on how to calibrate yours, read here.
Are Carbs Bad for Blood Sugar levels?
Since carbohydrates become the glucose that elevates blood sugar levels, it’s only natural to wonder if carbohydrates are something that should be avoided. But in actuality, it’s much more complicated than just “good” or “bad.”
Glucose is essential to life. In fact, in the absence of any glucose in the diet, the liver converts fat into usable glucose via a process called gluconeogenesis. We are also biologically programmed to love sweet tastes. In hunter-gatherer times, sweet flavor meant food was both safe and was rich in energy. Sweet tastes release dopamine in the brain, which registers as pleasurable, prompting us to seek more of it. We are literally designed to consume carbohydrates.
But, not all carbohydrates are created equally. Carbohydrates are made by plants during photosynthesis and consist of starches, fibers, and sugars, including glucose, fructose, and sucrose. These exist in different proportions in different plants: kale has lots of fiber and some starch, while cherries contain mostly sugars, and some fiber. The fiber in plants slows the absorption of the glucose. This is what nature intended. In modern times, we have learned first to breed plants for higher sugar content and sweetness, and then to extract sugar from the fiber in plants and use it to sweeten… everything! It is this that has led to chronic health problems and modern degenerative diseases, not carbohydrates themselves.
How Much Carbohydrate Should I Be Eating?
One of the most effective ways to prevent or reverse the excess production of insulin and cortisol is to balance the amount of carbohydrates and proteins that are eaten with each meal. The amount of carbohydrates that each person needs is highly individual, and is based on several factors: size, activity level, being physiologically male vs female, and biochemical individuality/genetics. For example, an average sized woman who is moderately active, and not trying to lose weight, might need 75-150 grams. If she’s training intensively, she might need closer to 200 grams, or more. An average sized man might need 150-200 grams, or up to 400 grams daily if highly active.
Proper macronutrient ratios (percentage of carb/fat/protein in the diet) vary by health goals as well, for example weight loss vs mood stabilization vs maintaining a healthy pregnancy. Weight loss is generally supported by lowering carbohydrate consumption, whereas some people with insomnia, anxiety, or depression may be better served by slightly increasing carb consumption. If you are only eating 50 grams daily, and not sleeping well, or suffering from energy or mood dips, consider increasing by increments of 25 grams daily up to 100 or 150 grams and noticing what happens.
The only way to know what is right for you is to experiment and observe how you feel. Additionally, wearing a Continuous Glucose Monitor (CGM – discussed above), can provide a sense of your carbohydrate tolerance at various times of day.
Beyond just the amount of carbs eaten, the type and way in which you eat carbs can also have a profound effect on blood sugar stability.
A few simple guidelines:
Include small amounts (1/2 – 1 cup) of starchy veggies (such as root vegetables, squash, or tubers), 1-3 times daily, depending on your personal carbohydrate need. Eliminate or minimize grains. If you do include grains, emphasize whole form, not flours, as flours have a higher glycemic load and will raise blood sugar more rapidly, and to a greater extent than their unprocessed counter-parts.
Include proteins with each meal in a weighted ratio of at least 2:1 of carbohydrate to protein.
Eat 15-20 grams/protein at each meal, unless directed otherwise by your healthcare provider based on specific health goals. This is approximately a palm-sized serving of fish, chicken, or red meat, or 2-3 eggs. You can also get some protein in the form of nuts, seeds, and legumes, just be aware of the carbohydrate load that beans naturally include. While this amount may be fine for some people, for people with blood sugar control issues, beans may be better as a condiment or salad topping.
Eat as many green, and then multi-colored (red, yellow, orange and purple) veggies as possible each day. Strive for 5-10 cups of veggies daily.
Use extra virgin olive oil, coconut oil/coconut butter/coconut milk, ghee, flaxseed oil (do not heat), macadamia nut oil, or avocado. Avoid canola oil and use seed oils sparingly.
Eat 1-2 servings maximum of fruit daily. Always consume fruit with a protein or fat: nuts, nut butter, or other fat/protein source.
If you struggle with elevated blood sugar levels, do not snack between meals, and instead eat at 3 specific times of day, or as your practitioner has recommended for you.
How to Flatten Glucose Spikes
#1 Deconstruct your meal
Instead of grabbing a bite of this and a bite of that, try this: eat veggies first (especially above-ground veggies and anything leafy). The fiber in veggies slows the breakdown and absorption of glucose. After you finish your veggies, eat protein and fat next, as fat slows the absorption of sugar. Save the starchy component of your meal for last.
#2 Add greens to the beginning of every meal
In addition to eating your veggies first, add a small salad or veggie appetizer before the meal, such as spinach leaves with a few artichoke hearts and vinegar and olive oil. Alternately, roast some low carb veggies like cauliflower and broccoli in the oven and store in the fridge to have on hand. Or, try grabbing a few bites of fermented veggies like sauerkraut or kimchi: eating even just a few bites of these prior to your meal lowers glucose spikes.
#3 Stop counting calories
Not all calories are equal. Weight management and health have much more to do with keeping glucose stable (using these techniques) than with sticking to an arbitrary calorie goal.Conventional wisdom says adding oil and vinegar to your salad only adds calories, but in reality those extra calories will keep you full longer, rev up fat burning, blunt the absorption of starches in the rest of the meal, and ultimately contribute to weight loss!
#4 Prioritize a high protein, lower carbohydrate breakfast with plenty of healthy fats
Extra points for fiber from veggies!This will set you up for better glucose control and energy through the day, as we are more sensitive to sugars first thing in the morning after fasting. Plus destabilizing glucose first thing with a high-sugar breakfast makes it very hard to regain glucose stability later in the day. (One note: Avoid smoothies containing lots of blended fruit, as this breaks up the fiber, making the sugar in the fruit more available, yielding bigger glucose swings. Some smoothies easily spike blood glucose as high as drinking a can of soda!
#5 Consume vinegar before a meal
To blunt glucose spikes, dilute 1 teaspoon to 2 tablespoons of any unsweetened vinegar– most people enjoy Apple Cider Vinegar the most– in water and drink before eating. Adding vinegar can reduce glucose spikes as much as 20%. Not a vinegar fan? This blog lists many delicious drink recipes based around apple cider vinegar.
#6 Move your body after you eat
With every movement we make, we burn glucose. If we stay still after a meal, glucose enters the bloodstream and then floods our cells and overwhelms our mitochondria. But, if we use our muscles as the glucose moves from the intestines into the blood, our mitochondria have a higher burning capacity and will use that glucose to make more ATP. This makes a huge difference when tracked using a glucometer or CGM: just adding exercise after a meal significantly lowers glucose levels. For best results, move anytime in the hour after you finish a meal – but it doesn’t have to be a hardcore workout. Just 10 minutes of walking is helpful, and if you can’t go for a walk, doing squats, planks, or lifting something heavy works just as well.
Sweet Foods & Dessert
If you’re going to eat dessert, the best time to eat it is at the end of a meal – meaning green starter, vinegar, then veggie, protein/fat, starches…..and then dessert. When snacking, opt for savory snacks whenever possible. Don’t eat carbs by themselves– always eat them with protein or fat beforehand. This includes fruit.
Replace sweeteners with monk fruit, allulose, or stevia (if you tolerate and enjoy stevia) where possible. Better yet, go sweetener free for a period of time to “reset” your taste buds. Avoid sweeteners like sucralose, xylitol, aspartame, maltitol, and erythritol.
Sample Blood Sugar Balancing Menu
Day 1:
- 8am breakfast: 2-3 egg scramble with 2-4 oz ground chicken or chicken sausage, chopped spinach, onion, garlic, herbs, cooked in 1-2 TBS of grass-fed butter or ghee or coconut oil. Ideally with a few bites of roasted broccoli from the fridge, beforehand.
- 11am snack if needed: 10 nuts or 1 TBS nut butter and 1 cup berries
- 1pm: leafy green salad with 2 cups of chopped veggies, hard-boiled egg, turkey or chicken breast, and salad dressing of fresh lemon juice and EVOO
- 4pm snack if needed: turkey roll-up (2-3 turkey slices rolled around avocado and hummus)
- 6-7pm: oven roasted fish (coconut crusted salmon: rub salmon with olive oil, sea salt and pepper and pat with flaked coconut. Bake at 375 for 20 minutes),1 cup of roasted butternut squash cubes, and 1-2 cups of sautéed leafy greens with garlic. Eat the greens first.
Day 2:
- 8am: Clean protein smoothie w/ 2 cups super greens, 2 TBS tahini, cinnamon, and 1 cup of berries blended in almond milk. Bonus: add 1 TBS of Paleo Fiber
- 11am: raw veggie sticks and guacamole
- 1pm: Lettuce wrapped lamb burger, leftover greens, 1/2 sweet potato with coconut butter
- 6-7 pm: shrimp fajitas (with 1-2 cassava coconut Siete Foods Tortillas) OR ground turkey lettuce tacos with organic pressure-cooked black beans . Eat the beans last!
Day 3:
- 8am: chicken sausage, grated parsnip hash cooked in avocado oil, with spinach and avocado 11am: protein powder smoothie with 1 cup berries and almond milk.
- 1pm: coconut milk soup with chicken, side salad
- 4pm: handful of almonds
- 6-7pm: pesto chicken breast, braised red cabbage (slice cabbage and sauté in olive oil + chicken broth), roasted beets in olive oil with rosemary.
- dessert/snack: dark chocolate (1-2 squares) with whipped coconut cream
Get Your Own Customized Plan
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