I recently got a continuous glucose monitor (CGM)!! After going to the Metabolic Health Symposium in January, my biggest takeaway was how carbohydrates impact our blood sugar.
Blood sugar and metabolic health
What is metabolic health?
Metabolic health is the optimal management of your metabolism without medications. Metabolic markers include blood sugar, insulin, triglycerides, HDL, blood pressure, and waist circumference.
Metabolic function is important because 88% of Americans are metabolically unhealthy and 2 million Americans will die of diet-related disease THIS YEAR.
Why blood sugar is important for metabolic health
68% of our food supply contains caloric sweeteners leading to an average consumption of 17 tsp of sugar per person in the US (recommended consumption is 6-9 tsp).
High consumption of sugar is a major cause of obesity, inflammation, disease, and cancer. When we eat high amounts of sugar, insulin is secreted to mitigate the damage. It's insulin's job to move that sugar (if it's not being used for energy) into the muscle/liver as glycogen or into the fat tissue. However, if we are not active, our muscle/liver glycogen stores will always be full, allowing fat stores to be filled first.
If blood sugar is consistently high, then insulin is consistently working overtime, eventually causing insulin resistance. Insulin resistance occurs when the insulin receptors become numb to secreting insulin and without insulin, the sugar stays in the blood. Sugar hanging around in the blood for too long causes major tissue damage (type 2 diabetes).
Even in non-diabetics, we don't want our blood sugar bouncing around all day. Extreme highs and lows of blood sugar can cause cravings, hormonal imbalances, daytime fatigue, and difficulty losing weight.
So, one way to improve our metabolic health is to optimize our blood sugar variability. This accounts for hypoglycemic (low blood sugar) periods, hyperglycemic ( high blood sugar) periods, postprandial (after meal) rises in glucose levels, glucogenesis (protein converted into sugar), and stress (cortisol) response to blood sugar elevations.
Lifestyle choices that support balanced blood sugar
Choose carbohydrates wisely
The glycemic index indicates the speed at which the glucose from a given food makes its way into the blood. The higher the glycemic index, the faster the blood sugar will increase after the food has been absorbed (Yuka 2022).
Low-GI foods: legumes (lentils, peas, chickpeas), nuts (walnuts, peanuts), some fruits (apples, pears, bananas, oranges, kiwis, grapes), some grains (multigrain bread, bulgur, brown rice, plain muesli), dark chocolate
Medium-GI foods: whole-grain pasta, some fruits (raisins, pineapple, cherries, melon), white rice, whole wheat bread, milk chocolate, jam
High-GI foods: potatoes, white bread, thoroughly cooked pasta, rice cakes, candy, dried fruits (dates, dried apricots, raisins, etc.), honey
Carbohydrate timing can also be beneficial for blood sugar management. Your body is more insulin sensitive in the morning and gradually becomes more resistant as the day goes on. So if you're having a high carbohydrate meal for breakfast, your insulin will control the spike better in the morning however this can cause reactive hypoglycemia (this happened to me) causing your blood sugar to dramatically drop after a blood sugar spike. So even though you are more insulin sensitive it isn't always wise to have more carbohydrates in the morning. I personally try to be in a carb deficit in the morning and afternoon, allowing my glycogen stores to empty during the day (if there's not enough sugar in the blood, the body uses glycogen stores first, then fat stores). Then for dinner, I will have more carbohydrates, knowing they will be stored as glycogen, not fat. More carbs at night can also help you sleep better!
Strength training
Research suggests that when you strength train, you increase your ability to drive glucose into the muscle tissue instead of fat tissue (Greenfield 2020). This also allows for decreased blood sugar levels and increases insulin sensitivity (opposite of insulin resistance).
Pre-breakfast fasted cardio
Working out before eating first thing in the morning keeps blood sugar down and increases your metabolic rate for the rest of the day.
Postprandial walks
Walking for 30 minutes after meals can prevent or manage blood sugar spikes better than sitting or standing.
Plants herbs and spices
Ceylon cinnamon, Gymnema sylvestre, berberine, rock lotus, and bitter melon extract are some natural ingredients that can decrease the length and intensity of blood sugar spikes and prevent diabetes (Greenfield 2020).
Fiber
When fiber is digested, short-chain fatty acids (SCFA) are produced as a byproduct. These SCFAs help manage blood sugar, reduce the accumulation of fat storage, and improve insulin sensitivity. Pretty awesome right? Eat your green veggies :P
Continuous glucose monitoring
Another way to support blood sugar balance is to get a CGM to see what kinds of foods cause fluctuation in your blood sugar, as everyone's response is different.
Normal blood sugar levels:
Fasting: 70-100 mg/dL
Postprandial:<150 mg/dL
My experience with a CGM
I have the freestyle libre 3, I am actually on my second free trial because my first one fell off LOL. But it's pretty awesome to see your body's immediate response to food!!
Some things I noticed:
It takes about 30-60 minutes for my blood sugar to respond to a meal
Most of my hunger did not correlate with low blood sugar, so my hunger is emotional/stress/gut related
After having a carb-heavy meal for breakfast my blood sugar would spike and then bottom out shortly after, this is called reactive hypoglycemia due to a hefty insulin response
My average blood sugar at work was higher than normal (stress)
My blood sugar barely moved when I ate a low-carb, high-fat, moderate-protein meal
My blood sugar increased during high-intensity workouts (glycogen emptying)
My blood sugar occasionally dropped to critically low around 2-4 am (nocturnal hypoglycemia). This is somewhat normal due to the impact of REM sleep on glucose levels and the fact that I eat dinner pretty early.
Overall, I have adequate insulin sensitivity but could improve on my stress management!
How to get a CGM
Option 1:
Get a prescription from a doctor. Sign up for a free 14-day free trial with Freestyle Libre. Fill the voucher at your nearest pharmacy.
Option 2:
If you want more time to explore your sugar handling or you can't get a prescription, check out Veri!! Veri is a membership program that combines a CGM with an easy-to-use app to help you find the right foods and habits for your body. You can log food, exercise, events and more. They even have metabolic health modules for you to review AND a community platform! Plus, they have CGM prescription-specific doctors that will approve your CGM, no need to ask your PCP.
Here is a $30 off link!
Other tips to improve metabolic health
Find out where you are and get your labs done. Ask your PCP for fasting glucose, fasting insulin, Hemoglobin A1C, and a lipid panel that includes VLDL and particle size. Stop eating processed food. Processed food contains chemicals like MSG that stimulate neurological hormones (dopamine and serotonin) to clinically cause addiction. So if you're constantly craving Chick Fil A or cosmic brownies, and literally CANNOT say no, it's not your fault. You need to heal your brain with REAL food and rebalance your neurological hormone pathways. This is important because processed food consumption is directly related to poor metabolic health. Reconsider what you know about standard nutrition advice. A traditional 'My Food Plate' will tell you to eat 65% carbs with every meal and the American Heart Association will tell you to stay away from saturated fats - TOMFOOLERY.
Focus on balancing your macronutrients. More fat. More protein. Less grains/sugars. Track your food intake for a couple of days this week, and see where you stand. Are you getting at least 100 g of protein? What percent of your food is made up of carbohydrates?
To be metabolically flexible, your body needs to be able to switch between using carbohydrates for fuel to using fat for fuel. Using fat for fuel has shown to be more efficient for your metabolism, improves metabolic health markers, and does not spike blood sugar!
References
Greenfield, B. (2020). Boundless upgrade your brain, optimize your body & defy aging. Victory Belt Publishing Inc.
Haney, M. (2022, October 9). What is glucose? Levels. Retrieved April 5, 2023, from https://www.levelshealth.com/blog/what-is-glucose
Haney, M. (2022, October 1). What is postprandial blood sugar and why does it matter? Levels. Retrieved April 5, 2023, from https://www.levelshealth.com/blog/what-is-postprandial-blood-sugar-and-why-does-it-matter
Yuka, J. de. (2022, March 2). Carbohydrates. Yuka. Retrieved April 5, 2023, from https://yuka.io/en/basics/carbohydrates/
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