Food isn't the only factor in blood sugar regulation

We’re wrapping up a series on blood sugar. Seriously you guys, this topic is so important. And now more than ever. The mainstream media isn’t great about sharing the data that researchers are finding on the relationship with COVID moralities and metabolic syndrome, but it’s incredibly frightening!!! 

The Lancet recently published some data from a study they performed in England looking at the relationship between COVID deaths and diabetes. They found that type 1 and type 2 diabetes were both independently associated with a significant increased odds of in-hospital death with COVID-19. 

Obviously all of this data is new, but the relationship between metabolic syndrome and pretty much every other disease is NOT new. The Journal of the American Medical Association published in 2004 (a long time ago!) that the presence of the metabolic syndrome was associated with a 1.4-fold increase in the risk of all-cause mortality for both men and women, and with a 2.3-fold increase in the risk of cardiovascular disease mortality for men and 2.8-fold for women. 

Metabolic syndrome is a series of conditions that increase the risk of heart disease, stroke, and diabetes. Those conditions include high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels. So obviously we need to be mindful of ALL of those conditions, but blood sugar is one that can affect EVERYONE (including lean athletes) regardless of their age and sex and often times people have no idea they have pre-diabetes. 

Pre-diabetes and type 2 diabetes can both be reversed pretty easily with more mindfulness around diet and lifestyle. So if you haven’t read the last 3 posts on the diet portion of how to balance your blood sugar, start there. If you have, and you’ve dialed in your diet but your blood sugar is still high, you’re in luck. Because that is exactly what we’re talking about this week!

In private practice, I have yet to find a client with high blood sugar who only has to adjust their diet to get back into normal blood sugar ranges! Usually, there are lifestyle factors that also need to be adjusted. So let’s dive into what those are...

Using Non-Caloric Sweeteners
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Have you ever heard of Pavlov’s dogs experiment? Pavlov was a scientist who showed the theory of classical conditioning through his infamous dog experiment. He presented a stimulus (e.g. the sound of a metronome) and then gave the dog food; after a few repetitions, the dogs started to salivate in response to the stimulus. 

We humans are also subject to classical conditioning. When you place something sweet into your mouth, your brain receives a signal that something sweet is on the way. In response, the brain can send a signal to the pancreas to release insulin to prepare for the sweet thing to enter the bloodstream. But nothing arrives. And you repeat this action again. And again. And again.

You continue to use non-caloric sweeteners, but your body continues to respond as if sugar is coming in leading it to wear out it’s blood sugar regulation system.

You can see how if you constantly chew sugar-free gum, drink non-caloric sweetened drinks (such as diet soda) or eat treats that are sweetened with non-caloric sweeteners, that your pancreas can quickly become incapable of keeping up with the insulin demands, and the cells of the liver and muscles can become immune to the signals of insulin. 

This is especially important for those that have a level of insulin resistance already. Limiting and/or avoiding non-caloric sweeteners all together can help your body be sensitive to insulin, which is what you want for longevity!

Stress
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In psychological terms, stress is the reaction to something that threatens our physical or mental equilibrium1. This means that it can come from a ferocious tiger threatening to eat us, or an overdue credit card bill that we don’t have the funds available to pay. 

Genetically, our body is hard wired to deal with stressors in a way that is meant to protect us from things like predators and angry enemies. Historically, these types of threats were typically quick to come and quick to go. Between threats, our body could unwind and had time to recover before another threat revealed itself. 

Today, most of us no longer have to worry about dangerous animals threatening to eat us, or our neighbors breaking into our house with a spear. Today’s threats are much different. 

In the book The Adrenal Reset Diet author Alan Christianson says “within the last few decades our world has gotten more toxic, a lot noisier, and much faster pace. Our food has more sugar, less fiber, and many more chemicals. We spend less time in sunlight and we sleep less. We take more medications, feel less certain of our financial futures, and have fewer friends.” 

Not only are all of these things causing increased stress, but the type of stress has turned from acute to chronic. This type of chronic stress has a completely different effect on our adrenal glands than acute stressors.

The adrenal glands are responsible for the production and output of our main stress hormones: cortisol and adrenaline. Neither of these hormones were intended to be in the system for the long term. These hormones help you survive immediate threats by raising your blood pressure, blood sugar and shunting blood to your working muscles and brain, so you can fight or flee. 

In today’s world, where threats are not solved in a single afternoon, these hormones are working overtime to try to protect you. Meanwhile, your blood pressure remains high, your immune system is weakened, your digestive system slows down and does not work properly, your sleep is affected because you are wired (and exhausted), your ability to learn decreases, and…you guessed it…your blood sugar stays higher than normal.

If you have balanced your diet and still feel frustrated that your fasting blood sugar levels are higher than normal, you needed to consider that stress is playing a large role in this. 

Remember that anything in your life that creates a chronic stress response can create a chronically higher than normal blood sugar. 

Many of these stressors are things that have become part of our normal day-to-day life and therefore we don’t look at them as a stress anymore. But how does your autonomic nervous system feel about that? 

Some of the areas to really explore when trying to reduce the stress load are:

• lack of sleep, lack of sleep, lack of sleep!
• exposure to toxins (chemicals, molds, etc)
• nutrient poor diet
• poor digestion, which creates a lack of nutrient absorption
• lack of social face-to-face interaction
• guilt, grief, depression, anxiety, lack of self-esteem
• increased financial obligations
• illness
• lack of sleep (did I already mention that?!?)

And the list goes on and on. 

In addition to higher blood glucose levels, other symptoms commonly associated with high stress are: you lack a sex drive; crave sweets and salt; get dizzy when you stand up quickly; have achy joints or other body aches; have low blood pressure; suffer from mild depression; require stimulants to get moving in the morning or stay awake in the afternoon; or have been told that your cholesterol is high. 

Reducing the load on the adrenals and supporting your system with the proper nutrients can help balance your steroid hormones and therefore lower your blood glucose over time.

Sleep
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Sleep is one of four biological needs (the others being: eating, drinking and mating). Sleep has been shown to have a direct impact on overall health, lifespan, productivity, safety and ability to learn. Sleep is one of the top five reasons that patients visit a clinic for care every year and lack of sleep has been associated with an increased risk of type 2 diabetes. 

A study performed at the Leiden University Medical Center took 9 healthy individuals, with healthy blood sugar response, and restricted sleep for one night (subjects were allowed to sleep from 1am to 5am). The result was insulin resistance in multiple metabolic pathways in all subjects. 

Additionally, data from large published studies, including: Sleep Heart Health Study; Finnish Type 2 Diabetes Study; Quebec Family study; Behavioral Risk Factor Surveillance System; National Health Interview Study; and Isfahan Healthy Heart Program, have all demonstrated that middle-aged to elderly subjects with self- reported short sleep duration are approximately twice as likely to be diagnosed with type 2 diabetes and are at higher risk for impaired glucose tolerance.

Most adults need between 7-9 hours of sleep each night. Not 7-9 hours in bed with the lights out laying awake. 7-9 hours of actual sleep. If this isn’t your situation, here are the first steps to dial in:

1) Follow a sleep schedule.

2) Eat a diet that promotes quality sleep at the right times:

• Eat a dinner full of melatonin rich foods.
• Avoid caffeine, including chocolate after 12pm.
• Avoid alcohol before bed.
• Avoid large meals and beverages 2 hours before bedtime.

3) Exercise at the time that best suits your chronotype. Avoid intense exercise 2-3 hours before bedtime. If AM blood sugar is higher than ideal, choose 20-30 minutes of a relaxing activity before bed, like gentle walking.

4) Get your daily dose of natural sunlight for a minimum of 30 minutes per day. If you can not get out into the natural sun, consider morning exposure to artificial light for at least 1 hour.

5) Only nap before 3pm.

6) Schedule time for relaxation for at least 20 minutes before bed. Espom salt baths, foot soaks, reading and meditation are all great options.

7) Create a bedroom that is most conducive for proper sleep.

• avoid electronics in the bedroom
• create complete darkness
• The general suggested temperature for an ideal night's sleep is between 60-67 degrees Fahrenheit.
• invest in comfortable and non-toxic clothing, pillow, mattress and linens.

​8) Avoid medications that cause stimulation before bed. Some examples of these medications are hypertension, allergy, and thyroid medications. Consult with your doctor about options for taking these medications at earlier times of day in order to optimize your ability to sleep.
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9) Don’t stay in bed if you haven’t fallen asleep after 30 minutes.

One book I absolutely love that talks about sleep is called Why We Sleep by Matthew Walker. If your blood sugar is still high and sleep is an issue, you definitely want to dive down this rabbit hole more deeply!

​If you are consistently following the 9 sleep foundations above, and are still experiencing constant fatigue and irritability during the day after getting 7-9 hours of sleep, waking up several times during the night, staying awake for more than an hour without being capable of falling back to sleep, or taking longer than 30 minutes to fall asleep, and/or higher than normal fasting blood sugar levels,  it might be time to seek out a sleep specialist for help.​

In Summary
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So there you have it. All the steps you need to test your blood sugar levels, test your diet to make sure it supports healthy blood sugar levels (carb testing), carb timing so you can still enjoy carbs and sugar from time to time without having it affect your overall wellness, and lastly, other considerations if you blood sugar is still high after dialing in your diet.

I hope this series has helped you step closer to optimal blood sugar and health. As always, if you're struggling with blood sugar or just reaching your health, wellness and/or sport performance goals, reach out to me! I’d love to set up a free discovery call with you to find out if working together to discover your own personalized path to reach your goals is the right fit for both of us!

REFERENCES:
1. https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30272-2/fulltext
2. ​https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/217011