You're healthy - should you care about your blood sugar?
Now that glucose tracking technology, once the domain of people with diabetes, is more widely available, it begs the questions: should you care about your blood sugar, and can monitoring it help you?
In this blog, I explain the relevance of blood sugar to health and energy, how eating habits can influence it, and how monitoring it for a while may be helpful for those wanting to better understand where they sit on the spectrum of glucose control and how to enhance health and habits in a meaningful way.
Why care about blood sugar?
The carbohydrates in fruits, starchy vegetables, legumes, grains (oats, rice, bread, pasta) are all broken down into glucose in the body to help your body and brain to function every day. Despite the wellness press often branding the whole food group as ‘bad’, this is far from being the case. The human body is designed to burn glucose for energy.
But it’s also fair to say that the typical western diet since the 1950’s has seen a rise in the dependence on ultra-processed starch- or sugar-rich foods (think white bread, baked goods, french fries, cereal bars, rice crackers, sweetened yoghurts, sugary sweets and drinks) which are often consumed excessively.
In the nutrition world, these are considered high glycemic foods as blood sugar increases rapidly after eating too much of them. In an attempt to regain balance, the body responds by overproducing insulin to help shuttle glucose in to cells for energy. And then it stores any extra sugar in the liver, muscles, and fat cells.
If blood glucose levels are mostly maintained within a healthy range, you’ll likely have a steady supply of energy and a healthy but balanced appetite. But, if blood sugar levels run too high for too long, or oscillate between too high and too low, you may well feel tired and lethargic too much of the time, have insatiable cravings, lose concentration easily, feel achey, develop acne, struggle with disturbed sleep, or experience lack of exercise endurance.
Having relatively stable glucose is known to reduce stress on the mitochondria, the body’s metabolic engines, and it helps protect against insulin resistance and inflammation – two major culprits in metabolic dysregulation and decline.
We use the term metabolic health to broadly describe how well our body produces and uses energy. Every one of the trillions of cells in our bodies is a small powerplant that converts fuel (usually glucose or fat) to energy the body can use (typically ATP). When our cells are comprised by sugar spike overload and cannot run those processes efficiently, it can eventually lead to any number of conditions depending on which cells in the body are suffering.
In the brain, poor metabolic health can contribute to cognitive impairment, decreased mental acuity (brain fog), anxiety, or Alzheimer’s. In the blood vessels, it can contribute to microvascular disease (like erectile dysfunction, retinopathy or kidney disease) and cardiovascular disease (like heart attacks and strokes). In the liver, non-alcoholic fatty liver disease. Metabolic dysfunction can also interfere with the body’s natural fat storage and burning capabilities.
This is why it’s now widely regarded that balanced blood sugar is a necessary foundation for energy, wellness and reducing the long-term risk of many diseases.
CARBOHYDRATES IN CONTEXT
Whilst food is understood to be the single biggest factor determining whether a person can maintain stable blood sugar levels and avoid spikes, and carbohydrate choices are clearly a key aspect of this, it is important not to jump straight to the conclusion that restricting all sugary foods or the whole carbohydrate food group is the healthiest solution.
Taking such a reductive and restrictive approach to nutrition overlooks the fact that nutrition is much more than glucose alone, and there is so much more to healthy eating than avoiding certain foods. You could eat for stable blood sugar, include a thoughtful mix of macronutrients (clean proteins, carbs, and fats); limit foods that contribute to the detrimental metabolic changes outlined above—and still not be optimally nourished on a cellular level, nor have a happy gut (which would in turn also play a role in your metabolic health). For optimal nourishment, you’d still need to add micronutrients: vitamins, minerals, trace metals, antioxidants, phytonutrients and fibres!
This is why I am always keen to help my clients at Gut Reaction understand more about the impact of carbohydrate quantity and quality on blood sugar in the context of a broad, diverse, nourishing and satisfying daily diet i.e. not getting so fixated on one aspect of nutrition or health that they lose sight of the big picture, or compromise the enjoyment of food and eating in the process.
Also, it’s important to recognise that beyond food, there are multiple other factors at play, both physiological and environmental, that will influence individual blood sugar response and overall metabolic health, and may even impact how a person metabolises the same meal on a different day. Some of the other major lifestyle factors to pay attention to are sleep, stress, emotional wellbeing, and physical activity.
The good news is that what all this means in practice is there are plenty of simple tweaks that can help a person maintain more stable blood sugar and energy and feel better in their bodies - without having to write off carbohydrates and certainly without focussing on dieting or weight loss (I’ll be sharing more tips about this in a future blog post!).
UNDERSTANDING YOUR GLUCOSE CONTROL
Given that blood sugar is a relevant marker of health, you might be wondering, how do you know where you personally sit on the spectrum of glucose control? In fact, many of the physical effects of dysregulated glucose are usually quite apparent when you are in tune with your body and know what signs to look for (check out the symptoms in the first part of this blog), But, that doesn’t necessarily make it easy for everyone to join the dots with their own health.
Blood testing can help and, if you have ever approached your doctor with low energy, it may be that you’ve had your fasting blood glucose tested to screen for diabetes or prediabetes. But this particular test doesn’t show the whole picture of your metabolic health. If your blood sugar is less than 5.5 mmols/l at the time of testing, you’re considered healthy.[1] But what about the other 99.9% of the time?
HbA1c, which is your average blood glucose (sugar) levels for the last two to three months, may be a better gauge, as HbA1c i.e. glycated haemoglobin is made when the glucose in your body sticks to your red blood cells. Your body can’t use the sugar properly, so more of it sticks to your blood cells and builds up in your blood. Red blood cells are active for around 2-3 months, which is why the reading is taken quarterly.
However, it’s estimated that 88% of people suffer from glucose spikes, most unknowingly, and studies show that even ‘healthy’ individuals can have glucose spikes reaching prediabetic ranges 15% of the time and diabetic ranges 2% of the time.[2]
Introducing THE BENEFITS OF continuous glucose monitoring
This is where continuous glucose monitoring (CGM) comes in. CGM works through a tiny sensor inserted under your skin, usually on your belly or arm. The sensor measures your interstitial glucose level over the course of its two week lifespan, and then can be replaced.
And, thanks to some innovatitve new companies developing applications suitable for people without diabetes, the technology is now available privately for anyone who wants to record blood sugar in real-time and identify patterns over a period of time.
In my practice at Gut Reaction, I have found that tracking with CGM over a period of two or four weeks can be a really useful tool for some of my clients because:
It helps to reveal where a person is on the spectrum of glucose control. One study from Spain suggested that CGM is a better indicator of glucose fluctuations than either fasting finger-prick tests or HbA1c tests.[5]
It helps build understanding of individual responses to food - and that can help someone tweak their food choices and combinations in ways that are meaningful to them. Some foods are the more obvious common culprits when it comes to spiking blood sugar, but not every person’s blood sugar response will be the same, even when it comes to whole foods like sweet potatoes and bananas for example.
It can help to build understanding of the effects of sleep, stress, and activity levels on blood sugar too.
It highlights excessive consumption of sugar, and if someone is really struggling in their relationship to sugar, we can then look holistically at how best to approach this, including at a more emotional level.
CONSIDERATIONS WHEN DECIDING WHETHER CGM IS RIGHT FOR YOU
It’s my belief that the body is giving us messages about its health, energy and needs all the time. One of the core aspects of my work is teaching clients to listen to their own bodies and intuitively responding to its needs. And it is relevant to point out that studies so far have associated Intuitive Eating, a self-care eating framework I draw on heavily at Gut Reaction, with lower blood glucose levels (as well as lower triglycerides, and higher ‘healthy’ HDL cholesterol).
So, do my clients (without diabetes) need CGM to help them do this?
Arguably many people don’t, and certainly shouldn’t need to track blood sugar on a long term basis. However, as a short term tool, I’ve seen how making use of science in this way can help some of my clients make better sense of what their body is telling them and give them meaningful ways to retune their habits.
But it is not an appropriate tool for everyone. Because a lot of people come to me when they are overwhelmed with dieting, stressed or stuck around food or emotional eating, I recognise that CGM may be too much information for some. Plus there is a risk that some people could use its insights from a place of fear to create more restrictive or rigid rules for themselves around food - as opposed to using it as a complement to the work we’re doing to eat more intuitively and improve their overall relationship to food and their body.
CGM is also not a financial investment that everyone can make. But I want to point out that, even without using the tech, anyone with an active interest can still learn about blood sugar balance, and experiment with making changes in their lifestyle and see how they feel as a result.
MY ConclusionS
Blood sugar is a foundational aspect of metabolic health and energy as well as broader health, and food is a key factor when it comes to maintaining generally well-balanced blood sugar levels, but by no means the sole factor.
Currently continuous glucose monitoring is one of the best windows we have into our body’s response to diet and lifestyle, and there are many insights and learnings that an individual can glean from CGM in relation to their food and lifestyle choices, which can in turn help them maintain more balanced energy, avoid brain fog and cravings, and improve insulin sensitivity.
When I do recommend it to my clients at Gut Reaction, the focus is very much on using the technology to help connect eating habits with health and energy, and to help develop their bodily wisdom by enabling them to curiously explore what works for them as an individual with the support of real time biofeedback so that they can be more mindful and purposeful in their approach to taking care of their body.
Next Steps
If you are interested in improving you own metabolic health and eating habits, please contact me and we can discuss the best next steps for you.
If you are keen and ready into jump into monitoring your own blood sugar, the CGM provider I recommend is called Veri and they offer a 28-day programme for people interested in the pursuit of optimal metabolic health via blood sugar.
You will receive two continuous glucose monitoring sensors to wear on the back of your arms (they each last two weeks), and use an accompanying app where you can track patterns and reap the learnings about what works for you and what doesn't.
My Gut Reaction clients and followers will receive 20% off the programme here. Code: GUTREACTION20
I do hope this blog is food for thought! If you have any questions about the information provided, or about how to move forward with your own health and habits, please contact me here.
References:
1. https://www.diabetes.org/diabetes/a1c/diagnosis
2. https://pubmed.ncbi.nlm.nih.gov/30040822/
3. https://jamanetwork.com/journals/jama/article-abstract/202670
4. https://link.springer.com/article/10.1186/s12933-020-01085-6
5. https://pubmed.ncbi.nlm.nih.gov/29807103/
