Most people out there don’t think about their blood sugar – EVER – unless they’re diabetic. When you get your blood work done and your fasting glucose is less than 100 mg/dL (what the American Diabetes Association considers “normal”) you are told you’re fine. Your blood sugar is “normal.” You’re the picture of good health and nothing’s wrong. On the other hand, if your fasting glucose is 100, 101, or 102 mg/dL, suddenly you’re pre-diabetic.
So let’s think about this: If your blood sugar is just under 100 (say 97, 98, or 99), does that mean you’re in optimal health? Of course not. This is a sign for you to start taking action to prevent chronic disease. This is where personalized, precision medicine comes in. This is what I do and my focus: disease prevention.
Your risk of inflammatory disease increases dramatically with poor blood sugar control – and I’m not just talking about obesity and type 2 diabetes. You’re twice as likely to have cardiovascular disease and certain cancers with type 2 diabetics [1,2,3]. On top of that, mood imbalances such as schizophrenia, bipolar disorder, and depression are linked to insulin resistance, high blood glucose, and metabolic syndrome [4,5,6]. Insulin resistance is so strongly linked to cognitive decline that Alzheimer’s disease is referred to as “type 3 diabetes”.
Maintaining control of your blood sugar is essential for metabolic, heart, and mental health. Below are some small changes you can make to stabilize your blood sugar using food, movement, and mindset.
1. Trade this for that.
Following the “SAD” or Standard American Diet by consuming mostly refined carbohydrates sends your blood sugar on a roller coaster ride. The good news is you can choose foods that are satisfying, taste good and keep your blood sugar under control. The list below highlights some delicious food changes (where you trade this for that!) you can explore. Remember, it’s not about avoiding these foods forever; you just want to make sure they don’t become the foundation of your diet.
| Trade this: | For that: |
| Rice, pasta (gluten-free or regular), potatoes | Cauliflower rice, broccoli rice, zucchini, or carrot noodles. Soba noodles, which are made from buckwheat is high in protein and fiber and can also be substituted for ramen or pho. My new favorite is Nupasta made with Konjac root; rich in dietary fiber and contains no starch making it a great choice for stabilizing blood sugar. |
| Smoothie bowls made from high sugar tropical fruits (mango, pineapple, papaya, passion fruit) | Smoothie bowls made from a smaller quantity (a 1/4 cup only) of low sugar fruits (blueberries, raspberries, blackberries, cherries) paired with 1 tbsp nut butter, raw nuts, and/or chia/flax seeds. |
| Sandwich on bread or tortilla wraps | Wrap up your sandwich using napa cabbage leaves, which are super firm and nutrient-dense. You can also use collard greens or nori. You can also do lettuce wrap-style and use Boston or romaine. All of these work great! |
| Potato chips, tortilla chips, crackers, pretzels | Chop up fresh veggies to eat with guacamole or hummus instead of chips or crackers. Carrots, celery, cucumbers, bell peppers, broccoli, and cauliflower are great for dipping! |
| Rolled oats (quick-cooking oats), granola | Steel-cut oats with cinnamon, nut butter, chia seeds, and berries. You can also try overnight oats made with steel-cut oats which turns into resistant starch which resists digestion (hence the name) and doesn’t spike blood sugar. |
| Oat milk, flavored nut milk, or dairy-free milk | YES – even unsweetened oat milk can spike blood sugar because it’s still highly refined and processed! Aim for unsweetened organic almond or macadamia nut milk without any gums or preservatives. One of my favorites is Malk Organic Unsweetened Vanilla Almond or Cashew Milk. I love this brand because it only contains water, sprouted almonds, organic vanilla beans and Himalayan salt. Yep, that’s it! |
Don’t think I’m perfect – no one is. I still eat these foods occasionally or when I’m out with friends and craving something sweet. The difference is that I have just enough to satisfy me and that’s enough. This way, I don’t feel like I’m missing out and I don’t feel guilty (or physically sick) from overdoing it.
2. Protein and fat first.
It’s a simple rule with the added benefit of keeping your blood sugar under control: Eat protein and fat first. This is especially helpful if you’re in a situation where you have no control over what food is available or if you’re at a party or when eating out with friends. This helps keep your blood sugar stable and your insulin from spiking after eating [10].
A terrific idea I’ve heard is, if you’re eating out and you order chips and guacamole for an appetizer, ask your server for a side of vegetables alongside. Use the veggies for dipping before your main course (which contains protein and fat). Then, after your main course, go for the chips with the guacamole. The idea is: if you’re in a situation where there are refined carbs around and you want to have some, don’t deprive yourself. Consciously planning to eat refined carbohydrates after protein and fat keeps your blood sugar from spiking so you can still enjoy them without feeling the negative consequences.
3. Breakfast like a king – lunch like a prince – dinner like a pauper.
Eat your bigger meals earlier in the day, instead of later. When the majority of calories are eaten earlier in the day (large breakfast, medium-sized lunch, small dinner) it helps you maintain stable insulin levels and energy throughout the day [11]. This also leads to less late-night eating, better weight control, weight loss, less hunger, insulin sensitivity, lower inflammation, improved circadian rhythm, and gut microbiome composition [11,12,13].
4. Decrease your stress.
Aside from food, there are many, many factors that spike blood glucose. A significant factor that is often overlooked is stress.
All our body cares about is staying alive. That is it. It doesn’t know if you’re stuck in traffic (non-life-threatening stress) or running from a lion (life-threatening stress), both of which create a stress response. This stress response releases glucose into the bloodstream to give us energy to run from that lion and save our lives. You don’t need that shot of glucose when you’re in traffic. It’s critical that we find ways to manage our stress AKA blood sugar spikes, which cause a sudden increase in insulin. Over time, stress can take a serious toll on blood glucose regulation, insulin sensitivity, and metabolic health.
Stop your cycle of stress. Meditate, read, get a massage, breath deeply, get outside – the list goes on and on.
5. Sleep better.
Sleep is often overlooked when it comes to blood glucose control. One night of sleep deprivation in a healthy person can decrease insulin sensitivity by up to 25% [15]. That’s huge! The good news is this can be corrected easily with a good night’s sleep.
On top of this, lack of sleep causes an increase in appetite and junk food cravings. This is because your body is trying to stay awake, which it does by craving glucose (sugar). This leads to insulin resistance, inflammation, weight gain, and increased risk for chronic diseases like type 2 diabetes, obesity, cardiovascular disease, depression, pain disorders, addictive behavior, and cancer [16,17]. Yes, even cancer. Sleep is critical for blood sugar control.
For more, check out my blog post 5 Tips to Get Your Best Night’s Sleep.
6. Take an after dinner (or lunch or breakfast or any meal!) walk.
Physical activity anytime provides a wide spectrum of benefits ranging from increased bone density, muscle mass, and mobility to weight loss, longevity, and decreased risk for chronic disease. However, movement after meals gives the extra benefit of improving blood glucose control.
Walking for 30-45 minutes after a meal for at least 20 minutes can significantly improve blood glucose and insulin levels [18,19,20]. What’s more, an after meal walk will increase adiponectin—a hormone responsible for enhancing insulin sensitivity, glucose control, and fat metabolism [21].
Once you get your blood sugar under control, everything else tends to fall into place (i.e. energy, mood, weight loss, lower inflammation). With your blood sugar under control, you can spend less time focusing on your health and more time focusing on what you really love.
References:
- Czech MP. Insulin action and resistance in obesity and type 2 diabetes. Nat Med. 2017;23(7):804-814. doi:10.1038/nm.4350
- Emerging Risk Factors Collaboration, Sarwar N, Gao P, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies [published correction appears in Lancet. 2010 Sep 18;376(9745):958. Hillage, H L [corrected to Hillege, H L]]. Lancet. 2010;375(9733):2215-2222. doi:10.1016/S0140-6736(10)60484-9
- Giovannucci E, Harlan DM, Archer MC, et al. Diabetes and cancer: a consensus report. Diabetes Care. 2010;33(7):1674-1685. doi:10.2337/dc10-0666
- Łojko D, Owecki M, Suwalska A. Impaired Glucose Metabolism in Bipolar Patients: The Role of Psychiatrists in Its Detection and Management. Int J Environ Res Public Health. 2019;16(7):1132. Published 2019 Mar 29. doi:10.3390/ijerph16071132
- Mitchell AJ, Vancampfort D, Sweers K, van Winkel R, Yu W, De Hert M. Prevalence of metabolic syndrome and metabolic abnormalities in schizophrenia and related disorders–a systematic review and meta-analysis. Schizophr Bull. 2013;39(2):306-318. doi:10.1093/schbul/sbr148
- Pearson, S., Schmidt, M., Paton, G., Dwyer, T., Blizzard, L., Otahal, P., Venn, A. Depression and insulin resistance: a cross-sectional association in young adults. Diabetes Care. 2010. 33(5):1128-1133. https://doi.org/10.2337/dc09-1940
- Tsai, C.J., et al., Macronutrients and insulin resistance in cholesterol gallstone disease. Am J Gastroenterol, 2008. 103(11): p. 2932-9; Mendez-Sanchez, N., et al., Metabolic syndrome as a risk factor for gallstone disease. World J Gastroenterol, 2005. 11(11): p. 1653-7.
- Nakeeb, A., et al., Insulin resistance causes human gallbladder dysmotility. J Gastrointest Surg, 2006. 10(7): p. 940-8; discussion 948-9.
- Hsu, C.S., et al., Increasing insulin resistance is associated with increased severity and prevalence of gastro-oesophageal reflux disease. Aliment Pharmacol Ther, 2011. 34(8): p. 994-1004.
- Shukla, A., Iliescu, R., Thomas, C., Aronna, L. (2015). Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels. Diabetes Care. 2015;38(7):e98-e99. https://doi.org/10.2337/dc15-0429
- https://www.endocrine.org/news-and-advocacy/news-room/2018/highenergy-breakfast-promotes-weight-loss-helps-reduce-total-daily-insulin-dose-for-type-2-diabetes
- Leidy HJ, Hoertel HA, Douglas SM, Higgins KA, Shafer RS. A high-protein breakfast prevents body fat gain, through reductions in daily intake and hunger, in “Breakfast skipping” adolescents. Obesity (Silver Spring). 2015;23(9):1761-1764. doi:10.1002/oby.21185
- Galgani JE, Moro C, Ravussin E. Metabolic flexibility and insulin resistance. Am J Physiol Endocrinol Metab. 2008;295(5):E1009-E1017. doi:10.1152/ajpendo.90558.2008
- Harris ML, Oldmeadow C, Hure A, Luu J, Loxton D, Attia J. Stress increases the risk of type 2 diabetes onset in women: A 12-year longitudinal study using causal modelling. PLoS One. 2017;12(2):e0172126. Published 2017 Feb 21. doi:10.1371/journal.pone.0172126
- Esther Donga, Marieke van Dijk, J. Gert van Dijk, Nienke R. Biermasz, Gert-Jan Lammers, Klaas W. van Kralingen, Eleonara P. M. Corssmit, Johannes A. Romijn, A Single Night of Partial Sleep Deprivation Induces Insulin Resistance in Multiple Metabolic Pathways in Healthy Subjects, The Journal of Clinical Endocrinology & Metabolism, Volume 95, Issue 6, 1 June 2010, Pages 2963–2968, https://doi.org/10.1210/jc.2009-2430
- Spiegel K, Knutson K, Leproult R, Tasali E, Van Cauter E. Sleep loss: a novel risk factor for insulin resistance and Type 2 diabetes. J Appl Physiol (1985). 2005;99(5):2008-2019. doi:10.1152/japplphysiol.00660.2005
- Institute of Medicine (US) Committee on Sleep Medicine and Research; Colten HR, Altevogt BM, editors. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington (DC): National Academies Press (US); 2006. 3, Extent and Health Consequences of Chronic Sleep Loss and Sleep Disorders. Available from: https://www.ncbi.nlm.nih.gov/books/NBK19961/
- Reynolds AN, Venn BJ. The Timing of Activity after Eating Affects the Glycaemic Response of Healthy Adults: A Randomised Controlled Trial. Nutrients. 2018;10(11):1743. Published 2018 Nov 13. doi:10.3390/nu10111743
- Frampton, J., Cobbold, B., Nozdrin, M. et al. The Effect of a Single Bout of Continuous Aerobic Exercise on Glucose, Insulin and Glucagon Concentrations Compared to Resting Conditions in Healthy Adults: A Systematic Review, Meta-Analysis and Meta-Regression. Sports Med (2021). https://doi.org/10.1007/s40279-021-01473-2
- Chacko E. Exercising Tactically for Taming Postmeal Glucose Surges. Scientifica (Cairo). 2016;2016:4045717. doi:10.1155/2016/4045717
- Achari AE, Jain SK. Adiponectin, a Therapeutic Target for Obesity, Diabetes, and Endothelial Dysfunction. Int J Mol Sci. 2017;18(6):1321. Published 2017 Jun 21. doi:10.3390/ijms18061321
