Healthy weight… what’s blood sugar got to do with it?

In short, everything. Keeping blood sugar, or glucose, balanced is so important to health that our bodies have a tightly regulated system of hormones to ensure levels stay within a very narrow range. When you eat sugary foods and simple carbs like bread, pasta, bagels, white rice, potato chips, etc., they are rapidly digested and converted into glucose, which can lead to sharp spikes in blood sugar. The pancreas responds by releasing a surge of insulin, the hormone that directs the glucose into the cells to either be burned for energy or stored; this removes excess glucose from the bloodstream, bringing blood sugar levels back to a normal range. When sugar and/or refined carbs are occasionally consumed in small amounts, this is an effective system. But when these types of foods are regularly consumed (looking at you, typical American diet), the body is constantly struggling to keep blood sugar levels in a normal range by continually pumping more insulin into the bloodstream.

Think of insulin as a key that helps unlock your cells to absorb the glucose circulating in your bloodstream to use for energy. When your cells are so full of glucose that they can’t absorb anymore, insulin signals the body to store the excess as fat. This is the problem with eating an excessive amount of carbs—when there is too much glucose in the blood and cells are saturated and can no longer take in glucose (because we can only burn a certain amount of energy at a time), the healthiest thing insulin can do with it is signal the body to store it as fat for future energy use. Chronically elevated insulin is also a potential cause of leptin resistance; leptin is the hormone that tells your brain you are full and to stop eating (it is sometimes called the “satiety hormone), and also regulates how energy is burned.^{1 2} All of this can lead to weight gain.

But insulin is not the villain in this story—it is doing exactly what it’s supposed to do. A carb-heavy diet is the culprit.

How to achieve healthy blood sugar balance… you are what you eat

Blood sugar and insulin levels are directly related to what you eat, so by shifting away from a diet built on a foundation of refined grains, starchy foods like white potatoes and white rice, sugary sodas and coffee drinks, and breads and sweets, to a lower carb diet built around an abundance of low-starch vegetables, healthy fats, and moderate amounts of quality protein, you can maintain healthy blood sugar and insulin levels. Most of us eat an excessive amount of carbohydrates—more than our bodies need, or can handle, which can cause dramatic spikes in glucose and insulin and leads to fat storage rather than fat burning. To maintain healthy blood sugar aim to get between 100 and 150 grams of carbs each day (the average American eats between 350 and 600 grams of carbs each day, mostly in the form of refined, processed sugars and grains).^{3 4} If you work to get the majority of your carbs from non-starchy vegetables, a moderate amount from moderate-carb veggies like winter squash, beets, and green peas, and a small amount of higher-carb veggies like potatoes, parsnips, and sweet potatoes, you will easily fall into this range. Add in healthy fats and a moderate amount of quality protein with each meal, and you’re on your way to healthy blood sugar balance—and a healthy weight.

Walk Your Way to Healthy Blood Sugar Balance

A healthy diet goes hand-in-hand with regular physical movement for maintaining healthy blood sugar and a healthy weight. Regular movement increases insulin sensitivity and helps the cells effectively use glucose. And it doesn’t have to be strenuous, or long: A study published in 2022 found that walking at a “light intensity” for as little as two to five minutes throughout the day blunted the rise in glucose and lead to more stable insulin levels. The researchers looked at the results of seven studies comparing the impact of sitting, standing, and walking on the body’s blood sugar and insulin levels. The best results were found in those who walked for at least five minutes intermittently throughout the day, for a total of about 30 minutes. Surprisingly, even taking standing breaks throughout the day had a positive effect on blood sugar, though not as significantly as walking.²²

Supplements to help maintain healthy blood sugar balance

While diet and exercise are vital for maintaining healthy blood sugar balance, there are also some key supplements that will give you extra support.

B-complex vitamins

This family of vitamins is intricately tied to cellular energy production via their role in metabolizing carbohydrates and sugars. When you eat an excess of grain-based carbs and other high carb foods your body quickly burns through the B vitamins to keep up, which can drastically deplete levels. When these important cofactors are missing, blood sugar imbalances can occur.⁵

MCTs

There are several hormones that come into play when it comes to appetite, satiety, and blood sugar balance; one of these is glucagon-like peptide-1 (GLP-1). One of GLP-1’s main roles is to stimulate the first-phase insulin response, which is essential for preventing the development of type-2 diabetes. It has also been reported to suppress appetite, slow gastric emptying, and promote burning of fat for energy. In studies, MCTs ingested before meals were shown to lower post-prandial (post-meal) blood glucose levels, improve glucose metabolism by increasing GLP-1 blood levels, and suppress appetite. Studies have used 10-20 grams of MCTs before meals. When first starting MCT oil, start slowly, working your way up to the full serving.^{6 7 8}

L-glutamine

The amino acid L-glutamine has also been found to increase GLP-1, as well as improve the first phase insulin response. The body releases insulin in two phases after eating—the first phase is a brief spike that lasts about 10 minutes, but is critically important in preventing major glucose spikes; a reduced first phase insulin response is a sign of poor glucose metabolism, and some believe it’s one of the first steps to developing type-2 diabetes.  One study using 25 grams of L-glutamine in type-2 diabetics found that the amino acid restored the first phase insulin response, preventing major spikes in blood sugar after eating. In another study, 30 grams of L-glutamine had a positive effect on blood glucose metabolism in “lean, obese, and type-2 diabetic subjects,” in part by increasing GLP-1 levels.^{10 11} Note: From studies, it appears that glutamine taken just before or with a meal is the most effective way to support the first phase insulin response.

Alpha-lipoic acid

One of this antioxidant’s important roles in the body is to support insulin function and research has shown that supplementation significantly decreases fasting glucose, insulin, and insulin resistance in a dose-dependent manner, that is, higher doses led to more significant decreases (daily doses ranged from 300 to 1,200 mg).^{12 13}

Berberine

Research has shown that the plant extract berberine lowers fasting glucose and insulin levels, post-prandial glucose (glucose levels after eating), and triglycerides. It also improves insulin resistance and stimulates the breakdown of glucose. It is one of few natural compounds that activates an enzyme in our cells called adenosine monophosphate-activated protein kinase (AMPK). AMPK is sometimes referred to as a metabolic “master switch” and regulates how energy is produced and used in the body; activation of the enzyme increases glucose uptake and fat burning for energy. Most studies have used between 1,000 and 1,500mg in divided doses daily; the biggest benefits are seen when berberine is taken 15 to 20 minutes before eating.^{14 15 16 17 18 19}

Healthy Blood Sugar by the Numbers

Fasting glucose is a measure of your blood sugar when you have not eaten and provides a snapshot of how well your body manages blood sugar. It’s long been thought that a normal range is 65 to 100 mg/dL, however, functional medicine experts define the optimal range as 82 to 88 mg/dL. This is because damage begins to occur in the body when blood sugar consistently stays over 88 mg/dL, the high end of “normal.” For example, one study found that fasting blood sugar in the high end of the normal range was associated with increased arterial stiffness in otherwise healthy subjects.²⁰ Another study found that subjects with blood glucose levels of 95 to 99 mg/dL (again, high end of normal) were twice as likely to develop diabetes. Each milligram per deciliter increase of fasting blood glucose increased diabetes risk by six percent.²¹

References

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10. Samocha-Bonet D, Chisholm DJ, Holst JJ, Greenfield JR. L-Glutamine and Whole Protein Restore First-Phase Insulin Response and Increase Glucagon-Like Peptide-1 in Type 2 Diabetes Patients. Nutrients. 2015; 7(4):2101-2108. https://doi.org/10.3390/nu7042101
11. Jerry R Greenfield, I Sadaf Farooqi, Julia M Keogh, Elana Henning, Abdella M Habib, Anthea Blackwood, Frank Reimann, Jens J Holst, Fiona M Gribble, Oral glutamine increases circulating glucagon-like peptide 1, glucagon, and insulin concentrations in lean, obese, and type 2 diabetic subjects, The American Journal of Clinical Nutrition, Volume 89, Issue 1, 2009; https://doi.org/10.3945/ajcn.2008.26362 .
12. Porasuphatana S, Suddee S, Nartnampong A, et al. “Glycemic and oxidative status of patients with type 2 diabetes mellitus following oral administration of alpha-lipoic acid: a randomized double-blinded placebo-controlled study” Asia Pac J Clin Nutr. 2012;21(1): 12-21 https://pubmed.ncbi.nlm.nih.gov/22374556/
13. Akbari M, Ostadmohammadi V, Lankarani K, et al. “The effects of alpha-lipoic acid supplementation on glucose control and lipid profiles among patients with metabolic diseases: A systematic review and meta-analysis of randomized controlled trials.” Metabolism, Oct 2018; 87:56-69 https://pubmed.ncbi.nlm.nih.gov/29990473/
14. https://www.naturalmedicinejournal.com/journal/2012-12/clinical-applications-berberine
15. Gottfried S, MD. “Berberine, Blood Sugar and Weight Loss” Oct 19, 2015 https://www.saragottfriedmd.com/for-the-love-of-berberine-what-it-is-and-why-i-take-it-to-lower-blood-sugar-bad-cholesterol-and-weight-plus-5-faqs/
16. Zhang Y, Li X, Zou D, et al. “Treatment of Type 2 Diabetes and Dyslipidemia with the Natural Plant Alkaloid Berberine” The Journal of Clinical Endocrinology & Metabolism, July 2008; 93(7): 2559-2565 https://academic.oup.com/jcem/article/93/7/2559/2598635
17. Bing P, Lin-Hua Z, Qiang Z, et al. "Application of Berberine on Treating Type 2 Diabetes Mellitus" International Journal of Endocrinology, 2015, vol. 2015 https://www.hindawi.com/journals/ije/2015/905749/
18. Yin J, Xing H, Ye J. “Efficacy of Berberine in Patients with Type 2 Diabetes” Metabolism, May 2008; 57(5): 712-717. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2410097/
19. Schor J, ND. “Clinical Applications for Berberine.” Natural Medicine Journal, Dec 2012;(4)12 https://www.naturalmedicinejournal.com/journal/2012-12/clinical-applications-berberine
20. Shin JY, Lee HR, and Lee DC. “Increased arterial stiffness in healthy subjects with high-normal glucose levels and in subjects with pre-diabetes.” Cardiovascular Diabetology, April 15, 2011; 10(30) https://link.springer.com/article/10.1186/1475-2840-10-30
21. Nichols GA, Hillier TA, and Brown JB. “Normal fasting plasma glucose and risk of type 2 diabetes diagnosis.” Am J Med. June 2008;121(6): 519-24 https://pubmed.ncbi.nlm.nih.gov/18501234/
22. Buffey, A.J., Herring, M.P., Langley, C.K. et al. The Acute Effects of Interrupting Prolonged Sitting Time in Adults with Standing and Light-Intensity Walking on Biomarkers of Cardiometabolic Health in Adults: A Systematic Review and Meta-analysis. Sports Med 52, 1765–1787 (2022). https://doi.org/10.1007/s40279-022-01649-4  

References