Let's talk blood sugar…
This is a transcript from the Nourished Practice podcast.
Today I wanted to discuss something I get asked about a lot when I meet people - they find out I’m a nutritionist and ask me my opinion on a certain product with girls name… and I mostly say I don’t support it, it’s not my area of expertise and point out that a lot of nutritionists work at / for said company - at one point I couldn’t go a week without a jobs alert for the company as they expanded their workforce. So the water is a little muddy in terms of fact vs. fiction. For this reason i wanted to add a little more detail to back up my common response of “you don’t need a glucose monitor unless you’re diabetic” and hopefully help if you’re confused…
First things first - blood sugar 101
Unless you have diabetes your body will naturally react to your blood sugar levels. Say you eat something sugary, your pancreas will create a hormone called insulin. Insulin will move sugar from the bloodstream to muscle, liver and fat cells to be used in future. If your insulin levels are low, sugar is released back into your blood. In between meals insulin levels are low (basal / background insulin levels) and so sugar is released and is fairly constant around 60 to 100 mg/dl. After you eat your blood sugar can spike to around 140 mg/dl before returning to baseline - but they do return to baseline.
Our body is ridiculously clever at maintaining homeostasis - normal levels. When our body produces insulin we also produce a hormone called Amylin - in a ratio of 1:100. Amylin increases our body’s level of satiety (fullness) from a meal and slows down our stomach emptying to avoid spikes of blood sugar. See, clever. But we think we know better with some new(ish) technology. I mean, diabetics have used monitors (the finger prick tests mostly) since the 1970s but there’s been a recent boom in commercial glucose monitors. We used to need a prescription to get one, but not anymore.
Our body has lots of sensitive receptors to let us know when our levels are too low or too high. Shah (2019) found that among 153 people in the study (aged 7-80) 96% had blood sugar in the ‘normal’ range with some of the abnormal levels being deemed implausible. So we’re quite good at keeping levels normal, unless we have diabetes. Which is a whole other topic, and there’s plenty of diabetes specific nutritionists that can go into that…
So, do the monitors work?
Long story short, yes. In that they measure / monitor your blood glucose.
How do the monitors work - they use tiny filaments / sensor wires that pierce the skin and assess your blood sugar levels - the patch stays in place, hence why you’ll see people walking around with a white patch on the back of their arm. Alternatives can be placed on the abdomen.
But there’s no evidence that they have health benefits. There’s no studies as of yet to support their use - or a positive effect other than anecdotal and the implied benefit of maybe being able to spot diabetes earlier (or prediabetes) in those who have high blood sugar but don’t yet meet the threshold for diabetes.
So why are we being convinced we need these monitors?
Not to be the boy who cried wolf but diet culture is at it again / mostly it’s to make money. That’s what all companies are for, sorry. And for some it is in earnest, if your favourite influencer is sharing their experience using these monitors they may believe they’re 100% helping their health but obsessing over glucose levels may be at detriment to your mental and physical health. Because more knowledge can be beneficial, but knowledge shouldn’t become a rule.
Why can I measure steps but not my blood sugar - isn’t that hypocritical
Touche eh, but I have the same outlook with step counters. I love competing with friends very tongue in cheek about how many steps I’ve done. But it’s never a HAVE to, or that I’m somehow less if I don’t hit 10,000 steps. It’s something I can use but don’t have to. Blood sugar is avoidable as it’s monitored and many work via alerts.
Should I be worried if I have a sweet tooth?
Snap, you’re speaking to (in the reading words of way) someone who has such a sweet tooth. But like I said your body is quite smart, it will secrete more insulin to help. As with anything food related, eating only sugar for every meal of everyday - not recommended. But we all tend to eat a varied diet naturally unless it’s something off limits. Telling yourself you can’t have sugar is 100% the best way to ensure you eat a fair amount of it.
Gentle Nutrition + Sugar
So you want something sugary…
Is there anything else you’d want to add to this meal to make it 1. More satiating, 2. Contain multiple macronutrients e.g. adding protein and fat to carbohydrate heavy meals can help.
What type of hunger is acting here - do you want the comfort of sugar? Or the feeling of rebelling against a diet? Is it a certain texture or sensory experience?
Remove the guilt. It’s sugar, you haven’t killed anyone.
Are you running low on energy in other areas e.g. when low on sleep we often turn to sugary drinks to help. How can you help in these areas? e.g heading to bed earlier, having some no screen time, noticing areas of stress in your life.
Are you on a diet / restricting - not only is this a case of off limits = I want it. But if you’re low on calories chances are you’re low on energy, so the urge for sweet foods might help.
Foods with a low glycemic index, higher fibre content and some fat in your meals can all help stabilise blood sugar.
Also remember most foods will affect your blood sugar, whether that’s fruit, vegetables or a dessert. No food is good or bad. It’s just something your body reacts to and breaks down. The only time you may need to work through your relationship with sugar is if it’s the only thing you want to eat, and you feel out of control around it.
Did you know - Intuitive eating is associated with better blood sugar management in those with type 2 diabetes and there’s a range of Intuitive Eating professionals who specialise in diabetes and Intuitive Eating.
A reminder my Gentle Nutrition 101 guide is on sale currently.
Some common questions -
“What about when I’m on a low carb diet, I’ve heard we can use fat for fuel” - Yes technically, but when your body uses fat / protein and creates ketoacids (hence the diet name keto) - this uses a lot of oxygen and takes longer so isn’t recommended when exercising or needing quick fuel. Those with diabetes have to be careful of keto-acidosis when the body becomes reliant on fat cells as fuel without insulin.
“I’m a runner / cyclist / endurance athlete” - should I be worried about sugar. Only in terms of your teeth - those gels and bars can affect tooth health. But sugar while training / performing helps fuel your performance and allows quick release energy
So, should I use one?
I will never tell you 100% yes or no, if you want to use one then go ahead. But monitor things like, are you becoming obsessive? Are you starting to add food rules into what you eat, or avoiding social occasions due to sugar?
On the 16th March this year the BBC shared an article titled ‘Doctors question science behind blood sugar diet trend’ so maybe the tide is turning?
Want some help? Click that ‘work with me’ button.
