My Top 5 Strategies for Healing Blood Sugar ProblemsRoland Pankewich, CNP May 1, 2016
The Role of Supplements, Low-glycemic Carbs, and Exercise
When we think of blood sugar problems, the most common association is with diabetes and the need for insulin. While blood sugar does play a central role in the management of that condition, most people would be surprised to know just how crucial blood sugar management is to all aspects of health and wellbeing. To give proper context to what I mean by this, let’s examine exactly what blood sugar is, and how we can focus on specific aspects to control it.
Blood sugar is the concentration of glucose within the body’s circulation at a given time, or put simply, the amount of digested carbohydrate we have in our blood. The body tries to keep it within a healthy range (typically 5 – 5.5 mmol/L or 90mg/dl) in a normal state, depending on which unit of measure your medical professional uses. Blood sugar will rise and fall in reaction to food consumption and will always have a large response based upon the amount of carbohydrates we consume. Carbohydrates are the main fuel which gets converted to glucose; this in turn is used as currency for all energy processed within the body. The actual amount of blood sugar in circulation at any one time is surprisingly low; 5.5 mmol/L in an average sized human amounts to roughly 5 grams. The reason we want to keep blood sugar within a tightly regulated window of control is that in high concentrations it can be dangerously harmful to our health.
Excessively high blood glucose levels can promote a whole host of associated side effects, none of which will help one live longer or healthier. The main reason the body wants to keep blood sugar levels on the lower side is because in high concentrations it’s actually toxic to the body. Luckily there is a built-in mechanism to deal with elevated levels, but that too comes with consequences. Humans have the ability to store glucose in the body in the form of glycogen which is just a series of linked glucose molecules. The muscular system is the largest site of glycogen storage which can hold up to 500 grams, followed by the liver which has the potential to store up to 100 grams. These variables are dependent on a multitude of factors which include: age, gender, physical size, endocrine sensitivity, and activity level. Muscle glycogen is a strategic site of storage for intense bursts of activity, which is why specific types of exercise can be so beneficial for blood sugar management. Muscle glycogen does not contribute to the regulation of blood sugar levels.
How the Body Handles Excess Sugar
Liver glycogen is our tool of regulation for blood sugar as this organ will either be storing glucose in the form of glycogen, or breaking down glycogen to release glucose into the bloodstream if needed. So the question becomes, when does this become a problem? Well, if we examine our storage potential we see that we can store a maximum of 600 grams of glycogen, so what happens if we continue to eat high amounts of carbs after we are essentially stocked full? In this situation, the body’s fail-safe mechanism is a process of conversion where glucose is stored in adipose tissue, more commonly known as body fat. Because we have a finite amount of glycogen storage capacity, and since high levels of blood sugar are both toxic and dangerous, the body in its wisdom will convert excess glucose to fatty acids in the liver and send them out in the bloodstream to be delivered to fat cells for storage.
The resulting weight gain is not the only issue we run into when it comes to the body’s effort to control excess blood sugar levels. In an attempt to get rid of excess blood sugar the body will “stick” sugars to proteins in a process called glycation. This process will render these essential proteins useless because they no longer resemble proteins which the body recognizes. This can contribute to metabolic disruption as well as accelerated aging from free radical damage.
Other conditions which can arise from chronic excess intake of sugar and carbohydrates include:
- insulin resistance, which results from excessive secretion and requirements of insulin to help control blood sugar elevation;
- increased levels of inflammation in the body;
- hypoglycemia which happens as a result of excessive blood sugar spikes and dips;
- elevated blood cholesterol and triglycerides;
- increased risk of Type 2 diabetes.
Newer research is showing that continuous challenges to glucose metabolism are also associated with neurodegenerative diseases and cognitive decline. In medical circles, Alzheimer’s is now being referred to as ‘Type 3 Diabetes.’ Fundamentally the human body was meant to have a very specific relationship with glucose and we as a society have unfortunately blurred the lines between necessary and excess. The leading causes of death in North America, which are heart disease and cancer, both have very strong ties to metabolic malfunction. To make an even stronger case, the rise in neurodegenerative disease development has a connection with the shift in consumer shopping habits. The question now becomes, what do we do about managing our blood sugar?
The solution to this problem, I believe, lays in the core decisions which will make the most impact, and then specific add-ons that will help in acute situations.
1) Reduce carbohydrate consumption: The big fundamental move that everyone who struggles with blood sugar management (especially in the case of obesity) can execute is to reduce carbohydrates in the diet. There are numerous health professionals who are supporting the new wave of lower-carb dieting, which I personally suggest with my clients. Knowing that we can only store a finite amount of glycogen is one side of the story. The other side is that our bodies are designed to burn fat for energy during periods of low-to moderate levels of activity (So this means everything from sitting at a desk to walking around.) We still need to sustain blood sugar but that can easily be done with the right kinds of foods – root vegetables, select gluten-free grains, low-fructose fruits, and non-starchy vegetables are my favourite options.
So focusing on consuming healthy fats as a basis of the diet, and removing sugars, high starch foods, and reducing the total quantity of carbohydrates is the foundational piece. Foods like avocado, nuts and seeds, cold pressed oils, coconut, and even butter are rich in healthy fats and other nutrients and much more satisfying to help curb food cravings. Most importantly they have minimal effect on blood sugar elevation!
From this foundational point we can implement some ‘added value’ habits to help keep blood sugar in check.
2) Choose Low-Glycemic Carbs: The first of these is to only consume carbohydrates with a low glycemic load. The glycemic load is a measure of how fast a specific carbohydrate will raise blood sugar, in relation to serving size, which is far more impactful than just how fast it raises blood sugar. This is the reason why eating a bowl of watermelon with a high glycemic rating will be far less impactful on blood sugar than a big serving of quinoa or sweet potato with a lower glycemic rating but much higher glycemic load. The watermelon might convert into glucose very quickly, but since a bowl of watermelon might have only 10 to 12 grams of carbohydrates whereas a large serving of quinoa might have 50 to 60 grams of carbs, the body will experience much different effects in terms of blood sugar regulation.
Foods with a low glycemic rating typically have a higher ratio of fibre-to-carbohydrates, as fibre cannot be digested into energy. This lends the benefit of slowing the speed at which we digest and absorb glucose into our system, and helps control blood sugar spikes. This suggestion is also connected to the idea of avoiding consumption of carbohydrates by themselves. Using the same example of quinoa or root vegetables, combining them with protein and fat will slow down their conversion to blood sugar, and reduce the risk of blood sugar spikes. This will also go a long way to help improve satiety and prevent you from getting hungry sooner, which I use as a subjective clinical symptom of blood sugar tolerance.
Beyond diet management, there are a couple of lifestyle “hacks” we can include to have a synergistic effect.
3) Do High Intensity Exercise: When we exercise intensely, the body burns glucose for energy which has the benefit of helping us empty glycogen stores. High intensity exercise also improves the insulin sensitivity of cells which will result in less conversion of glucose to adipose tissue. Lifting weights, sprinting, hill running – any activity which cannot be done with sustained intensity beyond 60 to 120 seconds will be very beneficial for glucose disposal.
4) Take Supplements to Aid Blood Sugar Balance: We can use specific supplements in the form of food and nutrients. Spices like cinnamon have the ability to help lower the glycemic index of a meal, and as an added benefit taste wonderful on roasted root vegetables. Different kinds of fibre can also help manage how fast carbohydrates enter into the bloodstream, and also make you feel full sooner by increasing the volume in your stomach so it’s harder to overeat.
Lastly, my three favourite supplements for improving metabolism are: B-vitamins, chromium, and l-carnitine. These nutrients all help improve energy metabolism, aid in insulin sensitivity, and in the case of l-carnitine, improve fat metabolism:
• Chromium is a trace mineral that works to improve the mechanisms of blood sugar control. It helps to facilitate the uptake of glucose into cells and is the key element in ‘glucose tolerance factor.’ Without proper levels of chromium in the diet, insulin’s action is blocked at the cellular level and blood sugar levels can remain elevated. My recommended dosage for weight loss is 400 mcg per day with food, preferably carbohydrates and protein.
• Cinnamon is getting popular due to its insulin-sensitizing effect as it has a moderately high content of chromium along with specific polyphenols which improve insulin signaling and glucose control. What this means is that simply adding cinnamon to carbohydrate-based foods can help with blood sugar response. Research showed that cinnamon reduces mean fasting serum glucose (18-29%), TAG (23-30%), total cholesterol (12-26%) and LDL-cholesterol (7-27%) in subjects with Type 2 diabetes after 40 days of daily consumption of one to six grams of cinnamon.
• L-Carnitine is an amino acid used by the body to help transport fat into our mitochondria for energy utilization. Fatty acids cannot enter directly into the mitochondria and without l-carnitine as an essential carrier, it would be impossible to burn fat for energy. Carnitine is most beneficial in a lower carb state when the body would turn to fatty acid metabolism as a primary fuel source. Optimal dosages rage from 1,500 – 4,000 mg on an empty stomach.
• B-vitamins are essential for energy metabolism and can be used as an insurance policy to maximize the efficiency of converting calories to ATP (the energy currency of our body). Deficiencies in B-vitamins can result in poor energy metabolism which, in and of itself, can sabotage exercise capabilities and cause a reduction in physical performance. Taking a good B-complex is the best idea so that the ratios of all of the different vitamins are in balance.
5) Reduce the Stressors in Your Life: Stress pushes us out of balance and will promote weight gain and blood sugar dysregulation. Finding ways to calm the nervous and endocrine systems will be a huge benefit as these two are intimately connected to metabolism and will help sustain the vicious cycle if not managed. High stress=high blood sugar, which promotes hypoglycemia and then cravings for sugary foods. This can then promote weight gain, insulin resistance, and so the cycle goes. Finding out what stress management means to you is vital, as not everyone can meditate, do tai-chi, or practice yoga. Within the spectrum of options, something exists for everyone, and committing to that will be crucial to long term success.
As you can see, when we understand what contributes to blood sugar imbalance, the decisions we make to help restore balance become much easier. The right kinds of carbs, plenty of healthy fats, vigorous exercise, and staying in balance from a mental perspective are all great initial steps in the march back to metabolic health.
Catch Roland Pankewich at the Institute of Holistic Nutrition's OPEN HOUSE on May 28, 2016. At 1:30 pm he will give a talk on “Optimal Sugar Balance Through Nutrition”. All are welcome to attend. Admission is FREE. The Open House will take place at IHN’s North York Campus, located at 18 Wynford Drive, suite 514, just east of Don Mills, in Toronto. There are additional lectures starting at 9:30 am and running until 3:30 pm; all are welcome. Light refreshments will be served. For more information call (416) 386-0940, or visit: http://www.instituteofholisticnutrition.com
– On glycation: http://tinyurl.com/jf7djkw
– On muscle glycogen breakdown: http://tinyurl.com/zgjkp4n
– On chromium for insulin resistance: http://tinyurl.com/jemexyn
– The Encyclopedia of Nutritional Supplements by Dr. Michael Murray
Roland Pankewich is a Certified Nutritional Practitioner and faculty member at the Institute of Holistic Nutrition. He runs a clinical practice focusing on optimizing health and metabolic function. He can be reached at Roland@peakperformance athletics.ca for all inquiries about blood sugar and other metabolic diseases.