In honor of Diabetes Awareness Month, I decided to highlight the importance of blood sugar balance here. It is very close to my heart as I recently said good-bye to my grandfather who lived with T2-diabetes for decades.
As most modern diets contain a surplus , sugar is a topic of discussion in nearly all of my office visits. Often when I ask about sources of sugar in an individual’s diet, what comes to mind for most is candy, desserts, soda and baked sweets. Most people understand that soda and candy aren’t healthy. But often people are surprised when I ask how much fruit and what types of fruit they eat in the day. Or how many servings of refined grain-based carbohydrates they consume.
While our body needs a certain amount of sugar in the form of glucose to survive, added sugars such as fructose, sucrose, dextrose, etc. can pose significant health problems over time. Regularly eating foods higher in added sugars can create a physical dependency that drives cravings, energy crashes, sleep issues, and over time can lead to conditions such as prediabetes, overweight, heart disease, adrenal fatigue, hormonal imbalance (i.e. PCOS), candida overgrowth, etc.
Although a one-off indulgence will not overtly harm to your body, knowing how to balance sugars in the diet is key to preventing disease down the road.
Processing Sugar & Its Bodily Impact
When we eat something high in sugars or carbohydrates, our brain’s reward pathway is turned on and the body produces a set of hormones including serotonin, dopamine and endorphins that promote a sense of happiness in the body. This association of happiness from eating sugary foods is then imprinted in the amygdala (i.e. the association center of the brain) and committed to the hippocampus (i.e. the memory center of the brain). Repeated exposure to this stimulus leads to an addiction, which can be extremely challenging to overcome.(1)
In addition to the brain’s response to sugar consumption, the body is affected metabolically from its presence. When sugar or high carbohydrate foods are eaten, blood sugar levels spike and a hormone called insulin is secreted from the pancreas. Insulin’s chief objective is to remove that sugar from the blood stream and bring it to your tissues to burn as fuel and add to storage. Once glucose is delivered to the tissues, your blood sugar levels go down until the next time you eat.
Over time, the highs and lows of sugars in the blood throughout the day can lead to blood sugar dysregulation and eventually insulin resistance.
Insulin resistance prevents glucose in the blood from being stored in muscle and fat cells and, instead, ensures that the glucose in the blood stream stays there. This sustained elevation in blood glucose can lead to diabetes as well as immune system dysfunction, cognitive impairment, inflammation, increased cancer risk, obesity, and worsened anxiety, depression and schizophrenia.(1)
Curb Cravings & Optimize Healthy Balance
The holidays are nearly here and it can definitely be challenging to avoid sugar when gathering with friends and family. Be kind to yourself during this time and do what you can! For those interested, here are a few ideas to get you started:
1. Protein + Fiber
Ideally when we eat, there should be some form of protein and/or fiber in the snack or meal. Protein in the diet not only increases satiety to prevent sugar cravings but, along with fiber, it has been shown to delay the time needed for glucose to enter the blood stream. Therefore, it helps to balance substantial blood sugar and insulin spikes after you eat.(2)
A few snack ideas that fit this pairing principle include:
Chopped veggies (i.e. carrots, cucumbers, peppers, celery) with hummus or black bean dip
½ cup of Greek yogurt with ¼ cup of berries and 1-2 tbsp of ground flax or chia seeds
Apples or celery with 2 tbsp of nut butter
Trail mix including nuts, coconut flakes or chocolate chips, & roasted pumpkin seeds with cinnamon
Personally, when cooking or baking I like to add ground flax or other seeds to most recipes to provide a nutritious source of fiber & protein. I also typically cut recommended sugar content in 1/2 and include alternatives to cane sugar such as coconut flakes or honey whenever possible!
2. Exercise
Exercise is a key pillar of health that has a positive impact on nearly all facets of our well-being, including our metabolism and healthy blood sugar regulation. Engaging your muscles pushes them to utilize the glucose in their cells for energy. Using the sugar for energy then increases the demand for more glucose to enter the cells, taking it from the blood stream.(3) This effect is greater the more frequently and vigorously you exercise. But that said, the most important thing is to move! Therefore, I encourage you to find a form of movement that is most appealing to you and feels good for your body.
3. Berberine
Berberine is a bitter compound that can be found in numerous herbs including goldenseal (Hydrastus canadensis), Oregon grape (Berberis aquifolium), barberry (Berberis vulgaris), etc. Research shows it is capable of increasing the number of insulin receptors on cells to take glucose out of the blood stream as well as activate AMPK, which helps transfer glucose from the blood into muscle cells.(5)
Published in 2008, a pilot study showed that 3-months of Berberine supplementation resulted in lower fasting and post-meal blood sugar levels similar to metformin in those with type 2 diabetes mellitus.4 Additionally, studies have shown it to be therapeutic in those with PCOS, hypertension, and high cholesterol due to its glucose balancing and insulin sensitizing effects.(6,7)
4. Cinnamon
A perfect spice for the season, Cinnamon has been shown to have mild insulin regulating and blood sugar lowering effects.(8) I encourage my patients to use it freely during the holidays, as it can serve as simple and tasty dietary add-in to support blood sugars, especially for those already on hypoglycemic medications.
To learn more about which optimization & management strategies will be best suited for your body and lifestyle needs, please feel free to connect with me or ask your Naturopathic doctor at your next visit!
Disclaimer: this information is meant for educational purposes only, and should not be used as a replacement for professional medical advice.
In honor of November as Diabetes Awareness Month and all those living with Diabetes.
References:
1. Jacques A, Chaaya N, Beecher K, Ali SA, Belmer A, Bartlett S. The impact of sugar consumption on stress driven, emotional and addictive behaviors. Neurosci Biobehav Rev. 2019;103:178-199.
2. Bae JH, Kim LK, Min SH, Ahn CH, Cho YM. Postprandial glucose-lowering effect of premeal consumption of protein-enriched, dietary fiber-fortified bar in individuals with type 2 diabetes mellitus or normal glucose tolerance. J Diabetes Investig. 2018;9(5):1110-1118.
3. Sylow L, Kleinert M, Richter EA, Jensen TE. Exercise-stimulated glucose uptake - regulation and implications for glycaemic control. Nat Rev Endocrinol. 2017;13(3):133-148.
4. Yin J, Xing H, Ye J. Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism. 2008;57(5):712-717. doi:10.1016/j.metabol.2008.01.013
5. Coughlan KA, Valentine RJ, Ruderman NB, Saha AK. AMPK activation: a therapeutic target for type 2 diabetes?. Diabetes Metab Syndr Obes. 2014;7:241-253. Published 2014 Jun 24. doi:10.2147/DMSO.S43731
6. Xie L, Zhang D, Ma H, et al. The Effect of Berberine on Reproduction and Metabolism in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Control Trials. Evid Based Complement Alternat Med. 2019;2019:7918631. Published 2019 Dec 13. doi:10.1155/2019/7918631
7. Lan J, Zhao Y, Dong F, et al. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015;161:69-81.
8. Ceylon Cinnamon. Natural Medicines Database. Reviewed June 24, 2020.
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