Blood Sugar and Inflammation

Do you know that Blood sugar regulation is essential to controlling inflammation? In other words, you can have your joints inflamed and don’t even know that your high blood sugar or insulin can be the cause, because everything in your body is related.

Let’s see how it works!

For energy production we need to eat fat, protein and carbs and it's important to have some healthy balance of these three at each meal.

 Any refined carbs (morning cereals, whole wheat pasta, etc.) or even complex carbs (beets, sweet potatoes) – quickly entering your blood stream as glucose.   When consuming carbs your blood glucose increases, then the pancreas release insulin to help transport the glucose to the cells in your body but because only a limited amount of glucose can be held by the cells the rest will go to the liver for processing.  Liver converts the excess of glucose into glycogen and it can be used by the body between meals, but there is also limited space for the glycogen.  If we have too much glucose in the blood from carbs the rest gets converted to triglycerides (fat storage). 

Glucose is good, every cell use it for energy, but too much glucose is toxic and very inflammatory.

When you eat a lot of carbs (oatmeal and orange juice for breakfast, sandwiches for lunch, whole grains for dinner, plus protein bars between meals) your blood glucose increases, and the body secretes more and more insulin to put away the blood glucose.  But when the storage are already full we have a lot of insulin circulating in the body which tries to tell the cells here is more glucose, but the cells start to ignore the insulin (that is called insulin resistance).

When more insulin is in the body the more inflammation is created.  Remember inflammation can happen anywhere in the body depending on your weak link.  That said, insulin itself is pro inflammatory, but when it overproduced that causes inflammation. 

When you eat protein, only small amounts convert to glucose but eating TOO much protein adds sugar to your body (particular man-made proteins like protein bars and protein powders in shakes and smoothies).

Natural fats (animal’s or plants) have minimum or NO effect on blood glucose.   

How about fruits or fruit juice?

Fruits contain fructose and corn syrup is almost pure fructose.  Consumption of fructose has exploded with the modern diet. 

Fructose, even more than glucose, is strongly connected to obesity, high blood triglyceride (fat storage), and causing insulin resistance which are all linked to systemic inflammation. Plus every cell in the body metabolizes glucose but fructose must be metabolized by your liver, the organ which already taxed from our toxic overload.

So avoid any processed foods (which are full of high fructose corn syrup).  Also consider that fruits traditionally were only eaten during the summer and fall and should be our goal. 

What you can do to balance your blood sugar?

#1 Test it and know your numbers.  If you don’t know your numbers, you can’t fix it. 

Ask your doctor for 3 tests follow:

1.       Fasting blood glucose: 

Ask your doctor for the blood test called a Metabolic panel for fasting blood glucose and be sure to follow the instructions for overnight fasting. 

Also try to monitor your blood sugar by yourself, buy a simple glucometer and measure it:  Take measurements first things in a morning which follows an overnight fast, but no later than 30 min of your waking time.  Normal blood sugar on this test is between 76 - 92 mg/dL with an optimal reading of about 83 - 85 mg/dL (US units).   If this number is between 101 - 125 mg/dL, it indicates prediabetes and a glucose level of 126 mg/dL or higher is positive for diabetes.  If your fasting blood sugar is in the high 90s to low 100s, repeated numbers indicate a problem and at this point you should ask your doctor to test you for fasting insulin.  Because by the time your glucose metrics show that you have high fasting blood glucose it means it has been spiraling for some time - it’s just that now your insulin can no longer control it.  That is why testing insulin levels are a much better way of evaluating your current situation.   Don't wait until you become diabetic and have a blood sugar of 300 or 400 mg/dL or more, do something right away to fix it.

2.       Fasting insulin:

Normal fasting insulin between functional ranges 2-5 uIU/mL, between 5-10 uIU/mL is decreased insulin sensitivity, where you start over producing insulin. Over 10 uIU/mL – there is insulin resistance here (and this start to rack the brain).  Can lead to formation of plucks which leads to Alzheimer's. 

3.       Hemoglobin A1c:

Helps diagnose, and monitors diabetes and prediabetes.  Test also is good for anybody who is at risk for Alzheimer's.

This test looks for glycation – tells how much glycation has been done to the cells.  Glycation is damage caused from elevated blood sugar.  Someone named it caramelization (similar like candy) and that is what similarly happens to the body.  But even with fasting blood sugar a little over 100, you can have already glycation. Some doctors see this is one of most predictive marker for Alzheimer's and dementia, but again you don’t even have to have high blood sugar. The lower your A1c test, the less chance that you'll develop complications of diabetes such as kidney disease, eye problems, sexual dysfunction, heart attack, stroke, dementia, and amputation.  It's important to realize that once your blood sugar moves into the diabetes range, there is substantial damage done to your cells and organs, including your liver and pancreas.

A1c should be less 5.4%.

#2 Food and Fasting

-          Limit your carb intake (even complex carbs)

-          Maximize healthy fats intake

-          Avoid snacking

-          Intermediate fasting for 12-16 hours

Focusing on non-starchy above ground vegetables, low glycemic fruits and nuts and seeds. These include vegetables like broccoli, cauliflower, asparagus, green beans, mushrooms, cucumbers, celery, tomatoes, bell peppers, garlic and onion, Brussels sprouts, cabbage and leafy greens like spinach, kale, collards, Swiss chard, dandelion greens and mustard greens.  Whereas sweet and starchy vegetables like beets, carrots, sweet potatoes, white potatoes, parsnips, radishes, yams, and winter squash should be limited. 

Fruits can be tolerated in moderation but should be limited to low-glycemic varieties such as raspberries and blueberries, strawberries, blackberries, cherries and citrus (lemon, lime and grapefruit).  If you want to enjoy some watermelon or mango occasionally, that's okay.  Just consider it more of a once in a while treat than a regular thing depending on your personal carbohydrate tolerance, you may need to limit or avoid fruit altogether.

Bread, pasta, pastries, doughnuts, cereals, cookies and other flour based products should be completely avoided as well as juices, sodas and other sugary foods and drinks.

Eliminate refined vegetable oils (canola, vegetable, corn, soy, etc.) and replace them with healthy animal and plants fats.

Beans also contain quite a bit of easily digestible starch which can raise blood sugar in many people, so it's best to limit beans to no more than one half cup per serving.

Whole grain such as breakfast cereals/muesli, wheat, rice, millet, corn, couscous, rye, oats … avoid pretty much all grains.  

Do you like to have your morning oats?  Here is a fact:  A cup of oats has over 100 grams of carbohydrates with only 10 grams of fat.  Remember that, of the 3 macronutrients, carbohydrates raise blood sugar the most and fat raises blood sugar the least.  While a cup of oats does contain 16 grams

of fiber, which can help buffer the rise in blood sugar and reduce cholesterol and triglyceride levels, still it is not considered a high fiber food.  Oats do contain a variety of macro nutrients such as vitamins like B1, B5, and B9, but there are many other ways to get these nutrients through lower carb options like fibrous vegetables.

Most people who test their blood sugar before and after eating oats report a huge spike in blood sugar levels from the meal. This is not safe or smart.

So start with a breakfast that is low is starch and sugar.  Don’t start your day by raising your insulin.

Avoid all foods that spike your blood sugar levels.  A simple pre and post meal blood sugar test will show you everything you need to know about your meal.  Occasionally check your blood glucose before and approximately one hour after a meal.   If your blood glucose increases by more than 30 mg/dL than this food is a problem for you.  It can even be dairy or protein for some, but in general it is caused by a high carbs diet.

Consider “The Dawn Phenomenon” it happens when higher blood glucose is in the morning but your overall blood glucose and insulin resistance improves over time.  The best way to tackle this problem is through fasting strategies, fasting for 20-24 hours occasionally can be helpful in stubborn insulin-resistance cases.

If you need to limit your carbs intake, how you’ll fuel your daily life with energy.  Maximize healthy fats intake!  And make sure you have enough protein. There is evidence to show that by including more fat in the evening that may be one of the most effective therapies at controlling cognitive decline as we get older, and so once you have eaten dinner, just do your best.

#3 Exercise

Physical activity is also important lifestyle strategies to help reduce and control blood sugar and insulin. Moderate carbs intake will provide you with sufficient fuel for moderate activities.  For high-intensity exercise, you may need to eat more carbs on those days.

References

·         Dr. Jason Fung “The diabetes code”

·         Ivor Cummins and Jeffry Gerber, MD “Eat rich, live long”

·         Sarah Ballantyne, PhD “The Paleo approach”

·         Diabetes Summit 2019,  www.thediabetessummit.com

·         Dr. Brian Mowll “Diabets Essentials”

·         Replenish PDX “Sweet tooth bitter truth: Sugar in your body and brain”

·         Diane Sanfilippo “Practical Paleo”