Blood Sugar Imbalances;
Keeping Your Blood Sugar in Balance
Blood sugar imbalances are among the top health issues that we face. Health issues such as hypoglycemia, insulin resistance, diabetes, high cholesterol and triglycerides, weight gains, increased waist circumference, and high blood pressure are all consequences of blood sugar imbalances.
We need an endless supply of energy to do everything we want to do in our lives. Yet, we are often overwhelmed by a desire to take a quick nap. Have you ever felt like curling up under your desk and spending the afternoon snoozing?
We need energy to fire up our body and we need fuel to fire up that energy. We obtain this fuel largely from our foods. Our vitality and our health depend upon a constant supply of energy and fuel from our foods. What types of foods we choose to eat, how often we eat, and when we eat will determine how well our energy is managed throughout the day. So, bear in mind that we need to eat foods that keep our energy stable and provide us the nutrients that keep us healthy.
Not All Foods Are Created Equal!
Not all foods are created equal! Some foods burn quickly while other foods burn slowly. The foods that burn quickly turn into blood sugar more quickly as well. These foods are called high “glycemic” foods or high sugar foods. These foods turn into energy more quickly, but burn quickly as well. Foods that are fibrous such as vegetables, whole grains, beans, and legumes, burn more slowly and are great energy sustainers. These are the low glycemic foods that will provide more long term energy and allow us to build energy reserves.
Also, most sources of protein and good fats provide a slower, more sustained release of energy as well. Foods such as meat, poultry, fish, eggs, dairy, olive oil, raw nuts, and seeds should be eaten throughout the day to provide a constant flow of energy. The most advantageous way to eat is to consume protein at every meal and to include vegetables and a small amount of starch and healthy fats as well. Eat fruit with a source of protein such as nuts or seeds or yogurt, if not sensitive to dairy. This way you will be eating foods that provide quick energy along with foods that provide a slower release of energy.
Blood Sugar Basics
In order to understand blood sugar regulation, it helps to have an understanding of how blood sugar gets into the cells for the production of energy. Blood sugar is known as glucose. It moves through the bloodstream and is the principal fuel of all body cells. It provides energy or ATP to every cell. Insulin, which is produced by the beta cells of the pancreas, is the hormone that increases the force at which the blood sugar enters the cells.
When you eat, your glucose will rise and insulin will be secreted. First, some glucose will be stored in the liver as glycogen for use later on when you haven’t eaten for awhile or when you get stressed, as the stress response needs to be fed with stored energy. Thus, the glycogen acts as a reserve of blood sugar to be used as needed. The rest of the glucose is shunted into the cells and used for immediate energy. If your body is working properly, the glucose will get into the cells and energy will be produced.
Also, if your body is working properly, when all of the sugar and fats are in the cells, blood sugar levels start to drop and insulin levels go back down. You eat again and the whole process starts over. If you eat balanced meals of protein, healthy fats, and carbohydrates, your blood sugar and insulin levels remain stable throughout the day and you won’t notice any dramatic fluctuations in energy or significant drops or spikes in blood sugar.
Energy Robbers and Blood Sugar Fluctuations
The quickest way to lose vitality and to keep your energy (your blood sugar) whizzing up and down all the time is to drink coffee and other stimulants and to always be under stress. Caffeine will activate the dumping of your blood sugar or glucose reserves so that you feel energized and alert. This is usually a temporary situation. In doing this you will constantly use up energy reserves. If you drink caffeine often enough, then you may start to crave sugar and have extreme ups and downs in your energy. If you don’t eat, you will also use up your energy reserves and crave stimulants and sugar to provide you with some energy.
What Happens if You Eat Too Many Starches?
If you eat lots of starches, you will have wild surges of insulin which rapidly gets blood sugar into your cells for energy. Yes, you will have energy, but usually for a short time. You will experience rapid bursts of energy and rapid drops in blood sugar and energy as well. You will feel as if you are on a roller coaster ride with fluctuating blood sugar levels and will eventually experience a low level of fatigue, low blood sugar (hypoglycemia), and sugar cravings. When you have reached the point where you blood sugar is constantly unstable then you might experience the following symptoms of hypoglycemia:
- Clammy skin
- Foggy thinking
- Panic attacks
- Heart palpitations
- Sugar cravings
In order to offset these fluctuations, you will need to eat balanced meals every few hours and severely limit your use of stimulants to provide more sustained energy.
If your bad eating habits and nutrition choices become a lifestyle, eventually your insulin levels will remain higher than normal in-between meals. Your cells will fill with sugar, fat, and energy it cannot use and you will end up with a sluggish metabolism and even more serious blood sugar imbalances.
Why a Sluggish Metabolism?
When your insulin levels remain high, the cells get overwhelmed and start to resist or close their doors to insulin. Consequently, each time you eat, your blood sugar is unable to properly get into the cells. The blood sugar now stays high as well and becomes stored as higher and higher levels of fat, triglycerides, and cholesterol.
Now, as insulin is having difficulty getting glucose into the cells to make energy, your metabolism slows down, you feel more tired and you gain fat weight, especially around the middle. You also crave sugar even more as your body thinks that it is being starved of energy because your glucose is blocked from getting into the cells. You may experience even more pronounced symptoms such as:
- Fuzzy brain
- Water retention
- Polycystic Ovarian Syndrome
- Decreased memory or concentration
- Feeling sleepy after a meal
- Frequent urination
- Lethargic and sluggish throughout the day
This increase in insulin and blood sugar levels cause an increase in free radical damage to your tissues and cells. This sets up high levels of inflammation and tissue damage.
By the time you experience any of these symptoms, and if this vicious cycle of inflammation and blood sugar imbalance continues, then you will experience a condition called “insulin resistance” or “metabolic syndrome.”
Insulin Resistance and Metabolic Syndrome
If you have never heard of metabolic syndrome, you may be wondering what is this condition? And why should I be concerned about it?
The answer is simple: You may already be suffering from it. It has been my experience over the past few years that this is the most predominant health issue that I see in my nutrition practice. It used to be relegated to those in middle age, but that is not true anymore as even children are experiencing this syndrome at such a high rate that there are some predictions that this generation will not live as long as their parents and grandparents.
Metabolic syndrome can accelerate aging and lead to other major health problems such as diabetes, heart disease, cancer, and obesity. It is common knowledge among medical professionals that each of these health issues can increase the risk of the others. But, often there is a failure to connect the dots and see these health issues as just symptoms of underlying blood sugar and metabolic imbalances.
The underlying issue of metabolic syndrome is insulin resistance. It is also possible to have insulin resistance without having metabolic syndrome. But, usually insulin resistance and metabolic syndrome go hand in hand. Diabetes is an advanced form of insulin resistance and normally follows metabolic syndrome.
As the cells become more and more resistant to the effects of insulin and glucose cannot enter the cells effectively, then symptoms progress and become more obvious:
- Feeling sluggish physically and mentally.
- A dark ring on the side of the neck.
- Fatigue after meals and feeling sleepy throughout the day.
- Sugar cravings, especially after meals.
- Inability to lose weight.
- Weight gain, especially around the middle (abdominal obesity).
- High cholesterol
- High triglycerides
- Fasting blood sugars 100mg/dl or more.
- Falling asleep after meals or if you eat starches.
- High blood pressure.
- Fat build-up around the liver.
By the time your blood tests indicate abnormally high levels of cholesterol and/or triglycerides and fasting glucose levels of 100mg/dl or more, there has already been significant damage to your cells and your metabolism. Your blood sugar remains high and the higher levels of circulating glucose will be stored as fat.
The bad news is that today metabolic syndrome is unbelievably common. The good news is that it does not have to cause long term problems. It is well known that diet and lifestyle play a significant role in creating this health issue, and play a dramatic role in resolving it as well.
The primary sign that you are becoming resistant to insulin, besides the above symptoms, is weight gain around the middle. For several years now, medicine has recognized that weight gain around the middle is the most significant factor in determining insulin resistance and metabolic syndrome and your long term health risks.
According to Dr. Mehmet Oz and Dr. Michael Roizen in “You On a Diet: The Owner’s Guide for Waist Management”: “For optimum health, the ideal waist size for women is 32.5 inches; once you hit 37 inches, the changes to your health increase. For men, the ideal is 35 inches, and the dangers to your health increase once you hit 40 inches.“ (1) Waist circumference is so well established as a serious health risk that the Japanese Government put into effect a law that waist measurements are to be taken for every adult and that to receive health benefits, the waist size needs to conform to health standards set by the government. “To reach its goals of shrinking the overweight population by ten percent over the next four years and 25 percent over the next seven years, the government will impose financial penalties on companies and local governments that fail to meet specific targets.” (2)
Furthermore, long-term high insulin levels create “pancreatic poop out” and you no longer produce enough insulin – which eventually leads to diabetes.
Your long term health depends upon your body’s ability to maintain normal blood glucose levels and maintain your sensitivity to the effects of insulin.
Adrenal Fatigue and Blood Sugar
After we have eaten and if our insulin and blood sugar are acting normally, our blood sugar will be used for energy and then begin to drop. The drop in blood sugar triggers the adrenals to make more cortisol (the primary adrenal and stress hormone). The cortisol increases the blood sugar by converting protein and fat into energy. Thus, the blood sugar rises to provide a continuous supply of energy when we are not eating. Cortisol, therefore, works side by side with insulin to provide a steady blood sugar level 24 hours a day and keeps our blood glucose levels within a certain range.
When the adrenal glands are in a fatigued state, many times as a result of chronic stress, the amount of their primary hormone cortisol drops below normal levels and becomes less able to make glucose and energy available to the cells. With less glucose, fatigue is experienced. As the blood sugar drops, hypoglycemic symptoms arise. At the same time, the body becomes desperate for energy and initiates a stress response which makes the situation worse. Those suffering from adrenal fatigue may suffer extreme ups and downs in their energy throughout the day.
Most of the people who have this pattern, crave sugar all day long. If they indulge their cravings, they are constantly feeding this cycle of energy and exhaustion. The sugar only provides a hit of energy, a quick fix, for a short period of time and thus must be fueled again as low blood sugar symptoms arise. By the end of the day, the body is totally exhausted!
The opposite will happen if the adrenals glands are pouring out high levels of cortisol. As stress increases, the body produces higher levels of insulin as the stress response forces the blood sugar reserves into circulation. This constant exposure of the cells to the increased insulin will eventually lead to insulin resistance and metabolic syndrome.
Test, Don’t Guess
Early testing is paramount to determine if you have this syndrome or any indications of insulin resistance (high cholesterol, triglycerides, low HDL, fasting glucose above 100mg/dl). It may not be enough to just have your fasting glucose tested every year or so. You may need to have your insulin levels checked as well. You can also be tested for your blood levels of Hemoglobin AIC (HbAIC), which will tell you how well your blood sugar has been managed over the past three to four months or so. It is also a measure of the levels of free radical damage and inflammation from the increased tissue exposure to higher levels of glucose.
Children should be tested as well!
There is an epidemic of obesity in our nation today and more children are showing signs of insulin resistance than ever before.
Eat Your Way to Good Health
The good news is that this syndrome is reversible! By improving your nutrition and lifestyle habits, you can balance your insulin and blood sugar levels. The first thing you need to know is that fat may not make you fat! Nor does it abnormally increase insulin and glucose levels. Many fats are essential nutrients and without them we cannot achieve or maintain health. Fats such as fish oil, flaxseeds, olive oil, sesame oil, and raw nuts and seeds slow down the release of glucose and keep insulin levels within normal ranges.
You need to eat some essential fats every day.
Trans-fatty acids aggravate insulin resistance, as they interfere with the burning of glucose for energy. Trans-fats are found in fried foods, baked goods, margarine, and in partially hydrogenated oils. Each meal we eat must contain a source of protein to keep blood sugar levels stable. Build your meals around protein. Sources of protein include organic poultry, meat, fish, dairy, and egg along with nuts, seeds, and beans.
Eating small snacks between meals is another great way to manage blood sugar. Including complex carbohydrates with your meals is also a great way to manage blood sugar – grains, yams, beans, fruits, and vegetables. If you react negatively to starchy carbs, then limit the amount to no more than two servings per day. When you have full blown insulin resistance, you are more likely to overreact to the sugar and starches by becoming sleepy after meals or not feeling right.
Vegetables are to be eaten in unlimited amounts throughout the day. These provide fiber, vitamins, minerals, and antioxidants. The key is to eat well-balanced meals that contain healthy sources of protein, complex carbohydrates, and a small amount of good fats.
The Exercise Connection
It is also important to get some exercise and move your body each day. The health benefits of exercise are well established. There isn’t a health practitioner or medical institution in this country that doesn’t recommend exercise for restoring and maintaining health.
The key to understanding how exercise benefits blood sugar regulation is to look at what type of exercise will produce the best results. We may think of the elite athlete as fit and energetic and unlikely to suffer from blood sugar imbalances. But, the athlete who does primarily intense aerobic exercise such as running and biking may be increasing free radicals and cortisol at extremely high levels. Insulin resistance may be the outcome, especially if the diet is high in starches and lower in protein and good fats. Remember, high levels of cortisol and inflammation can lead to insulin resistance.
This was first brought to my attention when I had a client who was a marathon runner who ate mostly carbohydrates and who complained of tiredness and not being able to complete even a seven mile run without burning out. We ran some blood tests and discovered that he was pre-diabetic and had insulin resistance. He was amazed that he had any “health issues,” as he had run daily for many years. His assumption was that he was fit and healthy.
How Does Exercise Affect Our Hormones and Blood Sugar?
There is still some controversy over what type of exercise produces the best results for insulin and blood sugar management, fat burning, and weight loss. Do we do intense aerobic exercise? How about strength training? How about just walking for exercise?
Since insulin resistance and weight gain usually go together it is important to choose what exercise works best to reverse both insulin resistance and to achieve weight loss. Here are some facts to keep in mind as you are trying to understand what type of exercise will be best:
- Exercise has been shown to decrease insulin resistance and increase insulin sensitivity in both aerobic (cardio) and anaerobic (strength) forms.
- Over-exercising can increase cortisol to such an extent that it can lessen fat burning.
- Anaerobic exercise increases muscle mass which can also increase insulin receptors.
- In moderate aerobic exercise, glucagon, the hormone that keeps blood sugar levels stable, stays dominant. This means that blood sugar remains more stable during exercise and more fat burning occurs.
The best program for reversing insulin resistance and any blood sugar imbalance is exercise that combines both aerobic and anaerobic activity. What this means is doing some type of aerobic activity several days a week – walking, bike riding, treadmill, etc. and strength training several days a week. The sessions should only last no more than thirty minutes.
Many of my clients who were doing one hour workouts of aerobic training were actually gaining weight and becoming more insulin resistant. When they switched to doing more strength training, they started to lose weight and lose the fat weight around the abdomen.
The key is to exercise in a way that helps you to become more insulin sensitive, increase fitness, and lose fat weight.
What You Can Do
- Eat meals that consist of protein, a small amount of good fats, and a small amount of complex carbs full of fiber for best blood sugar regulation. For example:
- ½ cup brown rice
- Vegetable salad
- Eat often enough to maintain good energy and blood sugar management.
- Engage in physical activity at least three days a week. Strength training will encourage muscle development and increase insulin receptors.
- Eliminate all refined foods from your diet.
- Don’t eat fruit by itself. Combine it with a source of protein. For example, eat an apple dipped in almond butter.
- If you experience sugar cravings, eat a source of protein instead.
- Roizen, M. & Oz, M. You On a Diet: The Owner’s Guide for Waist Management, 2006:
Free Press, N.Y.
- Onishi, N. (Japan) Seeking Trim Waists, Measures Millions, June 13, 2008, New York