Blood Sugar Dysregulation

Modern American society demonizes fat consumption and links it to obesity, diabetes, and cardiovascular disease. Unfortunately, this is a misconception and is not the reason why so many Americans are overweight with underlying systemic diseases in the making or already underway. The real problem is the overconsumption of sugar and carbohydrates (particularly processed ones) in conjunction with poor quality fat and protein in improper ratios.

In Paleolithic times (which encompass the majority of human existence and what shaped our current genome), humans consumed macronutrient ratios between 19-35% protein, 22-44% carbohydrate, and 28-58% fat with no trans fats. Today, these ratios have shifted to 15% protein, 52% carbohydrate, and 33% fat of which 2-3% are trans fats. This means we are consuming less protein, more carbohydrates, and eating on the lower end of the proportion of fats coupled with toxic trans fats. Furthermore, sugar consumption has dramatically increased from 10 lbs per person per year in 1821 compared to 199 lbs in 2005 (USDA statistics).

Excessive sugar and carbohydrate consumption coupled with a lower fat and protein intake can result in an unstable and rapid glucose metabolism that typically requires frequent replenishing and compensatory stimulants.  Carbohydrate digestion creates a quicker blood glucose elevation (high glycemic load) compared to fats and proteins which slow down the digestive process resulting in a steadier blood glucose state. The problem with rapid and large blood glucose surges (hyperglycemia) is that they ultimately create a stress response in the body. As blood glucose levels surge from either too much sugar/carbohydrate consumption and/or not enough protein and fat paired with it to slow the processing, the body reacts by releasing excessive insulin. This pancreatic hormone works to facilitate blood glucose transfer into liver and muscle cells for energy production and conversion into glycogen thereby lowering blood glucose levels. Any excessive amount that is not needed by the liver and muscle will then be converted into adipose tissue.

As a response to hyperglycemia, the body typically over reacts and shifts into a state of reactive hypoglycemia (too low blood sugar). Symptoms of hypoglycemia include fatigue, irritability, cravings for sweets, more carbohydrates, and stimulants in order to facilitate bringing blood glucose levels up again. The body then responds by releasing the hormones glucagon (from the pancreas), cortisol, norepinephrine, and epinephrine (from the adrenal glands) which all act to elevate blood glucose levels.  Stimulant cravings (particularly caffeine) are present in this reactive hypoglycemic state as the body desires increased sympathetic nervous system activity to help elevate blood sugar levels.  People will typically crave caffeine at times when their blood sugar is low such as in the morning or in the middle of the afternoon.  Stimulants may also be desired in cases of adrenal dysregulation where the adrenal glands are not producing adequate amounts of cortisol, epinephrine, or norepinephrine. The body’s response to a reactive hypoglycemic state will usually once again create a reactive hyperglycemic state and thus a vicious repetitive cycle is born characterized by a roller coaster blood glucose ride. Eventually, dysregulation may further occur where the cells are no longer sensitive to insulin either due to receptor downregulation and/or receptors being destroyed through glycation. Glycation occurs with elevated glucose levels which adhere to proteins (AGEs-associated glycation end-products) including tissue membranes, joints, neurons, and/or red blood cells thus creating inflammation and degeneration. When cells no longer can take in glucose, the body’s ability to produce energy is impaired. The excessive glucose is then converted into fat. Furthermore, insulin resistance impairs the body’s ability to break down adipose tissue. Therefore, obesity is even more encouraged.

Foods that are high in sugar also typically contain high amounts of the sugar fructose. Fructose is processed differently than glucose in that the liver has to completely metabolize it vs 20% in glucose processing creating stress on the liver. Furthermore, fructose does not trigger the release of the hormone ghrelin as glucose does which suppresses appetite. Therefore, one is more likely to overeat. Also, for every 120 calories of fructose, 40 of them end up being stored as fat. Finally, the free fatty acids created via fructose metabolism are eventually converted into very-low-density lipoproteins (VLDL) (harmful to the body) and triglycerides which promote more fat storage in the liver and muscle. This can also facilitate insulin resistance.

It is evident how weight gain and blood sugar dysregulation are associated with increased consumption of carbohydrates and sugar (particularly fructose), under consumption of fat and protein, and/or over consumption of food period (too much healthy fat and protein can also lead to weight gain). However, it is also important to realize that chronic stress can also contribute to obesity and endocrine dysregulation. The stress response involves the release of cortisol and epinephrine which, as just explained, results in increased blood glucose levels. Therefore, a stress stimulus by itself can also facilitate a roller coaster blood sugar ride, glycation, and eventually insulin resistance. Furthermore, increased activation of the stress response pathways can also impact the thyroid gland which is a primary regulator of metabolism. Hypothyroidism, which is becoming more common in today’s society, will contribute to weight gain as well. The unfortunate result from chronic stress can manifest in obesity, diabetes, and any variety of chronic systemic inflammatory disease process.

Based on this discussion thus far it is clear that one should attempt to limit their sugar and carbohydrate consumption while being mindful of adequate and nutritious fat and protein intake. The use of stimulants are also not recommended. Stress management and coping strategies with today’s societal, work, and family demands is also crucial. Everyone’s physiology and genealogy is different and therefore there is typically not a single formula that will work for all. However, below are some general food choice recommendations:

  • Breakfast
    • Eliminate or significantly reduce cereals, toast, bagels, muffins, pastries, and any other sugary/carbohydrate laden food. Breakfast bars are usually high in sugar and include a lot of processed ingredients.
      • Smoothie: Unsweetened coconut milk (preferred over almond milk) (do not use “light”), the least amount of berries needed to make it taste good, and protein powder.
        • Recommend: NOW unsweetened pure pea powder or Designs for Health pure pea powder.  Sold online at: www.naturalhealthyconcepts.com
        • Optional:  fresh ginger, greens (spinach, chard, kale (alternate them)), mint
    • Eggs with veggies/greens and/or meat (non-processed, organic, grass fed preferred). Yes to the yolk! Some individuals may have a sensitivity to eggs and thus need to be avoided.
    • A typical meal you would eat for lunch or dinner (see below)
  • Lunch and Dinner
    • Avoid/significantly reduce grains, sandwiches, pasta, rice, potatoes. Some individuals will be able to tolerate grains better than others.  Grains are best tolerated if they have been soaked (sprouted) before consuming.
    • Avoid processed foods
    • Consume lots of vegetables and greens coupled with high quality protein and fat. One’s bio-individuality will determine the type and amount of meat, seafood, and or grain sources of protein that will best nourish them and may require experimentation. If one is to obtain protein through grains then it is recommended they are sprouted. It is difficult to obtain a full protein profile via vegetarianism and thus supplemental support is likely required.
    • About 25-30% of your calories should come from protein. Athletes and a high level of physical training will require more while less active individuals will need less. If your daily calorie needs are 2000 calories, 30% of this is 600 calories which equals 150 grams of protein.
      • Good protein sources will be from:
        • Meat (preferably organic, grass fed)
        • Seafood
          • Wild is best, low mercury levels.
          • Sardines, anchovies, and salmon have high beneficial omega 3 levels
    • Depending on your bio-individual metabolic needs and qualities, your need for fat can range from 30%-~65% of your macronutrient needs.
    • Good sources of fat include:
      • Meat (preferably organic, grass fed)
      • Seafood
        • Wild, low mercury levels.
      • Oils
        • Preferably cold pressed and organic.
        • Avoid canola  and vegetable oil.
        • Many polyunsaturated oils sold are rancid and oxidized.Tropical oils such as coconut and palm provide the best fat energy source and are most stable under high heat. They should be used for cooking instead of polyunsaturated oils. Lard and butter (or ghee (clarified butter) are also good for cooking.
      • Avocados.
      • Be liberal with the butter (provided you don’t have any dairy issues)! Use on your vegetables. Butter is an excellent source of good quality fat for energy and nutrients provided it is from organic grass fed cows. If you have a dairy sensitivity then use clarified butter which is called ghee.
    • Provided you don’t have any issues with dairy, raw is recommended. Fermented milk (kefir) and raw cheese have a lot of beneficial bacteria and enzymes coupled with fat and protein macronutrients.
  • Snacks
    • When someone has switched over to a more efficient fat burning metabolism they will typically be able to go for longer periods of time without the need for frequent meals, snacks, and stimulants. However, in situations where a snack is required some suggestions are:
      • Coconut Butter (sometimes referred to as Manna Butter):
        • https://store.nutiva.com/coconut-manna/
        • http://www.artisanaorganics.com/coconut/coconut-butter/
      • Nut butter (preferably organic and sprouted) Almond is typically best. Peanut butter tends to have high levels of mold and best avoided.
      • Sprouted nuts (Recommend: http://www.livingnutz.com/)
      • Sprouted Crackers
        • http://www.goraw.com/c/20/sprouted-flax-snax
      • Avocado-guacamole or slicing up with olive oil + lemon juice + sea salt on some sprouted crackers
      • Smoothie (see above)
      • Raw cheese (provided no problems with dairy) and sprouted raw crackers
  • Fluids
    • Drink ½ your body weight in water ounces per day. More may be required depending on your activity level.
    • Green tea may be appropriate for some.
    • For every diuretic (caffeinated) beverage, you must have additional equal amounts of water.
  • Dessert
    • Chocolate Fudge
      • Combine 1 cup almond butter, 1/3 cup softened coconut oil, 1/2 cup cacao powder, 2-3 TB raw honey or 20 drops liquid stevia
      • Spread onto parchment lined dish
      • Freeze or refrigerate for 45 minutes
      • Cut into 1 inch squares and serve
      • Keep in freezer or refrigerator

Caveats

  • Consuming a balanced macro and micronutrient diet that fits your bio-individual needs is important but being able to properly digest and absorb it is even more important. If you still have problems after making these changes you may need further work up to determine if your digestive system is functioning correctly. One of the most common culprits with poor digestion and absorption are not effectively chewing, producing enough stomach acid, and/or pancreatic enzymes. Please refer to this article (http://heathercarrdpt.com/uncategorized/the-importance-of-stomach-acid/) to learn more about this.
  • Being on a low fat diet for awhile can result in a sluggish gallbladder. Therefore, one may have to gradually introduce fat into their diet as their gallbladder accommodates to the new bile production demands. Additional supplemental support may also be needed.
  • It can take some time for your body to adjust to a reduced carbohydrate/sugar/stimulant and increased fat/protein load. Some individuals may experience “withdrawal” reactions as they undergo this process. Cravings, irritability, and mood swings may reflect this. Another potential reason is systemic candida/yeast overgrowth and/or pathogenic bacterial overgrowth. Sugar feeds this condition and as you starve the yeast and/or bacteria toxins may be produced as they die off.
  • Malabsorption, increased gut permeability, food allergies, and autoimmune disorders can significantly complicate things and may require professional support.

References

The Clinical Importance of the Anti-Inflammatory VagoVagal Reflex.pdf. In R. M. Buijis and D.F. Swaab (Ed.), Handbook of Clinical Neurology. Elsevier B.V.

De Jonge, W. J. (2013). The Gut’s Little Brain in Control of Intestinal Immunity. ISRN Gastroenterology, 2013, 630159. doi:10.1155/2013/630159

De Palma, G., Collins, S. M., Bercik, P., & Verdu, E. F. (2014). The Microbiota-Gut-Brain axis in gastrointestinal disorders: Stressed bugs, stressed brain or both? The Journal of Physiology, 00, 1–9. doi:10.1113/jphysiol.2014.273995

Gedgaudas, N. (2014). Rethinking Fatigue: What Your Adrenals Are Really Telling You And What You Can Do About It.

Hannibal, K. E., & Bishop, M. D. (2014). Chronic Stress, Cortisol Dysfunction, and Pain: A Psychoneuroendocrine Rationale for Stress Management in Pain Rehabilitation. Physical Therapy, 1816–1825. doi:10.2522/ptj.20130597

Koolhaas, J. M., Korte, S. M., De Boer, S. F., Van Der Vegt, B. J., Van Reenen, C. G., Hopster, H., … Blokhuis, H. J. (1999). Coping styles in animals: current in behavior and stress-physiology. Neuroscience and Biobehavioral Reviews, 23(99), 925–935.

Sapolsky, R. (2004). Why Zebras Don’t Get Ulcers.

Wilson, James, Wright, J. (2001). Adrenal Fatigue: The 21st Century Stress Syndrome.

 

 

 

 

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