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Blood sugar balance – My top 5 tips to be in control

Updated: Dec 31, 2020

...and have energy all day without cravings and mood swings


In my previous blog post, I shared my story of blood sugar imbalances and provided some examples of what they might look like for different people. As I mentioned there, these are (only some of) the typical symptoms you might experience when your blood sugars are not sufficiently stable during the day:

  • Feeling better right after eating

  • Feeling tired right after eating

  • Sugar cravings after eating

  • Needing coffee or stimulants after eating

  • Cravings and feeling of hunger, inability to function without frequent (sugary) snacks

  • Feelings of “hangriness”: being hungry and angry

  • Need to eat “whatever, right here, right now”

  • Need to eat something sweet as soon as possible after waking up

  • Feelings of anxiety and nervousness

  • Mood instability

  • Snapping at people

  • Difficulties or inability to focus

  • Fatigue

  • Headaches

  • Metabolic dysfunctions and chronic lifestyle diseasesthink insulin resistance, pre-diabetes, diabetes…

  • Liver impairments, i.e. “fatty liver

  • Weight challenges

  • Hormonal challenges, i.e. with thyroid hormones and sex hormone balance – think premenstrual syndrome symptoms as well as conditions such as Polycystic ovarian syndrome

  • Challenges with sleep hormones and sleep

  • Nutrient deficiencies (linked to insufficient intake and/or absorption issues and/or high consumption of micronutrients as cofactors)

Are you experiencing any of these?


In the list above, there are both symptoms related to relatively high blood sugar levels as well as relatively low levels. This is because some of them might actually coincide. And the two situations of hypo- and hyper-glycaemia most often coexist in the same individuals.

While it might require investigative work and the help of a professional to get to the root of blood sugar imbalances and correct them - so that their downstream manifestations as a broad range of signs and symptoms can also be impacted - today I’d like to share some basic lifestyle and nutrition tips to get you started on the right track.

For some individuals, these tips alone might be enough to correct the imbalances and keep their blood sugar levels under control as well as to have an impact on other “downstream” symptoms. But it may not be the case for other individuals. However they are always going to be the foundations to keep building on in their health journey.


Unregulated blood sugar fatigue and metabolic health, Mark Hyman unregulated blood sugar


Without further ado, here the 5 tips:

  1. Sleep well

  2. Manage stress

  3. Start the day with the right break-fast

  4. Compose your meals with FAT, FIBRE and PROTEINS

  5. Move



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Are you already incorporating all of my tips in your routine? If not, are you already doing some of these things? Which ones? And were you already aware of their importance in relation to blood sugar balance?


Now let’s go to the geek-ier part!

Why are these recommendations so important? Let’s take a look in a little more detail.

1. Sleep


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What does sleep have to do with blood sugar control?

Well…a lot!


Sleep, in fact, impacts how hungry you feel, how much (as well as what you want to) you eat, and also how well you metabolise the food you eat.


This is because sleep timing, duration and quality have an effect on the release or timing of release of certain hormones (such as insulin, Growth Hormone, cortisol, ghrelin and leptin, more on that later). The sleep-wake cycle, furthermore, has a marked influence on tolerance to glucose, and sensitivity to as well as secretion of insulin [1].

Let’s start with insulin.

Insulin is one of the hormones that help us maintain healthy blood sugar levels. It is secreted by our pancreas in response to an increase (or even expected increase) of blood sugar level and it acts as a “key” to drive glucose (the “sugar” in the blood) in our cells for energy production, to be converted into glycogen for storage in the liver and muscles or into fat for storage.

Insulin sensitivity - the ability of our cells to respond to the effects of insulin (and take up glucose from the blood)- has been shown to be highly reliant on sleep. This has been described even in healthy young individuals [2,3].

In one study, healthy young adults were subjected to a moderate restriction of sleep (of 1-3 hours per night) and a significant negative impact on insulin sensitivity was observed after only 3 days, compared to 3 days in which they slept as much as desired [3]!

Not only does sleep restriction decrease insulin sensitivity. On the opposite, also an extension of sleep time can have a beneficial effect as shown by another study in which a sleep extension of 1 hour per night over a period of 6 weeks in sleep-restricted adults (sleeping on average 6.5h during weekdays and 7.7h during weekends) resulted in a beneficial effect on insulin sensitivity [4].


When insulin sensitivity is reduced, blood glucose levels may stay elevated, leading to an increased production of insulin from the pancreas.

Over time, our pancreas might not be able to compensate and keep up with the demand anymore and our blood glucose might stay at pathologically elevated levels. We are then on the way to pre-diabetes and diabetes type 2.

And now let’s take a look at ghrelin and leptin.

As you may know, each of us have a sort of internal clock, called “circadian rhythm”, which is defined by the recurring rotation of day and night. That rhythm also controls the release of hormones and, among these, the hormones that control hunger and satiety: ghrelin and leptin.

What do these hormones do? Leptin is commonly defined as our satiety hormone, and it curbs your appetite, while ghrelin is our hunger hormone, and it stimulates it. Also in studies on young adults, it was observed that overall levels of leptin, evening cortisol and the HOMA response (a measure of insulin sensitivity) to breakfast varied in close relationship with sleep duration. When the test subjects were sleep deprived (4 hours of time in bed for 6 nights), leptin levels were lowest (compared to measurements done after full recovery of sleep through 12 hours for 7 days and measurements taken 1 year later under the “normal” condition of 8 hours of bedtime). Leptin being the satiety hormone, this means that the brain received a signal asking for an unnecessary extra caloric intake. Glucose tolerance and insulin sensitivity (as measured through HOMA) also appeared to be decreased at breakfast time when the subjects were sleep deprived [5].

In a second study, a decrease in leptin levels was also observed in sleep-deprived subjects (4h of bedtime for 2 nights) together with an increase in ghrelin - the hunger hormone. In this case results were compared to those obtained after 2 nights of 10 hours in bed. Interestingly, in questionnaires on hunger and appetite filled in by the test subjects, they reported that they experienced an increase in appetite for high carb nutrients [5]. And what happens if you eat (unbalanced) meals high in refined carbs?

You go up again on the blood sugar roller coaster! And if you’re sleep deprived, you have a lower sensitivity to insulin…your blood sugar levels will likely spike more and you more easily get (or stay) on the roller coaster!


Do you need some help with your sleep? I have written two blog posts on the topic which might help get you started:


2. Start the day with the right break-fast

Break-fast, as the name states, is the meal that breaks the longest fasting period in our day.

Starting your day with a balanced meal that does not raise your blood sugars “high and fast” is key to avoiding getting on the blood sugar roller coaster!


Depending on our individual response and health state, when we eat a meal high in sugar or refined carbs our bodies tend to digest and absorb these foods very rapidly. And the faster the foods we eat break down into simple sugar (glucose), the faster (and possibly higher) our blood glucose level will rise. An insulin spike accompanies the blood sugar spike, as the pancreas releases this hormone to drive away glucose from the blood stream and into the cells.


High insulin might then plummet blood sugar, with some of the effects related to low blood sugar listed above: feeling jittery, anxious, needing to eat immediately, experiencing cravings (especially for sweets or foods high in refined carbohydrates)…

At this point, we are on the blood sugar roller coaster!

So how to avoid this and stay away from the roller coaster?


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You can do this by making sure to eat some (high-quality!) protein and fat. You can add some fibre too, from complex carbohydrates and depending on your tolerance. The ideal ratio of fat, fibre and protein differs for each of us and you might need to play a bit with different types of breakfast to find out what works best for you.

Interesting to know: our individual glycemic response to different foods depends a lot on our microbiome make-up! Did you know that?

A couple of extra tips.


If you currently wake up with low blood sugar and have an immediate need for a sugary or refined-carb rich meal, it would be a good idea to prepare your breakfast in the evening. And if you have no appetite in the morning, try to eat a small portion of protein anyway. And see how you feel then.


3. Compose your meals with FAT, FIBRE and PROTEINS

Eating a whole food diet (real foods vs highly processed food-like substances) and balanced meals is key to blood sugar balance. A meal (or snack) is balanced when it consists, as said above, of a mix of fat, fibre and protein.

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This means having a plate composed mostly of vegetables, some starchy vegetables/whole grains/nuts and seeds/pseudo-grains such as quinoa or buckwheat, some high quality protein and healthy fats.



Such a meal, packed with fibre and with a good quantity of healthy fats, is a slower to digest compared to a meal consisting only or mostly of (refined) carbohydrates!

The absorption of glucose is therefore slower, and this results in more balanced blood sugar levels and energy, a longer feeling of fullness and no cravings!


Bonus point. Eating lots of greens and colourful veggies, you also get a good dose of phytonutrients, vitamins and minerals that also play a role in regulating blood sugar levels!

4. Manage stress

Among the key hormones that regulate blood glucose levels, there are also the so-called stress hormones, among which is cortisol.

Under (perceived) stress conditions, our sympathetic nervous system (“fight or flight”) is activated, leading to the upregulation of the Hypothalamus- Pituitary -Adrenal (HPA) axis and an increased release of cortisol. Cortisol, in turn, promotes the mobilisation of energy stores, including glucose, into circulation. The objective of the body in such a response is to be ready to fight or run away when facing a threat. The same mechanisms that are designed to allow us to promptly react in a dangerous situation, however, are activated also when we are under psychological stress. And in our modern life, these mechanisms are often chronically activated. This can promote dysregulation in the cortisol profile and in blood sugar control.

On top of promoting glucose mobilization, cortisol and sympathetic hormones can also decrease insulin release and affect insulin sensitivity [6,7].

There is also another aspect to consider.

(Chronic) psychological stress often plays a role in our lifestyle decisions.

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Don’t you find it is much more challenging to make healthy diet choices, exercise, sleep well and avoid unhealthy choices such as smoking or drinking when you are under stress?


Do you need some help with managing stress? Head over to this post with useful tips for building resilience.




5. Move!


physical activity and blood sugar regulation, movement and insulin sensitivity


Going back to lifestyle factors, movement is also important in the management of blood sugar.




Muscles require energy to work and exercising helps lower the glucose in your blood by driving more glucose from the blood to the muscles. For this reason, exercising after a meal might be particularly helpful for people with hyperglycemia [8].

Not only does “acute” exercise help lower blood sugar, but also regular exercise actually promotes insulin sensitivity. This happens both in healthy as well as in insulin-resistant, pre-diabetic and diabetic individuals and across all ages, from children to older adults [9,10].

For as concerns the type of exercise, both aerobic and resistance exercise can help blood sugar regulation, and including both types of exercise in your routine might be more beneficial than either mode on its own [8].


Do you need some help getting started with an exercise routine? My colleague Karen Nijssen has some good tips for you here! Is this all there is to know about blood sugar balance?

Most certainly not!

Would you like to learn more? Do you have questions or maybe your own experiences to share? Let me know in the comments below!


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Or are you ready to go further and would like to receive 1:1 support with me?

Get in touch for a free 20-minute functional nutrition and lifestyle consultation and let’s find out how I can further support your healing journey.




References

[2] Buxton, Orfeu M et al. “Sleep restriction for 1 week reduces insulin sensitivity in healthy men.” Diabetes vol. 59,9 (2010): 2126-33.

[3] Wang, Xuewen et al. “Short-Term Moderate Sleep Restriction Decreases Insulin Sensitivity in Young Healthy Adults.” Sleep health vol. 2,1 (2016): 63-68.

[4] Leproult, Rachel et al. “Beneficial impact of sleep extension on fasting insulin sensitivity in adults with habitual sleep restriction.” Sleep vol. 38,5 (2015) 707-15

[5] Leproult, R., & Van Cauter, E.. Role of sleep and sleep loss in hormonal release and metabolism. Endocrine development, 17 (2010), 11–21.

[6] Rosmond R. (2003). Stress induced disturbances of the HPA axis: a pathway to Type 2 diabetes? Medical science monitor : international medical journal of experimental and clinical research, 9(2), RA35–RA39.

[7] Deibert, D C, and R A DeFronzo. “Epinephrine-induced insulin resistance in man.” The Journal of clinical investigation vol. 65,3 (1980): 717-21.

[9] Borghouts, L B, and H A Keizer. “Exercise and insulin sensitivity: a review.” International journal of sports medicine vol. 21,1 (2000): 1-12.

[10] Bird SR, Hawley JA Update on the effects of physical activity on insulin sensitivity in humans BMJ Open Sport & Exercise Medicine 2017; 2:e000143

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