Bite Back with Abbey Sharp - Are Glucose Goddess’ Blood Sugar Hacks BS? Sorting Fact from Fiction about Prediabetes & Type 2 Diabetes with Dietitian Mary Ellen Phipps

Starting point is 00:00:00 Stress also impacts our blood sugars, obsessing over, you know, oh my gosh, I eat a piece of rice before I ate the broccoli. Like if that's kind of what's going in your mind, then I would say the benefits don't outweigh the risks. Welcome to another episode of Bite Back with Abbey Sharp, where I dismantle diet culture rules, call out the charlatans spinning the pseudoscience, and help you achieve food freedom for good. This episode is long overdue because there has been an overwhelming surge in conversations around low carb diets and insulin and all things

Starting point is 00:00:47 blood sugars over the past few years. Some of it of course has been incredibly helpful, while a lot of it has only fed into folks' already heightened fears about nutritious foods. And my guest today, Mary Ellen Phipps, is here to help us set the record straight on what really matters when it comes to blood sugar control. Mary, also known as Milk and Honey Nutrition Online, is a fellow dietitian, cookbook author, and mom who's been living with type 1 diabetes since childhood. She specializes in diabetes and insulin resistance and shares my philosophy on an additive nourishing

Starting point is 00:01:24 mindset with food. diabetes and insulin resistance and shares my philosophy on an additive nourishing mindset with food. Today we'll be talking about the risk of obsessing over our blood sugars, the dangers of keto or low carb in diabetes, various sugar myths, glucose goddess hacks, and what we should be actually focusing on when trying to manage our blood sugars. Just a general disclaimer that the information in this episode is for entertainment and educational purposes only and is never a replacement for personalized healthcare. Also, I would love if you would follow or subscribe to the podcast and leave me a quick little review.

Starting point is 00:01:58 As a new podcast, it really does help me out. Alright folks, let's dive in. All right. Hi, Mary. Thank you so much for joining me. This is so amazing. Thanks for having me. Excited to be here. So you have had type one diabetes for basically your entire life. So obviously tracking your blood sugars and responding to it with insulin is a legitimate survival tool for you. How do you feel about this recent trend online, a lot of which has been popularized by people like Glucose Goddess and like Carnivore

Starting point is 00:02:39 and keto influencers of all these healthy folks without diabetes obsessing over blood sugars and insulin levels. Yeah, it's definitely mixed emotions because on the surface, like the personal side of my experience living with type 1, I'm like, why would anybody want to do this if they don't have to? I've been doing this since I was five years old and it gets old. But the professional side as a registered dietitian, I love when people are more interested in how our bodies work and what they can do to promote

Starting point is 00:03:10 a healthier lifestyle. And so having those two kind of seemingly conflicting opinions on it can be hard to navigate, but I think it just lands me right in the middle of, I do see a place where people paying attention to this metric, maybe just not as intensely as some people promote that people without diabetes should. Yeah, yeah. So speaking of that, let's talk about CGMs or continuous glucose monitors, because again, obviously a legitimate, an actual lifesaver for somebody with diabetes, and also a potential tool for folks who are kind of having some blood sugar mismanagement symptoms and they want to better understand how food affects

Starting point is 00:03:49 their blood sugars. Um, but I've seen a lot of, you know, healthy content creators sharing their CGM data and being like, see, look, I got a spike after eight, you know, a peach and that's why fruit is bad. And you need to kind of go carnivore and you shouldn't have any kind of any fruit or any whole grains or anything like that, any carbs whatsoever. Can you talk a little bit about the confusion that this has created around what normal blood sugar patterns look like? Yeah. So I think a lot of it stems from this.

Starting point is 00:04:19 Like you said, there's a device out here now that just like, you know, fancy fitness watch or a pedometer or something that people can use, but there's not the education to go along with it of what that means, because I think people forget CGMs were developed intended for people with blood sugar management issues, like diabetes or maybe metabolic syndrome or something, insulin resistance, something like that.

Starting point is 00:04:39 So when a healthy person puts it on, I think they expect to see just a straight line and no movement whatsoever. Because you mentioned the word spike. What is spike? What are they calling it? Is it just a blip up? I think they get these devices and then without the education to go with it of there's going to be ebbs and flows in blood sugar, it's going to look, yes, when you eat something like a piece of fruit that is predominantly sugar and fiber, you're gonna see a rise.

Starting point is 00:05:06 But what a lot of people I think don't, or choose not to focus on or don't know to focus on is the fact that it comes right back down if you have a healthy pancreas and endocrine system and metabolism. And that's what we wanna see. It's when we see extended rises, it's right the diagnostic criteria for diabetes

Starting point is 00:05:21 is two hours after you eat. It's when we see that extended elevated blood sugar that we think, okay, there's something we need to investigate here. Yeah, yeah, no. But I'm a big believer that knowledge is power. But I do worry that having a single metric like this, especially when that's often misrepresented

Starting point is 00:05:41 by a lot of people online, can have the power to turn impressionable people off of eating nutritious foods like a peach when we have ample research that a diet rich in fruits and vegetables can actually help to reduce the risk of diabetes and insulin resistance and obesity. And not to mention, I just kind of find that it's it can be very easy to kind of over fixate on something like this. And it could just become another form of orthorexia when we kind of have this heightened anxiety around every single food we put in our mouth having to check, okay, what did that do? What did that do? You know, again, so I think that these metrics can be helpful to kind of be like, oh, okay, so pizza will increase

Starting point is 00:06:20 my blood sugar faster than let's say like a bowl of oatmeal when I have peanut butter and protein powder and things like that in it. But to have to like meticulously track every single every single food you eat it's a slippery slope right. But I want to kind of talk to you about some of the big myths or misunderstandings that we see around blood sugars. The first being, do we need to kind of cut out carbs or go keto or go carnivore in general if you have insulin resistance or diabetes? So it's important to remember that there's more than one right way to eat for diabetes to manage diabetes. Everybody's different. Different things work for different people. I feel like that's my mantra I'm saying to people over and over again. And so the thing with low carb, keto, whatever label you wanna put on it is,

Starting point is 00:07:08 is it a way to manage diabetes? Yes. Should you be doing it under the supervision of a registered dietician and a doctor? Yes. Is it the only way? No, absolutely not. A lot of people I think default to that,

Starting point is 00:07:22 particularly in the type one community, but also in the type two community, because it's easier. Because it's easier in the sense that there in the type 1 community, but also in the type 2 community Because it's easier because it's easier in the sense that there's not a lot of you don't have to think through a lot of the food decisions You don't see a lot of movement in blood sugar. And so it's kind of the easier choice. Whereas Rounding things out still including carbohydrates the foods we love For most people takes a little bit more learning and thought. And so I can see both sides of it. But is it an option? Sure. Is it does it have to be the option? Absolutely. Yeah, no. And what is the alternative? Like what would be best practices for folks who do want to

Starting point is 00:07:57 include carbohydrates in their diet for various reasons for the nutrients that they provide for the pleasure that they provide? And I'm not just talking about like cake and candy. I'm talking about like any other form of carbohydrates, whether, you know, that's whole grains, fruits, starchy vegetables, things like that. What would you recommend in those situations? So the approach that I like to take is, you know, making food work for us and not the other way around. And so that's teaching people the art of pairing foods together. A lot of people might hear this as food pairing Fat fiber protein. Those are my nutrients

Starting point is 00:08:29 I talk about all the time of we want to pair simple carbohydrates or starches with sources of healthy fats fiber and protein To slow down that digestion process, which means we're less likely to see you know Our buzzword the dreaded blood sugar spike after we eat and in reality that means you're less likely to see, you know, our buzzword, the dreaded blood sugar spike after we eat. And in reality, that means you're less likely to see rapid fluctuations, but also sustained elevated blood sugars. I love this. This is, you know, for all my listeners who've been following me for a long time, this is my hunger question combo. I, you know, I've got a trademark framework. It's all about quote unquote, dressing up naked carbs with fiber protein and healthy fats. So so obviously very important for blood sugar management great for satiety great for you

Starting point is 00:09:12 know the overall food matrix which we know come part and parcel when we include these kinds of foods in our diet. Okay so I get that the thought process behind, you know, things like keto carnivore, I hear this online quite a bit, is that as long as I keep my blood sugars low, because again, not eating any carbs, then I can't get diabetes. But we also know that type two diabetes is on average about 50% hereditary. So you know, one person could just like eat only sugar and not develop diabetes, while someone else may be eating this like high protein keto diet and be predisposed. So focusing you know just on the carbs is just not necessarily looking

Starting point is 00:09:52 at big picture when it comes to nutrition risk. I'm curious from your perspective what would be the potential risk of folks who have diabetes who start a a keto diet, you know, hoping to put their, you know, diabetes or remission, maybe get off medication, whatever it is, but can't sustain it because it does have about a 60% dropout rate. So when someone starts keto or low carb diet, it can initially appear because they probably are going to see stable blood sugars doing that. It can appear like things have gotten better and insulin levels have normalized when in reality if they were to introduce carbohydrate again, we might see less efficient insulin, less insulin sensitivity. Yeah, no. And this is what people often don't think about when they make these very drastic changes to their diet, right? Whether it's

Starting point is 00:10:41 cutting out a food like dairy, for example, and then their body kind of down regulating their lactase enzyme. So then the moment that you have that like, you know, cup of ice cream, you're like, holy shit, I, I really can't eat that anymore. And so, you know, or in this case, cutting out carbs all completely and interfering with the carb tolerance. So I really do think that, you know, healthy eating has to be about the big picture. And that's why I kind of always tell people if there's no point in a cleanse or a detox or a 30 day challenge, if you don't think that you can sustain a specific way of eating for the rest of your life, it's probably not worth

Starting point is 00:11:17 starting in the first place. I want to talk about another related myth that is pervasive. Does sugar directly cause diabetes? No. There's this misconception that because the metabolism of sugar is impacted when you have diabetes, that it somehow caused it. I think anybody who has gone through school to be any kind of in this realm healthcare practitioner, we see these matrix of causes for health in general, but also for diabetes and the food we eat, and I'm saying like listeners can see what I'm doing, but the food we eat is just a small component of it. There's so many other factors that play into a diabetes diagnosis that could it be that they consumed large amounts of sugar over an extended period of time throughout

Starting point is 00:12:05 the course of their lives? Yes, but that alone is not going to go play into a diabetes diagnosis. We know intense athletes, they need to consume a lot of sugar to fuel their performance, but combined with the physical activity, you're not going to see the same result. And so just this idea of like a multi-factor diagnosis and the misconception that just because this the sugar digestion is what is impacted somehow that caused it. Yeah, yeah, you know, I try to remind people that it obviously it's so complex. A lot of this comes down to kind of calorie balance in the sense that, you know, sugar is easier to overeat because it's far less satiating, let's say fiber, protein, healthy fats, what we just talked about that can increase the risk of fat gain, especially that visceral fat around the mid

Starting point is 00:12:48 section, which then can interfere with insulin signaling, which then increases insulin resistance and that insulin resistance then has this like bi-directional effect on weight gain and fat storage. So it's messy, but you're absolutely right. Sugar does not cause diabetes. And if it did, we would see, like, you know, elite athletes who are literally like living off of sugar gels would be, have the worst diabetes, but we actually know that they have the best insulin sensitivity and the lowest rates of insulin resistance.

Starting point is 00:13:21 So yeah, something to kind of keep that in the back of your mind, I always try to remind people. So it's, it's really about the overall dietary picture and how sugar kind of fits into your diet, your needs, your, you know, your activity levels, all that stuff. I want to talk about some popular hacks that we see for lowering blood sugars. Um, and one that has been making the rounds, I'd say for like the past year or two, even though I've been talking about it for like a decade is retrogradation. I don't know about you as a fellow dietitian, but the lectures that we had in university on retrogradation are like seared into my memory because it just blew my mind. And it blows everybody's mind when we talk about this. I just think it's so cool. Can you explain how we can use the science of retrogradation for blood sugar control?

Starting point is 00:14:26 Yes. So this is one of my favorite food science hacks. And when you go to school to be a dietitian and you see you're going to take food science, it's always a little bit like, what exactly are we going to do in there? But a hundred percent. So this idea of resistance starch. So when we think about traditional foods that people with diabetes are told they should stay away from and that they can't have rice potatoes pasta bread these certain types of starches when they are in their raw form Have a lot of what we call resistant starch. It's exactly like a sound starch. That's resistant to digestion behaves like fiber Which is really good thing for blood sugars

Starting point is 00:15:01 But when we cook those starches a chunk of that resistant starch gets converted to traditional starch. And so we see a higher glycemic response from these starches. But when we've cooked them and then cooled them down and not just run under cold water, because I've gotten asked that before too, but completely cooled in the refrigerator, based on the studies I read, I like to say at least four hours, cold temper four hours.

Starting point is 00:15:23 So that means usually overnight, four to six hours, we see some of that starch go back to resistant starch. So that's pasta salad, potato salad, things like that. But also when we heat it back up as leftovers, we see even some studies have shown even an additional conversion of some of that traditional starch back to resistant starch. It's a fascinating thing and the follow-up question I actually get asked all the time too is for people on insulin, well does that mean I take less insulin? And I think of it like going back to calculus or algebra or I don't know whatever the

Starting point is 00:15:56 math class is of area under the curve. So you're gonna have the same area under the curve, your curve is just gonna look different. Instead of a rapid rise and a rapid fall, which leaves you feeling horrible, you're going to see a much more blunted response of that steady rise and fall. Still a rise and a fall because it's carbohydrate, but a steady rise and fall. Yeah, I know. Isn't it so cool? I'm kind of obsessed. Okay, another one that comes up often thanks to, you know, glucose goddess, of course, is this idea of meal order.

Starting point is 00:16:31 And literally I get sent messages about the meal order thing, which is this idea that if you eat your meal in a specific order, vegetables first, then you know your protein and then your carbohydrates, that it will, you know, reduce and then your carbohydrates that it will reduce your blood sugars. And I believe the statistic that glucose goddess uses is that it will reduce your blood sugars by 75%.

Starting point is 00:16:54 Do you want to explain what's actually going on here? Yeah. So it again comes down to metabolism and food science. And it's important to remember though that I think the science that she speaks of, it's rooted in, is there. We do see a difference in blood sugars. But if you have a functioning pancreas, if you have a healthy endocrine system,

Starting point is 00:17:16 this is not something you need to worry about. Again, it goes back to the level of detail we need to pay attention to. And if you have a healthy endocrine system and pancreas and insulin, you don't need to worry about that. But if you have a form of diabetes or pre-diabetes, this is an incredibly helpful tool

Starting point is 00:17:36 to help your body better metabolize carbohydrates and have healthier blood sugar levels. And I tell people all the time, if it's not gonna negatively impact your eating experience, if it's easy to have a side salad or a non starchy vegetable before you consume your carbohydrate, absolutely do it. Where it's a low risk. It's a low risk thing that you can absolutely use and hopefully see a difference in your blood sugars. Yeah, that's basically my take two. I mean, I think, you know, if you're going out for dinner and you're going to an Italian restaurant, you know you're gonna have a big bowl of pasta and it totally can make sense to have a green salad first and then you're gonna

Starting point is 00:18:12 kind of wait and then you're gonna have your pasta main. Like this works, right? This is a total logical way of eating. It doesn't interfere with your enjoyment of the meal and it might have, you know, some impact on lowering the glucose response of that meal. But should we all be like parsing out our sandwich and like eating the lettuce first and then eating the chicken breast and then eating the bread? No, that seems, you know, quite intense. Not to mention, just as an aside on kind of like research analysis here, but the 75% reduction in blood sugar stat that glucose goddess loves to pedal is a bit of a stretch and I'll kind of tell you why.

Starting point is 00:18:53 So in the study she's consistently citing that study only had, I believe, 11 participants. It was a pilot study and they had them go through two different conditions. In the first condition, they had them eat a green salad first and then they waited 20 minutes before they had the other components of their meal. And then in the other condition they drank orange juice and ate a bunch of white bread and then they waited 20 minutes before they had the rest of their meal. Of course we're going to see

Starting point is 00:19:20 a pretty big leap between those two conditions but I would say most people are not starting their meal with orange juice and letting their blood sugars rise before they eat the rest of their meal. They're probably eating a mixed meal. So the 75% is a real exaggeration of what would actually be seen in real life. Not to mention again, these are folks that actually, have type two diabetes or insulin resistance as opposed to the general population and other research has found a

Starting point is 00:19:49 much kind of lower response of closer to like 30 percent. Still a good tool in the toolbox for folks who have insulin resistance if it makes sense but I really wouldn't be stressing over it especially when we don't have any data to suggest that parsing of the meal like that is dramatically different than having a combined mixed meal where we have fiber, protein and healthy fats present. So yeah, if it makes sense, great. If not, I really wouldn't focus on that. One thing I always like to remind people of is when you're consuming content online, and Abby, I know you say this all the time, like if it sounds too good to be true, it probably is. A lot of these ideas that you hear being promoted are actually rooted in some element of science, but it's not this grand lofty promise that is going to solve all your problems. But the cool thing about a lot of these more food science, like I call them diabetes tools,

Starting point is 00:20:38 tools in the toolbox, is like I said, there's a low risk. So if you want to try it out and you notice a difference, that's wonderful. And it also comes down to thinking about ways that we can slow down how quickly your body's going to metabolize the carbohydrate. And so if we can throw some fiber in there, if we can throw some protein in there, regardless of if it's going to be this big lofty promise benefit versus just a small benefit, it's worth seeing if it's not going to negatively impact how you eat. So just some things to keep in mind. Yeah, 100%, I love that. And also kind of keeping in the back of your mind

Starting point is 00:21:09 that stress also impacts our blood sugars. So if you really have to kind of do a deep dive to yourself and say, okay, are making these changes easy enough for me, intuitive enough for me that I can incorporate them regularly or is obsessing over, oh my gosh, oh no, I eat a piece of rice before I ate the broccoli. Like if that's kind of what's going in your mind

Starting point is 00:21:34 and that's kind of, I can imagine that's such a burden to have to kind of think through those mental gymnastics, then I would say, you know, the benefits don't outweigh the risks. 100%. Yeah. Okay. Another hack is vinegar. Should we all be taking kind of shots of vinegar before our meals? No. This is another one of those that it's rooted in science and data that is there,

Starting point is 00:22:00 but it has gotten blown up and extrapolated and recommended to populations that don't really need it. So my opinion and approach to this is can vinegar be a tool for people with diabetes or pre-diabetes? Absolutely. And there are certain parameters we want to put around it. We want to dilute it or you want to take it in a capsule form. Do you need to take it with every meal? No, probably not. Could it be helpful with a higher carbohydrate or a starchier meal? Possibly. And again, one of those ones that given you've gotten approval, which you want to do anytime you're adding a supplement to your routine from your doctor or your dietician, it's a low risk

Starting point is 00:22:38 element there that you can try and see if you see a benefit for you. Some people will, some people won't. But with regards to the average person needing to take vinegar with every meal, no. Yeah, yeah. I mean, there was a study that found taking two tablespoons of vinegar lowered the glycemic peak of the meal by just 11%, but it actually didn't significantly change the total glycemic response. And I didn't see changed the total glycemic response. And I didn't see an impact in folks who don't have diabetes. But unfortunately, the way that's kind of glucose revolution has been kind of sold to us

Starting point is 00:23:12 is that these are hacks that we all should be doing. And like you mentioned, it's just not the case. Since we're kind of on the topic of glucose goddesses' popular suggestions, can you talk to me a little bit about her anti-spike supplement, which for those who are listening is basically a combination of mulberry leaf extract, lemon extract, and cinnamon extract. Would something like this be helpful? So I haven't taken a deep dive on actually where she's sourcing her ingredients and all

Starting point is 00:23:45 that, but I do remember when this first came out, myself and a lot of other professionals online were like, it's kind of odd that those were the elements to put in there that were selected. I'm not a huge advocate for everybody needs to take all the supplements. However, there are some supplements that we know from data could be helpful for people with diabetes, and I didn't see those in this specific formula. I also think as with anything, there were a lot of lofty promises made, which to you and I, that's big red flag. Oh yeah. Big red flag.

Starting point is 00:24:15 Okay, well show me the data to support this. And it wasn't there. So it's not something I would recommend. Yeah, that was exactly my thought. I felt like those were kind of like the low hanging fruits when it comes to supplements for blood sugar management, in my opinion. But out of curiosity, for folks who are kind of looking to better manage their blood sugars, what are the main supplements that you might recommend?

Starting point is 00:24:40 So usually when I'm talking to someone or talking online, I have a set of supplements that I say, these are worth talking to your doctor about. I don't want you to ever start anything without talking to your doctor or dietitian, but these have enough data to say, hey, you need to go have a conversation. A general multivitamin just to kind of pick up nutrient gaps. Sometimes we tend to see that more in the diabetes population, but particularly vitamin D, magnesium, and then with, because of the heart health component, some sort of omega-3 fish oil thing. But those are kind of the key, particularly with vitamin D and magnesium, because we know

Starting point is 00:25:16 those play a role in the body's metabolism of carbohydrate, also insulin production. And there's actual data to show that supplementing can possibly help people with pre-diabetes, type 2 diabetes, and type 1 diabetes. And then on the natural side, like we talked about vinegar, there is some data to support it. And so looking at could that be an option for you. Berberine is another one that there's a possible benefit for a lot of people. And not, I've heard you say this before, not as a replacement for your medication, but supplements are supplemental. They are meant to, when we're recommending them, come alongside the other strategies given to you by your doctor to

Starting point is 00:25:55 help make them more effective. Yeah, no, 100%. I'd also say that, you know, considering the data that we have on kind of dressing those naked carbs up with protein and fiber and healthy fats to stabilize blood sugars, you know, obviously I'm a food first dietician as we all are. But if you are struggling to kind of meet those needs, a fiber supplement can be helpful for a lot of people. Protein supplement is really great in my book. So, you know, we actually have studies that show that adding like 20 grams of protein powder to 50 grams of carbs could lower the peak blood sugar response by 27% and the total blood sugar response by 40%. So, yeah, just an easy tool in the toolbox that has some good evidence to back it up. And are there any other kind of like non-food, non-nutrition strategies that you find are, you know, particularly helpful for folks who are trying to lower their blood sugars?

Starting point is 00:27:05 Yeah. I think people's minds immediately goes to food and the food you eat because that's what metabolism of food is what's directly impacted. But quickly behind that, we need to discuss physical activity. And it doesn't have to be hitting the gym for two hours every day or anything like that. But we know that increased lean muscle mass can lead to increased insulin sensitivity, whether that's gardening, walking, biking, running, weightlifting, whatever it is that brings you joy, really doing what we can to increase that and increase lean muscle mass, both from

Starting point is 00:27:36 a cardioprotective benefit, but also the muscle mass that can help with insulin sensitivity and things like that. I think that's a really important conversation to have. And then you mentioned it earlier too, stress levels. Whether it's mental, emotional, physical stress can increase insulin resistance. We see it, I always joke, so I wear a CGM having type 1 and my younger daughter is an elite swimmer and every single time she has a swim meet, I just know it's coming. I see it.

Starting point is 00:28:08 It's not even a stress I'm expressing. It's just an internal stress that I'm feeling. And I always know it's coming, and I always know I'm going to treat it. But it's a picture perfect example of how stress of any type can increase blood sugar levels and insulin resistance. And so the stressors you do have control over and that you can change working to minimize those or better understand how they're impacting your day-to-day blood sugars. Yes, yes, yes.

Starting point is 00:28:38 And sleep, sleep again, like, you know, we, we as a society, I think, do not put a great enough emphasis on sleep. We're kind of all like living in the grind set, the hustle culture of, you know, I'll sleep when I'm dead kind of shit. And I'm like, no, we're going to die if we don't get good sleep because we know, you know, poor sleep affects everything in your body, your mental health, your physical health, you know, that spikes your cortisol that is going to, you know, interfere with your hunger hormones, make you more hungry, increase cravings for higher sugar foods, interfere with insulin sensitivity. It just, and also like make you less tired. So you don't want to work out.

Starting point is 00:29:19 You don't want to exercise. You know, you don't want to move your body. Um, like the trickle effect is just overwhelming. And I'm saying that as somebody who had a terrible sleep last night and had been up since 3.30 in the morning. And I'm like, yeah, I feel it today. I woke up ready to have pancakes. Like, right. At four in the morning, I was like, I'm hungry.

Starting point is 00:29:41 You add on top of that, a lot of people will then turn to increase caffeine consumption throughout the day, which can also increase insulin add on top of that, a lot of people will then turn to increase caffeine consumption throughout the day, which can also increase insulin resistance. So it's definitely a spiral effect. Yes. And I know it's obviously easier said than done for a lot of folks, just like get better sleep. But there are things we can do.

Starting point is 00:29:56 Power down your electronics early. Make sure that you have a really good, cool, dark sleeping space. And if you like sound, a sound machine, if it's loud or whatever it is create your little sanctuary uh you know get off the get off the phones uh read a book do a meditation journal um but i think you know screens have obviously made this so much worse and we see that reflected in the in the literature obviously so definitely something to focus on and i think an actionable step that we can focus on that is you know not only not stressful but feels good. It feels good

Starting point is 00:30:30 to sleep. Well thank you so much Mary this has been so helpful. Your wealth of information and for those who are listening who are working on blood sugar management I highly recommend following Mary at Milk and Honey honey nutrition on social media. And of course, I'll be leaving all links in the show notes below. So thanks so much, Mary. Thanks for having me. This was fun. Such an important conversation here. You know, and I feel like so much of the blood sugar management conversation online often centers just around diet and losing weight.

Starting point is 00:31:08 You know, you gotta swear off sugar, you gotta take this anti-spike pill, you gotta take apart your sandwich and eat the bread last. But you know, diet is only one piece of the blood sugar regulation puzzle. And considering that eating disorder rates in folks with type 2 diabetes are 2-4 times higher than in the general public, there is a lot of value in thinking beyond the impact of what we put on our plate. So I wanted to share some evidence-based, non-diet approaches to help you manage your blood sugars. Number 1.

Starting point is 00:31:40 Move your body. When we move our body, our muscle cells are able to clear glucose from the blood more efficiently, enhancing glucose storage and improving insulin sensitivity. Exercise also reduces cortisol and helps contribute to fat loss, which can then help to improve insulin sensitivity over time. So when we look at research on the immediate effects of movement on blood sugars, we see that walking for just 30 minutes after a high sugar meal can reduce the peak blood sugar by 13% and the total glucose response by 10%.

Starting point is 00:32:16 Even a 15 minute little quickie exercise snack, as we like to call it, can help. Resistance training or weight training also offers the additional benefit of building more muscle mass and since muscle tissue is one of the biggest consumers of glucose in the body, the more muscle we have the less glucose we have floating around in our blood. Number two, let's talk about better sleep. Numerous studies have linked inadequate sleep duration, poor sleep quality and sleep disorders like insomnia and sleep apnea to type 2 diabetes and PCOS.

Starting point is 00:32:51 And that's largely because under-sleeping puts extra strain on our pancreas to try to perform. So one study found that those who slept less than 6.5 hours per night had to pump out 50% more insulin than those who slept over 7.5 hours to get the same glucose readings. Another study found that folks with disrupted sleep from sleep apnea exhibited up to 14% higher fasting blood sugar levels compared to those who slept well. In contrast, research suggests that deep REM sleep helps to activate the parasympathetic nervous system, which then improves our body's sensitivity to insulin,

Starting point is 00:33:30 amps up glucose transport into the cells, and ultimately lowers our blood sugar levels the next morning. So don't let hustle culture convince you that sleep isn't sexy. Power down and get off that phone early, optimize your sleep space to be cool, quiet and dark, get into a good bedtime routine, and make quality sleep a priority. Number three is to manage your stress. Studies have shown that individuals that have high levels of chronic stress for one to five years are up to 45% more likely to develop diabetes compared to those with lower stress levels. Part of this is likely due to unhealthy lifestyle behaviors or habits that we often use to cope

Starting point is 00:34:11 with stress like smoking or drinking or eating less healthful foods, but the stress itself also directly impacts our blood sugars. Chronically elevated cortisol levels, aka one of our primary stress hormones, tells the liver to amp up making glucose and suppress the uptake of glucose into the cells as an evolutionary response to a threat. It's basically saying, you're about to get attacked by a bear, so you're going to need some immediate glucose to battle it out, or like, get the fuck out of there. Most of the time, or ideally all of the time, it's not a bear.

Starting point is 00:34:47 It's just like a deadline or a scary work email. But still, the result on increased blood sugars is the same. The good news is that taking care of our mental health undeniably helps to improve our physical health. With one review at the literature finding that mindfulness, stress-reducing activities and yoga reduced fasting blood glucose by 17% in those with diabetes. And another study suggested that stress management programs helped reduce participants' hemoglobin A1c by 28% in three months.

Starting point is 00:35:23 The fourth tip here is to reduce or eliminate alcohol and smoking. While alcohol can cause a transient drop in blood sugar, chronic heavy alcohol and cigarette use can further our inflammation, disrupt the liver's ability to regulate glucose production, and increase fat accumulation around the liver, which ultimately results in insulin resistance. And finally, don't go crazy on caffeine. A lot of you guys know that I try really hard not to ever tell people what to do with their coffee because coffee or a tea ritual is like sacred in my books. It like makes or breaks your day. And coffee isn't an absolute no-no for diabetes.

Starting point is 00:36:05 In fact, in one review of the literature, they found that regular, moderate consumption of coffee seemed to actually reduce the risk of prediabetes and type 2 diabetes. That said, in folks with existing insulin resistance, caffeine does appear to transiently increase blood sugar levels and impair insulin sensitivity, likely by stimulating the stressed neurotransmitter adrenaline. However, since everyone metabolizes caffeine differently, this is not a universal effect. So experiment to see what your blood sugars do with caffeine, and try to limit yourself to a cup or two in the morning to prevent issues with anxiety or sleep. The bottom line here folks is that diabetes or insulin resistance doesn't need to run your life. And the strategies I recommend to folks

Starting point is 00:36:51 with insulin resistance are actually not that different than what I would recommend to everyone else. Move your body, manage stress, get in good sleep and dress up those naked carbs with hunger crushing compounds, fiber, protein and healthy fats. And if you want more information on my HCC framework, I'm going to link to the full episode that I did in the show notes.

Starting point is 00:37:13 Thank you again to Mary for joining me and helping me bite back against misinformation online. And also please don't forget to give me a 5 star review and a little note and subscribe to the pod wherever you're listening because it truly does help me out. Signing off with Science and Sass, I'm Abbie Sharp, thanks for listening.

Bite Back with Abbey Sharp - Are Glucose Goddess’ Blood Sugar Hacks BS? Sorting Fact from Fiction about Prediabetes & Type 2 Diabetes with Dietitian Mary Ellen Phipps

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