Dhru Purohit Show - The Top Mistakes People Make When Wearing a Continuous Glucose Monitor with Brigid Titgemeier

Episode Date: March 21, 2022

This episode is brought to you by Vivobarefoot and Pendulum.   Poor metabolic health and blood sugar imbalances are the largest drivers of chronic disease. At least 50 percent of adults in the United States have abnormal blood sugar levels and/or insulin resistance. Research shows that of those with pre-diabetes, more than 84 percent do not know that they have it. A large contributor is a lack of access to information about your body.   Today on The Dhru Purohit Podcast, Dhru and Brigid Titgemeier talk about why tracking blood sugar is important, the benefits of wearing a continuous glucose monitor, and factors to consider when interpreting your data. Brigid Titgemeier is a Functional Medicine Registered Dietitian. She founded BeingBrigid Nutrition, in 2019 to offer individuals, and groups virtual programs and coaching that provide a data-driven, personalized, food-is-medicine approach to health. She teaches integrative and functional nutrition at Case Western Reserve University’s School of Medicine. Brigid was also a founding dietitian at the Cleveland Clinic Center for Functional Medicine, working under Dr. Mark Hyman. In this episode, we dive into:  -The importance of having access to vital health metrics (6:25) -The accessibility of continuous glucose monitors (12:48) -Why one diet doesn’t work for everyone and the key to personalization (16:05) -The myth of needing to have a flat glucose line (24:10) -How stress impacts glucose response (35:24) -Understanding how saturated fat affects blood sugar (40:24) -Brigid’s Blood Sugar Reset Program (46:23) -Brigid’s health journey (48:35)   Also mentioned in this episode: -Blood Sugar Reset Program   For more on Brigid Titgemeier, follow her on Instagram @beingbrigid, Facebook @beingbrigidfunctionalnutrition, Twitter @beingbrigid, YouTube @beingbrigid, and through her website beingbrigid.com. If you are interested in working with Brigid, email [e-mail] to learn more about her programs.  This episode is brought to you by Vivobarefoot and Pendulum. Vivobarefoot footwear is designed to be wide, thin, and flexible—as close to barefoot as possible. They promote your foot's natural strength and movement, allowing you to feel the ground beneath your feet. Vivobarefoot is offering 20% off your first order at vivobarefoot.com/DHRU. Pendulum is the first company to figure out how to harness the amazing benefits of Akkermansia in a probiotic capsule. To receive 20% off your first purchase of Pendulum’s Akkermansia probiotic supplement, go to Pendulumlife.com and use code DHRU20. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

Everyone is very quick to lean on how food is impacting their glucose, and they often miss the fact that stress can also lead to a glucose elevation all on its own. Welcome to the Drew Proet podcast. Each week we explore the inner workings of the brain and the body with one of the brightest minds and wellness, medicine, and mindset. This week's guest is Bridget Tigamire. Bridget is a functional medicine registered dietitian and health advocate on a mission to help you transform your health through personalized nutrition. Throughout her career, Bridget has worked with more than 4,000 clients. She founded the functional nutrition and health consulting business being Bridget Nutrition in 2019

to offer individuals, groups, and Fortune 500 companies, virtual programs, and coaching that provide a data-driven, personalized food-is-medicine approach to health. Bridget teaches integrative and functional nutrition at Case Western Reserve University School of Medicine. with a master's in public health nutrition and a board certification and integrative and functional nutrition, Bridget was a founding dietitian at the Cleveland Clinic Center for Functional Medicine working under Dr. Mark Hyman. On today's podcast, we've invited Bridget to talk about the do's and the don'ts and most importantly the top mistakes that people make when wearing a continuous glucose monitor.

If you've ever been curious about all the hype around continuous glucose monitors and how to make the most of them and the traps that people fall into when they start monitoring and looking at their blood sugar, today's episode is for you. Now, on to my interview with Bridget. So a while back, I was talking to my dear friend, Dr. Rungen Chatterjee, about this persistent knee pain that I was experiencing, which was super weird because I stretch regularly and I work out at least a few times a week with a big focus on mobility. Now, Dr. Chatterjee asked me a super simple. He said, could your shoes be causing the problem? That simple but profound question opened an entire rabbit hole for me around the idea that our footwear should conform to our feet, not the other way around.

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And I'm so thankful I've found them. Right now, Vivo Barefoot is always. offering my community 20% off their first order at vivo barefoot.com backslash Drew. That's Vivo, V-I-V-O-V-O-B-A-R-F-O-O-T-B-A-R-O-T dot com slash Drew, D-H-R-U. If you miss that, just click down to the show notes and you'll find it there. I also wanted to let you know that Vivo Barefoot is a certified B-C corporation, and it's extremely passionate about using sustainable and recycled materials. They make their footwear in small batches and certain styles are limited.

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to lowering overall levels of inflammation. So what's this strain called? It's called Acrimancia and it's made by the company Pendulum. So why the heck do you want Accomancy and what does it do for our overall gut health and microbiome? So Acrimandia feeds on our intestinal mucosal layer and modulates its thickness. That's a good thing. In exchange for providing Acrimandia with the house and food, pays us back by producing short chain fatty acids like propionate and enabling other strains

to produce butyrate, which is super important for healing a leaky gut, supporting the immune system, and maintaining overall health. I first heard about acrimancia for my business partner, Dr. Mark Hyman, when he got really sick a few years ago and his gut help took a turn for the worse. He said that building up his acrimancia was critical for helping him heal and support his overall gut restoration and getting his health back on track. Because acrimancia can only survive in an oxygen-free environment like your gut, it has been difficult for scientists to formulate it into a probiotic until now. Pendulum is the first company to figure out how to harness the amazing benefits of acrimancia in a probiotic capsule, which is why I've been taking the probiotic daily ever since

I got introduced to the company. Right now, if you're interested in acrimancia, and you're interested in Acrimancia, this flagship bacterial strain, Pendulum is offering my community 20% off your first purchase of their pendulum acrimancia probiotic supplement. All you have to do is go to their website, pendulumlife.com. That's pendulum, P-E-U-L-U-M-L-U-M-L-L-I-F-E dot com, and use the code Drew 20, spelled D-H-R-U-20 for 20% off your first purchase. Bridget, in preparation of this podcast, you put together five takeaways that we kind of want to get a chance to walk through that are related to this conversation of balancing our

blood sugar, the importance of health transparency, and also the focus on deep personalization. I'd love to walk through them all and to chat about some of the points. and maybe some takeaways from each one. So let's go into the first one. We've been chatting about this a little bit. Having access to vital metrics, talk about why that's so important and why you and also us. We're investors in levels.

We're advisors in levels. We've had their chief medical officer on the podcast a couple of times, Dr. Casey means. You also work with them as a dietitian and are one of their advisors as well. So let's talk about the challenge that's often there. for patients trying to get access to vital health metrics, but how important it is to start making it easier for people to have access to those things. I think that it's so important in order for people to be able to understand the role that nutrition plays in those metrics. And I love the episode that you recently did with Dr. Casey means talking about the different lab markers

outside of even just a continuous glucose monitor that you want to be able to check because so many of these labs are very modifiable with the choices that you're making on a daily basis. So being able to have access to them so that you understand your baseline, and then you understand whether the nutrition and lifestyle interventions are actually working for you and moving those markers in the correct direction. Because sometimes I see people make a lot of effort. They put a lot of effort into changing their diet, and the labs are actually moving in the wrong direction. So that really, health transparency is the first takeaway.

of how important it is for people to have access to the information. And, you know, we recently experienced a client who was told by her doctor, she has pre-diabetes. She was told by her doctor that requesting a continuous glucose monitor was similar in nature to her requesting chemotherapy or radiation for having a pre-cancer polyp. And he said, this is an exaggerated example, but it would essentially be like you having a pre-cancer polyp, and then us jumping to resecting a portion of your colon, doing chemotherapy, and doing radiation, when there's absolutely no commonalities in those two approaches. Having a continuous glucose monitor is a tool that gives you more information similar to a blood pressure cuff where you're able to see where you're at and how things are evolving over time.

And the unfortunate thing, he said to her, you know, we have to wait until you have uncontrolled type to diabetes in order to give you access to this. And it's a similar approach, actually, that the health care system takes with nutrition interventions. So for a very long time, I don't know if recently this has changed, but for a very long time, Medicare would not cover a dietitian appointment for patients until they had type two diabetes. So if you had pre-diabetes, you did not qualify for an appointment with your insurance to talk

to a nutritionist about your food and diet. lifestyle choices. They said, we're not going to intervene early when we know there's an abundance of research to show that pre-diabetes is much easier to reverse than type 2 diabetes. And we're not going to intervene early. We're going to wait until you are in a more critical state that your beta cell function is even less functional in order for us to tell you about the nutrition changes that you need to make to improve your health. And the mistake that we make is that we think that without making an intervention, or a change that things will just remain the same. But a diet that you've been eating that leads you to the point of prediabetes will not

keep your glucose levels the same as you age. They will only worsen. And they definitely won't get better. And I think people sometimes assume they'll just stay the same if they don't intervene. And the truth is that they only get worse over time with age. So it's really critical for us to to be proactive about this. In addition to, like I talked about in the beginning, for some of the younger listeners who may not have some of these comorbidities that are just thinking about starting a family, you know, that is an essential time to really think about the choices that you're making with food and lifestyle as well, because you can have a significant impact on the, on the DNA switches, you know, your epigenetics and which genes are turning on and expressing

themselves to impact the health of two additional generations after you. So critical. And basically what the doctors are saying, again, well-intentioned, you know, everybody's trying to do their best. You're not informed on the topic. And I think also, too, unfortunately, the American health care system in particular has been designed to expect so much from a doctor. Doctors have so much on their plate.

They have to be, you know, especially if they're a family physician, internal medicine, And there's such a range of things that they have to be good at. And what's really exciting is that places like the Cleveland Clinic, they're leveraging more of the help from individuals like yourself, dietitians, nutritionist, PAs, nurses who are more trained in the nuances of nutrition or other things. Not that the doctor shouldn't be aware of them, right? We want the doctor to be aware too because they're going to integrate it into their protocol. But I think we expect so much out of doctors.

and they're just trying to get through school. They have a massive amount of debt. There's just so much on their plate that they're dealing with. And I think education is a key part of it. But anyways, that whole setup was a way of saying that basically the doctor is saying, you're not sick enough for me to do anything. You've got to get sicker before I decide to do anything. And that's a tough thing to hear.

And it's not that they're exactly saying it that way, but those are the undertones of saying that it's not bad enough for us to be able to do anything, but the side note is that they actually are not sure what to do with that patient because they're not aware of all the literature and the studies that are there. So, you know, one of the things that I want to address here in this conversation of anytime we talk about CGMs, anytime we talk about levels, I like to address the fact that we live in a world right now because insurance is a sick care model. unfortunately, they're not incentivized to keep us healthy.

The huge percentage of our insurance dollars are actually spent in the last like five years of a patient's life to keep them alive with heart surgery and chemotherapy and all these crazy interventions that take hundreds and hundreds of thousands of dollars. And I'm so glad that we have them. But often at that point in time with patients who have two or more core morbidities is extending life by maybe a couple years and in some cases a few months. So we're not really focused on the preventative side. So if you're not diabetic right now, you can't get a CGM from your doctor.

Insurance is not going to cover it. So unfortunately right now, people who are going to pick up CGMs and, you know, they are having to pay out of pocket. Now the hope is that, okay, great, if you can afford it, awesome, it's available there. If you can, a glucometer is a cheap tool that you can have, and diabetics have been using that forever. And like you said, it's less than $100. You can get it off of Amazon.

That's another cheaper hack. But the hope is by doing more education and awareness, the people that can afford it will jump into it because it's that important for the health. The people who can't, well, at least we're going to do education because guess what? There's a lot of doctors. There's a lot of researchers that listen to this podcast. There's a lot of people who listen here and tell their doctor or they're, tell somebody who works at an insurance company. It's like, hey, maybe we should get on this

thing. So I just want to address that because anytime we talk about health, naturally it's going to be some things are just not accessible to everyone, but that's a factor of the system that we're in rather than people trying to make products expensive. Is there anything more that you want to add about that when it comes to accessibility and CGMs? I agree. I think it's also important to highlight that there's so much attention on a public health level with trying to figure out increasing access to health care as a whole. And I really feel like it's important to increase quality of health care for people at every level, which, you know, currently we see people that are at the highest level of access resources to really be able to afford anything.

And their doctors still are in a very conventional mindset where they're on several different pharmaceutical drugs that may or may not be necessary because, the person wasn't told about lifestyle interventions. So I think that when it comes to these things, that the ability to just order a continuous glucose monitor is the best first step in terms of being able to give access to people who can afford it so that then over time, the demand helps to drive down the cost. And hopefully then leads to research like I know that levels is doing to be able to make an argument for incorporating this into a more traditional health care model. Let's go into your second takeaway that we have listed here.

And that's all the topic of once somebody has ventured into the world of getting a CGM or glucometer, personalization is key. And one diet doesn't work for everyone. Can you expand on that? Yes. Regardless of your age, your health goals, any situation that you currently are in, it is so critical for you to not buy into this idea that there is one-size-fits-all approach to diet. Just like different medications and different doses of medications work for different people,

the same is true for our nutrition. And so much of that is driven by our gut microbiome, right? We have hundreds of trillions of microbes inside of us, and that really determines a lot of what we need on a personalized level and how our bodies respond. So when you eat foods, you release various chemicals that can really help to improve health. And in some cases, can actually lead to more inflammation for individuals who may have a specific food trigger or intolerance or also thinking about glucose response, different people having different levels of insulin sensitivity. So I work with some people

who actually need to increase carbohydrates in their diet. I see women who have blood sugar levels ranging from 65 to, you know, 100 at the most, even when they're eating more carbohydrate foods and have fasting insulin levels that are not elevated, but may have higher cholesterol levels or have difficulty having a regular menstrual cycle. And in those situations, a low carbohydrate diet is not going to be in that person's best interest. So like I said, there's a eight to tenfold difference in a person's glucose response to any individual food. And while we know that decreasing carbohydrates, the majority of the population is really the best first line approach, especially those refined carbohydrates that are going to lead to sharper and faster glucose increases, you really want to be able to understand your body so that you know what the threshold is for the amount of carbohydrates that you. you can tolerate the balance of macronutrients that really leads to optimal health because I see a lot

of people who are, you know, reading so much about ketogenic diets and intermittent fasting. And it's really important to highlight the fact that these are hormetic stressors. And we all have a different ability to balance different hormetic stressors. These are stressors that help to, they create resistance in the body, but eventually help to improve your overall health, similar to exercise being a hormonic stressor. And so the dose of those that are best for the individual is going to matter a lot. And that's especially for women that are menstruating, that are in a regular cycle that have hormonal fluctuations on a monthly basis and may not have as much body fat to lose.

I think that, you know, differentiating between health goals, the phases in life that you're at, your gender, those sorts of things are so important, and the phase of life being important as well. So different stages lead to different nutrition needs for each individual person. In addition to the fact that you have your own unique biochemical individuality, if you are in your 20s and not thinking about having kids and are super active versus being in your 30s and thinking about having kids, your nutrition needs will differ. post-pregnancy, your nutrition needs will differ. When you're going through pre-menopause, when you've gone through menopause, nutrition needs

differ. And so I think being able to recognize that instead of taking something that you hear about on a podcast or read about in a book and view it as like the Bible, that this is the approach that you have to take because this person said it's beneficial can be actually really damaging sometimes to people's health. What's an example from your personal life? You're a dietitian, but you're also a human being and you're trying to live in this world and figure out what works for you. Is there an example in your personal life that you have of how you were doing something and how that thing changed once you started to really track and monitor your blood sugar fluctuations throughout the day?

Anything that you can think of? Yes. I personally was following a ketogenic diet doing a 16-hour intermittent fast window or time-restricted eating window overnight, drinking bulletproof coffee in the morning, doing a lot of high-intensity interval training. This was around the time that I was working with creating nutrition programs that were centered around very low-glycemic nutrition interventions and also just trying to improve my own energy levels, which is something that I'm always trying to do. And I didn't realize at the time, this was, you know, five years ago, I didn't realize at

the time the importance of dosing hermetic stressors. I was just reading the research on the benefits of the intermittent fasting and some of the benefits of the ketogenic diet that were coming out. And it really created a large stress response on my body that impacted my, uh, impacted my adrenal health, increased my cortisol levels, actually really screwed up my metabolism, even though initially when I was following the ketogenic diet was developed a lot more muscle tone than I had ever had before. And after the fact, that really wasn't the case where I have never struggled before and am constantly having to think a lot more about what I'm eating and my blood sugar response in accordance with my weight, which has never actually been a thing

until I started eating ketogenic. So I think that, you know, thinking about these takeaways and what really works best for you and for females, especially tracking your menstrual cycle as a way to really understand the stress response. In addition to something like a glucometer, sometimes I actually see women who are eating a very low carbohydrate diet who have high fasting glucose levels and will rule out all of the other factors that may be contributing to this increase in fasting morning glucose. And really, it's correlated with a stress response that's happening because morning cortisol levels are also rising.

So that's the time that your blood sugar, sorry, that your cortisol levels are going to be at their highest point, first thing in the morning. And then you're, well, you had your cortisol awakening response and then you have your cortisol levels that continue to go down as the day goes on is your primary stress hormone. And a lot of times, even if you haven't eaten and are still in a fasted state, you could be experiencing morning glucose elevations. Sometimes that can just be like a dawn phenomenon that is common in some people. But for other people, it can be a cortisol increase where your cortisol, your stress hormone, is driving your liver to recirculate your stored form of glucose, glycogen, into the actual active form of glucose, which can increase

your fasting glucose levels. So in that case, trying to be more intentional about not having as long of a fasting window, layering in potentially more carbohydrates, and seeing what your blood sugar response does in accompanied with proteins and fats, trying to incorporate more meditation, breathing exercises, trying to slow down can be really beneficial for improving glucose response. That's fantastic. I think that's a perfect setup for our next point, which is that often when people get a continuous glucose monitor or again, they're using a glucometer, they start to get into the world of blood sugar. They think that, you know, I need to be flat all the time. I need to have my blood sugar flat and that there shouldn't be variation.

Talk about that from a dietitian's perspective and expand about on that a little bit and some of the myths that come with needing to be flat all the time. So this is something that I commonly see where people will put on a continuous glucose monitor and their inner overachiever comes out where they're like, I just want the best metabolic score. I want the flattest glucose lines, and I'm going to cut all foods out of my diet that don't help me achieve that goal. And so it's always important to also pay attention to how you're feeling because I have had people who are prioritizing a flat glucose line who say that their energy starts to actually

decrease because they are restricting their diet too much, or they start eating in a box where they're just eating the same 10 foods over and over again because they know that those foods are safe and they're actually not experimenting. I recommend experimenting when you have a continuous glucose monitor on. That is the time to be able to look at, you know, the difference between having a smoothie in the morning with with no fruit, a smoothie the next day with a half of a cup of blueberries, the same smoothie the next day with three-fourths of a cup of blueberries, the same smoothie the next day with half of a green apple so that you can really start to understand how different foods are impacting your personal blood sugar levels. And often people will

prioritize this flat glucose line. And I've seen people that remove onions and bell peppers from their diet because it's contributing to a five or eight points increase if they're adding that to their meal. And they're missing the importance of those fiber-rich foods that also have the antioxidants. and those fibers that help to improve the composition of their gut microbiome, that help to fuel more diversity, that help to increase those short-chain fatty acids that are so critical for driving down inflammation. And we know that when you have a larger diversity of microbes and you have a healthy gut microbiome composition, it actually helps with blood sugar regulation. So I compare it to being a business owner and thinking about trying to make the most amount of money in one month and sacrificing your yearly revenue as a result.

So for you as a podcast producer, you could choose to take all of the paid ads and endorsements and those sorts of things in one month. But at the end of the year, you might have sacrificed the trust of your listeners. and that could lead to less viewers and not actually a benefit in the long run. It's similar with food where you want to not only think about the immediate glucose response that's happening, but you also want to think about in totality, what is that doing to continue to build upon that foundation of health that will serve you in the long run with that flourishing, diverse gut microbiome that's really at the center of our health.

And it's also another important reminder that glucose is, only part of the picture. If we look at any sort of metric that's there and we look at it in isolation without the complete story, we start to miss things. It's an important one. It's in one that, you know, has a lot to do with many of the elements that we've covered, but it's only one part of it, which is why it's so great to see so many individuals and you referenced earlier. We had Casey Means on, we'll link to it in the show notes, talking about the full panel of metabolic tests that are there. And a lot of times when you start looking at those panels, you can, and if you, and again, not everything is food. If you have, if you have good stress outlets, you exercise on a regular

basis. And your base of your diet is whole foods. You can get away, quote unquote, with a lot of variability, metabolic flexibility, so to speak, that you wouldn't think that you could. Like, I have dark chocolate every night after like my dinner. I have fruit after my lunch and often after after dinner. And I'm not trying to be eating quote unquote perfectly all the time. And people would see that like my diet is fun. I try a lot of different foods. I was just hanging out with my wife and her mother-in-law this past weekend for my mother-in-law's birthday.

And we went and we explored a bunch of restaurants in this town nearby us, Ohio. in California, and we were getting a chance to try pastas. We were getting a chance to try a lot of different things. Now, I would eat my protein and fat and fiber first, and then I'd leave the pasta, and let's say if there was a piece of bread that I really wanted to try, like from this bakery that was there, amazing. They sit it down for us at the beginning part of the meal, and I'd just say, you know, great, I'm going to save my piece.

No judgment on what everybody else wants to do. I'm going to save my piece because I really do like to explore and try different breads with olive oils. and I bought this new type of olive oil that was there. And I saved that and I put that to the side for the end of my meal. So this is not about not being able to eat the things that you want to eat. Sometimes it's about changing order. And then sometimes it's also looking about all your labs in context.

So you can see what does my fasting insulin look like? What does my hemoglobin A1C look like? And so I can understand how my blood sugar fits in the context of all of those. Anything you want to add to that? Yeah, I think it's a great point of trying to. to enjoy the experience and use it as more of an experiment to see what's happening. And I would also say that really the flexibility that you have with your nutrition is going to vary from person to person.

So if you're a person that needs to restore your beta cell function so that your glucose levels and your insulin sensitivity is in better control, then you may do better following a low carbohydrate diet where you're not incorporating bread for dinner. and even though obviously you can decrease your blood sugar response with having bread at the end of dinner where you have a certain period of time that you aren't incorporating those things into your diet. Or maybe you realize that you have non-ciliac gluten sensitivity and the bread becomes a non-negotiable for you because of factors outside of your glucose levels, such as, you know, a flare in your joint pain or those sorts of things. And so this is where the personalization is really important.

one, giving yourself the flexibility to experiment within the parameters, I guess, of your food, non-negotiables or what makes sense for your specific health goals, if you're trying to decrease your blood pressure, medication, and get off of that alongside your doctor, and you're making very intentional food choices where, for the time being, you aren't incorporating those foods as often, you know, I think that that really is an important take-home message. Important point. Thank you for bringing that up. It reminds me this quote that I heard a few years ago. Most people know the first part of it.

They don't know the second part of the quote. So the quote is everything in moderation. We've all heard that before. So everything in moderation. And the second part of the quote is including moderation. So everything in moderation, including moderation, to me, there's so many layers of that quote. One is that there's natural variation of moderation. For some people, hey, my, my, my, my, my, my, my,

My version of moderation is, and this is not me. I'm just saying for some people, no judgment, two cigarettes a day, right? That's my version of moderation. And that might be their version of moderation if they were a pack a day individual that was smoking cigarettes and is like winning themselves off of cigarettes. So everything in moderation, including moderation. And that means that we have also our own variation that is there within that component. I previously would have gluten and I would break out immediately. I would feel like there's a brick in my stomach.

Now, if I can have bread that's from European grain, which there's a lot of restaurants and places around California that like advertise, there's actually a pizza place right down the street that every, you know, a couple months will order from there. And it's called Pisana. Shout out to them. No affiliation. But they make pizza with dough only in place. imported from Italy, and it's the short chain wheat flour. Now, in the past, before I healed my

gut microbiome, I would eat that and I'd feel like there's a brick in my stomach. Now, I don't eat it regularly, but I can get away every so often, I'm like, you know what, it's been a couple months since I've had some pizza and I'm just craving some. I can have it and I can be fine. But for a lot of people, depending on where they are on their healing journey, that could be a little bit problematic. So everything in moderation, including your own version of moderation that's there. Let's get into this. Oh, sorry, we're going to say something. Can I just add one thing?

Yeah. I think that also a lot of people hear the recommendation of moderation from their doctor or healthcare practitioner. And the important thing to recognize is that there is no definition of moderation. As you said, it's very subjective. I actually worked on a research study a few years ago where we did a survey of several hundreds of people, and we asked them what their perception of moderation was for weekly consumption of red meat, of alcohol, of added sugar, and several other foods. And what we found

as a result is that the individual perception of moderation is very wide ranging. That there's a lot of individual variation when it comes to that. And so if you're hearing recommendations from people saying, just eat that in moderation, you know, it's a really lazy recommendation. And in my perspective, if you're not adding that second. Exactly. Because like you said, it's your own personal context of what that is. And so for people to understand that, you know, sometimes the word moderation in itself can set you up for confusion is, I think, helpful to shine light on because there really

is no definition. I always say if you go to Times Square and you take 10 people at random and you say, hey, do you eat a healthy diet. On average, and probably even more than average, my bet would be that 80% of people would say that they do eat healthy. And everybody's definition of what healthy is is different. So this is really about personalization. It's going away from modern modern modern, and going towards personalization, right? Away from, let me say that again, away from moderation and towards personalization. A little tongue twister there.

Bridget, let's get into the fourth one that we wanted to get a chance to cover here. And that's expanding a little bit more on the topic of stress, blaming food for what stress did. You shared this as one of the top tips in the beginning. But what do you teach your clients about this topic? Everyone is very quick to lean on how food is impacting their glucose. And they often miss the fact that stress very much impacts. their glucose response at any meal and actually can also lead to a glucose elevation all on its own. In the middle of the day, you don't eat anything, but you've gone through a stressful meeting

or you have lunch with your ex-wife or something happens that creates that stress response and tells your body that you need more glucose because you're in a fight or flight situation and your body thinks that you need to be running. doesn't realize that you're sitting processing this stress. And often people actually won't even identify it as a stressful experience because they're so disconnected from what that feels like. So, you know, one of my greatest eye-opener's was a few months ago when I was wearing a Levels Continuous Flucose Monitor.

I was filming for a nutrition program that we were creating for one of our corporate clients. And it was like long days of filming. There was a ton of things that we had to finalize within a week period of time. I wasn't committed to my exercise routine and other practices that I have embedded in my routine on a regular basis. And my glucose levels were spiking like crazy. And I got a notification in the app saying your glucose is really high. And a lot of times what levels does when your glucose is high as they say, here, connect with the nutritionist to learn more about how you can manage that.

And my face came up saying, connect with the nutritionist, and then, you know, I'm there listed. And it was such a funny experience to be seeing the facts that I'm listed to provide people recommendations to manage their glucose. And yet I had difficulty in that moment doing that for myself. And I think that it highlights so much the fact that the nutrition knowledge and practices that you have can only, take you so far if you aren't also thinking about stress. And I see this even in people who are eating one meal on a Sunday when they have lower levels of stress because it's the weekend. For instance, this recently came up with a client of mine who had a bowl of oatmeal with collagen and almond butter and chia seeds. And he traditionally doesn't have large glucose responses

to a meal like that. Whereas, of course, other people could have large glucose responses. but his Sunday oatmeal bowl did not lead to a large blood sugar increase. He had the exact same meal on a Tuesday when he's under more stress. He has a lot of things on his plate at work. And his blood sugar response was very high. His blood sugar levels went up a lot. And he took that to mean that oatmeal is not good for him until I was able to point out the pattern that we had from previous data points to say this actually was just a one

one-off instance that could have honestly been driven by a stressful situation rather than the food itself. So I think that really paying attention to those patterns to say if you have one meal on a Sunday, does it lead to the same glucose response on a Tuesday and is stress playing a role? Or maybe for some people they have a spaghetti squash bowl agnase on a Monday night and that creates a larger glucose rise. They have the same meal the next day for lunch. And at lunchtime, that doesn't actually create a glucose rise. So it also depends on, you know, if you're exercising right before you have the spaghetti squash bowl agnese for dinner, and your muscles are more primed to utilize the glucose that's in the tomato sauce and spaghetti squash,

that for some people can surprisingly increase glucose levels. Or if you're sitting all day at work, sometimes it'll be the opposite, where people who are sitting for 10 hours straight and then eating lunch, will have larger glucose rises to whatever they're eating for lunch compared to if they have that exact same meal the next day for dinner because at 4 p.m., they're getting up from their desk, they're going to pick up their kids, even if it's just basic movements that are getting the body moving and helping the muscles be more primed to utilize that glucose, they may experience a lower blood sugar increase in the evening. So I think that factoring in these aspects of movement and

stress and how you have to think of this more holistically is really imperative to prevent you from judging a food and removing it from your diet entirely. Super important reminder. That sets us up sets us up for number five that we want to get a chance to go into. A mistake that people make when wearing a continuous glucose monitor or monitoring their blood sugar, and that's eating too much saturated fat. Talk about that. So this is a more controversial. controversial topic, and it really depends on the individual for your processing of saturated fats. There are some genetic snips that can decrease a person's ability to process saturated fats. Your APO-E gene is one of the really common ones when you have like an APO-E4 mutation and others that can,

if you have your genetic profile, that can decrease your ability to process saturated fats. Sometimes if you have a lower carbohydrate diet, you can actually tolerate more saturated fat. That's what a recent research study came out showing that there was no dramatic impact in cholesterol levels or blood sugar levels for people who had a 20% saturated fat diet or 20% of their fats were saturated fat compared to individuals who had a lower saturated fat intake. but the people that had the larger saturated fat intake also had less carbohydrates in their diet. So the absolute worst thing that anyone can do is eat a diet that's high in both carbohydrates and saturated fats.

And that's a lot of standard American foods, right, like pastries and cakes and these sorts of things that are high in saturated fat and also high in sugar. But even if you're eating like paleo, for instance, and you're using a lot of coconut oil and coconut sugar where you think you're making a better choice. It's something to really think about that you want to kind of go one way or the other. And this is going to be highly variable in each person, their tolerance for saturated fats. But what I do see in a lot of people who are using a continuous glucose monitor is that they start to adopt more of a ketogenic style diet that often leads to increases in saturated fat. And I recently had a client.

who was following a ketogenic diet with a very popular diabetes reversal company. And she had pre-diabetes. And she had been following the diet for a year, getting her labs done twice a year by her doctor and then working with her health coach. Her blood sugar and her cholesterol and her triglyosterides only continued to increase once she started the program. And the doctor told her that she just wasn't following it close enough. And one thing that I just want to make a side of is that if you're adhering to something and you're working with a practitioner who's telling you that you're the problem rather than questioning the protocol, it's a big warning sign that you want to consider switching practitioners that you're working with because, you know, there is no one size fits all.

But back to this woman, she ended up decreasing her saturated fat intake, increasing some of her complex carbohydrates like beans and legumes and to other foods. that are carb sources that create more of that low lycemic response. And she actually lowered her cholesterol by close to 40 points in a six-week period of time. She lowered her fasting insulin. Her hemoglobin A1C went from a 5.8 to a 5.6. Her triglycerides cut by, I think, 50 points. Her LDL levels went down significantly, all within a six-week time period. And so it really just reinforces the fact that, one, you want to make.

make sure that you're working with a practitioner who understands that you aren't the problem and that you need to continue to modify protocols. And two, that you want to continue to use these lab metrics to help you understand if the choices that you're making are leading to improved health outcomes. And so often people are used to just using the scale as a way to assess this. But you need to start thinking more comprehensively at other markers that can tell you whether you're on the right track. I love it. And just another reminder that the way out of the diet wars and the way out of, is this the best approach or is that the best approach? Partly, one of the ways out of that is actually everything works and everything doesn't work. It's more about personalizing it for you and then

having metrics to track it along the way. Of course, there's areas that people will be hotly contested. You know, there's a group of individuals that feel LDL isn't as a stronger, strong of a warning sign if it's elevated, if inflammation is lower. There's groups that say total cholesterol doesn't really mean anything, which is most functional medicine practitioners. It's more about the ratio of cholesterol that's there. And so there's going to be numbers that people disagree on. But in general, there are some basic ones. Again, you can go to some past newsletters and articles that we've written about it. that there is a pretty universal understanding.

Like, I don't think anybody's out there advocating for a higher fasting insulin, right? There's no one that's telling you that you should have a higher fasting insulin. So at least that's one marker in addition to some other ones we've written about, where we know we can monitor these things and that we also know a lot of variation in blood sugar. Even if people disagree about what optimal numbers look like, a lot of variation is linked very strongly with that production of inflammation inside of the body. So there are things that we do know. And now if you want to be a vegan, if you want to be vegetarian, if you want to do any

particular diet or lifestyle approach, that's completely up to you. And just watch yourself and see if you're heading in the right direction or if you're not. Bridget, I think that's a good opportunity to share here a little bit about some of the programs that you run. and one of them in particular that's coming up here, that if people are interested in this and they're like, you know what, I might want to dabble in this and try a CGM and get a little bit of community support along with it. What are some of the things that you have coming up? So in May, we're going to be running a blood sugar reset that's a 10-day program with recipes for breakfast, lunch, and dinner that you can use as a framework or as a template that have been tested on my continuous glucose monitor as a way to just get started.

And also for people that have been using continuous glucose monitors to experiment with foods that you might not have otherwise tried. We had a lot of people in our last blood sugar reset who had been previously using a continuous glucose monitor who said that it really helped to open the rotation, diversity of foods that they were incorporating into their diet. So that's a free program that we are going to run. And we have a Facebook group for that community support. it's a great place to really get started or continue to better understand your body. You don't have to have a continuous glucose monitor for it. We had plenty of people that did not use a continuous glucose monitor, knowing that I'm at least testing my glucose levels, although obviously glucose varies for every single person.

It at least highlights the fact that they're low glycemic recipes that are abundant in phytonutrients, micronutrients, your dietary fiber and protein that are really the building blocks of so much of the health, decreasing cravings, improving your energy. And so I'm really excited about that. We're going to do that in the beginning of May. And I can send you a link for people to sign up for that if they're interested. And because this podcast is Evergreen and people will watch it on YouTube and other places that are there, if you're watching this at a much later date, and we're talking about May 2022, Bridgett has programs that are running all the time. So you can go to her website, Beingbridged.com, I believe, and we'll have the link inside of the show notes,

and you can sign up for any one of the future programs that are there. Bridget, before you start to wind down a little bit, I actually think this would be a really good opportunity to understand a little bit more of your why. Would you mind sharing about your health journey and what brought you into the world of functional medicine and inspired you to become. functional medicine dietitian? I'd love to. My journey started 17 years ago as a patient. I was struggling to stay awake for my life, falling asleep not only in every single class, every single day, but also sometimes when I was sleeping, or sorry, sometimes when I was eating, I would be sleeping.

Sometimes when I would be working out in track and cross-country practice, I would fall asleep in the middle of practice. And I was having about 20 to 30 mini seizures a day that, would last for about five to 10 seconds each. And I was diagnosed with narcolepsy and cataplexies, and that's a neurological autoimmune condition that's also a sleep disorder. And I remember the appointment that I was diagnosed where my doctor said, this is what you have. And he essentially pulled on his prescription pad and said, here's the game plan. You're going to take these drugs to mask these symptoms. Your symptoms will only get worse with age. So you'll only need to continue to increase the dose and the number of medications that you're on.

And that's the game plan. And I was 15 years old. My parents were super concerned about the fact that these drugs were very new to the market, no long-term data on the safety or side effects. And they just asked, is there anything that we can do to improve how she's functioning on a daily basis. And the answer was very clearly no. They chose to go against that recommendation and sought out a functional medicine doctor that we worked with who did lots of labs, put me on an elimination diet, did a supplement protocol, breathing techniques, and a sleep hygiene protocol. And within about four weeks, it became very undeniable, even to me who just wanted to take the drugs right away. it became very undeniable that it was working.

And we were so excited to go back to the neurologist to tell him about my progress. And he didn't look at us at all the entire appointment and just continued to adamantly state. Nutrition has nothing to do with your condition. We have no scientific evidence to show any association. And he actually refused to continue seeing me. My parents are very respectful people. So we weren't making a scene. but he didn't agree with the fact that we were trying to use lifestyle interventions to optimize

my health first before starting on the medication route. So it wasn't that my parents were opposed to medication. It wasn't even that changing my diet cured me of narcolepsy because I still do take a low dose of medication. But my level of functionality is so much higher than it otherwise would have been had we not taken those first steps. And I remember about a year later just saying to my mom, there has to be a million other people that are just like me who are being told by their doctor that nutrition has nothing to do with their condition when they're diagnosed with a symptom or a condition that is either created by or exacerbated by poor nutrition and lifestyle. And I want to help those people. And I didn't want to become a dietitian to teach

people how to count calories to lose weight. I grew up in a household. We didn't even own scale. But I believed with every ounce of my being that food is medicine based on my own personal experience. And what I felt then as a young teenager only stands to be so much more true today after working with thousands of people where I can state that it's not just my own personal story. It's hundreds of thousands, if not millions of other stories of people who are going to their doctor and are not being given the recommendations or even the, like you said, not even being given the opportunity to make some of these interventions and take their health into their own hands. And that's what really fuels everything that I do.

Well, we wouldn't wish that experience on anyone. And yet I'm so thankful that you have been in the position of being the patient because that clearly inspires your work. of how to make things accessible and what actually will improve. Even if it doesn't get to the root issue, as you mentioned, you know, you still suffer from narcolepsy episodes and I believe also seizures. They still occasionally happen. Is that correct? My diet completely resolved all of the seizures.

Oh, that's huge. That's huge. What a sense of hope for anybody who's listening who's in that same category. Obviously, everybody's root issues are slightly different, but diet plays a huge role. And so just going back to it, even if it didn't completely get rid of, you know, one particular area like the narcolepsy and you're on low-dose medication, still the fact that you can function, be a normal, beautiful young woman who does all the things that you should be able to do. And on the flip side, there's people out there that are suffering that they can't even get up and go to work. It's tough for them to think about maybe having a relationship or going out on a date. because they're worried, you know, are they going to be normal? Can they function that same way? And it's

not just with people with your conditions, individuals that have things like IBD and IBS who are just nervous about traveling, about going anywhere. So the fact that there's more individuals that have come on the other side of heavy lifestyle interventions and often simple lifestyle interventions who are sharing their case studies. And in some cases like you, our practitioners, is really inspiring. So I appreciate you coming on the podcast and sharing your story with the audience. And I'm really hope that if anybody's interested in this topic

and just feels like they're waiting for the right community to jump in, I would highly recommend joining one of Bridget's programs and getting a chance to see how great you can feel when you're put in the right conditions and circumstances. Bridget, any final closing thoughts that you want to leave our audience with? I would just say to not underestimate the power that you have. the power that you have over your own health and how you feel on a daily basis and the impact that you can have on other people's lives and also the impacts that you can have in making

change in our health care system and in our food system and in these industries that exist. Sometimes it can feel a little overwhelming when you go through all of the points that we went through in this podcast. And I think that bringing it back to a positive light to say that so much of these companies can only say in business if you continue to support them financially. And even though sometimes it feels so small to just be one consumer in this, you know, this trifecta of the healthcare industry and the diet industry and the food industry, you really can have a huge impact on the choices that you are making, that your family is making. You can impact your community by leading by example.

And voting with your dollars really makes a huge difference. Not only voting with your dollars at the grocery store or at your farmer's market, but also voting with your health insurance dollars by choosing practitioners that are more aligned with a progressive approach. Because the more that this demand shifts, the more that this demand shifts, the more the industries will be forced to shift. And even just in sharing information that you know, sharing Drew's podcast episodes, sharing books that you've read about with people that are in your network, can make a huge difference on the momentum that we have as a society to make things better

for future generations so that they don't suffer with so many of these chronic conditions and autoimmune conditions that are largely preventable by nutrition and life. interventions. A hopeful and inspiring message. Bridget, thank you for coming on the podcast. Bridget's website is being bridget.com. You can find all the information there or clicking the show notes to learn more about the programs. Bridget, it was great to catch up. We haven't seen each other in a long time. We're overdue. I'll give you a big hug next time we see each other in person. And thank you again for coming on. Thank you, Drew.