The Dr. Hyman Show - Top Tips For Managing Your Blood Sugar And Avoiding Insulin Spikes

Starting point is 00:00:00 Coming up on this episode of The Doctor's Pharmacy. Your muscles are really your biggest ally in reducing your glucose spikes. After your meals, use your muscles for 10 minutes. Hey everyone, it's Dr. Mark. One of the most important tools I have for helping my patients optimize their health is testing, and that is why I love what Rupa Health is doing. Functional medicine testing can require placing orders with lots of different labs, and it can kind of get really complicated for doctors and their patients to easily access results and keep track of everything. But Rupa Health has totally streamlined that process.

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Starting point is 00:03:11 Hi, this is Lauren Fee and one of the producers of The Doctor's Pharmacy podcast. Food should be a tool for helping us feel our best. Unfortunately, however, experiencing symptoms of blood sugar imbalance is an everyday occurrence for most people. Feeling hungry even after you just ate, craving sweets, and dealing with acne, hormonal imbalances, and signs of aging like wrinkles are just a few of the many symptoms of blood sugar swings. When they continue to go unchecked, more severe dysfunctions can occur like type 2 diabetes, infertility, fatty liver disease, and dementia. In today's episode, we feature three conversations from the doctor's pharmacy on simple hacks to help manage blood sugar levels and maintain insulin sensitivity. Dr. Hyman speaks with Jesse and Chape on tips

Starting point is 00:03:56 to reduce blood sugar spikes and why that's important, with Max Lugavere on how choosing the right time of day to eat can positively impact our blood sugar, and with Dr. Casey Means on how adding protein and fat to starchy foods can help with blood sugar balance and much more. Let's jump in. Sugar is the biggest problem that we have in terms of not allowing these longevity switches to work properly. And so we literally turn off the longevity switch. We should have rapidly accelerate aging when we over consume sugar. And I would say starch as well. I mean,

Starting point is 00:04:31 that's just the same as sugar because you can eat a bagel or sugar is the same thing. Yeah. And so we end up in this situation where we know it's bad for us and we know we need to avoid glucose spikes, but often people can be a bit lost as to where to begin. Does it mean I should never eat starch and sugar again? That feels very draconian for most people. And so what I've developed are these 10 principles, these food principles that allow you to keep your glucose levels steady without giving up all the foods you love. Because personally, Mark, I need a chocolate cake for my birthday. I'm not going to have a Brussels sprout, low carb, no sugar cake. I need chocolate cake. This is a non-negotiable part.

Starting point is 00:05:10 You're a better human than I am, but I love sugar. And so when I first discovered the world of glucose, my fasting glucose levels was 95. I was 23 years old and that was high. And through my hacks, I've lowered it to 79 without giving up all the stuff I love. And that's two hacks. So we've got the timing of what you eat when, right? Vegetables, protein, and starch. And then the vinegar before you eat.

Starting point is 00:05:37 What else? So if anybody is still having a sweet breakfast, this is a very important hack. Have a savory breakfast. And of course, nobody listening to this podcast ever eats a sweet breakfast because they've been listening to this podcast and they know that we should not have dessert for breakfast.

Starting point is 00:05:51 But just in case you haven't heard many of the podcasts, just in case this is the first podcast you listen to, have a savory breakfast. So in the studies, what they've done is they've taken two groups of people and they've given them two breakfasts, one of two breakfasts, same number of of calories we know calories don't count but still it's important to mention this one group had a breakfast that spiked their glucose levels the other group had a breakfast

Starting point is 00:06:15 that kept their glucose levels steady what happened was in the group that had the spiky breakfast they got hungry again after two hours. Whereas the group that had the steady glucose breakfast didn't get hungry for five hours. So the curve, yeah, of course, the curve of your breakfast really determines how you're going to feel for the rest of the day and whether you're going to feel in control and connected to your body or whether walking by that bakery is going to give you an irresistible urge to buy all the cookies like it used to be for me. I used to have a Nutella crepe for breakfast every morning growing up, Mark.

Starting point is 00:06:50 And by 10.30, I was starving. I mean, it was bad. Nutella crepe, yeah, that'll do it. But I'm recovered now, I'm recovered. And if I really want a Nutella crepe, what I do is I have it after lunch or dinner as a dessert and I have some vinegar before. So that's another hack. You know, if you want something vinegar on your cookies, is that, is that the thing?

Starting point is 00:07:13 Yeah, just pour vinegar all over my cookies. My friends love me when I come to parties. No, it's, it's, so it's having a, you know, the vinegar in the water before you eat the sweet thing, having the sweet thing after a meal, and also then using your muscles for 10 minutes. So your muscles are really your biggest ally in reducing your glucose spikes. And so what I recommend, it's another hack. After your meals, use your muscles for 10 minutes. Top favorites include dancing to your three favorite songs really loud in your living room going for a walk with your dog doing the dishes the laundry whatever use your muscles that way

Starting point is 00:07:52 you'll curb the spike and you'll feel better that's a really important point i think people don't realize this but the data is so compelling on what you're saying which is if you just take a walk after dinner for 15 20 minutes half, half an hour, you will see a dramatic change in your metabolism and your blood sugar. Absolutely. Absolutely. It's really incredible. And this works particularly well to combat the post-meal sleepiness that a lot of us

Starting point is 00:08:15 feel. If you just use your muscles afterwards, you have all this energy again because you're not experiencing such a big crash. And if you can't go outside and you're just home and you're watching, for example, a TV show after dinner or a movie, people can get really creative. So you could hold a plank in front of your couch while you're watching the movie. You could get some kettlebells and do some bicep curls, whatever works, whatever floats your boat. But that'll really help your body deal with the glucose coming through. Amazing. What else? You've said 10 things. There's a lot more. I know. I'll give you one more, but then the rest are in my book,

Starting point is 00:08:49 Glucose Revolution. One more is putting clothes on your carbs. So what do I mean? Do not let your carbs. Clothes on your carbs. No naked carbs? No naked carbs. No naked carbs. So anytime you're eating... What's a naked carb? Aha. So a naked carb is sugar or starch that you're eating on its own. Naked. You just eat it naked and it lands naked and it creates a big glucose spike. So to put clothes on your carbs, what you do is anytime you eat something sweet or something starchy you make sure to put some protein fat or fiber on it you put some clothes on that so example I'm gonna take the chocolate cake example I put Greek yogurt on it if I ever want it in the middle of the day if you want a piece of sourdough bread put some avocado on it put some butter on it if you ever want to eat some rice have some eggs with it

Starting point is 00:09:45 some smoked salmon some greens that you saute that's brilliant i think i think the the idea that we need to not be eating any of this stuff in a way that spikes our blood sugar is key and what we're learning what you learn through measuring your blood sugar for years and tracking everything is how different foods affect you. But the interesting thing is that what might affect you might not affect somebody else and what affects somebody else might not affect you. So can you talk about the differences in glucose metabolism from person to person, depending on their genetics and even their microbiome? Absolutely. So when I started discovering the world of glucose monitoring, I set a few of my

Starting point is 00:10:25 friends up with one as well, and we tested the same foods. So for example, we would eat the same cookie and then compare our glucose spikes. Turns out mine was bigger than other people's. I was like, darn it, I really love cookies. And so I started thinking, what does this mean? Why is my spike so much bigger than my friend Luna's spike?'s going on here well many things could be going on so as you mentioned microbiome could be a factor hydration level tiredness how well we had slept the night before muscle mass obviously because your muscles soak up glucose insulin sensitivity so you know how metabolically healthy we are and just many many more things the phase of your menstrual cycle your

Starting point is 00:11:10 stress levels there's a lot of stuff going on there so it was really interesting to notice what choices might be better for my glucose levels compared to other people but I kept coming back to the fact that the science shows that the hacks work in all of us so if me and my friend who both ate the cookie had both put some clothes on the cookie let's say you know ten almonds both of our spikes would have been proportionately smaller than the naked cookie spike so you have to keep that in mind these principles work for all of us but then if you have to keep that in mind. These principles work for all of us. But then if you have the opportunity to use a glucose monitor, you might discover much more personalized and in-depth, you know, preferences that your body has. Yeah, you know, Jessie, I remember reading that Israeli study where they looked at the microbiome and how that uniqueness of each of our ecological community that we live in, which is our gut.

Starting point is 00:12:06 That lives in us, yeah. How that actually is so determinant of what happens with our metabolism. And we know from animal studies that if you take the poop out of a skinny mouse and you put it in a fat mouse, the fat mouse will get skinny. Yeah, or in a diabetic to not diabetic. Yeah, if you take a healthy metabolically healthy person which there's not that many of us around anymore there's about only 12 of us in america that are metabolically healthy but if you find a person good luck and you transmit their poop into

Starting point is 00:12:34 a diabetic their blood sugar gets better and i remember i remember a case uh which i had years ago i think i might have mentioned on the podcast, of a gentleman who had type 2 diabetes. We really poorly controlled, his sugars were well over 200 all the time. And we got him down to like 150, but we couldn't just get him all the way normal, even on a ketogenic diet. And one day he called me up and he said, Dr. Hyman, I'm having a lot of digestive symptoms. I'm bloated, I'm distended, I'm all those issues. And I said, okay, well, let's do some diagnostic workup, a stool test or anything. But in the meantime, you know, while you're suffering, just try some charcoal to see if that can absorb some of these, these sort of bloating and the gas and the toxins, which, which can cause these symptoms. And he did. And then he called me back and says, Dr. Hammond,

Starting point is 00:13:19 I don't know what happened, but my blood sugar went to normal. I don't even understand. But, and I did understand because the microbiome plays a huge role in our metabolic health and something called metabolic endotoxemia, which means that the toxins produced by bad bugs in the gut when we eat the wrong things get absorbed and they cause inflammation. The inflammation causes us to be insulin resistant and that makes us more diabetic. I mean, it's just a whole cascade, a vicious cycle. And so simply by absorbing the metabolic toxins in his gut from bad bugs, we were able to actually correct his blood sugar. So it's quite fascinating.

Starting point is 00:13:52 It's not as simple as we think. It's just, oh, just eat this or don't eat that, or exercise or don't exercise. It's really, it's kind of a personalized story. And I think there are universal principles like you mentioned. I think I just want to loop back on something you said before as well, because you talked about these sort of toast that happens when proteins and sugars in your blood and you become toast and you're literally toast. I mean, it's actually true.

Starting point is 00:14:18 You're toasting your system. And there's a phenomenon that's called advanced glycation end products. And we measure this when we measure our average blood sugar through hemoglobin A1C, which is just measuring the proteins in hemoglobin getting glommed onto by sugar and forming this like crusty creme brulee, like chicken skin, that kind of, that phenomenon, it's called the Maillard reaction, happens inside your body, not just when you're cooking. And that is one of the hallmarks of aging, is the abnormal proteins that form in the body

Starting point is 00:14:48 that gum everything up. And this happens in your brain, it's called type three diabetes, it happens in your heart, your organs. It really is the phenomenon that leads to rapid aging and death. And then what's even funnier is that these things are called ages, advanced glycation end products,

Starting point is 00:15:02 and they bind to receptors on your cell called rages so the ages make you rage literally and turn on all the inflammatory downstream phenomena that that we see as inflammation so it's such an important thing to understand and regulating your blood sugar is probably the single most important you can do i remember being at kenya ranch years ago and there was a cardiologist that came from har, and he gave a lecture, and he said, you know, if you could take a group of 100-year-old people, and you could find a group with clean arteries, they'd have one thing in common. What would that be? They're insulin sensitive, meaning they're very good at keeping their blood sugar even without a lot of insulin. That's the key to longevity and healthy aging, and not just

Starting point is 00:15:44 that, but all these other conditions that you mentioned from acne to infertility to depression to panic attacks to fatigue, energy, insomnia. I mean, night sweats are even a common symptom. You know, men get night sweats too. And often it's because they have these hypoglycemic spikes and they can wake up with soaked sheets. So really important to get your sugar dialed in. So that's one of the things that happens when we have a glucose spike. It's the toasting. And maybe I can mention something else that happens when our glucose levels spike. So every cell in your body needs energy to function.

Starting point is 00:16:17 You know, your brain cells need energy to think, your eye cells to see, your toe cells to dance all night long. Like every cell in your body is really hungry for energy. And the most easy place they get this energy is through glucose that we eat. And so as you digest a meal and glucose goes into your bloodstream, it heads to your cells to be converted to energy. And the little organelles that do this work are mitochondria. They take glucose, turn it into ATP, which is energy. And so you might think, okay, well, if I need energy, then the more glucose I eat, the more energy I have, right? There must be a correlation just like that. It turns out that's not the case. If you overwhelm

Starting point is 00:16:56 your mitochondria with too much glucose, which is the case when a glucose spike happens, your mitochondria don't get excited they actually shut down they're like whoa whoa can't deal with all this stuff don't know what to do i'm stressing out i can't work anymore your mitochondria shut down and they get stressed and they release these things called free radicals into your cells and free radicals they harm everything that they touch so if they touch your dna they might harm and create a mutation that could lead to cancer later on if they touch your DNA, they might harm it and create a mutation that could lead to cancer later on. If they touch a cell membrane, they can break the cell membrane and damage the integrity of the cell. And so your body's response to these free radicals is inflammation.

Starting point is 00:17:33 And that's one of the ways that glucose spikes increase inflammation. The problem is, in this case, if it becomes chronic inflammation, it's not good. And that is another thing that creates a terrain for chronic diseases. I mean, three out of five people are going to die of an inflammation-based disease. I mean, I don't know if it's three, it's probably 100%. You think? Actually, sure. I mean, unless you get hit by a truck or fall off out of a train or something, I think most of the people die from inflammatory-related conditions because all aging itself leads to more inflammation through a whole series of mechanisms, including your blood sugar, including environmental toxins, including your microbiome, including latent infections, including our unprocessed inflammatory diet, including chronic stress.

Starting point is 00:18:19 I mean, all the things that we see around us all the time are all driving this inflammatory process. But sugar is sort of the king, queen queen and prince of driving inflammation in your body and so it's it's it's such an important thing that's why i've been talking about this for decades because you know as a doctor seeing patients and testing this stuff when no one else was looking at it it was like wow people are messed up like i would do glucose tolerance tests, not on diabetics, but on almost everybody who came in as a screening test for their metabolic health. Because your blood sugar can be perfectly normal and you can still be a mess, right? Yeah, absolutely.

Starting point is 00:18:55 And I think that's an important lesson. We've had Dr. Casey Means talk about this on the podcast, talking about how there's patients who literally have perfectly normal blood sugars, but their insulins are so high that they're keeping their blood sugar normal. And that causes a whole other cascade of problems. Yeah. Cause I think insulin increases for 10 years before fasting glucose levels increase. Yeah. I mean, the last thing that happens is your fasting glucose going up, right? Yeah. And then the second thing that, second thing, second to last thing is your fasting glucose goes up, but then your insulin, I mean your glucose

Starting point is 00:19:29 after you eat goes up. But that's again a late stage phenomena. Earlier stages are high insulin after two hours than high insulin fasting. And then it's like, so we're getting on the train so late in medicine, we need to think about how to go upstream to get to the cause. Yeah, and for a long time we only thought diabetics should worry about this. Only if

Starting point is 00:19:47 you have diabetes should you then think about managing your glucose levels. And by the way, to manage it, just eat better and exercise more. I mean, come on. We need to give people the hacks, Mark. We need everybody to be using this because it's so easy. Hey, everyone. It's Dr. Mark. If I've learned one thing during my two decades in functional medicine, it's that we're all unique. No two people are alike, which means we can all benefit from personalized medicine. But for most of the history of medicine, individualized healthcare just was not possible. We couldn't look inside the body and see what was really going on. But now, thanks to advances in technology, that is changing for the better, and it's doing so in some amazing ways. And I've got a great example of amazing healthcare technology that I'm excited to tell

Starting point is 00:20:28 you about. It's called InsideTracker, a wellness tracker that uses science and technology to deliver ultra-personalized healthcare guidance. It can analyze your blood, your DNA, your lifestyle habits, and then give you actionable recommendations to help you meet your health and wellness goals. InsideTracker provides you with the information you need to make powerful health decisions. It gives you a customized dashboard to help you track and reach your goals. And the numbers are calibrated to your body as opposed to just listening to the normal ranges that your doctor might tell you. It also helps you understand those numbers and take action on them. If you're curious about getting your own health program dialed in to meet your unique needs,

Starting point is 00:21:07 I highly recommend checking out InsideTracker. Right now, they're offering my community 20% off at insidetracker.com forward slash Dr. Hyman. That's D-R-H-Y-M-A-N. That's InsideTracker, I-N-S-I-D-E-T-R-A-C-K-E-R.com slash Dr. Hyman, D-R-H-Y-M-A-N. And you'll see the discount code in your cart. We often focus on what we're eating, how much we're eating, but we really don't focus that much on when we're eating. And there's a lot of interesting research lately on the when, on fasting, intermittent fasting, time-restricted eating, all kinds of ideas that

Starting point is 00:21:46 people are having that extend lifespan, that reduce the risk for many diseases. So tell us more about the importance of when. Yeah. Well, it seems that there's this eating paradigm that's emerging in the literature and it's being called early time-restricted feeding. So basically eating an earlier dinner seems to be associated with improvements in blood pressure and blood sugar independent of weight loss. So a lot of people online will say that intermittent fasting is really only useful insofar as it's, you know, it has an ability to help us control the amount of calories that we consume. But it seems to be the case that by not eating too late at night, you know, because as I mentioned,

Starting point is 00:22:23 light is a major time setter that the brain uses to know what time of day it is and optimize its processes accordingly but food is another time setter and it's a time setter for the periphery for the clocks that are in our metabolic organs you know in the organs of digestion and what have you and so eating too late at night might actually negatively affect things like blood pressure blood sugar so people like do intermittent fasting or when we call time-restricted eating, they'll eat at noon and they'll eat to eight at night. Is that a bad idea? It should be more like eight in the morning till four in the afternoon. I mean, that might be ideal. The issue is that

Starting point is 00:22:58 we're not waking up with the sunrise and going to sleep with the sunset like our ancestors might have used to do. We, I mean, wake up a lot later. We go to sleep a lot later. So I think that to try to recreate the optimal eating paradigm for the bodies that we've inherited might be a futile effort. So the recommendations that I make are to not eat for an hour or two after you wake up, especially if you wake up with an alarm clock. Because the problem is a lot of people who wake up artificially with an alarm clock to wake up, get ready for work, their melatonin levels actually haven't properly,

Starting point is 00:23:35 it's likely that their melatonin levels haven't come down. So they could be groggy when they wake up. Groggy, but also less insulin're eating a if you're drinking a glass of orange juice or eating a bran muffin or whatever first thing you probably shouldn't do anyway for breakfast right that's not a genius breakfast right well your listeners are savvy they're not eating like that right but um i hope you're not but um but no i mean there there's a that is a mechanism by which you know your blood sugar can stay abnormally high um whereas if you just perhaps are to wait an hour or you know and and also a way stay abnormally high. Um, whereas if you just perhaps are to

Starting point is 00:24:05 wait an hour or, you know, and, and also a way that you can make sure that your melatonin levels have come down is again, to get that bright light in through your eyes in the morning. So eat light for breakfast, eat light for breakfast. Yeah. Eat light, eat, eat light, especially if you have to wake up early. Um, and then to eat a, I mean, I would say that if you were going to eat a heavy meal, do it in the, in the daytime and then eat eat a I mean I would say that if you were going to eat a heavy meal do it in the daytime and then eat a lighter dinner of course you'll be wanting to take

Starting point is 00:24:31 a siesta in the afternoon so the Spanish had it right that's right yeah but you know the thing is I agree I always said you shouldn't eat three hours before bed because your body's getting ready to repair and heal if it's digesting it doesn't do such a good job and if you want to gain weight the best way to gain weight is. If it's digesting, it doesn't do such a good job. And if you want to gain weight, the best way to gain weight is night eating. It's the best way.

Starting point is 00:24:49 Yeah. And it's not because, here's the thing. So like sometimes I have these confrontations with people in the fitness world who say, well, a bagel isn't magically going to be 200 calories at 8.01 p.m. if it's only 100 calories at 8 p.m. And that's true. The calorie content of food doesn't change from one time to the next. But it might actually, the disruption of your body's circadian rhythm might negatively affect hormones involved in energy metabolism, in hunger. So eating late at night could actually make you more hungry the following day. My favorite study I read when I wrote my book, Ultra Metabolism, like 15 years ago or more, was

Starting point is 00:25:29 they fed people the same calories in three meals over the day, or they fed them like one meal at night. And the ones who had the one meal at night with the same amount of calories gained weight compared to the other group, even meal at night with the same amount of calories gained weight. Wow. Compared to the other group, even though they eat exactly the same amount of calories. Yeah. Because it might reduce leptin, which is the metabolic throttle, essentially, that dictates our resting energy expenditure. It might actually increase levels of ghrelin, which is a hormone involved in hunger. Um, so these are all the indirect ways in which late night eating can

Starting point is 00:26:11 actually make you gain weight, whether or not. And leptin also, um, actually causes a reduction inflammation. It's anti, anti-inflammatory. Yeah. Yeah. Yeah. So the system that we've inherited is very complex, but there's a great way of expressing it that I was able to glean from my interview with Sachin Panda, who's one of the leading experts on circadian biology. At a certain point in the evening, you have to kind of consider the kitchen having closed. You know when you go into a restaurant after an hour?

Starting point is 00:26:43 It happened to me last night. I was in Washington, D.C., and I went with my friend, Congressman Tim Ryan. We were trying to go to a Mexican place. It was like this healthy, vegan kind of taco place, and they were shut. Kitchen closed. Kitchen's closed.

Starting point is 00:26:56 Yeah. We had to find some other place. Yeah, so I mean, if you just think about your body in the same way, and it's a little bit of a term of art. You could digest anything at any time of day. Does that mean it's going to be optimal? Not necessarily. So at a certain point I would say, give yourself, give yourself an 8 PM or 9 PM cutoff and say the kitchen's closed in your body and that's it. You know, you're winding down,

Starting point is 00:27:17 you're getting ready for bed. You're not going to be as insulin sensitive in the evening as you were during the day. Also, uh, especially when eating lots of carbs, can cause insulin to spike, which can negatively affect hormones like growth hormone. It can affect the way that your brain cleans itself up because of an interaction with insulin degrading enzyme, which we know dismantles the plaques that are associated with Alzheimer's disease.

Starting point is 00:27:44 Which is often called type 3 diabetes. It's basically diabetes of the brain. If you're diabetic, your risk of Alzheimer's is four fold higher. That's 400% higher. That's staggering. Combinations. We see a lot of people log something like an apple and then they'll log an apple with like peanut butter and yogurt. And that peanut butter and yogurt is adding, of course, fat and protein. Sometimes they'll put some chia seeds on that. That's some fiber. And we've definitely seen that when carbohydrates, sort of naked carbohydrates, like a fruit, are paired with fat, protein, and fiber, people do better. In terms of alternatives, we've seen some really interesting things. We just published an article on Chipotle. We see people logging all sorts of things at Chipotle. Some of them,

Starting point is 00:28:29 disaster for glucose. Some of them, virtually no glucose response, like an average of seven milligrams per deciliter, very low. So the really minimal glucose spiking things is the keto bowl. This is a salad that has protein, you know, fajita veggies, guacamole, salsa, virtually no glucose spike, tons of nutrients. Burritos, on the other hand, with that gigantic tortilla, send people on average through the roof. So people start learning, if I'm going to go to McDonald's, if I'm going to go to Chipotle, if I'm going to go to Sweetgreen, what should I order that's going to give me the best, you know, bang for my buck in terms of blood sugar? And then I think the last thing I would-

Starting point is 00:29:11 And everybody's different, right? Everybody's different, right? So, you know, it doesn't mean that, you know, what works for you. Like you say, oh, I found that this screwed up my blood sugar. It doesn't mean it's going to screw up your friend's blood sugar, right? That's definitely true. So these are more of the population-based sort of things that we're seeing that can kind of give you, I think, a general gestalt of where you should start. And then, of course, it's about actually trying it for yourself and seeing what actually works for you. There may be that person out there that doesn't spike to a huge flour tortilla. But for most people, knowing that getting the keto bowl is going to have totally stable blood sugar on average for the population,

Starting point is 00:29:52 they can at least go in there and get that and see what it does to them. So it kind of, I think, nudges people in the right direction. And then the last big insight that I think we're seeing is around, this is so simple, but it's profound, is walking. We have seen that a simple walk after eating significantly reduces glucose responses. And we actually did an experiment with our members where we sent people a 12-ounce can of Coke, two of them. And we said, hey, if you want to do this drink this coke on one day and then on the next day drink the coke and take a walk right after you drink it yeah yeah yeah and we actually

Starting point is 00:30:31 saw across this population that of the people who completed both aspects of the experiment the median delta of the glucose rise was 33 percent lower if you just took a walk. So that was going from an average of 162 milligram per deciliter peak to 132. Over the course of your lifetime, if you're doing this every day, that's a huge difference. So how soon do you have to walk after you eat? Well, there's a lot of research that looks into this and it really comes down to the sooner the better better. Um, if anytime you walk after a meal, even if it's an hour or two, do it. That's fantastic. But because our glucose tends to peak in about that within an hour after a meal, I would say what I would recommend to people is after a meal, you know, finish the conversation, how, you know, 15, 20 minutes. Get up with the family. Take a spin around the block.

Starting point is 00:31:26 You know, put the dishes in the sink. Go take a nice stroll around the block and then come back. And if you don't want to walk outside because it's cold, put on some great music and have a dance party in the kitchen. Or, like, do a few squats. Like, it's really just about moving. But these are significant effects. So that's kind of the general layout of some of the things that have been so interesting to me, just from looking at this huge, huge data set. That's just so fascinating. It's like, we, you know, we just sort of have this one size fits

Starting point is 00:31:57 all approach in traditional medicine. And it's just so far from that, right? You know, you also learned about, for example, what would be things we should never eat, like one of those things we should just never eat. Well, I'll go off of just what we're learning in our data set because we could obviously, you and I could talk about this forever about general principles. I think getting the specific data is just so fascinating. That's why I want to get in there. Absolutely. Of the categories of things that at this point, based on what we've learned, I would not really eat anymore would be certain candies, which I'll go into each of these in more detail, cereals, certain cereals, soda for sure, fast food, and lots of common takeout.

Starting point is 00:32:42 So when we look at candy, this is actually really interesting. The worst food in our entire data set of 51 million glucose data points is... I want to hear this drum roll, please. Skittles. Skittles. Skittles. Wow. Not surprising because it's a refined carbohydrate. Obviously, there's refined sugar in there, but it's also kind of a naked carb, right? It doesn't actually have fat protein and fiber. Like a Snickers bar at least has some fat and some protein. The Skittles are just like naked carbs. So the Skittles have an-

Starting point is 00:33:14 Naked carbs. I love that term. I never heard that. I love that. They're just on their own, you know, like, and you can think of like fat protein and fiber as kind of clothing the carbs. So Skittles have an average glucose rise in our data set of 83 milligrams per deciliter. So that's certainly going to take you up. It's way more than a Coca-Cola and you are going to almost inevitably crash after that type of spike. Because of course, when you spike that high, you release all this insulin to soak up that glucose out of the bloodstream. And that huge surge of insulin can overshoot. The body responds sort of in an exaggerated way. You take

Starting point is 00:33:52 up all that glucose. And then people often dip to below their baseline and have that reactive hypoglycemia after the spike, which is when they feel shaky, tired, lethargic. So go up and then down. after the spike, which is when they feel shaky, tired, lethargic. Yeah, exactly. You want to, the beauty of achieving more of the gentle rolling hills is that you don't end up having that reactive hypoglycemia that can make you feel really crappy, that post-meal slump that people are often like, oh, I just need a cup of coffee or something. It's like, no, it's the Skittles, you know? And so Skittles have a huge... The other candies that are in the worst part of our data set are Sour Patch Kids, Caramel Corn, Twizzlers, and Jelly Beans.

Starting point is 00:34:32 So you notice they all are similar. They're all these kind of... Jelly Beans. Not chocolatey, no protein, no fat, just like straight congealed sugar, basically. So those are the candies. We used to have those things when I was a kid. It was like this powdered stuff, Lick-A-Mate or something. Like I forget what it's called. You put a stick in, you lick it, it's just pure sugar.

Starting point is 00:34:54 Yes. And the stick was made out of sugar too. Wasn't it like a candy stick? I don't remember seeing that anymore. I mean, I don't really look for it, but I was like, that was my main go-to thing. It's like when I was six, seven years old, I wanted to lick a maid. It was like a fentanyl lollipop, you know?

Starting point is 00:35:12 I mean, we use sugar as a pain management tool in hospitals. This is abhorrent, but when children undergo circumcision in the hospital in their first days of life, what do they give them for pain medication? This little dropper called a Sweeties, which is just sugar water. That is the analgesic. So it's like exactly like you said, it literally is like a functional lollipop. Um, so that's candy. So yeah. So get, get rid of the Skittles. Um, you know, a Snickers bar literally has half the glucose spike of Skittles. So it's amazing then it's cereals oh my gosh get the cereal out of the house so you mentioned takeout and other things too right well just to tell about the cereals cinnamon toast crunch honey nut cheerios lucky charms about 60 or above on glucose responses wait wait, wait, wait. Honey nut Cheerios. So we think honey is good, nut is good,

Starting point is 00:36:06 and Cheerios are good. So it's like actually just a wolf in sheep's clothing, it sounds like. After Cinnamon Toast Crunch, it's the worst. Yeah. Oh my God. Worse than Froot Loops or Pebbles or Cocoa Puffs or any of that? Those, you know, I haven't checked those precisely in our data set. But when you look at just like the top 50 worst foods that people log, all three of those, I mean, these kids are going to school after having these spikes and crashes. And, you know, Mark, like a lot of them are probably eating a glass of OJ on the side, which, you know, these are isolated food logs. So I mean, you know, Casey, I just break in for a minute.

Starting point is 00:36:44 I remember when I was filming the movie Fed Up and one of the, one of the scenes was where the mother was like trying to get her kids to lose weight and her family to lose weight. And she's like, well, what I really focused on is healthy breakfast cereals. And she pulls out these cereals that are marketed as quote health foods. I mean, Kellogg, who invented breakfast cereal as a breakfast food, which wasn't a thing, right? These are basically dessert for breakfast. It's 75% sugar.

Starting point is 00:37:14 And that is, you know, having a soda with breakfast. So I think people need to get that cereal and starch for breakfast is a huge no-no. And if you can do one thing to change your biology quickly, it's get rid of any starch or sugar for breakfast. Yes. Yes. You said that it's like eating sugar for breakfast. I will up the ante here. It's much worse than eating dessert for breakfast. Peach pie has an average glucose spike of 46 milligrams per deciliter, cinnamon toast crunch is 59. It's, you know, and they both have, of course, the refined seed oils and the flour, it's worse. So give me the peach pie. I love peach pie. I know, exactly, exactly. So you mentioned, you know, getting rid of the breakfast foods that have the refined starches. This has been

Starting point is 00:38:00 one of the most fascinating things we've seen because all the common American breakfast foods are in the worst hundred foods that score. And, and these, um, just to run through them really quick, we're talking about, this isn't our worst 50 foods, egg McMuffin, bagel with cream cheese, French toast, pop tarts, cereal, English muffin, blueberry scones, cinnamon roll, Cheerios, croissant toast with jam. Those are all above a 40 milligram per deciliter spike. So that's a big spike. Which is a lot. It's a lot. If you look at then the best foods in our data set, like very little glucose spike, you also see a handful of breakfast foods. And so these are the ones we want to eat. Like what?

Starting point is 00:38:41 We see frittata. We see avocado and egg, avocado and greens, chia pudding, Greek yogurt and berries. And we actually see this, a lot of people log this, I think because Kelly Levesque is sort of close in our network, but we get a lot of logs for the Fab Four smoothie, which is a smoothie that she has popularized, which was really balanced. It has very minimal fruit, a lot of protein, fiber, fat, and greens. And all of those that I just mentioned all score below 20 milligrams per deciliter. So you want to get it. I mean, it's basically, Mark, it's the Pagan diet. People can read your book. But it's the beautiful sort of like nutrient dense foods that none of those have refined carbs.

Starting point is 00:39:27 And I think people sometimes assume that, oh, if I'm going to have a keto breakfast or a low carb breakfast, I need to eat the animal products. That's not true. Half of those things I just mentioned don't have animal products, the Fab Four smoothie, the chia pudding. You could do non-dairy yogurt with some berries, some avocado. And so that's just something important to remember, that breakfast is this one's straightforward. Don't eat those first things. Eat those things.

Starting point is 00:39:54 Fat and protein for breakfast. Get rid of the starch and sugar. Yes. Very important. And I think it's super important. In my sugar detox book, I create a smoothie, which is essentially nuts and seeds. So it's raw nuts almonds walnuts pecans whatever hemp seeds chia seeds flax seeds um putting in like cranberries which

Starting point is 00:40:12 is actually very low glycemic the lemon uh maybe some berries unsweetened macadamia milk or whatever and it's it's like basically and greens you can put in there an avocado and it's basically in greens, you can put in there an avocado. And it's basically a protein and fat smoothie that tastes delicious. Yeah. And it's not all the typical, I mean, oh my God, like things like Ensure, Boost, all these sort of meal replacement things. Most traditional smoothies are full of sugar, artificial sweeteners are processed, highly processed protein powders. And it's so good to get just real food.

Starting point is 00:40:42 So I love that real food smoothie. I hope you enjoyed today's episode. One of the best ways you can support this podcast is by leaving us a rating and review below. Until next time, thanks for tuning in. Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you to all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks.

Starting point is 00:41:10 It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays.

Starting point is 00:41:29 Nothing else, I promise. And all you do is go to drhyman.com forward slash pics to sign up. That's drhyman.com forward slash pics, P-I-C-K-S, and sign up for the newsletter, and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Just a reminder that this podcast is for educational purposes only.

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The Dr. Hyman Show - Top Tips For Managing Your Blood Sugar And Avoiding Insulin Spikes

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