ZOE Science & Nutrition - Blood sugar hacks to give you more energy | Glucose Goddess Jessie Inchauspé and Prof. Tim Spector

Episode Date: August 22, 2024

Why do some people feel fine eating lots of carbs when others feel energy slumps? Is blood sugar to blame? In this episode, we learn why blood sugar varies so much between people, and the tools to manage these levels.  Tim Spector and Jessie Inchauspé (aka the Glucose Goddess) will discuss the latest science around glucose control, what the cool new device on the block – the CGM – can tell us and why blood sugar levels are only one part of the picture of our health. Jessie is a bestselling author and science communicator with a community of over 5 million followers. Tim is a professor of epidemiology at King’s College London and ZOE’s scientific co-founder. 🥑 Learn how your body responds to food 👉 zoe.com/podcast for 10% off 🌱 Try our new plant based wholefood supplement - Daily 30 *Naturally high in copper which contributes to normal energy yielding metabolism and the normal function of the immune system Follow ZOE on Instagram. Timecodes: 00:00 Introduction 01:14 Quickfire questions 02:39 What is glucose? 07:50 What are blood sugar spikes? 09:15 Are lots of spikes dangerous? 10:45 What happens when your blood sugar spikes? 14:03 Should I worry about blood sugar levels? 15:11 HbA1c and fasting glucose explained 19:30 What are CGMs? 23:24 How breakfast impacts the rest of your day 29:07 Eat these foods first 33:12 Can physical activity reduce spikes? 35:46 How gut microbiome and blood fat play a role 41:39 The risks of ultra-processed foods Find more from Jessie at glucosegoddess.com  Books by our ZOE Scientists: Every Body Should Know This by Dr Federica Amati Food For Life by Prof. Tim Spector Fibre Fuelled by Dr Will Bulsiewicz Free resources from ZOE: Live Healthier: Top 10 Tips From ZOE Science & Nutrition  Gut Guide - for a healthier microbiome in weeks Studies relevant to this episode: CGMap: Characterizing continuous glucose monitor data in thousands of non-diabetic individuals. (2023) published in Cell Metabolism. Dose–response relationship between genetically proxied average blood glucose levels and incident coronary heart disease in individuals without diabetes mellitus. (2021) published in Diabetologia. Optimised Glucose “Time in Range” Using Continuous Glucose Monitors in 4,805 Non-Diabetic Individuals Is Associated With Favourable Diet and Health: The ZOE PREDICT Studies. (2022). published in Current Developments in Nutrition.  Normal Fasting Plasma Glucose Levels and Type 2 Diabetes in Young Men (2005). published in NEJM  Have feedback or a topic you'd like us to cover? Let us know here. Episode transcripts are available here.

Welcome to ZOE, Science and Nutrition, where world-leading scientists explain how their research can improve your health. I'm your host, Dr. Federica Amati, Head Nutritionist at ZOE, filling in for Jonathan today. Today we're going to be talking about blood sugar and why everyone, whether you have diabetes or not, should care about their blood sugar levels. Here to tell you why your blood sugar levels are important and how looking after them benefits your overall health are glucose goddess Jessie Inshalspih and Professor Tim Spector. Jessie is a biochemist, science educator, and New York Times bestselling author. Tim is one of the world's top 100 most cited scientists, a professor of epidemiology, and the scientific co-founder at Zoe. Jessie and Tim, thank you for joining me today.

We have a tradition here at Zoe where we always start with a quick fire round of questions from our listeners. You can give us a yes or a no or a very short sentence answer if you can. here at Zoe where we always start with a quick fire round of questions from our listeners. You can give us a yes or a no or a very short sentence answer if you can. Tim, I'm going to start with you today. Is too much sugar in my blood really bad for my health? Usually, yes. So it depends on the context, but I'd say usually yes. Okay. And if you, Jesse and I all eat the same food, will we have the same blood sugar response? Absolutely not. Jesse, over to you. Yes. If I regularly get blood sugar peaks, am I going to feel it? Yes. And is there one thing everyone can do to improve their blood sugar levels? The first thing is to switching from a sweet breakfast to a savory

breakfast. Very good. Tim, is blood sugar the only thing that I need to worry about for my health? Absolutely not. It's one of several things we need to be worried about. And Jessie, what's the most surprising thing that you've learned about blood sugar in the last year? I think the connection between glucose spikes and brain fog. That's really good. We'll get into that later. So I'm personally really interested in blood sugar levels because my grandmother died of type 2 diabetes complications. And in my family, we have prediabetes. And I was shocked when I first to see how my blood sugar could vary throughout the day. So I'm really interested and I'm excited to know more about what blood sugar means and what insights we can get nowadays with novel technologies and new ways of looking at it.

Jessie, you're amazing at this. Can you please help our listeners understand what blood sugar is? I love this question. Yes. So blood sugar or glucose is your body's favorite source of energy. And every single cell in your body uses glucose for energy so right now as we're listening to each other or listeners as you're listening to this episode your brain cells are using glucose to understand what's going on

if i move my hand or make a fist the cells in my fingers are using glucose to contract so glucose is very important to us as humans and the main way that we provide glucose to our body, not the only way, but the main way, is through eating foods, specifically through eating starchy foods like bread, pasta, rice, potatoes, oats, or sweet foods. Anything from my favorite chocolate cake to a banana. And then I love taking this example of a plant. So there's a little plant behind us. And if you have a plant at home, you know that your plant needs some water to survive. But if you give

your plant too much water, what happens? The plant dies. And the human body is a little bit the same. Some glucose is great, but too much glucose is going to cause issues. And unfortunately, today, most of us are giving too much glucose to our body. Glucose is our preferred fuel, should we say, for our bodies. That's really good. Thank you. Tim, can you tell us about how that blood glucose is regulated and what insulin is and does? Yeah.

So the main way of getting rid of the glucose quickly from the body is this hormone called insulin, which is produced by the pancreas and the insulin is triggered to go up when our glucose goes up so there's a tiny little lag with just after your your glucose is is being released your insulin is being released so it doesn't hang around in the bloodstream too long because it's actually quite toxic to have it in there too long. Too much sugar can lead to very bad effects. So we've had this evolutionary effect that these two contrasting chemicals in our body, one to reduce it and that is always following the glucose around and what it does it unlocks a little key in all those organs. So nearly all the cells in our body have a little doorway for glucose to come in, but it needs the insulin to unlock it.

And people don't realize, but things like our muscles are a really big, important place for the glucose to go temporarily. But it also gets stored back in our liver and other organs, as well as being used all over the body for energy. And the muscle part is very interesting. So that I lift a lot of weights because I'm trying to get big biceps and it's really difficult. But the more muscle mass you have, the more you have these disposal areas for the excess glucose. So it's really important to build up that muscle mass, especially as women, as we age, we tend to lose it. So that's one of the reasons that I try to lift every week. That's great. So it sounds like incidents like this key that unlocks our storage cupboards, where we can store the excess sugar for when we need it later. Great. And so Tim, can you just take us through what happens when

we eat something? So if we take a croissant, maybe because we love a croissant. Everyone likes eating a croissant, super light and fluffy, nothing in them is what most people used to think. And I probably did a bit until I had my glucose monitor on me. So you eat a croissant, which is a mixture of carbs and fats with a little bit of protein from the wheat. And as it goes into your body, obviously through your mouth, enzymes start already to break it down in your mouth. You have some amylase in there breaking down the starches. And so by the time it's gone to your stomach, it's in a little ball. Your body's getting ready for it by then.

It's sort of sensing there's food on the way. So all the gastric juices are ready to break it down. And the main way the sugar goes into the body from the croissant is in the small intestine, which is the tube that's really much after the stomach and before the large intestine. That's where most of the nutrients absorb in the body. So the sugar is broken down from the starch and is released there and then goes into the bloodstream. And that's when you get your sugar spike, which is normally 15 to 30 minutes after you've ingested something. After that peak, it would then slowly fall down. And the rate at which it falls down is going to vary between people. And the peak is also going to vary between people so i know my wife and i have very different peaks after eating a croissant very annoyingly hers hardly tickles up at all mine you know can

go up to a level or around you know 10 millimoles you know 180 milligrams okay so i'm going to stop you there and just recap quickly so it sounds as though different people have different responses to sugary foods. How you respond with insulin changes how well you deal with removing some of that blood glucose from your blood. And what I'm also hearing is that having these peaks is completely normal after a meal, but there's something about these peaks that could lead to problems further down the line. Jessie, I'm going to come to you for this. Can you tell us more about what a blood sugar peak is and why is this bad and in what context does it become a problem? So a blood sugar peak or a blood sugar spike is when after eating the concentration of glucose in your bloodstream and then in your body rises very quickly. So it starts looking like a

big steep mountain and then depending on your metabolism, it's going to come down more or less quickly. But yes, of course, the peaks are normal in the sense that the more sugar or carbs you eat, the bigger peak you will have. But that doesn't mean they're good for you. It's still important to try to eat in a way that is not going to cause 10 millimole, you know, 180 milligram spikes multiple times a day. So no croissants every day for Tim. Well, listen, I mean, I love croissants. I love carbs. I love sugar. I'm a total chocolate, you know, addict. But there's ways actually that we can eat these things while reducing their impact on our blood glucose. And these spikes are not something we should be

trying to achieve. We should actually try to make our glucose levels look a bit more like, you know, some rolling hills versus very steep Alps where you go skiing. You know, we want to keep our glucose levels steadier. I don't think we should aim for a totally flat glucose curve because that can be done in very unhealthy ways. Yet, you know, trying to keep that a little bit more under control is going to be beneficial for our health. So what we're trying to avoid is these repeated peaks leading to actually a gradual increase over time. So I think, you know, having that birthday cake, having that cross on occasionally isn't so much the issue. And Tim, I'm coming to you again here to say, so if I do get a lot of peaks in my blood sugar levels, does it mean I'm pre-diabetic or

have diabetes? Not necessarily, no. So I mean, there are some people who seem to be sensitive and have lots of peaks and that can cause its own problems. It absolutely doesn't mean you are going to go on to get diabetes. There's probably statistically a slightly increased chance. But I think there are many people who can have these rather aggressive up and down peaks with very strong insulin responses that never get diabetes. So I think that's really important for people to realise that. We can all take some food to produce, I'm sure we could come up with something that would give us all a big shocking sugar peak, right?

May I suggest 12 cookies? Yeah. You work that out. That works for everyone, doesn't it? Yeah, it does. I did an afternoon tea for my biggest peak when I had my CGM on, my glucose monitor. I went for afternoon tea with champagne. Oh, boy.

Yeah, I think it's really important to sort of separate these. You know, a one-off event, we shouldn't worry about it. If that event is happening multiple times in the day, it's going to raise your average blood sugar levels during the day. And I think that we now know from the epidemiology is linked to these longer term risks of disease. And we've actually got some data from our own Zoe studies on these blood sugar dips, Tim. And I'd love for you to explain a little bit about what these sugar dips are, what happens and why is it bad? And then Jesse, from you some examples that I know you've touched on in your books before. Before we do this study, I think sugar dips were just a very vague concept. So in the first PREDICT study, people didn't know what their glucose levels were. This is

really important. So they were blind to it. And we found that people who three hours after eating had a dip below baseline were reporting greater greater levels of low energy low mood and hunger and ended up overeating by about three to four hundred calories i think it was in that day so i think we're going to get more data soon from from many you know tens of thousands of people to to really sort of try and work this out. And we're hopefully moving towards being able to predict who is a likely dipper and non-dipper because those people really need to pay attention

to their breakfasts because at the moment, unintentionally, you know, they are going to be overeating much more than someone else who's got a really good, say, insulin, glucose glucose stability long term. And then they get hungry at 10.30 a.m. and they didn't know it was because of their breakfast. And Jessie, from your community who's so active and amazing, what have you learned from them about sugar dips and how we can control those cravings? And also, you just touched on your breakfast, savory breakfast. Can you give us a bit of insight of the feedback you've had from people

and how that's helped them in their day? Yeah, absolutely. So most of my community actually does not wear a glucose monitor, but they do report, you know, I think 90% of them report cravings, excessive hunger that they can't figure out how to solve. And so the tips that I share seem to apply to everybody, really. So importantly, let's talk about the breakfast, for example. So in Tim's example, if at 10.30 you really want biscuits, it's possible that your breakfast was causing a big glucose spike and that 90 minutes or two hours later, you're getting this dip. So I teach people about switching from a sweet breakfast that is generally full of carbs.

So traditional sweet breakfast would be cereal, orange juice, muesli, toast and jam, oats with honey and a banana, to something savory built around protein. So protein keeps your glucose levels really nice and steady. And I recommend nothing sweet except whole fruit if you want for taste in your breakfast. And I got lots of recipes. And this seems to create such a profound change in people's experience of their morning and of their day, on an energy level and a cravings level and a hunger level, that they feel like a completely new person. So that's why I really focus on the savory breakfast as the first place to look, because unknowingly for so many people, that really intense breakfast spike is deregulating

their entire day afterwards and causing overeating and then lunch and dinner create bigger spikes and you're in this vicious cycle and you don't even understand that it was caused by your morning oats and honey so that i'm very passionate about this because you feel like you're you know walking through a mirror like you're in a movie like alice in wonderland kind of style you really have a different experience of life when you fix your breakfast i love that message i think a lot of people listening could just relate to that and think, okay, I'm going to change my breakfast. So we've talked about these peaks and what happens with dips. We've talked about how insulin helps to regulate blood glucose. Let's get into some more

details. So I would love to start with you, Tim, and ask you, how do I actually know if my blood sugar level is normal? At what point do my levels indicate that there's a problem and how do I find out? You can go and see your doctor, get a fasting blood glucose test, which is the sort of classical start to this. You might also get a continuous glucose monitor and take the average of your morning levels. So there are two key to that various things kick in at that point particularly for diabetes and then they'd probably go on and do an oral glucose tolerance test where you actually get a 75 gram glucose drink which is somewhat similar to the zoe cookies and then see what happens what your level is two hours later because that that would show that actually it's not so much the peak, but the glucose is not being cleared from the body in two hours,

which it would do if your insulin was working normally. So in those cases with type 2 diabetes, your insulin is just not doing the job. The cupboards are not opening with a key any longer. The keys are all jammed up or half of them are. And so that's why it's hanging around in the body and it has all these toxic effects. So I go to my doctor and I ask for a fasting glucose. And I've heard a lot about HbA1c and A1c in the States.

And fasting insulin. And fasting insulin. So if I go in and I get my test results, what am I looking out for, Tim, on my HbA1c and fasting glucose? And then Jesse, I want to hear more from you on what we can do day to day to help this. So HbA1c, you will commonly get, you often don't get insulin levels from your general practitioner, but the HbA1c normally comes as a percentage. 5.7 percent is generally sort of cut off for any any problem so you want to be below that to be normal and above 6.5 percent is generally considered to be in that diabetic range

it it goes back to jesse's point about you know yes we can all live with the odd sugar spike but it's it's about these cumulative high levels that are not good for us. And I think it doesn't matter whether you're measuring this as HbA1c, you're measuring this as your CGM average, measuring it as, you know, your blood sugars from your doctor or even your symptoms, as Jessie's describing from her followers who are logging their meals, their foods, their life, that they know if things are stable or not, and they get an idea of it. So, you know, I think all of these things together are pointing us towards really changing the way we think about blood sugar, rather than only being about diabetes or not into something much more interesting in the same way that I think we've transformed blood pressure you know from 50 years ago where it was either you had hypertension or you didn't now people are measuring it at home themselves much better than they are

at doctor surgeries and we're very much in the same scenario with still a fair bit of resistance from the medical community. I think that's a really good analogy with hypertension and keeping an eye on your blood pressure. And Jessie, all the work you've done, can you tell us a little bit about what happened when you first wore a continuous glucose monitor? Can you explain what that is for us? And also what insights it gave you that you've then communicated so well with your community. I mean, it completely changed my life and I was not expecting it. So when I was a teenager, I had an accident and I broke my back jumping off a waterfall, physical pain, surgery, etc. But then a lot of mental health problems. And I used to get these episodes where I would feel like I was

kind of leaving my body, disassociating, feel really anxious. And I had these for 10 years with no real idea about what to do about them or where they were coming from, what was triggering them. And I had the opportunity to wear a glucose monitor five years ago. And I don't have diabetes. Nobody in my family has diabetes. I didn't really think it was going to give me any very interesting insights, to be honest. And then I saw that these mental health episodes were correlated with big glucose spikes. And one morning, I almost felt like a big glucose spike for my breakfast triggered one of these depersonalization episodes. So that was a big moment for me. And, you know, it was a personal experience. There's no studies linking glucose spike study personalization.

But I started thinking, hmm, maybe the way I'm eating is having an impact on my mental health. And that's where the passion began. So I looked at all the studies and I realized it's not just for people who have diabetes. You know, your glucose levels can impact your mood, your hunger, your cravings, your energy, your sleep, your hormones. It was like, wow. So I started to dig into the studies to try to understand how I could reduce these spikes without giving up the croissant and the pasta and the chocolate, because I love to eat those things. And I didn't want to go on a crazy keto diet. That was not the goal. And through looking at all these studies,

I summarized 10 easy principles that allow you to steady your glucose levels without dieting, without counting calories, without restricting any foods, that to me have become principles that I live by every day and that I've shared with people. And it's helped people across the world because we live in a situation today where we're very confused by the food industry, marketing messages, diet fads. It's quite difficult to go back to common sense. Hi, I hope you're learning a lot from Jesse and Tim about why blood sugar matters so much for your health. Now, I have a small favor to ask.

We want this podcast to reach as many people as possible as we continue our mission to improve the health of millions and seeing this show grow motivates the whole team at zoe to keep up the hard work of creating new episodes each week so if you've ever enjoyed this podcast please follow us in your podcast player of choice thank you and now back to the show and so tell me so your cgm it's like still thing you just put it in your arm, right? Painless. And it measures your blood glucose levels.

And it gave you that insight to how the varying levels of your blood sugars impacted your mood and your actual mental health. And it was very personal. And depending on your body and your medical history and who you are, you might see tons of different sorts of insights and correlations. But that was the reason I got into it. That was the gate for me, the first clue. At Zoe, we use CGMs. And Tim, can you give us a little bit of insight of how we use them in the Zoe program? But also going back to you, Jessie, what can people do if they can't access a glucose monitor? How can they be aware of the changes in glucose levels? I think CGMs are very hard to use if you're not given any

instructions on them at all. And I think definitely advise against people just buying their own and doing their own thing. It's much better to do it as part of a clear plan and you can see what other people are doing and you know what's normal and not normal because it can cause quite a bit of stress or worry about, because they're set up for people with diabetes. I get so many messages every day on Instagram. My glucose is 88 now, it's 96, and my diabetic. I mean, it's very stressful to interpret the data with no guidance and no information.

For people who are constantly getting these red signals at night, don't worry about it. Your body is really good at keeping you alive you know we wouldn't have been here for millions of years if we didn't have these really good methods to to stop us getting really low in sugar and energy at night so don't worry about that we just integrated it so that we would be giving people lots of tests to do while they were taking the glucose monitors and i think that's the thing you need something systematic to do whether it's making diary notes of your meals or it's recording how you're feeling just after it so these things are

recording all the time but you've got to do other stuff in addition to really get the benefit from it so if you're just sort of randomly wearing it and you sort of, you know, yeah, you get a few wow moments, but I think all the real insights come from actually recording it on the app. And now we record things like mood and energy and these things that no one used to record before.

Yeah, so I think education around what the CGM can do for us and what those peaks and dips can mean and not to worry. And I think, Jessie, what you've done with your platform is to offer people a way of understanding their blood glucose without the need for a glucose monitor. Can you tell us a little bit more about the symptoms and what to look out for in your day? And I'm very passionate about that because I think those of us who need this information the most often cannot afford to buy a glucose monitor, cannot afford to buy my book, for example. So I'm trying to do as much free content as possible. So the symptoms to look out for are, well, the top ones we spoke about during this episode are cravings and hunger and energy dips.

So chronic fatigue, feeling like you need coffee or Red Bull multiple times a day just to stay awake. You don't have the energy to go to the grocery store. Your to-do list is never getting shorter. You know, this kind of sense that your life is kind of running away from you. And then there's a lot of interesting correlations between glucose spikes and your mood, your brain fog, your mental health, your hormones, your fertility, your sleep. And then long term, of course, as Tim was saying, heart disease, type 2 diabetes. And it's so all-encompassing that was saying, heart disease, type 2 diabetes.

And it's so all encompassing that it can feel like glucose is related to everything. And it actually is because it's in each of your cells and each of your organs, you know, is sensitive to it. So I like to say that if you could feel better than you currently do, then you should try to manage your glucose levels and see how much it improves your quality of life. It's pretty clear that it's important to look after our blood sugar levels from this conversation. Tim, how can I get started today? What's your top tip for starting to think about better blood glucose levels today? Start by doing an experiment with your breakfast. We've discussed this before. Breakfast is the perfect time to do your own self-experimentation. We to be in control of it generally at home or we can take we can make it and take it to our office and you've generally been fasting overnight so everyone

is in a similar position and as long as you you know you haven't been doing lots of late night snacks and you know you've got some at least seven hours, then everyone should be in a very similar position. And that's where we got our best results from Zoe was in those first readings in the morning because we could really compare absolutely everybody. Just take a week recording what's going on with your regular breakfast, with maybe skipping breakfast,

with going to the opposite type of breakfast. So if you have a carby breakfast and you go for a full fat one with a full fat yogurt, nuts, seeds, and avoiding sugar and carbs. And then you might have other ones, more high protein ones or ones with high fiber, a sort of salad or, you know, have what you'd normally have for lunch. I love that one. Just treating breakfast as a normal meal.

So fish and vegetables. Yeah. When you travel a lot around the world, you do see, certainly a lot of Asia, there's no real difference between your breakfast and your lunch. But the idea of having sugar for breakfast is a total invention. It's a food industry invention. This is not how we used to do things 200 years ago. Breakfast food is a whole category, isn't it? For sure. It's a food industry invention. This is not how we used to do things 200 years ago. Breakfast food is a whole category, isn't it? It's desserts.

Well, I think even before that, yeah, I mean, it used to be people didn't make another meal at breakfast. So you would have what was left over from your dinner the night before would be the, if you did have breakfast at all. And as I know, when I visited the Hadza tribe, they didn't have a word for breakfast. It's just a meal. And Jesse, you have so many great breakfast ideas in your book. Could you just share a couple of them with us here? Of course. One that comes to mind is the avocado accident. So this comes from me just opening my fridge one morning and saying, hmm, I have hummus, I have tuna, and I have an avocado.

I'm going to make a breakfast salad with these ingredients and some lemon, and it's delicious. So just treat your breakfast as a regular savory meal. I mean, my top one would be the three egg omelet with feta and tomatoes, but leftovers from dinner works super well. You can just fry up in a pan your leftover chicken and some rice, pop an egg in there, you know, some spinach, a couple tomatoes and voila. And what I love about your advice is that this makes a really nourishing meal. So often people grab breakfast on the go and they're just like, you know, grab a biscuit and of course they're going to be hungry. And of course that's only really providing carbs. So your advice is

really, you know, treat breakfast as a meal if you're going to have it. And you can even pre-boil some eggs and keep them in your fridge for the week. It's always better to have a little bit of protein than to go to the store and grab a cookie or a muffin. So yeah, lots of recipes in my book, and I'm a very lazy cook. So it's all super simple, six ingredients or less. And the intention with my recipes is that once you read them, you never have to look at them again because they're more assembling different ingredients than doing something too complicated. And so both of you, really, if I manage to control

my blood sugar better, I'm acing it, I am getting, having a savory breakfast, I'm moving throughout the day, you know, what can I expect? Will I feel better with improving my blood sugar? And then is there anything else I should think about to help improve my health? You will feel better, but there's many other things to think about. I like to say that glucose is the foundation in your house. Then you have to look at exercise, you know, medication, maybe even emotional connections, stress levels, sleep, water. I mean, there's so many things and it can be a bit overwhelming. But I think glucose is a great place to start. Absolutely.

Short term, that's really true. And I noticed in the early days of Zoe, we had these muffins and I had 24 hours with other 10 zoe colleagues only eating muffins every four hours and i was trying to write my book at the time and for the first time i noticed this huge link between food and mood if you do an experiment like that and i could see my sugar spikes and my dips and i just couldn't concentrate i was just in a sort of, you know, I do have a bit of ADHD, you know, attention deficit anyway, and it was just magnified tenfold. For how long you had to eat muffins?

Well, it was just 24 hours. I was just eating these muffins. So you got these big spikes, then, you know, big dip, and then I had to do it all again. And I didn't sleep very well either. And then it was really interesting. It's an artificial experiment, but I think, you know, it is interesting to do those ones because, in a way,

we're experimenting on ourselves without knowing about it all the time. And, you know, there is other data we've got from our study, which is not published yet, but it should be out this year from Cape Birmingham, but ultra-processed foods themselves, even when you've taken into consideration some of the actual sugar content, cause greater sugar variability than other whole foods with the same amount of sugar. So I think also thinking about the structure of the foods, we haven't really talked about that, but that's really important. I just posted recently a graph on Instagram

where I compared 100 grams of lentils and then 100 grams of lentil spaghetti, exact same composition, just in one the food is whole and the other one has become a flour. And the glucose spike from the pasta is massive, whereas the lentils as a whole food keep my glucose levels very steady. And that's just to show that just ingredients and composition is not enough.

You have to think about the matrix, right? And the fiber and how it's structured, is it still intact, et cetera. That's really interesting. And that makes me think, so we've talked about these experiments and so trying the whole lentil with a lentil pasta and Tim eating muffins for a whole day.

But if I want to make these changes in the long term, do I have to completely change the way I eat? Do I have to overhaul my diet? How do you advise people to approach changing their diet in a way that's sustainable, I guess? You can eat the same meal that you usually do, but if you have a plate of vegetables at the beginning of your meal, you're going to harness the power of the fiber in your veggies at the beginning of your meal, you're going to harness the power of the fiber in your veggies at the beginning of your meal to help reduce how quickly glucose gets absorbed in your small intestine, creating this sort of viscous mesh, right? So it's all these little additive things

that overall are going to make you crave less sugar and want fewer processed foods. Then you have the vinegar hack, which is something to use once in a while. So a tablespoon of vinegar and a big glass of water if you're in a carb emergency and you're going to have a big chocolate cake. That one's really interesting.

And, you know, there's all these little tools and tricks that you can add to your life that add up to a lot. It doesn't have to be an expensive vinegar, does it? It can be the cheapest vinegar you find because it's the acetic acid that matters. And even the cheapest vinegar at the corner store contains acetic acid. But we want to avoid the vinegar at the corner store contains acetic acid. But we want to avoid the cleaning vinegar because that doesn't taste great.

If it's next to the mop and the toilet paper, you do not want to drink that. And actually, Tim, I know you're keen on making your own vinegar. So it's something that if you have some wine left over and you're not quite going to finish the bottle, could we make our own at home? Absolutely, yes. So I mean, vinegar really costs virtually nothing. Everyone should be having more dressings. And I think certainly I've noticed in the UK and the US, don't do really vinegary enough dressings. I'm always disappointed if I'm going out to some pub or something

and there's a slight drizzle of hardly anything on the lettuce or anything. So, yeah, really train yourself to get more vinegary dressings how do you make vinegar from wine you just leave it out on the counter and it turns to vinegar it will do yes and you can speed it up if you can get a vinegar mother and just put it in there it needs air so often have it in a in a tube where you've got a good entrance of air and you'll create your own wine very easily. Your own vinegar. Yeah, your own vinegar, Tim. Yeah, you just made your own wine.

I can do anything. No, yes, I have got some. I do make some. I apple cider vinegars and these things. But I think they're speciality stuff. I don't think you need to have them every day. People would just be having more. And it's also a good excuse to get your your olive oil in there as well so i

think extra virgin olive oil the only oil you should be having plus you know the the acetic acid which we know does have this effect plus if you put that on a salad at the beginning of your meal you get so many powerful effects on your glucose levels that's the best way to start a meal a lot of countries do this um certainly the french crudité you know used to be i don't know if it's still common in france but you know it's something that our grandparents used to do all the time and somehow we've lost touch with these habits but now you know i share the science behind these so i'm trying to bring them back and make them you know sexy again because these habits are there for a reason they make a lot of sense We just have to go back to them and understand scientifically why they were there in the first place.

Because I always used to go, I used to do a French exchange a million years ago, and you said the grated carrot. For sure. And even in Italy, you know, antipasti in the Middle East, they have herbs by the bunch at the beginning of a meal. Vinegar is in every single person's kitchen. I mean, it's everywhere. And as we were discussing for the breakfast breakfast used to be savory it didn't used to be these desserts and

this juice but somehow we've been brainwashed into thinking that should be the case so i think it's really interesting when we find these correlations between modern science using glucose monitors explaining the impact of these habits on our health and then we realize heck my grandmother used to do this this is not actually cutting edge science. It's not groundbreaking. It's just going back to basics. I think it was in your book, Jessie, where you talk about, you know, the walk after dinner, the passeggiata, which, you know, in Italy, and you get your family and after dinner, you go for a nice walk around and have a look at the shops. That's basically... Walking after eating, moving after eating, because as we were saying at the beginning,

your muscles are really wonderful allies to help you reduce your spikes. So after a meal, if you go for a walk for 10 minutes, do some calf raises at your desk, you know, clean your apartment, dance on a few of your favorite songs, your muscles as they contract are going to absorb some of the glucose from your meal, therefore reducing the spike of that meal. So again, very simple. It's free and it's going to have a great impact on your health. So go for it. And I really want to touch just once more on your community. And can you just give us a couple of examples of the most powerful stories that you've heard

from your community? A few very powerful ones are when I receive messages with people sending me PDFs of their lab results and saying, hey, a month ago I had type 2 diabetes and now I don't anymore. And my doctor cannot believe it and has run the test five times because they cannot believe that I've been able to put it into remission. So that for me is just so wonderful to teach people that, yes, you can impact your type 2 diabetes diagnosis and you can put it into remission. And then probably the most emotional one for me is women who were on the birth control pill, they stopped taking the pill, realized they're not ovulating anymore. They have

insulin resistance, they have PCOS, but they want to have a baby and they can't, and they're told they have to start IVF, et cetera. And they decide to give these hacks a go because insulin resistance can be also reversed, and they're able to get pregnant naturally. So for my second book, I ran this experiment on 3,000 people who went through the four-week method, and three women during those four weeks were able to get pregnant, even though they hadn't been able to in months. And there was no control group, et cetera. It was just an experiment.

But for me, those are really, they just make me go, wow, this is why I do what I do. Little glucose goddess babies. They named after you, I wonder. Oh, no. Little angels. I should make like little baby t-shirts. Baby t-shirts.

I love that. How big is the community now? How many people have you got? Over 3 million. That's amazing. Over 3 million people, yeah. And how many people do you think are participating in these experiments? I think only a very small fraction wear a glucose monitor. I think most of them are using the hacks as a way to feel better,

feel more like themselves, feel comfortable in their clothing, feel like they're going to get healthier as they age, not see their health deteriorating. But they're from all over the world. And the great thing about these hacks is that they can be applied to whatever culture, whatever situation, whatever budget. So it's really exciting and it's growing more and more every day. What I really want to unpick is what else matters. So blood glucose is certainly one of the pieces of the puzzle. And Jess, as you said, it's something that people can really visualize and they can kind of see it. But Tim, can you give us some more detail on the importance of, for example, blood fats and the gut microbiome and anything else that you think is really crucial? Yeah, just to remind people that when we did the PREDICT study, we saw this

10 to 20 fold difference in blood sugar levels, people eating the same muffin but we also saw the same six hour differences in blood fat levels it was triglyceride and exactly this similar one it was a later time so it took longer and the fat wasn't disappeared but the difference the rate at which people got rid of the fat from their their blood the range was as high as it was for the blood sugar. So people eat the muffin, it's high in sugar, it's high in fat. And we measured the way that they cleared that blood sugar, but also whether they were able to clear the blood fats from their blood within six hours. Can you tell us a little bit more about that? Yes. So normally, most people would clear it within six hours and it goes to the liver and gets repurposed. And, you know, we need fats for all the essential bits of our body. But in some people it's rather sluggish. And for various reasons, it stays there and you get these really tiny particles that hang around and when those tiny particles hang around they cause irritation

to the blood vessels inflammation and so that inflammation then goes widespread and causes general stress throughout the body and why is it a problem if our blood vessels become inflamed why is that an issue because that can cause heart disease that is also believed to help initiate diabetes as well. We don't quite know how it does that, but certainly if you've got borderline blood sugar level, but you've already a high blood fat level that's not getting cleared, your risk of diabetes is increased massively. So the two together do seem to have this metabolic effect. So ideally, you want to have low blood sugar levels and these low blood fat levels, particularly these triglycerides, which are related to diet more than some of the other ones in more immediate time.

And what was interesting is that although they both had some effect, there was even more inflammatory effect of having that fat hanging around. But we think the two are interacting. So, you know, there's this clear crosstalk between what's going on and how you're sort of clearing your sugar and your fats. But the microbes are even more involved in getting rid of your fats properly. And how do they do that? So the gut microbiome, these bacteria that live in our gut,

which we also test at ZOE, how are they involved in moderating the amount of blood fat and blood sugar? Well, the blood fat is quite well known now because they've actually got these microbes that produce bile salts, which chop up the fats and will send them to the liver in packaged forms and so there's actually fat eating microbes so they actually eat them for us they eat them for us that's amazing isn't it they're so great they are so great and they break them into their little constituents these fatty acids which they use as energy and are used all around the body so we used to think it was only done in the liver and we now know that microbes do this directly as it is still done in the liver by enzymes breaking it down so once they get transported to the liver then it's broken

down but microbes are also involved much more than we we thought about that so if you've got the right microbes you can break down your fats quicker and therefore get a really efficient you know streamlined uh way into it and we we're still struggling to understand how they affect sugar but we think it's the microbes in the small intestine higher up they're really hard to study that are having this this. And so there's a definite link between the gut health and the ability to clear sugar and fats from your body. Yeah, glucose and blood sugar is not everything. And I have a very easy example here. If you were only focusing on your glucose levels, you could reduce the glucose spike of a croissant, for example, by adding a ton of butter to it. And I mean,

like add a kilo of butter to that croissant, the glucose spike is going to be smaller. But by adding that kilo of butter, you are also making a lot of negative consequences in your body with all of that fat. And it won't taste so good. It won't taste so good. You can also add wine to your meal, and that is going to reduce the glucose spike of the meal. That does not mean that you should be having alcohol all the time. It means there's something else physiologically going on with your liver. Another good example is that when you exercise intensely, you might see a big glucose spike. So if you're only looking at your glucose response, you might think, I should add butter to everything, I should have alcohol all the time, and I should definitely not exercise.

Goodness. So you see that there are really important limitations. That's why if you just slap on a glucose monitor with no context and no education, you can draw some very wrong conclusions. So you see that there are really important limitations. That's why if you just slap on a glucose monitor with no context and no education, you can draw some very wrong conclusions. So we have to be careful and we have to be educated in the world of blood sugar. So it feels to me like blood sugar is something people can really relate with and they can picture it and it helps them to engage with the changes that Jesse, you outlined so well with your advice.

And these changes resonate with the research that we do at Zoe and what Tim has been speaking about for a long time, which is this idea of adding more whole foods to your diet, really embracing the idea of plants first, like having a salad before your meal, having the crudités, having some antipasti, and then, you know, moving your body throughout the day, giving your body the opportunity to use up some of that energy with your muscles. And reducing sugar intake. And reducing sugar intake. So we know that these, you know, ultra-processed foods and these highly refined carbohydrates are having a negative impact on our health. And Tim, would you say that possibly ultra-processed foods are what is driving a lot of this

over-consumption of freely available sugars, of these like super simple sugars that people are eating. Absolutely. I mean, I think overwhelming evidence that ultra-processed foods do this in all kinds of ways. Artificial tastes, flavorings, making you want it more. Its matrix is gooey. It's like baby food. So it's like you eat it really fast it's you swallow it fast you don't chew it and it gets into your bloodstream super fast so that doesn't give the time for any of these signals of you know being full or anything else to happen and as you know these studies have shown when you break it get rid of all the cell walls, and you only use the extracts of food, reacts completely differently. If they're reduced down to just the-

Or fruit, right? When you take an apple and you dry it or you juice it, completely different story. Orange juice or an orange. I mean, that's what we're doing. And that's why they are so bad. It's just so fast in a way that nature hadn't intended, that our normal defenses just can't deal with it get these big sugar spikes we don't get you know the feeling of fullness so we still have the hunger you know and all these signals to our brain are just being mixed up because we weren't designed to deal with these very clever food scientists who are fooling us all the time just so you mentioned that you're really doing more work and supporting initiatives

to help improve the food environment. What are your thoughts on ultra-processed foods and how it's impacting our health? It's very difficult because it's everywhere. It's very tasty. People love their chocolate and their candy. It gives us a quick dopamine hit. And when most of us are stressed and tired and not feeling great, no wonder we turn to them.

And they're cheap. They're easily available. And I think we need more regulation in the food industry. We need to stop, for example, advertising of ultra-processed foods to kids. I'm all for individual responsibility. And I love teaching people about science and how they can navigate this food landscape in an easier way. But we also need regulation top-down to out with the food industry, how can we progress and evolve these food products so they're less harmful to our health? Because we're facing

a massive public health crisis. You know, 1 billion people in the world today have type 2 diabetes or prediabetes, 1 billion, and it's increasing every single day. So we need to all work together to improve our health. That's really, really inspiring, actually. And Tim, I want to come back to you to one of your favorite sayings about food and, you know, how can food help us to become healthier? Why is it so important that we think about our food differently? Well, our food choices are the most important tools we have for our health. And I think we can't repeat that often enough. And with this new science, people are being given extra tools in order to make those right choices, which are very different

to the ones, you know, that are traditionally out there that people think about, thinking about only about calories, you know, only about protein or fats, even sugars. You know, if you just stop there, you'd miss 90% of the picture as we've discovered. So everyone needs to learn more about this. Everyone needs to be a little bit more of a food expert so they can make the right food choices, but it's not that hard. So I would love to ask both of you one more question

before I try to summarise. And that is, if there's one key takeaway that you'd love people to leave with today, what would it be? I'll go with you, Jessie, first. That symptoms that you feel on a daily basis, cravings, mood swings, hunger, chronic fatigue, are actually messages from your body telling you there's something going on within and that food is going to be your primary tool to fix them. And if you fix your glucose levels, a lot of these symptoms are going to dissipate. So symptoms, listen to them, don't suppress them, they're messages. Love that. Tim?

Everyone could do with slightly lower average glucose levels. So experiment with your own life and your own context, your own culture to work out how you can best achieve that and i think we all need to be self-testers and don't take anything for granted just because someone says it's good don't believe them test it yourself and see how you feel and yeah and it doesn't matter if you can't afford a glucose monitor, getting a diary and a notebook and just working out every hour how you're feeling. I'm sure you'd be in a lot better place after a week of doing that. Both of you coming with a strong message of listening to our own bodies, which is, I think, so important. Okay, I'm going to try and summarize here.

We started off by talking about glucose as the body's preferred energy and that we need it for pretty much every single cell in our body. A blood sugar peak is when the sugar level rises steeply like Mount Everest. I think Jesse, you referred to it as Mount Everest and then very high after eating and sometimes falls very quickly back down again or sometimes doesn't quite make it back down to baseline. Sugar peaks repeated over many times throughout the day, we think from emerging evidence, can lead to inflammation. So when blood sugar dips too low, which can also happen, that's when we really can feel it. It doesn't happen to everyone, but the people it does happen to can feel very tired, very hangry, might need to lie down. And Jesse, you've seen

this in your community as well. If you want to know if your blood sugar levels are normal you can go and see your doctor who can do a blood test and there is a fasting blood sugar test anything above 126 milligrams or 7 millimole depending on where you live would indicate diabetes. There is also a measure called HbA1c in America it's AC, which is how sugary your blood is long-term. And 6.5% or higher, which is about 48 millimole per mole, would indicate diabetes. How can you tell if your blood sugar levels are going astray without going to your doctor? Well, you can use a continuous glucose monitor, which are these little devices that we use at Zoe and that more people are using more widely now and are very important for people with diabetes and they tell you your blood sugar levels throughout the day but they're not available to everybody and we have to be mindful of using them without guidance because they're quite hard

to interpret how can you look after your blood sugar levels we're starting with breakfast so jesse you have loads of ideas on making really delicious savory breakfast that can set you up for the day and avoid these blood peaks and crashes that will make you hungrier and tired throughout the day. Really focusing on these savory foods and avoiding these sort of breakfast foods, which you call desserts, which is I think quite accurate, and see how you feel when you make those changes. Making your own vinegar at home is really easy, and you can add that to your salads before your meals and make it taste delicious and give you this acetic acid, which helps to reduce the blood sugar peak, which is great. Another thing which we all love to do,

especially when the weather is a bit better, is to go for a walk after a meal. So go with your family, go with your friends for a walk after a meal, use those muscles that will use up that blood glucose. And finally, blood sugar is really important and it's something that people really resonate with, but it is not the only thing that matters for health at zoe we know that blood fats and the gut microbiome dietary history and your personal health history are also really important factors so we have to remember to keep a very holistic view of health and use the tools that work best for us at individual level it's been an absolute pleasure to talk about this topic. It's so nuanced and it's so important and it's gaining so much attention rightly to help people with their health. I've

loved talking to you both. Lovely to meet you, Jessie, and good luck with your paperback. And we can't wait to have you back again soon to talk about your next exciting ventures. Thank you so much for having me. I really enjoyed having Jessie and Tim on the podcast today. I hope this conversation opened your eyes to the importance of blood sugar as one of the important measures for overall health and that your food choices impact how you feel today and your long-term health. If you'd like to find out more about your blood sugar levels and maybe try a glucose monitor to understand your blood sugar control control as I have done

then you might want to consider becoming a Zoe member. With Zoe you'll receive personalized advice on how to eat the best foods for your blood sugar as well as your blood fat levels plus the gut microbiome to support overall health. Our clinical trial shows that this can help you feel better now and live healthier in the years to come. Go to zoe.com forward slash podcast to learn more and get 10% off your membership today. I'm your host, Federica Amati. As always, the Zoe Science and Nutrition Podcast is not medical advice. It is for general informational purposes only.

If you have any medical concerns, please consult your doctor. See you next time.