ZOE Science & Nutrition - How to control blood sugar spikes

Episode Date: July 21, 2022

Biochemist Jessie Inchauspe heads into work one morning at a genetics lab in California. During the morning meeting, management offer staff the chance to self-test a new medical device. Jessie accepts.  She couldn’t have known this device would take her on a journey of discovery to reshape her health and help countless others do the same.   The device was a continuous blood sugar monitor, and it was this, combined with her academic background, and a remarkable willingness to use herself as a lab rat, that began a journey of discovery into how blood sugar affects our health.  In today’s episode, Jonathan is joined by two leading experts on the topic: Jessie Inchauspe is a biochemist, bestselling author, and founder of the Glucose Goddess movement who’s helped hundreds of thousands of people improve their health by making cutting-edge science accessible. Dr. Sarah Berry is one of the world's leading experts on human nutrition, who has personally run over 20 randomized clinical trials looking at how humans respond to different fats. Download our FREE guide — Top 10 Tips to Live Healthier: https://zoe.com/freeguide Timecodes: 00:00 - Intro 00:10 - Topic introduction 01:28 - Quickfire questions 02:39 - What is blood sugar? 03:29 - Why do we have blood sugar? 05:25 - Blood sugar monitoring 07:30 - How does blood sugar affect our health? 09:12 - Do we want a flat blood sugar? 14:03 - Blood sugar responses and menopause 19:20 - Personalization in blood glucose responses 23:17 - Actionable advice to better control your blood sugar 23:55 - Food ordering 28:30 - Vinegar and blood sugar 34:15 - What foods should I eat to control blood glucose spikes? 37:39 - Blood glucose & exercise 40:02 - Summary 41:45 - Listener question 43:03 - Goodbyes 43:17 - Outro Episode transcripts are available here. Buy Jessie’s book here. Read ZOE’s PREDICT Studies here. Follow Jessie: https://www.instagram.com/glucosegoddess Follow ZOE on Instagram: https://www.instagram.com/zoe/ This podcast was produced by Fascinate Productions.

Welcome to ZOE Science and Nutrition, where world-leading scientists explain how their research can improve your health. Biochemist Jesse Nchausipe heads into work one morning at a genetics lab in California. During the morning meeting, management offers staff the chance to self-test a new medical device. Jessie accepts. Unusual, sure, but not entirely out of the ordinary where she worked. But Jessie couldn't have known this device would take her on a journey of discovery to

reshape her health and help countless others do the same. The device was a continuous blood sugar monitor, and it was this, combined with her academic background and a remarkable willingness to use herself as a lab rat, that led her to a realization. Much of the food she was eating was creating havoc with her blood sugar. She should stop worrying about calories and start understanding how her body responded to the food she ate. In today's episode, I'm joined by Jessie and Dr. Sarah Berry, who has carried out dozens of clinical trials looking at blood sugar responses to different meals. Together, we will explore how blood sugar impacts our health.

We'll also discover Jessie's simple hacks to control blood sugar spikes and crashes, and find out the real reason why breakfast might be the most important meal of the day for your health. Jesse and Sarah, thank you for joining me today. And why don't we start with our usual quickfire round of questions from our listeners. So Sarah, do blood sugar spikes and dips matter for our long-term health? Yes. If you've had a diet high in sugar and you're in midlife, can you reverse the damage?

Partially. Could I react very differently to you to cereal, for example, for breakfast? Absolutely. By about tenfold difference, possibly. Amazing. And Jessie, is sugar a poison to the body? Yes. Controversial. We'll discuss that some more. Has understanding your blood sugar changed how you eat? 100%. Absolutely. If we eat our food in a different order, does it change our blood sugar responses?

It can change it by up to 75%. Amazing. So Jessie, what's the biggest misconception surrounding blood sugar? That in order to have steady blood sugar, you have to give up eating all starches and all sweets. Brilliant. And I'm sure we're going to talk quite a lot about this. All right, why don't we start at the beginning? Sarah, can you explain what is blood sugar? Yeah, so blood sugar typically refers to the level of glucose that circulates in our blood. And this is mainly determined by the foods that we eat. So when we consume foods or meals containing carbohydrates, they're broken down into very simple molecules called glucose. And we tend to use the term blood sugar when we're talking about blood glucose. And so when you consume a meal containing carbohydrates, what happens is

that after about 30 minutes, you get this quite big increase in circulating blood sugar that returns to baseline around two hours. And so imagine how we typically eat where we consume multiple meals and multiple snacks throughout the day. This means that your blood sugar levels are going up and down and oscillating all around throughout the day. And Sarah, help us understand what it's for. Why do we have blood sugar? Why are we even bothering to have a podcast to talk about it?

Obviously, we eat and most of us eat foods that contain carbohydrates. So every person every day is experiencing these oscillations, these peaks and troughs in blood glucose. So this is relevant to everyone listening. And the reason that it's particularly important is because we also know that these increases and these dips in glucose play quite a large role in disease. We know that if you have excessive peaks, it causes a whole downstream effects of oxidative stress, inflammation, for example. And so not only does it increase our risk of type 2 diabetes, which most people associate blood sugar with, but it also increases our risk of any disease that's underpinned by inflammation.

And this can include cardiovascular disease, some cancers as well, for example. And so why do we have blood sugar at all, Sarah? I've heard all of these bad things about it. So should I get rid of blood sugar? No. So you have it, like I said, because obviously from the food that you eat, but you also need sugar in your blood to provide fuel for your muscles to function, for your tissues, for your organs to function. So it does have a role to play. Where the problem comes, in my opinion, is where you have excessive spikes, you have these excessive peaks and these excessive dips in blood sugar. So what we don't want to do is encourage everyone to flatline,

but it's when it becomes uncontrolled. Just to help us understand, Sarah, could I function if there was no blood sugar in my body? No, you need a certain amount of it and particularly for brain function. Got it. So like no blood sugar, I die. Yes. Okay. So we need it. So that sounds good. And then we talk about maybe sometimes too much of it might be bad. And I think that's what we're going to explore now. Thank you, Sarah. So one way we can explore this is there's this new sort of blood sugar monitoring device, right, Jessie, that you can wear at home, that can measure your blood sugar every five

minutes. Could you tell us about it and your own experiences with it? Yeah, absolutely. So the first time I wore a continuous glucose monitor was about four years ago. And it completely changed my life because I realized, Jonathan, that glucose spikes, so these rapid increases in your blood sugar concentration after we eat, were actually one of the triggers for my difficult mental health episodes that I had been experiencing since I was a teenager. So I finally had found a cause or a trigger for something that had been plaguing me for a really long time. And with this glucose monitor, I was able to see how what I ate, how I moved, how I slept, and all of these other variables were impacting my glucose spikes. And it's pretty cool, you know, on your phone to be able to see that your blood sugar levels are responding to how you're living. And to me, it was a bit like

finally being able to communicate with my body, finally feeling like I had a channel. It was open communication. There was a dialogue. I could see what was happening underneath my skin. And so it really fascinated me, firstly, because I wanted to heal myself and not experience these mental health problems anymore. So I dove into the research and I actually discovered that I wasn't alone, that about 80 to 90 percent of the population experiences glucose spikes every day. And then I discovered these really easy tips that allowed me to avoid these spikes, feel better without giving up carbs and eating sugar and pasta, which I love. So it sort of gave you suddenly this insight into something that's going on inside your body, which previously you were feeling these results, but you had no idea what was going on. Yeah, it was a bit of a black box. I didn't understand how what I was eating and what

I was doing was impacting how I was feeling. So it was really light bulb moment for me. It completely changed my life. And you've talked about your particular experience about how it links to mental health, but maybe we just step back and talk more broadly about how blood sugar affects our health. So I think we've already established that if you have no blood sugar, you're dead. So that's not a good place. What about the other side? I think there's an easy image we can use. Imagine that you're a plant. If we give a plant too little water, the plant dies. That's what Sarah was saying, no blood sugar, you die. But if we give ourselves too much glucose, then problems start arising. And there's a wide array of symptoms that you might feel if your glucose levels are imbalanced, if you're experiencing these glucose spikes on a daily basis. And the most common ones are experiencing cravings, becoming hungry very quickly after a

meal. So within 90 minutes or two hours, feeling like you really need to eat again, having energy dips throughout the day. So, you know, feeling a bit controlled by this sort of roller coaster of you eat something high in carbs, then you crash and you're hungry, you have cravings, you're tired and sort of staying on that roller coaster. And in my own experience and in my community, those are the most common symptoms that anybody can feel and anybody can relate to even without wearing a glucose monitor. And then if you look a bit more medium term and long term, you know, glucose spikes have been associated with hormonal dysfunction, conditions like polycystic ovarian syndrome. And Sarah, I know you did a lot of research into menopause, acne, poor sleep.

There's a correlation with weight gain right there. And then long term, of course, type two diabetes. And as Sarah mentioned, because glucose spikes lead to inflammation, they really create a very favorable terrain for all chronic diseases to develop. I just wanted to ask about like a flat blood sugar. So because I think one of the natural consequences, I think if you're listening to this is, okay, this all sounds bad. So presumably, my ambition is to have a completely flat blood sugar through the day. Is that the right takeaway? So no, because you can actually have a very flat blood sugar while eating things that are really unhealthy. So let me give you an example. If you add a lot of alcohol to your diet,

it's going to flatten your glucose curves. If you add a glass of alcohol to your diet, it's going to flatten your glucose curves. If you add a glass of wine to your meal, it's going to flatten the glucose spike of that meal. Similarly, if you add a lot of fat to a meal, and this can be very unhealthy fat like trans fat, that's also going to flatten the curve of the meal. But that does not mean that you're actually helping your body be healthier. So in my mind, it's not about trying to reach for this perfectly flat line because that's an objective that can be abused. Really what we're looking at, Jonathan, is trying to just reduce this roller coaster, sort of flatten the spikes, minimize the dips as well

by using simple hacks. And we don't need to be super anal about it and go for something incredibly flat. We just need to think, okay, based on how I feel today, could I feel better? And if the answer to that is yes, you can start applying these hacks, flatten your glucose curves and start getting the benefits. Yeah. I mean, I want to kind of second that because I think this is one thing that worries me about this explosion in healthy individuals of using continuous glucose monitoring, which I think is highly valuable, but I think that people need to use them in an informed way. And the one thing that I worry about is people being obsessed with flatlining. And exactly like Jesse said, Jonathan, is then selecting these very unhealthy, highly processed, high fat foods, and going into keto

diets, which are based on incredibly unhealthy aspects of a keto diet. And I think that's really important that people make sure they still consume a balanced diet. They can still consume carbohydrates, but there's ways, and I think Jesse can talk about this in a lot more detail, there's ways that you can do this in a way that doesn't have downstream unfavorable health effects. I guess the message is if you just think about one thing and then you don't think about what you're switching to, you could easily go from something that is actually worse than where you were before. And I guess if you're not eating any carbohydrates, you have to eat fats. And if you're not eating really healthy fats, you're potentially in the worst place. And something else, Jonathan,

when I first wore a glucose monitor, so I was noticing that, you know, alcohol and high fat foods were keeping my glucose levels steadier, flatter. And I also noticed that exercise created glucose spikes. So if I had just focused on keeping my glucose level steady, I would have stopped working out and started drinking heavily and eating a lot of fat. I think this is a diet that many people would love to follow, Jesse. You're not recommending it? No, absolutely not. So I completely agree, Sarah. We really need information.

And that's what I've spent the past several years of my life trying to do is distill the useful parts of using glucose to make informed food decision while also nuancing, giving context. And there's a chapter in my book, it's one of the first ones, and it says what not to take away from your glucose levels. It's incredibly important.

And it's a complex subject. And if you're just thrown into it and you get a glucose monitor and you haven't read anything about this topic, you might be very confused. It's quite difficult data to interpret. And you might start, you know, drawing conclusions that are actually not good for your health. So if you want to wear a glucose monitor, check out my work. I have lots of stuff for free on Instagram. I also have a book, but that'll give you context so that you can go into it armed with the right information. Yeah. And just to add to that as well, I think it's also important that people are aware in

this context that it's one piece of a big puzzle, that it's not the only thing that drives our health. It's not the only thing that will determine our cardiovascular type 2 diabetes obesity risk. It's an important piece of the puzzle and it interacts with the other important pieces of the puzzle. So it interacts with our blood fat control. It interacts with our microbiome, for example. But we also need to consider the bigger picture as well. And what's great about, you know, wearing a CGM and being able to monitor your glucose is you can do that in real time and you can have some control. Yet a lot of the other risk factors, you can't measure and monitor and modify in the same way.

But I think it's really important people know it's one piece of a big puzzle. And I think that's what's great with the work that we're doing at Zoe is that unlike what's been done previously in research where we tend to focus on one exposure, so one risk factor, for example, blood glucose and one outcome, we've been looking at all of the pieces of the puzzle and we can see how important the blood sugar is for different individuals, how important your microbiome is and how it all interrelates. So can we talk a bit about menopause now? You were talking about changes in these blood sugar responses. Yeah. So we've done some great research on the ZOE predict studies where we've looked at how the menopause impacts a whole host of factors. We know that the menopause is this state of, you know, great upheaval and causes lots of symptoms that people feel physically, whether it's hot flushes, whether it's lack of sleep, brain fog, etc.

But what we also wanted to look at is how does the menopause impact how we process our carbohydrates? How does it impact our blood glucose levels? And interestingly, we found that postmenopausal women have a really big increase in circulating blood glucose levels compared to premenopausal women, even when we match their age. And this is really important because this shows it isn't just an age-related change that happens anyway. As we age, sadly, we do put a bit more weight on, we do increase our blood pressure, et cetera. But what we found is when we matched people for their age, we still found this big difference between the pre and post. And we also saw this big difference as well as in the

peaks. So these peaks that we know are really important in terms of inflammation and oxidative stress, we saw a big difference as well in the dips. The difference in the dips was a lot more pronounced in postmenopausal women than premenopausal women. And so if I'm listening to this and that describes me, what does that mean about what I should be doing differently? What does it mean about how my body is going to be reacting if I'm, say, eating the same food that I was eating for the last 20 years? Yeah. And I think this is something everyone, certainly people my age, I'm mid-40s, and sadly, myself, many of my friends are going through this perimenopausal transition. And it's something that

everyone talks about now, thankfully, that we weren't talking about in previous generations. And people say exactly what you said, Jonathan, but I was eating exactly the same foods that I've ate for the last 20 years, but I'm putting weight on, I'm feeling a bit rubbish. And interestingly, we did actually see from the ZopaDict research that postmenopausal women were tending to eat more sugar and more carbohydrate rich foods. But I think what's really interesting with this is that we know that it's the peaks, we know that it's the dips that are changing postmenopausally, and we know that there's things that we can do about it. So we can either suggest to people, okay, try and modify the types of food we're having, or we can suggest to them the kind of

hacks that I think Jesse will talk about a little bit later that would also be able to modify the peaks. So you can say, okay, carry on with the food you're having, but do these hacks as well so you can attenuate that. So it's just saying you're at higher risk. And so fundamentally, Sarah, you're saying, I just want to make sure that this is clear. I might be eating exactly the same breakfast, say, that I was eating 15 years ago. And before I wasn't having very big peaks with it. My body could deal with this. And now I'm perimenopause or menopause and I'm having the same food, but I'm having these much bigger peaks and then these are having the impacts that you were talking about before? Yeah, absolutely.

So basically the menopause just is really blimmin' unkind to us women. And it does mean, yes, 20 years ago you could have had exactly the same pan of chocolate or whatever, and then you have it post-menopause and you're having a very different response. And you're also increasing your cravings for the same food, right? You're eating the same food, but your dips are now bigger probably. And this also, we see this even in people who are still menstruating. The week before your period, your glucose control is not as good. So the same food that you had just a week ago is going to create a bigger spike and likely a bigger crash. So the same usual food is just creating cravings where it wasn't creating them before. And that's really interesting,

Jessie, because new research that's very hot off the press, Jonathan, we only crunched the numbers yesterday that we've done from our Zoe Health Studies data, where we had hundreds of thousands of pre and postmenopausal women telling us about their diet and telling us about their menopause symptoms. And what we found is that people that had higher intakes of sugar sweetened beverages, so basically sugary drinks, had a lot worse symptoms. And so you're getting these cravings that you said, Jessie, it's craving them, people having cravings to have more sugar sweetened beverages, and then that's acting to then just make their symptoms worse. And the kind of symptoms it was making worse were the ones that people find most burdensome, things like the brain fog, like the hot flashes,

like the anxiety, for example. And so are you suggesting that if you switch what you're eating, then potentially, and I know you're not saying this is proven from this, but potentially that can impact your symptoms? Yes. Based on the research that we looked at, or the data that we looked at yesterday, there's a really strong association between the foods that you're eating and the severity of your symptoms. And this is the first data or first study to ever look at that, which is super exciting. That's amazing. And not yet peer reviewed and published, I guess we should add in that case, Sarah. No, these numbers were literally crunched yesterday. So this is a real kind of preview. We're getting a preview.

She'll still be AP right now. That's good. Well, I know scientists are normally rather cautious about what they talk about. And not when it's this exciting, Jonathan. When it's this exciting, then that means Sarah feels very confident. Yes. And other than menopause, do we also see a lot of personalization elsewhere or is this specific to that situation? So we see huge differences in individuals. And I touched on this at the beginning that

from the PREDICT program of research, one of the key aims is actually looking at how different are people. So in nutritional research and population-based guidelines, we typically have a kind of one-size-fits-all approach. And what we're trying to do at Zoe is move beyond that one-size-fits-all because we know that we're all individual. We have all of our thousands of biochemical processes are slightly different. And when we look at people's blood glucose responses in our PREDICT studies to identical meals, again, in this very tightly controlled setting that I mentioned, Jesse, earlier, we see there's a huge difference. We see probably more than a tenfold difference between individuals. And these are healthy

individuals that we recruited into this study consuming exactly the same breakfast. And I think what I find particularly fascinating, as well as the size of the variability in responses to the same meals is that the variability is so much greater in this, what we call the post-prandial phase. So it's so much greater in the two hours after consuming the meal compared to fasting. And the reason I think this is really interesting is because what this allows us to do is for people like myself and Jesse, for example, might have exactly the same fasting glucose, exactly the same HbA1c, which is a measure that is often used clinically to look at people's blood glucose control.

But if we were to consume exactly the same breakfast, Jesse might have a really high response and I might have a really low response. Now, we wouldn't have seen that by just measuring fasting levels. And this is what I think excites me a lot about the blood glucose variability that we see from the PIDICS studies, that we see so much bigger variability in the postprandial, so this two-hour post-eating the meal phase. So it allows us to discriminate long before anything's played out in that fasting state. So it gives us a real peek into the future also of someone's long-term health, I think. It's very cool. And you mentioned, Sarah, if we both had the same breakfast,

we would probably see very different responses. And I think that's really interesting and it's fascinating and it's really cool once you're able to get into that phase of sort of personalization. And I would also say for people who do not have access or the ability to see their own glucose spikes and how they might relate to like their friends or their partners or, you know, yours, Sarah, mine. There are hacks that everybody can use that regardless of what the height of your spike would be, if you used one of the hacks, your spike would be smaller. So Sarah, if you and I both had cereal for breakfast and I had a much bigger spike than you, if we both use, let's say the hack of having vegetables first, both of our spikes would be smaller. So in my mind, people often ask me like, how much of this is personalized? How different am

i really and do we have general principles that can apply to everybody and i believe the answer is yes you have a baseline of like easy principles and then you can get into the personalization i don't know how you feel about that sarah yeah i mean this is what i think is really exciting that traditionally i think people have always thought it's all about what you eat. So the foods that you're eating is what determines your response. That's it. It's all set in our genes. You know, I was a child growing up in the seventies where my mum said, well, everything's predetermined by your genes. And what our research shows, which is really exciting is that your blood glucose response is not just about who you are, but it's also about how you eat. And I think some of your

hacks are great on this. And it's also about what you eat. So it's who, how and what. And I think that's really empowering for people because there will be people that don't want to change the food that they're eating. So they can adapt how they're eating it, for example. And I think it's a brilliant point, actually. So let's talk about that. We like talking about actionable advice on this podcast. So what can we do to control our blood sugar? And maybe let's start with what we eat, because I think that is the most obvious, Sarah. And then let's talk about all those other things that we can do after that. So I think, Jessie, you're best placed to maybe talk about this. And what I'd love to do is also

jump in, Jessie, on a few examples where we've actually applied your hacks within our predict studies. So we have some mini protocols in our predict studies and some results that I think would be interesting to let you know, again, hot off the press. Nice. Oh my God, this is so exciting. I didn't know I was going to get all this cool data. Okay. So I think the easiest hack, which is very simple for people who actually don't want to change what they're eating, because that can feel a bit daunting in the beginning, is actually simply looking at the order in which you're eating the constituents of a meal. So in the studies, they found that just by eating your food in the right order during a meal, you can reduce the glucose spike of that meal by up to 75%

while still eating the exact same foods. And this has a tremendous impact on your physical and your mental health. And so the correct order is during a meal, vegetables first, proteins and fats second, and then starches and sugars last. And one of the main reasons this works in reducing the glucose spike of the meal is thanks to the effect of the fiber that is in the vegetables. And that fiber will reduce the speed and the quantity of glucose absorbed for later on in the meal. And then proteins and fat second,

we know those also slow down gastric emptying, digestion speed. And so overall, if you're eating your meal in that correct order, you'll have a smaller glucose spike. And that means fewer cravings, being less hungry a few hours later, fewer energy dips. And then whatever symptoms you're contending with, you know, maybe

it's difficult menopause symptoms, maybe it's like acne, maybe it's just generalized inflammation. Those will also be able to be reduced when you use the food order hack. And Sarah, is that a hack you guys have been testing? Because I'm so curious. That is a hack we've been testing. So we've had lots of our participants who have tried the food ordering hack where they have cheese, they wait 15 minutes, and then they have white bread. And this is fasted, so it's a little bit controlled. And then the next day, they just have the cheese on the bread. So they have exactly the same food, but they don't have that 15-minute break. And we do see a significant reduction in their blood sugar, blood glucose response. Nice. And for those listening, you don't have to wait 15 minutes, even if you just

reorder and have veggies first and carbs last, you'll still see an improvement in the glucose response. Because I think for most people, like waiting 15 minutes would be pretty impractical. Yeah, I mean, we were doing this to really kind of show the proof of principle. And that was a question I wanted to ask is, could I have my mixed meal where maybe I have my bit of pasta or rice, some chicken and some vegetables? Can I literally just eat my vegetables and then straight away the next minute start on to my protein, my chicken or whatever, and then straight away start on the pasta? Absolutely. So, you know, it's a spectrum. So if you were to wait 15 minutes between each

constituent, you would see a greater effect. But also if you just eat them one after the other, you will still see a pretty good effect as opposed to eating them all together or starting with the carbohydrates. So it's always a spectrum. You can always do a bit worse for your glucose and a bit better for your glucose. But if you just reorder and eat everything in sequence you will still see a pretty big impact so let's say we're out in a restaurant and we're having a starter if i was to consume maybe a starter that was either vegetable based or protein based and then i was to have as typically would happen it would be about 15 minutes later that your main course would come. When I'm consuming that main course, could I consume everything kind of all mixed in at once, having at least before that, having had either my vegetable, my high fiber or my high protein

and fat starter? So you don't need to do anything. You can decide how much you want to use the food order hack. But would that work? Yes, it would work. Absolutely. And your example of adding, I just want to mention because sometimes people can feel like, oh, does this mean I have to separate out every single dish, deconstruct every sandwich? And no, that's not the point. The point is using this information when it's easy. And so Sarah, the fact that you mentioned the starter is actually the hack I was about to talk about. So we're just like super connected. The other hack is just add a starter that is built around vegetables, a vegetable-based starter to all of your meals.

And then eat your regular meal as you would usually. That's just another way to use that same principle of fiber first to impact your glucose curve. And so let me give you an example. If you're having like a mixed dish, let's say you're having pasta with chicken in it and maybe parmesan and some cauliflower, you can just add a veggie starter, like a green salad, maybe with some vinegar at the beginning of the meal

and then eat the mixed main dish and still get a really big impact. And that'll be better than not having the vegetable starter. And you can compose with it as you wish. Does that make sense? Yeah, absolutely. Thank you. Yeah, of course. Of course, of course. So what other than food ordering can we do, Jessie? So I want to mention vinegar, because this was quite shocking to me when I saw the clinical studies that were looking at the impact of vinegar on your meal's glucose spike.

So if you have a tablespoon of vinegar, it can be any type of vinegar, avoid balsamic glaze because that has a bunch of sugar in it. If you have a tablespoon of vinegar before a meal, either in a tall glass of water and you drink it or as a dressing on your starter, for example, you can curb the glucose spike of that meal by up to 30% without changing anything of what you're eating during the meal. So you're just adding this vinegar ingredient. And the way it works is because vinegar contains a magical molecule called acetic acid that has a few impacts on the body. One, it slows down the breakdown of starch into glucose. And two, it encourages your

muscles to uptake more glucose as it arrives in your bloodstream. And so as a result, the glucose spike of your meal is smaller, but you didn't change anything about what you were eating. And there are some really early studies that show, for example, the impact of just adding two vinegar drinks a day on glucose levels, on diabetes markers, also on polycystic ovarian syndrome symptoms. And they seem to have a pretty good effect. Small studies, of course, for these specific diseases. But overall, we understand the mechanism and it's really easy. And personally, this has helped me hugely with my cravings. If I have a vinegar drink before a meal, I know I'm going to be curbing

those sugar chocolate cravings that usually happen for me an hour and a half after meals. And something else that I find really cool about this topic is that vinegar has been used for millennia in many cultures around the world, for example, in Iran. And people know culturally that it's a healthy thing to have in our diets, but they didn't understand why. And now we have some clues that it has something to do with glucose levels. And Sarah, this sounds a little controversial. What are your thoughts on vinegar as the magic solution for our blood sugar? So I must say, I was very skeptical. I thought, oh my gosh, this is one of those quacky food things.

So yeah, I did go and check out the research and I have to admit I was wrong in my opinion. And yeah, the evidence seems quite good on this. So I think it's a great hack. If you'd have asked me two weeks ago, I wouldn't have said that. And are there at this point, are there any randomized control trials actually showing sort of the long-term impact? Because I guess this is always the question, which is you can see an impact on your blood sugar, but you don't actually know what the long-term health impact. Have they reached this at this point or is this sort of upcoming? There are a few like six-month long studies, but I think those are the longest ones.

While we're on vinegar, I think something to ask, and this is more for something I don't know about. For people that then want to go away and do this and want to have a tablespoon of vinegar before every single meal, and let's say they're consuming a typical kind of UK eating style where it's three main meals and three snacks, you're having six eating events throughout the day. If they were to have then six tablespoons every day before a meal, are there any possible side effects to this? So I'm just being cautious because I know that people will take these recommendations and I don't know the answer. And I know because you've researched this a lot, hopefully you will have the answer. Of course. So there are a few key things to keep

in mind. One, always dilute the vinegar in water. Two, if you can, use a straw because that'll be better for the enamel of your teeth. So in the literature, I was looking like, are there any side effects? Can you overdose on vinegar? Like, what's the situation? And the only thing I found is a woman who was consuming, I believe, 30 tablespoons of straight vinegar for a few years started having potassium deficiencies. So that's the only thing I have found. And vinegar, it's just another food. And it seems there's no real side effects of having it several times a day. Of course, listen to your body. If it doesn't agree

with you, you know, stop. Personally, I do very well if I have it three times a day. You don't need to have it before every single meal. For example, you know, I'll have some vinegar if I see it on my counter in my kitchen and I remember to do it or if I'm like, I could have a little vinegar drink right now. But how much you apply it to your life is really a function of how you're feeling, how much you think you have a glucose spikes happening all the time, and then how much you enjoy it. Because if it's stressful and you don't like the taste like don't even force it but from

a purely health perspective that doesn't seem to be any side effects of having vinegar multiple times a day okay and one more question on this topic are you talking about kind of table vinegar that in the uk for example we would put on our fish and chips or are you talking about a different kind of vinegar very simple like table vinegar that buy, that you put in your salad dressings, that you put on your chips. Definitely do not buy the vinegar that's with the cleaning products in your supermarket. That's 6% acetic acid, and that's too strong. You're just looking for the regular vinegar that you might see on the table at the restaurant or that you might use when you're cooking. So like a white wine vinegar, red wine vinegar.

White wine vinegar, red wine vinegar, cherry vinegar, apple cider vinegar, any type of vinegar, rice vinegar, plum vinegar. It's really about the acetic acid and it's present in all types of vinegar. So you're fine. Well, I've got a great idea for our next research, Jonathan, that all of these hacks,

I think we should try and see how it affects glucose dips. Oh my God. Yes. Please, let's do it. You heard it here first for sure. You heard it here first. You heard it here first for sure. So just before we go to the next hack, I'm conscious that there'll be people listening here saying, okay, but I'm open to changing what I eat. And I'm actually not at all clear what foods really affect my blood sugar. So could we sort of address that also for a minute?

What should I be eating if I want to reduce these spikes? I am maybe concerned. I feel like I'm having these. What's causing it? What could I shift to? Yeah, absolutely. So the two main types of food that contain glucose are starchy and sweet foods. So put very simply, if you reduce the quantity of those in your diet, so if you reduce,

you know, bread, pasta, rice, potatoes, and you reduce also sweet foods, desserts, sugar, you know, fruit juices, fruit products, you're going to reduce the glucose spikes in your body. But then it's really important to not sort of replace those with unhealthy processed foods that might keep your glucose level steady, but are really high in fat, for example. So the one place, Jonathan, that I think is actually really, really valuable and important to change what you're eating, and this is the place with the biggest bang for its buck, is breakfast. So at breakfast, if you're able to switch from eating sweet and starchy foods to eating

savory foods based around protein, this is going to have a humongous impact on how you feel for the rest of the day. As Sarah mentioned, it's going to control your glucose dips and spikes for the rest of the day as well. So that's the only hack where I really encourage people to truly change what they're eating, going from sweet to savory. Jesse, some of what you're suggesting here is at odds with what people are told about whether they have their carbohydrate in the morning or afternoon. So I'd just love your opinion on this. So we've seen, again, in our ZOE PREDICT studies, but also there's been other published

research on this that shows that you have better glycemic control in the morning. And so, you know, many people might be aware that if you do want to have carbohydrates, have it in the morning, because we see a lower blood sugar response in the morning compared to if you consume it later in the day. And we see this with our own research, although it's very variable between individuals. And so this is something I often advise people who are worried, but now that's at odds with that. So how do we not give contradictory advice? I think one of the problems with that is that you're looking at it in a vacuum, right? So you're looking at cookie

at 9am versus cookie at 6pm and it says, oh, 9am cookie is better. But you're not necessarily thinking about what the impact of a 9 a.m cookie is going to have on the rest of your day and that the 9 a.m cookie is going to create an 11 a.m crash and an 11 a.m craving and you're going to be hungrier for the rest of the day so i believe that the benefits of eating you know your carbs earlier in the day do not outweigh the benefits of having a savory breakfast so i personally have seen and i recommend of having a savory breakfast. So I personally have seen and I recommend you have a savory breakfast. And if you do want to eat carbs, actually, or something very sweet, for example, a cookie, best time to do that is as dessert after lunch, or dinner, because I believe

the 9am 6pm time of day thing is just less impactful than using the food order and having a savory breakfast. But there's a lot of different pieces of advice and it can be confusing to put them all together for sure. Yeah, that's why I just want to get your opinion on that. I think that's really helpful because I want to make sure, you know, we do other podcasts where we'll talk about time of day. So it's really important we make sure that we're giving unified advice. So I think we have time for one final hack, Chessie, which you touched on a little bit, which is about exercise. Yes. Okay. So Sarah mentioned in the beginning of the podcast that, you know, glucose is your body's source of energy and your muscles specifically are really happy to

use glucose if you need them to contract. So a very simple hack is after your meals, use your muscles for 10 minutes. This can be walking, it can be dancing, it can be whatever, folding your laundry, cleaning your apartment, whatever you want to do for 10 minutes. Because as you exercise and contract your muscles, they will soak up glucose from your bloodstream to power themselves. And as a result, the glucose won't accumulate as much in your bloodstream, but rather will be used for energy directly. So within an hour after the end of a meal, just get up, move for 10 minutes. You'll see a big impact on your glucose levels and on how you feel.

Jonathan, there's one other hack that we did in our ZopaDict studies that is actually one that Jessie has as well in her book. So I would quite like to mention that. And this is about food combinations. So we had individuals on one day having just white bread for breakfast, then on another day layering onto their white bread, some cheese and some spread. And so each day they were consuming the identical amount of carbohydrate, but one day they had the added fat and protein. And we saw a significantly lower increase in blood glucose levels when they layered on the fat and protein.

And I know this is something that you talk about as well, Jessie, and about how you combine your foods. Yeah, I talk about don't leave your carbs naked. So always put some clothing on your carbs, so protein, fat or fiber. And so anytime you're eating something starchy like white bread or something sweet, make sure you add protein, fat, or fiber because that way the glucose from the starchy or the sweet food won't hit your bloodstream as quickly. And as a result, you'll get a smaller spike. Now, there's a little caveat to this because, you know, we mentioned just add some fat to your carbs. Don't add two pounds of butter to your piece of white bread because that might cause, you know, other downstream consequences. So the best clothing is really fiber. Then second best,

I would say, is protein. And third best, and make sure it's healthy fat, will be the fat. I think we could keep talking about hacks for the rest of the day, but I think we'd better wrap this up. So let me try and quickly summarize what was a very wide ranging conversation. So to start with big blood sugar spikes over and over are bad. A lot of processed food in particular can cause these high blood sugar spikes. That said, blood sugar is just one of the things that matters when we think about our diet. We shouldn't be trying to aim for a flat blood sugar. Otherwise, we would have the all butter diet, have no blood sugar spikes. And no one that I've met so far says that the all butter diet is a healthy diet.

All butter and all alcohol. All butter and all alcohol, Jessie, yes. So we'll call that the Jessie diet now. No! So definitely something that we can't do. Menopause is one of the points in our lives where we can see a huge change in blood sugar responses as well as other responses that Sarah talked about. More broadly, there's lots of personalization. So some people have very high

responses like me, other people much lower. So that clearly affects how much you care about it. And then we talked about some fantastic hacks about trying to manage your blood sugar better and that breakfast is a place where you can really make a big change and have probably a big impact on your total blood sugar through the day. We talked about a tablespoon of vinegar and it sounds like the full verdict is not yet in. And then we talked about two final hacks, I think. One is use your muscles for 10 minutes after eating. Go for a little walk, for example, do something in your apartment or your house. And finally, we talked about food combinations. So you can take whatever you wanted to eat, the piece of bread, add some high quality fat and protein to it and actually sort of improve the quality of that meal and lower the blood sugar

spike. Did I capture the hacks, Jessie? Jonathan, you're officially a glucose goddess. No one has ever said that to me. That's amazing. So just before we go, I've got a final listener question from Gemma on Instagram for you, Jessie. And she said very simply, how do I stop craving so much sugar? Well, Gemma, I think you'll find something quite interesting is that often when we crave sugar, we are actually being the victims of these blood sugar spikes and dips. We're on this blood sugar roller coaster. And often the response to a craving is feeling shame about it, feeling guilty, trying to apply willpower to sort of overcome it. And so what I would say, Gemma, is look at the root cause. See if using the hacks is something that you can easily do in your life. Because if you do, you'll be able to reduce your glucose rollercoaster. And naturally, your cravings should dissipate. And what happened for me is that when I studied my glucose levels,

my relationship to things I used to crave really changed. Instead of feeling this impulse, instead of feeling controlled by my cravings, I now could decide with joy and pleasure to eat the chocolate cake, the chocolate ice cream, the Nutella crepe without feeling controlled by it. So hopefully, as you balance your glucose levels, the cravings will dissipate and you'll change your relationship to sugar. Amazing. Thank you both so much, Jesse and Sarah.

I really enjoyed that. And I think our audience will have had a lot to take away from this conversation. I hope we'll be talking again soon. Thank you both. Can't wait for the studies. Fabulous. Thanks, Jesse.

Great to chat with you. Thank you. Thank you to Jesse and Sarah for joining me on Zoe Science and Nutrition today. We hope you enjoyed today's episode. If you did, please be sure to subscribe and leave us a review as we love reading your feedback. If this episode left you with questions,

please send them in on Instagram or Facebook and we will try to answer them in a future episode. At ZOE, we want to improve the health of millions by understanding the right food for each of us to improve our health and manage our weight. Each member starts with an at-home test, comparing them with participants in the world's largest nutrition science study. If you're interested in learning more about Zoe,

you can head to joinzoe.com slash podcast and get 10% off your personalized nutrition program. As always, I'm your host, Jonathan Wall. Zoe Science and Nutrition is produced by Fascinate Productions with support from Sharon Fedder and Alex Jones here at Zoe. See you next time.