Should you care about your blood sugars? On blood sugars and current trends.
CGMs, ACV, BG, A1C...abbreviations galore!
Some people eat pizza and chocolate without giving it a second thought. They don’t feel shame or guilt after indulging, and don’t have to manage conditions that have them cutting, counting, portioning, or injecting as an aftermath of said craving. Some people do worry; some about their indulgence and its aftermath, others about its effect on their blood sugars.
To be conscious of what we eat and responsible of our choices, and to be fearful, hyper-fixated, and overly cautious are two different things and the fine line between both is how we relate to the eating experience at the moment, as well as before and after.
Is the thought of having chocolate robbing your peace of mind? Is the act of eating it bringing up discomfort? Are you feeling guilty for having eaten it or compensating hours after?
There are many factors that contribute to our relationship with food, one example being growing up in an environment where foods were categorized as “good” or “bad.” The message follows us as we grow older. We hear it from peers, from colleagues, online, or we become preachers of it ourselves.
We make food a moral cause and have strict and defined lists of our “goods” and “bads.” It might take time to reframe our thoughts around food and heal our relationship with it, but it’s not impossible. Working with a professional, surrounding yourself with more positive connections who have a similar outlook, and unfollowing people online who use judgment and don’t inspire are big steps you can take to start.
There’s a lot of misinformation out there and many “professionals” looking to push their agenda in order to sell you something (think supplement, product, course, you name it), reinforcing the notions that foods are “good” and “bad.” Fear-mongering tactics and sensationalized posts keep us hooked and wanting to restrict in search of their promise of “optimal health.”
“Don’t eat this it’s full of x, y, z,” or “throw out all your x,” or “5 reasons you shouldn’t have x,” are all phrases used to peak your interest, shame your choices, and keep you engaged.
CGMs:
A new trend that I’ve seen creeping up online is “biohacking,” or tactics to control bodily functions and your environment so it “performs at its peak”, an example of this being the desire to control blood sugars, and with that the rise in popularity of continuous glucose monitors (CGMs) for people without diabetes.
CGMs are usually placed on the arm and use filaments that pierce the skin to frequently assess blood sugar levels and the results are then sent to the user’s phone for review. They’ve been revolutionary for diabetes care especially in type 1, as patients don’t have to prick their fingers constantly, and are a tool to easily track trends and help make care decisions with real-time and recorded data.
Research shows that there likely isn’t a lot of benefit for people without diabetes to wear a CGM (shocking, I know!) Glucose variability is a measure of blood glucose levels’ rise/fall during the day and is a measure of glucose tolerance, or how well our body can efficiently use glucose for fuel. For people with diabetes, variability gives us insight into the effectiveness of diabetes management and treatment. For people without diabetes, glucose typically remains in a narrow range, and blood sugars, though not a set standard, tend to fall at 80-140 mg/dL. This means that the body’s ability to regulate blood sugars in people with normal glucose metabolism is highly efficient, and glucose levels typically return to normal range a few hours after eating.
No data has shown that the benefit of CGM use on people without diabetes translates into improved health. This is a big incentive for many companies that offer CGMs as a tool for weight loss, enhanced performance, or better heart/brain health. And I understand that just as with a fitness tracker, the data from CGMs may help you stay motivated and lead to behavior change, but there are no set standards for assessing these values in people without diabetes and there’s a lack of consensus on what to do with said data as a professional.
Having more data can give you a sense of control over your health, but data that is useless may lead you to stress over your food choices, lead to the development of food fears, and disordered eating which in turn ultimately harms your health more than helps. These devices also aren’t cheap and can be inaccessible even for folks with diabetes (ring a bell, like the Ozempic scarcity?) There are a lot of hypotheticals and maybe more data will help with the establishment of parameters and protocols, but for now, assess the risk/benefit (and cost/benefit) before jumping on the trend.
ACV:
Other blood sugar-related trends include the use of apple cider vinegar (ACV) to lower glucose spikes. ACV improves insulin response and decreases blood sugars after a meal by having the acetic acid block some of the starch in the meal (think pasta or bread). But again, what’s the intention behind this? For actual blood sugar control in diabetes, you’ll likely need more than vinegar. And for regular people (actually, for both groups) balancing your meals and having a proper dietary pattern will take you farther. If you like ACV, consider adding it to your salad dressing (yum!).
It’s normal to have our blood glucose rise, and when it drops quickly, it may leave us feeling tired or hungry, but in the long run, if you have an A1C within range, a single spike doesn’t define anything or truly make a big difference to your health.
Supplements & Diet:
There are also supplements now targeted towards glucose spikes. The Glucose Goddess (GG- a French biochemist) launched her “Anti Spike Formula” this week, which is a blend of herbs that was created to lower glucose spikes. But the blend of all these herbs together hasn’t been tested, and supplements aren’t regulated by the FDA, so how do we know if it does what she claims? We don’t, and at $65 a bottle, best to save your money and follow a balanced diet.
PSA: you don’t need a supplement to lower your glucose, you have insulin, and your body will do it for you. (again, not applicable to people with diabetes or insulin resistance, but your meds as prescribed by your doctor will help you achieve your glucose targets, and you should always consult with your doctor about adding supplements like these to your regimen.)
This supplement comes after GG went viral several years ago for her “glucose hacks,” stating one should eat:
Veggies first
Proteins seconds
Carbs last, in hopes of avoiding a glucose spike.
And that’s pretty evidence-based, and a great tool for blood sugar control-if it’s something you need. Most of this research has been done on people who have diabetes (people who actually need to control their blood sugar levels). This is all great for folks with insulin resistance, and even strategies I’ve talked to some patients when appropriate, i.e. try having your salad, and then your meats and rice.
But in the past, she’s talked about how “it’s a spectrum,” and points to data showing how it’s ideal to wait 15 minutes between each of the food’s components (veggies, then after 15 minutes protein, then after 15 minutes carbs). But data is just data, and may not apply to real-life situations, like when you go celebrate Valentine’s Day at an Italian restaurant with your boyfriend or have pizza and wings at your Super Bowl watch party.
Is this me saying go off and have all the carbs in the world and all the refined sugar and processed foods? Not at all! It’s not rocket science, she’s making claims of eating more whole grains, fruits, and vegetables and it’s what professionals like me have always said (for greater satiety, for greater variety, for sustained energy, etc.).
But scaring people with normal glucose metabolism that something truly bad will happen if they eat fruit alone or have a cake before their meal, is not right. Or telling them to have vinegar after having eaten a cookie sounds disordered, and after all the spike already happened! Rejoice and move on.
Remember to have your carbs with protein, fat, and fiber, and move your body in ways that feel good to you. Let’s think about adding to our plates and not reducing foods’ nutritional value to just glucose spikes. Let’s start thinking about how to add balance to our lives, instead of “biohacking” it.
Keep chewin’!
Interesting!!!