Blood glucose, ie the glucose we have in circulation (I know), is a critical source of energy for our body. However, as is the case with everything in the body, if it is too high or too low then we have potential problems. So keeping it balanced is of vital importance. When these levels fluctuate it can lead to everything from short term fatigue and energy crashes, through to driving chronic degenerative disease. There is a good reason why it has always been number one in my three keys to good health.
Blood sugar regulation and why it is important
Our body’s glucose levels need to sit within a tight range. They cant get too high. they cant get too low. When our blood glucose rises. the body responds by releasing insulin from the pancreas that then causes our cells to take up glucose that is above the standard threshold of what should be in circulation. This extra glucose taken up by cells to used to manufacture ATP, that our cells run on (Newsholme at al, 2014). If this process gets over run or indeed if glucose remains chronically low, then we can rapidly run into problems.
The complications arising from prolonged high blood sugar
The occasional spike in blood glucose that we associate with a bit of dietary carbohydrate or the odd treat is of absolutely no consequence whatsoever. We pump out some insulin, the cells take it up, everything is good. However, if we are following the typical Western diet that is a very high percentage of ultra processed foods like white bread, white pasta, ready meals, frozen convenience foods etc, then we will be pushing our blood glucose up to damaging levels almost consistently. When this happens we are at an immense risk of chronic degenerative disease. Firstly, or risk of cardiovascular disease increases. Chronically elevated blood glucose can cause damage to the endothelium - the ‘skin’ that lines the inside of our blood vessels. This damage sets the stage for cardiovascular disease (Brownlee, 2001). This is compounded by the fact that elevated blood glucose causes us to produce higher levels of LDL cholesterol, that manifest in the highly damaging ‘small dense’ particle size. These tiny particles can actually enter the site of endothelial injury and begin to form a plaques known as atheroma that can later rupture, leading to blood clots known as an embolus - the cause of heart attacks and strokes. Chronically elevated blood glucose has also been associated with significant damage to the kidneys and the nervous system by means of glucotoxicity (2001).
Then of course over time if this state continues, our risk of type 2 diabetes increases as our insulin signalling and reception capacity changes. If blood glucose spikes consistently every day, week, month etc then after a while the receptors that are listening out for the glucose signal start to get a bit suspicious. After prolonged periods of very high insulin, they think something has gone wrong, so they start to become less receptive to the insulin signal. We move into a state called insulin resistance. When this happens then elevated blood glucose gets even worse, which can lead to glucotoxicity of the beta cells in the pancreas and before we know it we have type 2 diabetes (Hu & Manson, 2001).
The final thing to note is that chronically elevated blood glucose can lead to weight gain too. When our cells have taken up all they can, and we have stored a small amount in the muscles and liver as glycogen, any excess that is left over must be dealt with. It is sent to the liver where it is converted into triglycerides that are then stored in our fat cells. If this is happening daily then excess weight can soon sneak up on us.
Is low blood sugar a problem?
Low blood sugar, whilst certainly something that is far less common, can also come with its own set of issues. For patients with diabetes and on glucose lowering medications it can prove to be a very serious problem. These can range from dizziness, brain fog, fatigue and confusion, right through to severe responses like lack of consciousness or even coma (Cryer, 2001). So whilst rare, still a potential issue.
How to we get off the blood sugar rollercoaster?
You will probably see this recurrent trend throughout my work. In every recipe I post or book I write or interview that I give. The core message is always the same. Move to a whole foods diet. The simplest way to start getting a better glucose response to the food that you eat is to cut out refined carbohydrates, fill up on fibre and protein, and get back to basics with the ingredients you use and how you cook them (Jenkins et al, 2002). Combining a small amount of slow burning carbohydrates like brown rice, quinoa, new potatoes etc, with an abundance of high fibre non starchy vegetables and a generous portion of protein will create a meal that just gently drip feeds your blood glucose, keeping it stable and avoiding all the pitfalls we have covered above.
Another obvious thing we can do to really improve things is to ensure that we prioritise physical activity. Exercise enhances our muscles ability to to take in extra glucose, increases the number of insulin receptors, and expends excess circulating glucose (Hawley & Lessard, 2008).
The final thing, and certainly one that I am working on, is stress management. The stress hormone cortisol stimulates our adrenal glands which in turn trigger the release of glycogen - the stored glucose we have in our liver and muscles. This releases causes blood glucose levels to shoot up. This is in nature designed to give us a burst of energy to escape from a sabre toothed tiger…but the tiger never comes. A day filled with stress will push blood glucose up just as high, if not higher than a day eating pasta and fizzy sweets (Rosmond & Bjorntorp, 2000).
Balancing blood glucose is in my opinion essential to long term good health. Not to mention that it will make us feel so much better in the short term too. With a good low glycemic whole foods diet, regular proper physical activity and a plan in place to manage our stress, we can keep it in the sweet spot and safeguard our metabolic health for a lifetime.
Brownlee, M. (2001). Biochemistry and molecular cell biology of diabetic complications. Nature, 414(6865), 813-820. doi:10.1038/414813a
Cryer, P. E. (2002). Hypoglycemia: The limiting factor in the management of IDDM. Diabetes, 48(4), 751-758.
Hawley, J. A., & Lessard, S. J. (2008). Exercise training-induced improvements in insulin action. Acta Physiologica, 192(1), 127-135. doi:10.1111/j.1748-1716.2007.01783.x
Hu, F. B., & Manson, J. E. (2001). Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. New England Journal of Medicine, 345(11), 790-797.
Jenkins, D. J., Kendall, C. W., Augustin, L. S., Franceschi, S., Hamidi, M., Marchie, A., Jenkins, A. L., & Axelsen, M. (2002). Glycemic index: overview of implications in health and disease. The American Journal of Clinical Nutrition, 76(1), 266S-273S.
Newsholme, P., Gaudel, C., & Krause, M. (2014). Mitochondria in the regulation of insulin sensitivity and insulin resistance. Comprehensive Physiology, 4(2), 1089-1112.
Rosmond, R., & Björntorp, P. (2000). The hypothalamic-pituitary-adrenal
axis activity as a predictor of cardiovascular disease, type 2 diabetes and stroke. Journal of Internal Medicine, 247(2), 188-197.
Sacks, D. B., Arnold, M., Bakris, G. L., Bruns, D. E., Horvath, A. R., Kirkman, M. S., Lernmark, Å., Metzger, B. E., & Nathan, D. M. (2002). Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clinical Chemistry, 48(3), 436-472.