Updated: Apr 21, 2022
What is blood sugar?
Blood sugar, or blood glucose, is a measure of the amount of sugar in blood. This sugar comes from the foods we eat -- specifically, from foods that contain carbohydrates.
When we consume carbohydrate, it breaks down into glucose, enters our blood stream, and our blood sugar rises. Our bodies like to keep our blood sugar level in a narrow range (between 70-100). When our blood sugar rises above this level, our body releases the hormone insulin. Insulin’s job is to regulate our blood sugar by lowering it. It takes sugar out of our blood and makes it available for our body to either use as energy, store it in our liver for later energy use (carb loading), or store it as fat.
Foods that affect blood sugar
Of the 3 macronutrients, carbohydrates have the most significant effect on blood sugar levels. When you eat anything that has carbohydrates in it, it breaks down into glucose in our bodies.
The main food groups that contain carbohydrates include: grains/starches, starchy vegetables (potatoes, peas, corn), fruit, and dairy. That’s not to say that other foods don’t contain carbohydrates. Most foods do not exist as solely a carbohydrate, or solely a protein, or solely a fat. They are a mixture of macronutrients. For example, peanut butter is considered a “fat” but also contains protein and carbohydrates -- just in smaller proportions.
Not all carbohydrates are created equally
Different carbohydrates can have very different effects on blood sugar levels. A donut has little in common with a sweet potato although they are both carbohydrates. The main difference between the two is that a donut is a simple carbohydrate and a sweet potato is a complex carbohydrate.
Simple carbohydrates, also referred to as refined carbs, typically spike blood sugar levels much more than complex carbohydrates. There are two main reasons for this: the first is that almost all simple carbohydrates are man-made and processed (white grain products, cookies, candies, cakes, chips, soda. The second reason is that simple carbohydrates lack a key component that is beneficial for blood sugar control: fiber!
Complex carbohydrates are whole-food based carbohydrates sources and include: beans, legumes, fibrous grains (like oats), starchy veggies like potatoes, peas, or corn, and fruit. These are unprocessed, contain fiber, and digest more slowly and should more moderately increase blood sugar and prevent spikes in insulin.
When considering blood sugar, it’s not as simple as simple vs. complex carbs. Other factors that affect blood sugar include:
The macronutrient composition of your meals/snacks: the balance of protein, fats, fiber and carbohydrates
Timing of meals: in addition to what macronutrients your meal is composed of, when and how often or not you eat can have a large effect on your blood sugar.
Inflammation, stress or illness can cause high blood sugar, also known as “hyperglycemia.”
Sleep: Poor sleep quality or decreased sleep can increase insulin resistance and blood sugar levels. Have you ever noticed that all you want are carbs or sweets the day after a night of poor sleep? This could explain why.
Gut Health: Research shows our gut microbiota play a role in a variety of mechanisms in our body including glucose tolerance.
Alcohol: How alcohol will affect blood sugar depends on what you're drinking, how much you're drinking and how you're drinking (ie fasted, with a meal etc). Alcohol consumption initially causes blood sugar levels to drop by inhibiting the liver’s ability to release glucose. This drop is not necessarily beneficial as it can cause a significant drop that results in a cascade of reactions such as cravings, imbalanced blood sugars, poor sleep etc. There's mixed research on how alcohol affects blood sugar health long-term.
Genetics can play a role in just about every system in our body, so it’s no surprise they can have an influence on blood sugar regulation.
What is poor blood sugar control associated with?
Decreased insulin sensitivity, pre-diabetes, diabetes
Increased LDL cholesterol
Poor gut health, dysbiosis
Weight gain, inability to lose weight, obesity
Hormone imbalances, PCOS, fertility
Signs you are on a Blood Sugar Rollercoaster
Excessive food/sugar cravings
Unbalanced vs Balanced Blood Sugar Graphs
To help better understand the below graphs and to the right, keep in mind that optimal levels are:
Fasting glucose < 90 mg/dL
Post-meal glucose < 140 mg/dL
Post-meal glucose should return to pre-meal levels 2-3 hours following intake of food or beverages
As shown in the image above, a blood sugar rollercoaster, or unbalanced blood sugar for a period of time, is depicted on the graph as sharper peaks and valleys that resemble spikes. I would classify anything over 130-140 as a spike.
On the other hand, the stable blood sugar graph pictured above, shows elongated, smoother curves, with gradual rises and falls of blood sugar. This is the goal to prevent unwanted symptoms that occur during a blood sugar roller coaster and long-term consequences of poor blood sugar control. Most important is that your fasting glucose is stable and low (ideally below 90), that you have few episodes over 130/140 and that you recover quickly when your blood sugar does rise.
How can I improve my blood sugar control?
A piece of advice I give to almost all clients is to avoid ‘naked carbs’ aka avoid eating carbohydrates alone. Instead focus on balanced meals and snacks that include protein, fat and fiber - these 3 components slow blood sugar release and absorption and elongate blood sugar curves.
See graphic to the right from my continuous glucose monitor for an example of how pairing your carbohydrate with protein + fat can significantly decrease your blood sugar increase. The banana paired with protein + fat results in about a 20 point increase in blood sugar vs. the grapes alone resulting in close to a 70 point increase and significant spike in blood sugar levels. A better snack option example would be to decrease the grape portion to 1/2 cup and add a string cheese or handful of nuts to add protein/fat.
My Balanced Plate Method
An easy way to create a satisfying and blood sugar balancing meal is to follow my balanced plate method. The balanced plate method emphasizes both quality and portions of complex carbs + protein + fat + fiber.
Here are few other recommendations and blood sugar balancing action items that you can start to incorporate today:
Monitor blood work: fasting insulin, fasting glucose, hemoglobin a1c
Wear a Continuous Glucose Monitor
Start a food + mood symptom journal and find patterns in how food makes you feel
Take a walk after meals
Drink 1 tbsp of Apple Cider Vinegar in 4-6 oz water before meals
Follow my balanced plate method (prioritize protein + fat + fiber)
The sequence of your meals matter: eat non-starchy veggies/fiber/protein/fat before carbs
Avoid naked carbs (eating carbs alone)
Consider supplements (certain supplements and the optimization of nutrients can support your body in balancing blood sugar)
Want a bit more support and specific recipes and structure to balancing blood sugar? Check out our 5-day Reset Week Guidebook. This 45-page guidebook includes 16 recipes and will give you a day-by-day plan to get you started in nourishing your body and building meals and snacks that balance your blood sugar to help you take control of your weight, cravings, energy, fertility, sleep and mood.
Carbohydrates are the body’s main source of energy and it’s important to do some research or consult a dietitian before jumping into a low carb diet or labeling all carbs as “bad.” The goal is to find balance and prioritize quality and quantity carbohydrates. If you want help in optimizing your blood sugar through diet, lifestyle, supplements, and monitoring bloodwork, please contact us to learn more about working together!
Cleveland Clinic. 2021. High Blood Sugar Levels in the Morning: Causes and Prevention. [online] Available at: https://my.clevelandclinic.org/health/articles/11443-blood-sugar-hidden-causes-of-high-blood-sugar-levels-in-the-morning> [Accessed 26 October 2021].
Jandhyala, S., 2015. Role of the normal gut microbiota. World Journal of Gastroenterology, 21(29), p.8787
International Diabetes Federation. International Diabetes Federation - Facts & figures. Idf.org. Published 2019. https://www.idf.org/aboutdiabetes/what-is-diabetes/facts-figures.html
Alpana P. Shukla, Radu G. Iliescu, Catherine E. Thomas, Louis J. Aronne; Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels. Diabetes Care 1 July 2015; 38 (7): e98–e99. https://doi.org/10.2337/dc15-0429