You can do detective work right now to start to get to the truth about your blood sugar
Many people have a sugar problem – difficulty maintaining a healthy level of blood sugar – and they don’t know it. And a sugar problem is serious because it often leads to metabolic syndrome, the mother of most chronic conditions. In this blog, I look at how sugar works in our bodies and what you can do right now to determine your degree of risk.
In which foods is sugar hiding? What can you do if you have sugar cravings? How good a risk indicator is your BMI? Why is WHR (waist-hip ratio) better? What if your BMI is high, but you are muscular? What blood testing can you do yourself?
Sugar is a sweet-tasting carbohydrate, the primary source of fuel to power our bodies. But sugar has also gained a bad reputation as an addictive substance (more addictive than cocaine!), causing obesity, and associated metabolic diseases such as diabetes. You should always maintain a steady blood sugar level. Higher or lower levels, if they persist, will have severe consequences for your health.
After a meal, sugar is absorbed into the bloodstream and distributed to every cell in your body. After delivering an adequate amount, excess sugar is stored as glycogen or fat. The body has a limited capacity to store glycogen in the liver and muscles. When these are full, extra sugar is stored as fat in adipose (fat) tissue.
Storing body fat was a survival trick for our hunter-gatherer ancestors. They stored fat in feast mode and drew upon it in times of famine. In modern life, every day is a feast day for most people – with no corresponding famine! – so, there is no need to keep a large amount of body fat, which is, in fact, a recipe for health problems. Visceral fat accumulation is the underlying cause of diabetes, hypertension, and heart disease.
Blood sugar levels
Healthy people in the UK have fasting blood sugar levels between 4.0 mmol/L (72 mg/dl) and 5.4 mmol/L (97 mg/dl). Studies have confirmed that a level below 4.7 mmol/L (85 mg/dl) is associated with a low risk of disease. The disease risk starts to escalate gradually from 4.7 mmol/L.
A fasting blood sugar level between 6.0 mmol/L (108 mg/dl) and 6.9 mmol/L (124 mg/dl) reaches prediabetic level. Like diabetes itself, this increases your risk of diabetic complications such as heart attack and stroke. A level of 7.0 mmol/L (126 mg/dl) and above is diagnostic of diabetes.
If you would like to check earlier how efficient your body is at dealing with sugar, then a blood sugar test 2 hours after a meal (or 75g of glucose) is more appropriate. Two hours after a meal, a normal level would be below 7.8 mmol/L (140 mg/dl).
A ‘snap’ blood sugar test like this is helpful, but a cumulative one is more accurate, as it reflects your blood sugar control over the last three months. Haemoglobin A1C (HbA1C) test returns a reading of less than 5.5 in normal people, 5.5 to 6.4 in prediabetes, and 6.5 and above in people with diabetes.
The main sugar problem is a failure of delivery to the cells. This is because body cells have become less sensitive to the action of insulin, the hormone that opens the gates for sugar to enter. This causes the hungry cells to prompt the pancreas to produce more insulin to open more gates. This works for a while, delivering adequate sugar to the cells and keeping blood sugar within the normal range.
So………. high insulin is the earliest sign of a sugar problem because, at this stage, blood sugar levels are still normal – and so not a red flag. A fasting insulin level of over 5 is an indication that the person is finding it hard to process sugar.
Eventually, as the pancreas increases the amount of insulin to compensate for the delivery blockage, fat starts to accumulate in internal organs, including the pancreas itself. The pancreas then loses its ability to produce more insulin, and the blood sugar starts to rise, stays permanently high, and at this stage, becomes a relevant test to assess blood sugar problems.
Do you have a blood sugar problem?
People claim, “I don’t eat sugar,” but all carbs are broken down into sugar, and these, of course, include bread, rice, pasta, pizza, and potatoes.
Sugar problems can start with fluctuating blood sugar levels – you may feel strange, get brain fog, feel sleepy after a meal, or experience a major afternoon slump. You may frequently feel hungry. You may wake up at night and not get back to sleep. You may even start shaking, become sweaty and have light-headedness through low blood sugar (hypoglycaemia).
High sugar and processed carb consumption during the day put your body on a blood sugar rollercoaster. Once the cycle starts, it’s hard to stop. A series of big sugar spikes are usually followed by a big dip. This is debilitating to the extent of making the affected person think of nothing but where is the next dose of sugar or fast carb coming from.
Every time your blood sugar plummets, cortisol kicks in to find sugar to top up the blood sugar level for use in the brain. Cortisol, the stress hormone, pushes your body for more sugar consumption with a negative impact on insulin sensitivity. The series of sugar dips and spikes can break down into a stress response and cause or exacerbate anxiety.
Other symptoms include premenopausal symptoms (PMS), headache, cravings, weight gain with an accumulation of body fat but shrinkage in muscle mass, sleep disturbance, frequent infections, gestational (pregnancy) diabetes, giving birth to a baby more than 9Ib. and infertility.
You can usually spot people with sugar problems because they have unique body features like a pot belly, gynaecomastia (man boobs), buffalo hump (fat at the back of the neck) and acanthosis nigricans (dark spots on the skin.)
How to know if you have a sugar problem
The body mass index (BMI) is the most common test. It is easy to do, measuring your weight and height and then using a BMI calculator. In Caucasian people in the UK, BMI figures are 18.5 to 24.9 for normal, 25.0 to 29.9 is overweight, 30 and above is obese, and 40 and above is morbid obesity. If your BMI falls in the obese or overweight range, you are likely to have a sugar problem.
Because muscles are heavier than fat, athletes, particularly bodybuilders, are always going to have a high BMI without them being obese. A high BMI, in this case, would not increase the risk of disease.
People of Asian descent have a higher risk of disease with a lower BMI. They have double the risk of developing type 2 diabetes than Caucasians, with black people probably in the middle between Asian and white in terms of their disease risk. This explains the lower cut-off for obesity and overweight in Asians, where a normal BMI is 18.5 to 22.9, overweight 23.0 to 26.9, and obese 27 and over. In China and Japan, the overweight cut-off is 24 and obesity at 28.
BMI is the most widely used measure of obesity, but waist circumference or WHR (waist to hip ratio) is more accurate in predicting the risk of cardiovascular disease.
Waist circumference and WHR
A circumference of more than 40 inches in men and 35 inches in women puts them at high risk of developing obesity-related conditions. And your WHR (waist-hip ratio) should be less than 0.90 in men and less than 0.80 in women.
You can also do some initial blood sugar testing yourself, using a glucometer and a Lancet strip. A series of blood sugar readings, ranging from fasting, before and after eating your meal, at different times of the day, would give you a better picture of your risk, as well as the impact of different types of food on your blood sugar. Healthy blood sugar is > 5.5 mmol/L fasting.
Persistent hyperglycaemia (high blood sugar) is usually accompanied by symptoms of dry mouth, feeling thirsty and drinking water in excess (polydipsia.) Your body will be working high hard to push sugar out in your urine, meaning frequent urination (polyuria) but also symptoms of fatigue, blurred vision, and headache.
Persistent hyperglycaemia damages body tissues by the process of glycation, and vascular disease can result in vision loss, kidney failure, erectile dysfunction, foot ulcers, peripheral neuropathy, and increased risk of heart attack and stroke
Hypoglycaemia (low blood sugar) presents with tremors, palpitations, sweating, difficulty concentrating, and aggressiveness and can progress to confusion, seizures, coma, and death. Symptoms of hypoglycaemia can happen at a higher blood sugar level in diabetics compared with normal people.
Sugar is biologically addictive, triggering the release of the reward hormone dopamine, which makes you feel great, the reason for its addiction. According to research, sugar is more addictive than cocaine!
Think about it. Maybe you wake up in the morning and have a large carbohydrate-based meal of cereals and toast that keeps your mind fixated, waiting impatiently for the mid-morning coffee break to enjoy a piece of cake, biscuits, or a big chocolate bar.
Then, having a large portion of potatoes, pasta or pizza for lunch simply focuses you on having a big sugar or processed carb-based snack in your afternoon break.
Why does this happen? A large meal of sugar and processed carbs cause a sugar spike. This stimulates the pancreas to produce too much insulin, bringing your blood sugar too low and resulting in a sugar crash. This creates the urgent need for another load of sugar to restore the balance.
It’s a survival response. Extremely low blood sugar is a life-threatening situation if you are not able to use alternative fuels like fat. Sugar is a necessity for your brain function. When it gets too low, it can result in a seizure, coma or even death.
Therefore, people find it hard to give up their mid-morning candy bar and late-afternoon chocolate cake.
How to prevent the craving
- Get adequate restful sleep
- Manage your stress and practise stress-relieving techniques
- Eat protein (plant or animal) with every meal to settle your appetite
- Eat non-starchy vegetables (potatoes, bread, pasta, pizza, and rice contain loads of fast sugar that raises your blood sugar too quickly)
- Eat healthy fats, including omega 3 in fish, nuts, and seeds
- Take multivitamins and multi-minerals – B vitamins, chromium, magnesium, zinc, and vitamin D are key nutrients
- Eat more magnesium-containing food, such as nuts and seeds
- Take probiotics, ashwagandha and fermented food, such as kefir, yoghurt, and sauerkraut (these enhance the microbial diversity in your gut)
- Bake with natural sweeteners (sugar substitutes) like Stevia
- Sweeten your food with spices like cinnamon that do not contain sugar
- Apple cider vinegar makes your cells more sensitive to insulin and lowers cravings
Simple steps to abort sugar craving when it strikes
- Drink a cup of herbal tea, a glass of water or fresh, unsweetened lemon juice. Rehydrate as thirsty is frequently mistaken for hunger
- Eat a healthy snack like avocado, seeds and nuts, or dip celery or cucumber in hummus
- Chew a piece of gum to reduce your craving
Please, my friends, don’t be one of the millions who have a sugar problem and don’t know it. Do some initial assessment and testing yourself, and if you are in any doubt, please get in touch, and we will be delighted to put you in the right direction.
Please share your thoughts and ask any questions on this subject – in the Comment section below is always best so that I can respond most quickly – and please do subscribe to the newsletter so that you don’t miss further vital information. Thank you!
What causes food cravings?
Cravings sugar? Your body is probably lacking this nutrient
Blog: blood sugar control the key to metabolic health
Blog: all about metabolic flexibility
International Diabetes Federation. The IDF consensus worldwide definition of metabolic syndrome. Brussels. 2006.