The impact of stable blood glucose levels on health

Glucose is the primary source of energy for your body, and the cells in your body rely on this energy to function. Balancing your blood glucose levels can contribute to managing cravings, fatigue, hormonal and fertility issues, skin conditions, ageing/wrinkles, poor sleep, menopause and mental health symptoms. Glucose control is not only necessary in people living with diabetes.  All of us need to improve our knowledge and implement skills to ensure optimal blood glucose control and prevent spiking glucose levels that contribute to oxidative stress and inflammation, which have a magnitude of negative implications on human health.

How is glucose metabolised?

When you eat a meal, the carbohydrate gets broken down into simple sugars also known as glucose.  The glucose is absorbed into the bloodstream which can either result in a stable release or a spike of glucose (often referred to as hyperglycemia/high blood glucose), depending on the type and quantity of carbohydrate in the meal that is consumed. A term often used to describe the measurement of the amount of glucose in your blood after eating a meal is post prandial blood glucose level. As the blood glucose level rises, so does the level of insulin. Insulin is a hormone that carries the glucose from the blood into the cells so that it can be used where it is needed for energy. 

Why avoiding blood glucose spikes is essential!

Hyperglycaemic spikes can impact inflammation by contributing to increased inflammatory cytokine concentrations more significantly than continuous high blood glucose levels. These up and down, roller-coaster-like blood glucose levels may lead to cravings, fatigue, poor sleep and low mood which can affect you on a daily basis. The consequences of the increase in inflammation are being highlighted as a key concern when assessing overall health because the associated inflammatory response and oxidative stress are root causes of lifestyle diseases that develop when there is a constant state of chronic inflammation. Moreover, prolonged high blood glucose levels after meals is usually the first indicator of a defect in glucose tolerance which may pose as a contributing risk factor in the development and progression of cardiometabolic diseases and conditions including heart attack, stroke, diabetes, insulin resistance and non-alcoholic fatty liver disease. With persistently high blood glucose levels protein glycation (sugar molecules adhering to the skin’s collagen and elastin proteins that can result in inflammation and signs of skin aging) occurs which further contributes to complications such as vascular dysfunction (e.g. damage to retina/kidney/nerve), the generation of free radicals which cause further harm to the cells, fibrosis and skin aging.

Carbohydrates and their effect on blood glucose levels.

Carbohydrate rich meals are the main drivers of glycemic excursions throughout the day. The quality and quantity of carbohydrates can be categorised according to their effect on the blood glucose levels.  This measurement of how a certain carbohydrate will impact blood glucose levels is known as the Glycemic Index (GI). Carbohydrate food items are compared to glucose and can be categorised into the following groups: high, medium and low GI; with high GI foods (white bread) exerting a higher effect or spike on the blood glucose level when compared to eating a low GI food (rolled oats). The portion of carbohydrate consumed is just as important as the quality of the carbohydrate, as the quantity ingested will contribute to the amount of glucose available for absorption. Ways to reduce the post prandial blood glucose levels include reducing the quantity of carbohydrate or glucose available for absorption or digestion; reducing the rate of carbohydrate digestion and absorption; altering the insulin response and increasing the utilisation of glucose post meal ingestion. 

Five tips to reduce glucose spikes:  

1. Carbohydrate - Quantity and Quality

Be mindful of the type of carbohydrate and portion eaten at a one sitting.  A portion of starch is normally about ½ cup of cooked starch. Giving preference to low GI foods over high GI foods e.g., unprocessed high fiber carbohydrates (more than 6g of fiber per 100g) will generally have a lower effect on blood glucose levels. Aim to eat foods in their natural, unprocessed form. Give preference to eating fresh fruit as opposed to having fruit juice or uncontrolled portions of dried fruit. Be cautious with dried fruit. All the fluid has been removed, and the portion size equivalent to one fresh fruit is a whole lot smaller. 

2. Add natural food adjuvants 

Mulberry leaf (ML) and mulberry leaf extract (MLE), as found in Nestlé OPTIFAST® GlucoSmart™, have numerous biological properties, such as regulating glucose and lipid metabolism, reducing blood glucose, and increasing insulin secretion.  These benefits may be attributed to the phytochemicals they contain. Mulberry leaf extract is best taken with a meal as we want the MLE to reach the small intestine at the same time as the carbohydrate so that it can compete for glucose absorption.

MLE has been shown to reduce fasting blood glucose and HbA1c (measurement of blood glucose level over 3 months) in a recent systematic review. Taking mulberry leaf extract preparations premeal appear to be safe and tolerable solutions in preliminary studies, longer term research is required.

Adding apple cider vinegar to your meals or salads as a dressing or consuming some apple cider vinegar (diluted with water) prior to meals may aid in stabilising the glucose and insulin response. However evidence supporting the long term use of vinegar is lacking, one of the concerns is the demineralization of teeth and therefore it is recommended to avoid taking vinegar in large amounts. 

Protein consumed before a carbohydrate meal can stimulate insulin secretion and slow gastric emptying which leads to reduced postprandial blood glucose levels in type 2 diabetes.  

Adding cinnamon to meals may lower the post prandial blood glucose response by increasing the insulin sensitivity. 

3. Leverage Food Combinations

Adding slow-release carbohydrates, more fiber, protein or fat to a higher GI carbohydrate slows the absorption of the glucose from the carbohydrate and leads to a lower postprandial blood glucose level.

If you do eat a high GI carbohydrate combine it with a low GI carbohydrate to slow the glycaemic response of the meal e.g., add milk and berries to “instant” oats porridge/ other high GI cereals. 

Pair carbohydrates with proteins or fats i.e., serve an egg or avocado with a slice of wholemeal toast instead of with only butter and jam or serve meat/chicken/fish/eggs/ plant protein with grains/pasta’s/potato mash, and prepare the meal with olive oil. 

Add more fiber to the meal by adding a salad or vegetables (focus on variety of colours) to the plate; topping breakfast cereals with oat bran, nuts or seeds; or adding lentils, beans/pulses to soups/stews all in one dish.

4. Pay attention to food order

Eating foods in a particular order i.e. eating the vegetable/salad/protein/fat portion before the carbohydrate portion on the plate appears to reduce the postprandial glucose release when compared with other meal patterns by stimulating a lower insulin and higher glucagon-like peptide 1(GLP-1) response which plays an important role in maintaining glucose homeostasis. 

5. Get moving

A non-dietary way that is known to help reduce the post prandial blood glucose rise includes exercising after eating. Only 10 minutes of activity, walking; bench stepping; taking the stairs or clearing the table and cleaning the dirty plates at home instead of being sedentary is an effective way to burn the glucose that has been absorbed into the bloodstream. The exercise duration and intensity will no doubt impact the glucose response, however it is evident from research that moderate exercise is sufficient to improve the glucose response to a meal.

The overall benefit of keeping blood glucose levels more uniform or stable include less cravings; improved energy and sleep; slower aging due to reduction in inflammation; improved gut and mental health; improved glucose tolerance, reduced risk for disease and promoting remission from diabetes type 2. 

How can this be achieved? In summary: opt for more fiber, protein and fats with all meals; give preference to unprocessed carbohydrates in sensible quantities; preload with add-ons (vinegar in small quantities, cinnamon, whey or mulberry leaf extract); eat the carbohydrates last, start with the vegetables and protein and opt for a walk after your meal. 

Information supplied by Nestlé

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