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HEALTH CONCERN? BioHealth Health Concerns

The Role of Blood Sugar

Contributing Author: Kalish, Daniel D.C.

Daniel KalishFor two decades Daniel Kalish, D.C. has successfully treated patients with hormone imbalances, food cravings, fatigue, depression, digestive distress, and many other health complaints. Dr. Kalish founded The Natural Path Clinic California, where he led a staff of physicians, nutritionists, chiropractors, psychotherapists, physical therapists, personal trainers, massage therapists and acupuncturists for more than ten years. He currently maintains an active international phone consultation practice with patients and trains physicians in natural medicine. He has designed health programs for countless professional athletes including the world’s top skateboarders, hockey players, elite runners, tri-athletes, golfers, tennis players and world-class weight lifters. Download his ebook Your Guide to Healthy Hormones.

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Any healthy diet must be based on adequate blood sugar control, also referred to as glycemic control.  Think of your blood sugar control like a car with gas in the fuel tank.  If your car runs out of fuel, it will stall and you will be stranded.  Similarly, food is your fuel.  Eating the proper foods gives you fuel by providing adequate blood sugar.  A car that runs out of gas will just stop, but if your body runs low on blood sugar, it will literally break down muscle, organ, and bone tissue to keep itself going.  This creates a catabolic or breakdown condition.  The moment your blood sugar drops below a certain point, you lose the fuel that supplies your brain and other organs.  At this moment, physiologically, biochemically, and metabolically, you can become immune compromised.

Maintaining blood sugar is based on balancing two hormones, insulin and glucagon.  Both are produced in your pancreas in response to the types of foods you eat.  Insulin is produced in response to eating carbohydrates.  Glucagon is produced in response to eating protein.  If you eat too much food or too many carbohydrates at one time, insulin will quickly lower your blood sugar.  If you skip meals, you will experience low blood sugar.  Classic symptoms of low blood sugar are headaches, brain fog, cravings for sweets (or cravings for carbohydrates), nervousness, inability to think clearly, and depression in severe situations.  Since some people do not experience any symptoms when they are low blood sugar, the problem can go unnoticed.

Insulin responds to carbohydrates.  Glucagon responds to protein.  Glucagon works to counter insulin and thus helps maintain a steady blood sugar level for up to four to six hours.  When you eat any carbohydrate, it acts as a sugar, which is technically what a carbohydrate is.  These sugars enter the blood stream and trigger the pancreas to release insulin.  Insulin’s job is to open the cells in your body to allow the sugar or glucose in your blood to enter.  Insulin continues its job of taking sugar from the blood and putting it into cells unless its partner hormone, glucagon, is present.

Since glucagon is only released when you eat protein, a meal of only carbohydrates willcause low blood sugar, compromising your immune system.  Eating a bagel, toast, fruit, muffins, pastries, donuts and other carbohydrates alone will create a hormonal imbalance between insulin and glucagon.  Your body interprets these low blood sugar states as potential starvation and it will go into emergency mode, burning healthy tissues for fuel and storing fat for future use.  If you eat protein with a bagel, you will produce insulin from the carbohydrate in the bagel and glucagon from the protein and you will achieve hormonal balance.  This will keep fuel supplied to your brain for an extended period and you will feel better.

Basic Guidelines for Glycemic Control
In practice, there are a few simple rules to follow to regulate your blood sugar.  The first rule is the rule of five, which states “eat five times a day.”  Eat a balanced breakfast, lunch, dinner, and have two very small snacks.  The second basic rule is to “eat before you become hungry.”  Unfortunately, many people do not think about food until they are hungry.  By that time, their blood sugar is already low.  Eating three meals and two small snacks provides for balanced blood sugar throughout your day.  Skipping meals will lead to low blood sugar.  The longer you go between meals, the longer you will be in a catabolic state and the more stress you’ll place on your immune system and adrenal glands.

Breakfast is the most important meal of the day because you are coming off an all-night fast.  Many people do not have time to prepare an elaborate meal in the morning.  If you have time to prepare a balanced meal, it is wise to do so.  Avoid starting the day with foods such as breads, cereals, doughnuts or waffles, as these and their kind serve only to give you a quick burst of energy, soon succeeded by a blood-sugar crash.  A properly balanced breakfast will provide you with energy and a clear head start to your day.  Eating within an hour of waking is best, as this sets the stage for a day of balanced blood sugar.  Within four to six hours, you will need a meal or, at minimum, a protein and carbohydrate-based snack to maintain steady blood sugar.

Examples of Meals with Protein and Carbohydrates
Examples of protein and carbohydrate combinations for breakfast are low-fat yogurt or cottage cheese with your favorite fresh fruit.  Protein can also be in the form of nuts, such as almonds or walnuts, or seeds such as sunflower or pumpkin.  Combine protein sources like eggs, chicken, or turkey sausages with carbohydrates like fresh fruit and a small amount of potatoes or toast.  If you rush out the door without time to cook in the morning, hard boiled eggs or sliced low-fat deli meats such as turkey, will provide protein for breakfast, while a piece of fruit can be your ready-to-eat carbohydrate.

Whenever you eat, keep in mind the effects that food combining has on your blood sugar.  Are you eating toast or cereal?  These foods provide a large amount of carbohydrates quickly.  If that’s all you are eating, you’ll get a sugar rush, and an hour or two later your blood sugar will decline and you will likely feel sluggish, irritable, and may experience difficulty thinking clearly.  However, if you have that bagel with an appropriate amount of yogurt, cheese, turkey or any food with protein and a small amount of fat, then you will slow the rate of entry of glucose into the blood and you won’t experience the sugar rush.  This prevents the peaks and valleys of blood sugar swings.  The idea is to maintain an even keel.

Glycemic Index
To understand how to create balanced meals, you need to become familiar with the glycemic index of various foods.  Once you understand this basic concept, you can eat all of your favorite foods in the right combinations.  The glycemic index of a food refers to the rate at which foods cause glucose or sugar levels to rise in the blood.  The higher the glycemic index, the faster that food converts to blood sugar.  The faster a food converts to glucose, the more insulin your body makes and the harder it is to bring your insulin levels into balance.  Please refer to ‘Balancing Meals for Glycemic Control’ in the Appendix.

Many good reference guides exist on the glycemic indices of foods.  In general, all above-ground vegetables have a low glycemic index, such as broccoli, lettuce, cabbage, etc.  All below-ground or root vegetables have a high glycemic index, including potatoes, carrots, and yams.  Corn, potatoes, rice, breads, pasta, bagels, and all of the grains are carbohydrates with a high glycemic index.  Even certain juices and fruits like bananas are high glycemic carbohydrates.Refer to the glycemic index included in this book for more information.  To keep it simple, every time you eat, just remember to include larger amounts of low glycemic index carbohydrates, such as above-ground vegetables and certain fruits, and smaller amounts of high glycemic index carbohydrates like breads, bagels, potatoes and pasta.

How to Balance Your Ratios
When you choose the correct proportion of carbohydrate to protein, consider the carbohydrate’s glycemic index.  If a carbohydrate has a high glycemic index, eat about a one-to-one ratio of carbohydrate to protein, based on portion size.  For example, if you eat eggs and potatoes, since potatoes have a high glycemic index, you would have a portion of potatoes roughly the same size as the amount of eggs you’re eating.  If you are eating lower glycemic index carbohydrates like green peppers, onions, and mushrooms with your eggs, you could have a portion size of these carbohydrates at least twice the size of your protein source.  Our dietary requirements also change depending on activity level and age.  You need to experiment to find the ratio of protein and carbohydrate that works best for you as we are all slightly different in this regard.

What Are Proteins?
When selecting protein sources, eating low-fat proteins more frequently than those with higher amounts of fat is best.  Low-fat proteins include chicken, turkey, most fish, low-fat yogurt, and cottage cheese.  Other sources of protein are tofu, tempeh, eggs, beef, pork, lamb, cheese, nuts like almonds and walnuts, nut butters, and sunflower, pumpkin, and sesame seeds.  If you eat meat, getting sufficient protein is not difficult.  Vegetarians usually need to rely on dairy products and concentrated soy products like tofu and tempeh as sources of protein.  Dairy and soy are commonly found to cause food reactions and digestive stress.  If you are a vegetarian, get tested for your ability to digest these foods.

What Are Carbs?
Many people have misconceptions about what foods are carbohydrates.  Carbohydrates include vegetables, fruits, grains, and beans.  Ideally, eat a variety of carbohydrates since a wide selection of foods gives you a broad range of nutrients.  Carbohydrates come in a bewildering array of types.  Eating carbohydrates rich in vitamins and minerals and minimizing those with low nutrient value is best.  Vegetables and fruits are the most nutrient-rich carbohydrates and each meal of the day should include them.  Eating lightly cooked or raw vegetables helps maintain their vitamin and mineral content.  Raw vegetables also maintain their enzymes, which make them much easier to digest and to extract nutrients from.

You also benefit from a good mixture of carbohydrates.  Most carbohydrates should be from lower glycemic index foods like fruits and above-ground vegetables.  These can be eaten in combination with a smaller amount of higher glycemic carbohydrates like potato, yams or carrots, or higher glycemic foods like bread, rice or pasta.  Having a wide selection of carbohydrates also gives you a wide variety of fiber.  Fiber, both soluble and insoluble, assists normal bowel movements and normal digestion.  Fiber also helps slow the rate of entry of glucose into the blood stream.  Remember, eating meals containing a combination of protein, carbohydrate, fat, and fiber is ideal.

The dreaded macronutrient fat is probably the most maligned, misjudged, and misunderstood of all macronutrients.  Healthy fats called essential fatty acids are required in very small amounts for many life-sustaining physiological functions.  These fats are commonly found in fish, seeds, nuts, and plants.

Essential to Health
Organic extra virgin olive oil, flaxseed oil, walnut oil, sesame oil, almonds, and avocados are examples of healthy sources of fats.  Omega-3 oils from fish like salmon and sardines, or fish oil supplements, are also healthy essential fats.  These essential fats have many health benefits.  Additionally, since fat slows down and regulates the rate of entry of glucose into the blood stream, instead of getting a quick sugar rush from a meal, you experience a controlled release of glucose.  In this respect, fat actually helps us control our weight when eaten in small amounts.  Good fats are the building blocks for hormones and are major constituents of all cell membranes, where they perform vital functions.  They are also responsible for healthy nerve conduction.

The confusion over fat comes down to how much fat we need, what types of fats are essential, and which are potentially harmful.  Margarine and other hydrogenated oils are less healthy and potentially harmful because they are trans-fatty acids.  These trans-fatty acids have been artificially altered to preserve their shelf life through a process that makes them harmful to your cells.  Trans-fatty acids are similar enough to the healthy fats to fit into cell membranes, but they cannot perform the normal functions of healthy fats, thus causing significant health problems.  Saturated fats found in red meats and dairy products such as cheese and milk are also best eaten less frequently.  Healthy fats should be included with all meals.  Did you know it takes fat to burn fat?  Healthy fats and oils do not put fat on your body – insulin does!

Smart Eating
Keep it simple and follow these general guidelines:

  • · Eat a small meal or snack every four to five hours.
  • · Eat within an hour of awakening.
  • · Eat a small afternoon and bedtime snack. 
  • · Eat before becoming hungry.  If hungry, you have already allowed yourself to run out of fuel (a state of low blood sugar/hypoglycemia), which places additional stress on the adrenal glands.
  • · Eat 70–80% of your total carbohydrate portion of each meal from foods lower than 80 on the glycemic index.
  • · Take time to sit down in a relaxed environment to eat.  We do not digest well when we are stressed.


Blood Sugar Balance
An excessive ratio of carbohydrates to protein results in excess secretion of insulin, which often leads to intervals of hypoglycemia.  The body, in an attempt to normalize blood sugar, initiates a counter-regulatory process during which the adrenals are stimulated to secrete increased levels of cortisol and epinephrine.  It follows that an excessive intake of carbohydrates often leads to excessive secretion of cortisol, contributing to chronic cortisol depletion and consequently, adrenal exhaustion.  Reduced DHEA is an early sign of adrenal exhaustion.

To stabilize blood sugar, a balance between two hormones, glucagon and insulin, which are produced by the pancreas, must be maintained.  Protein in the diet induces the production of glucagon.  Carbohydrates in the diet induce the production of insulin.  Insulin promotes fat (energy) storage.  Glucagon promotes mobilization and utilization of fat for energy.  When excess carbohydrates are eaten, the body produces excess insulin and little glucagon.  This excess insulin results in more fat being formed and stored.

When insulin is high and glucagon is low, the adrenals are called upon to produce excess cortisol as a backup response to help raise blood sugar in the absence of adequate glucagon.  This occurs at the expense of the adrenal glands, contributing to adrenal exhaustion.

General Glycemic Control Guidelines

  • · Eat a small meal or snack every four to five hours.
  • · Eat within an hour of awakening.
  • · Eat a small afternoon and bedtime snack. 
  • · Eat before becoming hungry. If hungry, you have already allowed yourself to run out of fuel (a state of low blood sugar/hypoglycemia), which places additional stress on the adrenal glands.
  • · Eat 70–80% of your total carbohydrate portion of each meal from foods lower than 80 on the glycemic index.
  • · Take time to sit down in a relaxed environment to eat. We do not digest well when we are stressed.

Making the Most of Meal Balancing
As there is no exact dietary balance that applies to all people, understanding your role in the development of the ideal eating plan is critical. To determine how well a glycemically balanced diet is working, you must pay attention to your own body.

For example, if a person feels mentally and physically alert throughout the day, this is a generally a good sign that he or she is eating frequently enough and in the right balance. Eating small, carefully balanced meals every four to five hours will preclude hunger and fatigue in most people. It is up to each person to become aware of how they respond to the meals they eat.  A properly balanced meal with good digestion and absorption should sustain mental and physical energy for four to five hours.