Transcript Balancing Blood Sugar

Balancing Blood Sugar
with
Rachel Schaefer L.Ac, M.S
Objective: Maximize Balance
.
WHAT DOES NORMAL LOOK LIKE?
Glucose from food is disposed via insulin in (primarily) muscle
tissue and stored as glycogen. The other 10% will go to the liver
and 5% will go to adipose tissue and other organs.
Our muscles and liver use glycogen to protect in periods of
starvation. If blood sugar drops low, the pancreas will produce
glucagon. This hormone instructs the liver and muscle to convert
the stored glycogen into glucose and return blood sugar to normal.
Take home TIP: Use small portions of longer burning molecules
(protein, raw fats) thru-out the day to avoid blood sugar drops
and spikes. Exercise to build muscle to increase glycogen
storage. Muscle cells are by far the most sensitive to insulin.
Normal Regulation
What happens in Dysregulation?
–Once glycogen storage sites in the muscle and liver are filled, if glucose
remains in the blood stream, it will be converted to and stored as fat—
at the waist region, called centrifugal obesity.
- Fat cells are inherently “insulin-resistant” whereas muscle cells are
inherently insulin sensitive.
- Insulin is an anabolic hormone, meaning it BUILDS, and alerts the body to
store more fat. Excess insulin is also stored in the ovaries where it
contributes to anovulation via the syndrome PCOS.
Take home TIP: Increasing muscle mass will up-regulate
responsiveness. Glycemically regulate diet to stimulate less
insulin production and fat cell production
Early signs of Dysregulation
-Yeast infections
-Thirst and dry mouth
-Excessive appetite, esp for sweets
-Fatigue after meals
-Hypoglycemic episodes: urgency for food and sweating palms,
frustration when hungry
-Excessive urination, especially at night
-Frequent dental infections
-Anovulation in female with centrifugal obesity
-Aromatization (estrogen trending) in males
-Fleeting anxiety, insomnia, depression. Often concomitant to
bipolar and manic disorders
-Blurry vision
HYPOGLYCEMIC ROLLERCOASTER
HYPOGLYCEMIA
• Hypoglycemia is a form of
glucose dysregulation
• Excessive gluconeogenesis from
the liver will tax beta cell insulin
production from the pancreas.
• Often accompanied by adrenal
exhaustion. Cortisol is
responsible for normalizing low
sugars, so if IT is low,
hypoglycemia will not be
corrected.
Chicken or the Egg?
Etiology of Type 2 Diabetes
•How reliable are genetic markers for Diabetes and Glucose
Dysregulation? Informative but not entirely predictive.
•Obesity trumps
•High lipids are correlated with insulin resistance.
•Triglycerides are not the result of dietary fat intake. Fusion of
carbohydrate consumption and existing body fat. High
triglycerides=Predisposition to sugar imbalance.
•All OBESE individuals are insulin-resistant, in that fat cells are
inherently insulin resistant.
•Take home TIP: Maintain or achieve normal BMI via diet and
exercise
Uncontrolled Blood Sugar spikes
•Hyperinsulinemia promotes inflammation, dementia, aging and
infertility:
•Insulin activates NF-kappa B transcription– source of
inflammation. Inflammation is now thought to be at the etiology
of nearly 90% of pathologies, from cancer, to arthritis, to heart
disease.
Insulin signaling may actually shorten lifespan
•Insulin resistance increases production of testosterone in
women—seen in PCOS and infertility
•Metabolic syndrome contributes to dementia and cognitive
impairment—associated with inflammation in the brain.
Nutritional Strategies
•Eat Anti-inflammatory rather than Pro-inflammatory.
But HOW?
•Use Raw oils and avoid cooking with oils that become rancid—
stick to Coconut and Ghee for high heat.
•Use tumeric for its anti-inflammatory properties.
•Use only organic forms of protein
•Avoid excessive use of dairy product, esp non-organic.
•Employ fish oils and prolyetic enzymes (i.e Wobenzyme between
meals)
•Support detoxification in the liver, kidney and skin. Start simply–
lemon juice supports liver detox, unsweetened cranberry the
kidney and gentle sweating thru the skin.
Good choices have GREAT outcomes
Unique Cause of Imbalance
•Infection
–Immune response triggers a stress reaction which raises blood sugar
•Overeating
–“Chinese Restaurant Effect”: even eating large amounts of glycemically
stable foods require the body to spike higher than optimal insulin
•Role of stress
–Cortisol surging alters glucose control. Resultant “fight or flight” forces liver
into gluconeogenesis-- even more sugar is produced for body to cope with!
–One unique cause of stress: OVERTRAINING athletically. “Metabolic
overtraining syndrome” is a literature documented condition leading to
glycemic dysregulation and fatigue. The body chronically thinks it is being
“chased by a tiger!” And the adrenal cortex hormones, like cortisol, become
depleted.
–Take Home TIP: Eat smaller meals more frequently and reduce stress
How to DE-Stress
So if stress is a culprit in blood sugar instabililty, how to mitigate
it?
Intentional RELAXATION—meditation, yoga, guided visualization,
walking following meals, technology breaks, assurance of proper
sleep, pursuit of joy and sense of “safety” in relationship and
environment.
Lifestyle Practice: Elevated knees at 90 degrees for ½ hr between
2 and 6 pm
Herbal medicines in the ADAPTAGEN class– Retrain the body to
adapt to stress without cortisol surging
(ie Rhodiola, Ashwangdha, American Ginseng, Astragalus)
What DIET is most effective?
•No “ONE SIZE FITS ALL”
•Individualized approach to achieving appropriate BMI.
–High in phytonutrients and soluble fiber (beans). Low glycemic foods,
healthy oils (raw oilve, cooking coconut), organic forms of protein,
avoidance of allergic foods, reduction of carbs later in the day when they
won’t be converted and used as energy.
•Digestive function as modifier—what are YOU digesting?
•Avoid undereating or eating in stressful conditions
HOW to BALANCE: Start the day with protein based breakfast of
high quality. Don’t exercise in the morning without some caloric
imput to stabilize sugars. Follow exercise with fruit and protein to
rebuild muscle. Create rituals around mealtimes.
Special Cases
•Do NOT begin your day with COFEE or TEA without BF
–Stimulates liver to produce sugars without caloric imput (Source of adrenal
fatigue)– Can’t go without it? Test for and Treat Adrenal fatigue.
•ALCOHOL
–High in sugar, interferes with insulin response to food. Response becomes
severe and overshoots. Reactive hypoglycemia common following a large
meal where alcohol has been consumed. Avoid taking alcohol on an empty
stomach where a large insulin surge will follow consumption but the actual
food will not be there to cover (resulting in hypoglycemia)
–Take home TIP: look for morning beverages with little or no caffeine and if
consuming alcohol, have protein or fat in conjunction. Avoid excess.
Breaking Fast..
HOW To BALANCE:
–“Break Fast”—numerous studies show that skipping this meal
contributes to obesity and diabetes Type 2. Eating within an
hour of rising contributes to weight control.
–What’s for breakfast—Gluten free oatmeal with egg, Low glycemic
smoothie with hemp protein powder. Lentils and brown rice with
veggies. Greek yogurt with berries and walnuts. Egg based muffin
with almond butter.
Simple Tips
•CINNAMON on fruits will decrease sugar spikes. Cinnamon has
an insulin-modulating affect.
•Legumes for source of slow burning carbs and protein.
•Where beans are substituted for faster-acting carbohydrates,
postprandial blood sugars increased more slowly and peaks
reduced.
“Carb blocker” products usually contain legumes.
Traditional Chinese Medicine
•Chinese Medicine Dietary theory
To strengthen pancreas/spleen function, eat warm foods— predigested, such that the body does not have to effort.
HOW to BALANCE: Root vegetables and Soups. Miso broth, Long
cooked grains and grasses (millet, quinoa, wild rice). Fluids and
Minerals– Seaweed. These strengthen the pancreas function and
digestion.
In heavy training periods, be sure to up protein intake and use
“bone stocks” from organic meats to cook vegetables. Typical
female should have a minimum of 60 gr protein daily. Athletes
would need 20 more per hour of activity.
•What is the ideal dietary support?
•THE IDEAL FOOD FOR YOU is what you are capable of digesting!
•Clinical investigation of your unique constitution
–Digestive enzymes and probiotics may be useful to repairing the
digestive tract should this be an issue. Blood sugar will spike in the intake
of allergic foods (immune modulation effect)
–Begin with a Food/Mood log to help your practitioner assess for digestive
imbalance or food allergy.
–Elimination/Provocation diets may be prescribed to vet potential irritants
–Testing can be provided should the case merit deeper quantitative
assessment
Day in the Life
•
-
Begin with a long burn breakfast
Prep protein and stabilizing snacks for the day
(Consider hard boiled eggs, jerky, bean dips, greek yogurt,
almond butter and veggies, avocado and almond cheese)
Use support like Green Tea (TNF-alpha inhibitor, an antiinflammatory action) only following a meal or chiro-d-inositol
with higher carbohydrate meals to increase sensitivity.
Avoid undereating
Engage in exercise with an emphasis on muscle building and
avoid overtraining or working “on empty”
Bring in a daily relaxation practice
Reduce carbohydrate intake as the day goes on
Assure an adequate night’s rest
Green Tea Works..
Constitutional Remedies
•Chinese herbal medicine uses syndrome differentiation to assess
imbalances particular to each patient.
•Classical formulas are useful to pre-diabetic and diabetic
conditions, a licensed herbalist modifies to an exact diagnostic
picture. No two patients are alike.
•Chinese herbalists are trained as “pharmacists” in the
application and combination of over 300 single herbs.
•Herbal formulas are typically given as teas, powders and pills.
Supplementation may be helpful
•Vitamin D: Low levels contribute to metabolic syndrome.
Deficiency linked to poor beta cell function and polycystic
ovarian syndrome (PCOS).
•EPA/DHA: Anti-inflammatory. Supports Regulatory T-cells.
Healthy fat to ease sugar surges.
•Pantothenic Acid (B5): helps produce energy from glucose and
modulate lipid metabolism. Lowers LDL cholesterol, triglycerides
and raises HDL.
•Chromium: Essential mineral, also known as “Glucose Tolerance
Factor”—positive effect on insulin sensitivity, lower cholesterol
and triglycerides, raising HDL and improves body composition.
•Alpha Lipoic Acid: Works on liver detoxification, lowers serum
glucose, treats peripheral neuropathy.
Exercise for optimal blood sugars
•Exercise every day or every other. 72 hour window for cumulative
effect. 25 minutes is sufficient.
•Aerobic exercise lowers blood sugar.
–Criteria: something that doesn’t bore you, something that doesn’t cause
problems for your body. Pool exercise is often useful to those with joint
discomfort.
•Strenous exercise will raise HDL and lower triglycerides.
•Anaerobic exercise (body building or strength generating yoga)
lowers serum LDL.
•Muscle reduces insulin resistance. Muscle stores glycogen
efficiently.
Take a walk 30 minutes after a meal
Post-Exercise Nutrition
•THE CAVEAT
•To normalize sugar levels, ingest higher glycemic food, like
watermelon or other fruit, immediately following exercise.
•Restores glycogen in muscle tissue for the next workout.
•Protein intake within an hour for muscle repair and growth. Also
prevents sugar spiking from the high glycemic snack.
Multiple Factors
•“What if STRESS or sluggish digestion are causing my blood
sugar imbalances?”
The typical patient: 40 yr old female, overworked, fatigued with
sugar cravings and excessive urination. Tends to gas and
bloating with meals. Anovulatory cycles and infertility
HOW to BALANCE: Acupuncture treatment to retrain nervous
system, strengthen digestion and endocrine signaling. Dietary
intervention to make empowered choices for energy production
and glycemic support.
Acupuncture
• Acupuncture enjoys many
centuries of clinical trial
• Meridian systems affect
physiological changes
• As thin as a strand of hair,
acupuncture needles are
sterile and disposable
• Research shows that
acupuncture decreases
cortisol production. This
lowers sugar production by
the liver.
Integrative Medicine
What’s available to you?
-Herbal formula written constitutionally
-Acupuncture to modify stress response and treat imbalance
-Holistic lab assessment: assessing physiological FUNCTION—
thyroid, adrenal fatigue.
-Digestive assessment: what do you assimilate, what to avoid,
how to maximize absorption. Blood typing.
-Detoxification program development
-Wellness coaching: Step by step modifications as you go
Resources
Books to get you started:
The Practical Paleo Cookbook
Ultrametabolism Cookbook
The Paleo Diet for Athletes
Elana’s Pantry (blog)
Food prep and delivery:
Three Stone Hearth (Based in berkeley)
Good Eggs
Square Meals
Monitoring
Begin with a three day Food/Mood Log
*This includes what you’ve eaten and how you “felt”
with intake (digestion, energy, mood)
*Note other things that alter your blood sugar, like
exercise, stress, lack of sleep, changes in menses,
colds etc. Note pitfalls/challenges in meeting your
objective.
*Use a glucometer if you’d find it useful to test different
meals or conditions against one another
Take home TIP: accounting makes assessment easy!