10 Ways To Balance Blood Sugars
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“Let Them Eat Cake”, She Said…
This is Jessie Inchauspé, a French biochemist and author. She’s most known for her best-selling “Glucose Revolution: The Life-Changing Power Of Balancing Your Blood Sugar”.
It’s a great book (which we reviewed recently) and you absolutely should read it, but meanwhile, we’re going to distill at least the most critical core ideas, 10almonds style. In this case, her “ten hacks”:
Eat foods in the right order
The order is:
- Fiber first
- Protein and fat second
- Starches and sugars last
What happens here is… the fiber perks up the gut bacteria, the protein and fat will then be better-digested next, and the starches and sugars will try to jump the line, but they can’t because the fiber is a physical speedbump and the proteins and fats are taking the prime place for being digested. So instead, the starches and sugars—usually responsible for blood sugar spikes—get processed much more gradually, resulting in a nice even curve.
Add a green starter to all your meals
We know what you’re thinking: “that’s just the first one again”, but no. This is an extra starter, before you get to that. If you’re the cook of the household, this can absolutely simply mean snacking on green ingredients while cooking.
Stop counting calories
Especially, she advises: stop worrying about extra calories from fats, such as if doing an oil-and-vinegar dressing for salad—which she also recommends, because all three components (the oil, the vinegar, and the salad) help even out blood sugar levels.
Flatten your breakfast curve
For many, breakfast is the starchiest meal of the day, if not the sugariest. Inchauspé recommends flipping this (ideally) or softening it (if you really must have a carb-based breakfast):
- Top choices include: a warm vegetable salad, fish, or eggs (or tofu if you don’t do animal products).
- Next-best include: if you must have toast, make sure to have butter (and/or the aforementioned egg/tofu, for example) to give your digestion an extra thing to do.
- Also: she recommends skipping the juice in favour of home-made breakfast smoothies. That way, instead of basically just sugar with some vitamins, you’re getting a range of nutrients that, if you stack it right, can constitute a balanced meal itself, with fiber + protein + fat + carbs.
Have any type of sugar—they’re all the same
They’re technically not, but the point is that your body will immediately take them apart and then they will be just the same. Whether it’s the cheapest white sugar or the most expensive organic lovingly hand-reared free-range agave nectar, your body is going to immediately give it the chop-shop treatment (a process so quick as to be practically instantaneous) and say “this is now glucose”.
Pick a dessert over a sweet snack
Remember that about the right order for foods? A dessert, when your body is already digesting dinner, is going to make much less of a glucose spike than, say, a blueberry muffin when all you’ve had this morning is coffee and juice.
Reach for the vinegar before you eat
We recently did a whole main feature about this, so we’ll not double up today!
After you eat, move
The glucose you eat will be used to replace lost muscle glycogen, before any left over is stored as fat… and, while it’s waiting to be stored as fat, just sitting in your bloodstream being high blood sugars. So, this whole thing will go a lot better if you are actively using muscle glycogen (by moving your body).
Inchauspé gives a metaphor: imagine a steam train worker, shoveling coal into the furnace. Meanwhile, other workers are bringing more coal. If the train is moving quickly, the coal can be shoveled into the furnace and burned and won’t build up so quickly. But if the train is moving slowly or not at all, that coal is just going to build up and build up, until the worker can shovel no more because of being neck-deep in coal.
Same with your blood sugars!
If you want to snack, go low-sugar
In the category of advice that will shock nobody: sugary snacks aren’t good for avoiding blood sugar spikes! This one probably didn’t need a chapter devoted to it, but anyway: low sugar is indeed the way to go for snacks.
Put some clothes on your carbs
This is about olive oil on pasta, butter on potatoes, and so forth. Basically, anything starchy is going to be broken down quickly to sugar and sent straight into the bloodstream, if there’s nothing to slow it down. If you’re wondering what to do with rice: adding a tablespoon of chia seeds to the rice while cooking (so they’re cooked together) will add very healthy fats to your rice, and (because they’ve been cooked) will not seem like eating seeds, by the way. In terms of texture and appearance, it’ll be as though you threw some black pepper in*
*which you should also do for many reasons, but that’s beyond the scope of this “about blood sugars” feature!
Wanting to know more about the science of this?
We’ve done all we have room for here today, but Inchauspé is, as ever, happy to explain it herself:
Prefer text? Check out:
The Science Behind Glucose Goddess
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What Weston Price Got Right (And Wrong)
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Weston Price: What Stood The Test of Time?
This is Dr. Weston Price, a dentist. You may guess from the photo, or perhaps already knew, his work is not new in 2023. We usually feature current health experts here, but we’re taking a day to do a blast from the past, because his ideas endure today, and inform a lot of people’s health views. So, he’s a good one to at least know about.
What was his deal?
Dr. Price (1870–1948) wanted to study focal infection theory—the idea that repairing root canals allowed bacterial infections that caused everything from heart disease to arthritis. His solution was that the teeth should be extracted instead.
This theory was popular in the 1920s, was challenged in the 1930s, ignored in the 1940s (the world was a bit busy), and by broad medical consensus anyway, rejected in the 1950s. But, while it was being challenged in the 1930s, Dr. Price decided to find more evidence for its support.
The result was his famous world tour of peoples living traditional lifestyles without the influence of “modern” diet. His findings, and the conclusions he drew from them, extended to far more than just dental health.
What did he find?
Dr. Price found that people living traditional lifestyles, with their traditional diets based on locally-sourced foods, had much better overall health. Of course, he was a dentist and not a general practitioner, so aside from examining their teeth, he largely relied on self-reported diagnoses of illness, or lack thereof.
In short: he found that people in places without modern medical institutions had fewer diagnoses of disease. From this, he concluded that incidence of disease was much lower.
There was also an unexamined element of survivorship bias—an undiagnosed disease is more likely to be fatal, and he questioned only living people, which skewed the stats rather. Nor did he examine infant mortality rate nor adult life expectancy, both of which were not great.
Was it all useless, then?
Actually no! He did hit upon some observations that have stood the test of time:
- He correctly concluded that modern diets with sugar and white flour were ruinous to the health.
- He correctly concluded that locally-sourced food, and grass-fed in the case of pastoral farming, tended to have much more nutritional value than the mass-produced results of intensive farming.
- He correctly concluded that many modern preservation methods robbed foods of their nutrients.
- He correctly concluded that many grains and seeds are more nutritions when fermented/soaked/sprouted.
About that “locally-sourced food”: the reason locally-sourced food tends to be more nutritious is that it has required less in the way of preservation for a long trip around the world, and will also tend to be fresher.
On the other hand, this does mean a lot of the foods that Dr. Price recommends are very much subject to availability. It may well be true that the Inuit people do not eat a lot of fruit and veg (which mostly do not grow there), but if you live in Nevada, maybe locally-sourced whale fat is just as difficult to find.
One person’s “this fatty organ meat contains the vitamin C we need” may be another person’s “that’s great; I have an apple tree in my garden though”.
Want to learn more?
Dr. Price’s most influential work is his magnum opus, “Nutrition and Physical Degeneration”. It’s a fascinating book in its historical context, but do be warned, it was written by a rich white man in 1939 and the writing is as racist as you might expect. Even when making favourable comparisons, the tone is very much “and here is what these savages are doing well”.
If you don’t fancy reading all that, here are two other sources about Weston Price’s work and conclusions, presented for balance:
- The Weston A. Price Foundation (Official Website)
- Weston Price’s Appalling Legacy (Science-Based Medicine.org)
Enjoy!
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Online Reaction Tests & Women’s Cognitive Health (Test Yours!)
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A team of researchers have looked into the use of online reaction tests (in which, for example, one clicks whenever a certain prompt is shown, or for more of a cognitive challenge, one presses a numerical key when the corresponding digit is shown) to cognitive health in women at different ages.
Why women? To quote the man who had the honor of being the first-listed author on the study (something that happens mysteriously often in science),
❝Women have long been under-represented in healthy aging research, despite making up more than half the population. We developed an easy way to measure cognitive function in the home, without the need for individuals to travel to clinics or receive home visits. Our research shows that testing of cognitive function in the home largely acceptable, easy and convenient❞
About that convenience: they used data from the UK Women’s Cohort Study, which involved over 35,000 British women, and then specifically focused on a follow-up study of 768 participants aged 48–85.
Of the two kinds of online reaction tests we described up top, they used the numerical kind. The participants also filled in a questionnaire about their personal traits (demographic data, mostly, though things like self-reported level of health literacy, and how they would rate their overall health).
What they found
The findings included:
- Younger women were more likely to participate, with participation rates dropping from 89% at age 45 to 44% at age 65.
- Each higher level of education increased the likelihood of volunteering by 7%.
- Women who rated themselves as having “high” intelligence were 19% more likely to participate than those who considered themselves of “average” intelligence.
- Women with lower self-reported health literacy made fewer errors, possibly due to taking longer to decide on answers—consistent with findings from older adults.
You can read the full paper itself here: Health literacy in relation to web-based measurement of cognitive function in the home: UK Women’s Cohort Study
Why this matters
We wrote, a little while ago, about the use of online games (of a specific kind) to improve cognitive function:
Synergistic Brain-Training: Let The Games Begin (But It Matters What Kind) ← the good news is, these are very accessible too
When it comes to rapid and/but correct reactions, this becomes really critical:
How (And Why) To Train Your Pre-Frontal Cortex ← Dr. Sandra Chapman advocates strongly for this, and it’s closely related to working memory and the ability to focus
Want to test yours?
Here are two ways to do it (now, for free, without needing to sign up for anything; the tests are right there on the page):
- HumanBenchmark.com’s Reaction Time Test ← this one’s just a “click when the red panel turns green” test, but the merit here is that it compares your scores to a very large dataset of other people
- Keypress Reaction Time Test ← this one’s the kind that was used in the study, and requires pressing the correct numerical key when the corresponding digit is shown on the screen. You can make it easier or harder by restricting or increasing the range of numbers it uses (default setting is to use the numbers 1, 2, 3, 4, 5, and 6)
Enjoy!
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Aspirin, CVD Risk, & Potential Counter-Risks
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Aspirin Pros & Cons
In Tuesday’s newsletter, we asked your health-related opinion of aspirin, and got the above-depicted, below-described set of responses:
- About 42% said “Most people can benefit from low-dose daily use to lower CVD risk”
- About 31% said “It’s safe for occasional use as a mild analgesic, but that’s all”
- About 28% said “We should avoid aspirin; it can cause liver and/or kidney damage”
So, what does the science say?
Most people can benefit from low-dose daily aspirin use to lower the risk of cardiovascular disease: True or False?
True or False depending on what we mean by “benefit from”. You see, it works by inhibiting platelet function, which means it simultaneously:
- decreases the risk of atherothrombosis
- increases the risk of bleeding, especially in the gastrointestinal tract
When it comes to balancing these things and deciding whether the benefit merits the risk, you might be asking yourself: “which am I most likely to die from?” and the answer is: neither
While aspirin is associated with a significant improvement in cardiovascular disease outcomes in total, it is not significantly associated with reductions in cardiovascular disease mortality or all-cause mortality.
In other words: speaking in statistical generalizations of course, it may improve your recovery from minor cardiac events but is unlikely to help against fatal ones
The current prevailing professional (amongst cardiologists) consensus is that it may be recommended for secondary prevention of ASCVD (i.e. if you have a history of CVD), but not for primary prevention (i.e. if you have no history of CVD). Note: this means personal history, not family history.
In the words of the Journal of the American College of Cardiology:
❝Low-dose aspirin (75-100 mg orally daily) might be considered for the primary prevention of ASCVD among select adults 40 to 70 years of age who are at higher ASCVD risk but not at increased bleeding risk (S4.6-1–S4.6-8).
Low-dose aspirin (75-100 mg orally daily) should not be administered on a routine basis for the primary prevention of ASCVD among adults >70 years of age (S4.6-9).
Low-dose aspirin (75-100 mg orally daily) should not be administered for the primary prevention of ASCVD among adults of any age who are at increased risk of bleeding (S4.6-10).❞
~ Dr. Donna Arnett et al. (those section references are where you can find this information in the document)
Read in full: Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology
Or if you’d prefer a more pop-science presentation:
Many older adults still use aspirin for CVD prevention, contrary to clinical guidance
Aspirin can cause liver and/or kidney damage: True or False?
True, but that doesn’t mean we must necessarily abstain, so much as exercise caution.
Aspirin is (at recommended doses) not usually hepatotoxic (toxic to the liver), but there is a strong association between aspirin use in children and the development of Reye’s syndrome, a disease involving encephalopathy and a fatty liver. For this reason, most places have an official recommendation that aspirin not be used by children (cut-off age varies from place to place, for example 12 in the US and 16 in the UK, but the key idea is: it’s potentially dangerous for those who are not fully grown).
Aspirin is well-established as nephrotoxic (toxic to the kidneys), however, the toxicity is sufficiently low that this is not expected to be a problem to otherwise healthy adults taking it at no more than the recommended dose.
For numbers, symptoms, and treatment, see this very clear and helpful resource:
An evidence based flowchart to guide the management of acute salicylate (aspirin) overdose
Take care!
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Saunas: Health Benefits (& Caveats)
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The Heat Is On
In Tuesday’s newsletter, we asked you your (health-related) opinion on saunas, and got the above-depicted, below-described, set of responses:
- About 53% said it is “a healthful activity with many benefits”
- About 25% said it is “best avoided; I feel like I’m dying in there”
- About 12% said “it feels good and therefore can’t be all bad”
So what does the science say?
The heat of saunas carries a health risk: True or False?
False, generally speaking, for any practical purposes. Of course, anything in life comes with a health risk, but statistically speaking, your shower at home is a lot more dangerous than a sauna (risk of slipping with no help at hand).
It took a bit of effort to find a paper on the health risks of saunas, because all the papers on PubMed etc coming up for those keywords were initially papers with “reduces the risk of…”, i.e. ways in which the sauna is healthy.
However, we did find one:
❝Contraindications to sauna bathing include unstable angina pectoris, recent myocardial infarction, and severe aortic stenosis.
Sauna bathing is safe, however, for most people with coronary heart disease with stable angina pectoris or old myocardial infarction.
Very few acute myocardial infarctions and sudden deaths occur in saunas, but alcohol consumption during sauna bathing increases the risk of hypotension, arrhythmia, and sudden death, and should be avoided. ❞
~ Dr. Matti Hannuksela & Dr. Samer Ellahham
Source: Benefits and risks of sauna bathing
So, very safe for most people, safe even for most people with heart disease, but there are exceptions so check with your own doctor of course.
And drinking alcohol anywhere is bad for the health, but in a sauna it’s a truly terrible idea. As an aside, please don’t drink alcohol in the shower, either (risk of slipping with no help at hand, and this time, broken glass too).
On the topic of it being safe for most people’s hearts, see also:
Beneficial effects of sauna bathing for heart failure patients
As an additional note, those who have a particular sensitivity to the heat, may (again please check with your own doctor, as your case may vary) actually benefit from moderate sauna use, to reduce the cardiovascular strain that your body experiences during heatwaves (remember, you can get out of a sauna more easily than you can get out of a heatwave, so for many people it’s a lot easier to do moderation and improve thermoregulatory responses):
Sauna usage can bring many health benefits: True or False?
True! Again, at least for most people. As well as the above-discussed items, here’s one for mortality rates in healthy Finnish men:
Not only that, also…
❝The Finnish saunas have the most consistent and robust evidence regarding health benefits and they have been shown to decrease the risk of health outcomes such as hypertension, cardiovascular disease, thromboembolism, dementia, and respiratory conditions; may improve the severity of musculoskeletal disorders, COVID-19, headache and flu, while also improving mental well-being, sleep, and longevity.
Finnish saunas may also augment the beneficial effects of other protective lifestyle factors such as physical activity.
The beneficial effects of passive heat therapies may be linked to their anti-inflammatory, cytoprotective and anti-oxidant properties and synergistic effects on neuroendocrine, circulatory, cardiovascular and immune function.
Passive heat therapies, notably Finnish saunas, are emerging as potentially powerful and holistic strategies to promoting health and extending the healthspan in all populations. ❞
~ Dr. Jari Laukkanen & Dr. Setor Kunutsor
(the repeated clarification of “Finnish sauna” is not a matter of fervent nationalism, by the way, but rather a matter of disambiguating it from Swedish sauna, which has some differences, most notably a lack of steam)
That reminds us: in Scandinavia, it is usual to use a sauna naked, and in Finland in particular, it is a common social activity amongst friends, coworkers, etc. In the US, many people are not so comfortable with nudity, and indeed, many places that provide saunas, may require the wearing of swimwear. But…
Just one problem: if you’re wearing swimwear because you’ve just been swimming in a pool, you now have chlorinated water soaked into your swimwear, which in the sauna, will become steam + chlorine gas. That’s not so good for your health (and is one reason, beyond tradition and simple normalization, for why swimwear is usually not permitted in Finnish saunas).
Want to read more?
You might like our previous main feature,
Turning Up The Heat Against Diabetes & Alzheimer’s ← you guessed it, sauna may be beneficial against these too
Take care!
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The Cluttered Mind – by Deborah McKenna
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Coming from an eclectic psychotherapy background, Deborah McKenna outlines a wide array of techniques to “do what it says on the tin”, that is:
Organizing the junk drawer of your mind.
McKenna argues that it’s natural for something so gargantuan as our mind to get cluttered… but that it’s perfectly possible, with a good system, to tidy up considerably.
The benefit of this is much like the benefit of tidying a room:
Imagine a kitchen in which half the things have not been put away; there are dishes in the sink, something is growing behind the trash can… and you have a vague suspicion that if you open a certain cupboard, its contents are going to come falling out on your head. How are you going to cook a meal here?
Imagine a mind when many thoughts have been left untended; there are things you needed to process, and there’s a steady resentment of something growing in some dark part of your mind… and there’s some part of your memory that you’re afraid to even look at it, because of all it’ll cause to come surging back at you. How are you going to strategize your life here?
Fortunately, McKenna is here to guide you through doing for your mind what Marie Kondo would do for your home. And, even better, McKenna does it with a simple and clear writing style, assorted diagrams, and a step-by-step approach to getting everything in order.
Give Your Mind A Spring-Cleaning With This Book From Amazon Today
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The Diabetes Drugs That Can Cut Asthma Attacks By 70%
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Asthma, obesity, and type 2 diabetes are closely linked, with the latter two greatly increasing asthma attack risk.
While bronchodilators / corticosteroids can have immediate adverse effects due to sympathetic nervous system activation, and lasting adverse effects due to the damage it does to metabolic health, diabetes drugs, on the other hand, can improve things with (for most people) fewer unwanted side effects.
Great! Which drugs?
Metformin, and glucagon-like peptide-1 receptor agonists (GLP-1RAs).
Specifically, researchers have found:
- Metformin is associated with a 30% reduction in asthma attacks
- GLP-1RAs are associated with a 40% reduction in asthma attacks
…and yes, they stack, making for a 70% reduction in the case of people taking both. Furthermore, the results are independent of weight, glycemic control, or asthma phenotype.
In terms of what was counted, the primary outcome was asthma attacks at 12-month follow-up, defined by oral corticosteroid use, emergency visits, hospitalizations, or death.
The effect of metformin on asthma attacks was not affected by BMI, HbA1c levels, eosinophil count, asthma severity, or sex.
Of the various extra antidiabetic drugs trialled in this study, only GLP-1 receptor agonists showed a further and sustained reduction in asthma attacks.
Here’s the study itself, hot off the press, published on Monday:
JAMA Int. Med. | Antidiabetic Medication and Asthma Attacks
“But what if I’m not diabetic?”
Good news:
More than half of all US adults are eligible for semaglutide therapy ← this is because they’ve expanded the things that semaglutide (the widely-used GLP-1 receptor agonist drug) can be prescribed for, now going beyond just diabetes and/or weight loss 😎
And metformin, of course, is more readily available than semaglutide, so by all means speak with your doctor/pharmacist about that, if it’s of interest to you.
Take care!
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