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The season of indulgence is here. For some, it may start with furtive sneaks into your kid’s Halloween stash, for others it starts with the first pumpkin spice latte of the season, but it can quickly snowball, and before you know it, you’re saying yes to every sweet thing in sight. The barrage of sugar isn’t good for anyone, but for someone who struggles with type-2 diabetes, or any type of blood sugar imbalance, this time of year can be especially challenging. More than 30 million Americans have type-2 diabetes and another 84 million have prediabetes, a precursor to the disease, according to Centers for Disease Control and Prevention—that’s close to half the population.1 Poor blood sugar control is clearly a common problem in this country. While the numbers are staggering, the good news is that you can maintain healthy blood sugar balance with food and supplementation—even through the season of indulgence.
The simplest thing you can do to support healthy blood sugar balance is to shift your ratio of macronutrients so that you are eating a lower carb diet. You can do this by shifting the base of your diet from high-carb foods to lower carb foods. High-carb foods include grains—both whole and refined—legumes, starchy vegetables like potatoes, sweet potatoes, and carrots, and high-glycemic fruits. Lower carb foods include non-starchy vegetables and low-glycemic fruits like berries, apples, and pears. If the majority of your carbohydrate intake is from the lower carb group, with a limited amount (one to two servings a day) from the higher carb group, you will make the shift to a lower carb diet, a way of eating that is proven to maintain stable blood sugar balance. Most of us eat an excessive amount of carbohydrates—more than our bodies need, or can handle, which causes dramatic spikes in glucose and insulin.
When you eat grain-based carbs, starchy vegetables, or high-glycemic fruit, they are rapidly converted to glucose, which our bodies are fine-tuned to clear out of the bloodstream because it can cause major damage to the body. The pancreas releases insulin, a hormone that directs the cells to absorb the glucose to burn as energy; but once the cells are full, insulin tells the body to convert and store the excess glucose as fat. When you are constantly filling up on a lot of starchy vegetables, grain-based carbs, and/or high-glycemic fruits, the pancreas continues to pump out insulin, but cells that are already overloaded with glucose start to become resistant to insulin’s signal, so the glucose remains in the bloodstream, causing even more insulin to be released (remember, insulin’s job is to clear excess glucose out of the bloodstream), making cells even more insulin resistant. Then, in addition to having excess circulating blood glucose, you also have high levels of insulin, damaging in its own right. Overtime, if this dietary pattern is not broken, insulin resistance develops, and eventually, full-blown type-2 diabetes.
In our sedentary world, we can get more than enough carbs to fuel our bodies from non-starchy veggies and low-glycemic fruits, with a small amount of the higher-carb foods mentioned above. It is estimated that our hunter and gatherer ancestors got about 80 grams of carbs a day (mostly in the form of non-starchy vegetables) while the average American intake today is between 300 and 600 grams.2 To maintain healthy blood sugar aim to get between 100 and 150 grams of carbs each day.3 If you work to get the majority of your carbs from non-starchy vegetables and a small amount of those other higher-carb foods, you will easily fall into this range. And when you approach eating in a way that maintains healthy blood sugar balance, then an occasional indulgence—sweet treats included—shouldn’t be a problem.
There are certain foundational supplements that everyone should take but are especially important for someone struggling with blood sugar control. One of these is the B-complex family of vitamins, which are intricately tied to cellular energy production via their role in metabolizing carbohydrates and complex sugars.4 When you eat an excess of grain-based carbs your body quickly burns through the B vitamins to keep up, which can drastically deplete levels. When these important cofactors are missing, blood sugar imbalances can occur. Another foundational supplement is magnesium. It is estimated that at least half of all Americans don’t get enough through diet, making supplementation necessary.5 Magnesium plays a key role in regulating insulin activity and cellular glucose uptake, and low magnesium levels can worsen insulin resistance. Additionally, low magnesium intake has been associated with the development of type-2 diabetes and metabolic syndrome.6
Alpha-lipoic acid, or ALA, is a vitamin-like compound that acts as a powerful antioxidant. “Its principal job is to help burn glucose for energy,” Helena Linzy, Nutritional Health Coach (NHC) at Natural Grocers in Temple, TX says.7 “It also supports the function of insulin and it even transports glucose into cells without the use of insulin.”
One double-blind, placebo controlled study investigated ALA’s effect on blood glucose in patients with type-2 diabetes. Thirty-eight patients were divided into five groups and were given varying doses of ALA (300, 600, 900, or 1, 200 mg/daily) or a placebo, along with their standard diabetes medication for six months. After six months, both fasting glucose and HbA1c (a measurement of blood sugar over a period of time) were found to have decreased in those taking ALA, while they increased in the placebo group. The results were in a dose-dependent manner, i.e., the higher doses lead to more significant decreases.8
A meta-analysis published in late 2018 investigating the effect of ALA supplementation on blood sugar and lipid profiles among patients with metabolic diseases, including type-2 diabetes and gestational diabetes, found that ALA significantly decreased fasting blood glucose, insulin, insulin resistance, and HbA1c, in addition to lowering triglycerides and LDL cholesterol.9
“Alongside a well-balanced, nutrient-dense diet, one of my favorite supplements to recommend to those looking to support healthy blood sugar balance is berberine,” Jennifer Reznick, NHC at Natural Grocers in Vancouver East, WA says.10 Berberine is a bitter-tasting plant compound that is frequently used in China as part of a treatment program for type-2 diabetes, hyperlipidemia, and hypertension.11 In one trial of 36 newly diagnosed type-2 diabetic patients, berberine’s effect of lowering blood glucose was similar to that of metformin, a common diabetic drug, with researchers reporting significant decreases in HbA1c, fasting blood glucose, postprandial (post-meal) blood glucose, and triglycerides in the patients receiving berberine. The patients took 500 mg of berberine three times daily, before meals, for three months.12 In a second trial, the same researchers tested the effects of berberine on patients with poorly controlled type-2 diabetes and found that berberine lowered HbA1c, fasting blood glucose, and postprandial blood glucose in those patients as well; berberine also reduced fasting insulin and insulin resistance. The patients in this study took 500 mg of berberine three times daily, in addition to their other diabetes medications, for three months. Other research has found similar results, leading researchers to recommend berberine for therapeutic use.13 14
Linzy says chromium is an essential mineral for supporting healthy insulin sensitivity. It is involved in the metabolism of glucose, insulin, and blood lipids and has been shown to improve blood glucose in patients with type-2 diabetes.15 Chromium picolinate in particular has been shown to improve insulin resistance and blood glucose control.16One thing that makes chromium all the more important is the fact that diets high in refined carbohydrates and sugar actually deplete chromium levels,” she explains. One four-month trial including patients with poorly controlled type-2 diabetes found that 600 mcg of chromium picolinate daily, in addition to their prescribed diabetic drugs, significantly reduced fasting glucose and postprandial glucose as well as HbA1c.17 Studies have found that people with type-2 diabetes tend to have lower blood levels of chromium than those without the disease18 and that people who take a chromium-containing supplement are less likely to have diabetes.19 Supplements containing 200-1,000 mcg of chromium have been found to improve blood glucose control.20
Receiving widespread attention as an aid to support healthy blood sugar balance, is cinnamon something to take as a supplement or can you simply sprinkle it on oatmeal in the morning to get the benefits?
Reznick says it depends on what kind of support you are looking for.
“Cinnamon can be taken as a supplement to get a higher dose or it can be enjoyed as a spice on your food or as a tea,” she says.
Whole cinnamon has both fat-soluble and water-soluble components, she explains. The water-soluble component is responsible for the blood sugar benefits; therefore, when you opt for a cinnamon supplement you are getting more of the blood sugar-supporting water-soluble component.
One small study tested the effects of cinnamon on eight healthy male volunteers, who were supplemented with 3 grams of cinnamon or a placebo daily for two 14-day periods. The cinnamon reduced glucose and insulin responses in the participants, in addition to improving insulin sensitivity. However, the effects were lost when the supplementation ended, indicating that cinnamon must be taken long term for its blood sugar benefits.21
An earlier study of seven healthy male volunteers produced similar results. After supplementing with five grams of cinnamon, there was an immediate improvement in glucose response and an increase in insulin sensitivity, and the effects sustained for 12 hours.22
The holidays, and all of the sweet treats and carb-heavy dishes that ensue, can wreak havoc on blood sugar balance, especially for someone already struggling with blood sugar control. But if you start with a healthy diet as a base, then you can occasionally indulge without causing major damage. The key is to change your approach to eating—rebalance your macronutrients, with the bulk of your carbs coming from non-starchy vegetables, with limited amounts of other healthy carb sources like starchy vegetables, and the rest of your calories coming from healthy fats and moderate amounts of protein. This will help maintain a steady blood sugar balance, without the dramatic spikes that come with a diet that contains excessive amounts of grain-based carbs. Consider giving your body extra support with a few choice supplements that are proven to help maintain healthy blood sugar. And lastly, don’t be too hard, or too restrictive, on yourself! The holidays—and the treats that come with them—are meant to be enjoyed… in balance.
For personalized guidance and support for maintaining healthy blood sugar through the holiday season, call or visit your neighborhood Natural Grocers to schedule a coaching session with your local NHC.
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