Recently, I received a call from a friend, and it went something like this:
“Hey, I just got my lab results back from my doctor’s visit. My blood sugar is high, and I need to reduce it quickly. I don’t like these numbers, but I don’t know how to do it because I don’t eat a lot of sugar.”
I paused a moment and then responded. “You regularly eat bagels and muffins, right?”
“Yes.”
“And soda?”
“Well, yes. But I know it has sugar,” she said.
“And fruit juice?”
There was a pause, and then she said, “Yes, but I don’t put sugar in my coffee!”
Confirming she was at home, I asked her to pull out the almond milk that I knew she put into her coffee. “Can you look at the label of your almond milk and tell me how many added sugars there are?”
There was another pause, and then she said, “Holy cow! There are 12 grams in a one-cup serving. I had no idea!”
“Now, can you pull out your cranberry juice? How many added sugars in that?”
I heard her moving things around in the refrigerator and then she spoke. “There are 12 grams in a 4 oz serving. I can’t believe it; I thought this was healthy.”
“Okay, so this is part of the problem. There are places you are getting sugar and don’t even realize it. Assuming an 8 oz cup of cranberry juice and 4 tablespoons of almond milk (1/4 cup), you are at 27 grams of added sugar just at breakfast with things you are drinking. When trying to lower blood sugar, you need to think about all the places that sugar hides, like fruit juice, muffins, and non-dairy milk, as well as foods like your bagel, which will readily convert to sugar after eating them because these can also drive up your blood sugar. One of the easiest first steps is to look at the foods you readily eat and assess exactly how much you really are consuming.”
Part of the Problem: Hidden Sugars
Part of the problem is that hidden sugars lurk everywhere. They are in things like condiments, baked goods, prepackaged soups, dressings, sauces, crackers, yogurt, spaghetti sauce, granola, coffee drinks, energy drinks, non-dairy milk, tea drinks, protein bars, cereal, pre-made smoothies, baked beans, and so much more.
According to the American Heart Association (AHA), American Adults consume about 17 teaspoons of added sugar daily, roughly 60 pounds annually. Our children are also consuming a lot too, roughly 16 teaspoons of daily added sugar or nearly 53 pounds annually. The problem? We don’t actually need any added sugars. This figure is significantly higher than what the AHA defines as the maximum daily recommendation: only 9 teaspoons for men (36 grams) or 6 teaspoons for women (25 grams).
How We Are Designed
We are designed to eat food and have our bodies break it down into sugar or glucose. The body then senses the circulating glucose and releases insulin, which helps the glucose enter the cells where they can use it as energy. As this process happens, the glucose in the bloodstream lowers. The body stores the extra in your liver, using it for energy later. But if we have too much sugar and our body either cannot produce enough insulin or our cells are no longer sensitive to the insulin, we produce and don’t take in the glucose, blood sugar rises and becomes harder to control.
The Problem
Unfortunately, high, or uncontrolled blood sugar can become a significant problem because it puts us at risk for many health conditions, such as (1,2):
- Obesity
- Cardiovascular disease
- Metabolic Syndrome
- Type 2 Diabetes
- Non-alcoholic fatty liver disease
- High cholesterol
- Cognitive Decline
- Higher levels of chronic inflammation
- Autoimmune disease
What Can You Do?
Understand Your Levels
Maybe you know your levels, and even if you don’t, there are things you can do. As someone who operates with data, it is helpful to know your baselines through lab results:
- Fasting Glucose
- Normal < 100 mg/dL (ideal is closer to 90 mg/dL)
- Prediabetes 100-125 mg/dL
- Diabetes 126 mg/dl or higher
- HbA1c
- Normal <5.7% (ideal is lower than 5.3%)
- Prediabetes 5.7%-6.4%
- Diabetes 6.5% or higher
Your doctor may also assess your C-peptide levels or fasting insulin to get a complete picture of your body’s ability to regulate glucose or blood sugar well. If your levels are on the higher side (including high “normal”) and you want to take further action, read on.
Assess Hidden Sugars and Intake of High Glycemic Foods
Hidden sugars hide everywhere! Take a moment to assess the hidden sugars in your food. Foods may contain natural sugars, added sugars, or both. One great way to start is by examining the area labeled “added sugar.” Do a “sugar audit” and see how much you are consuming.
Next, take a sample day and write what you eat, yes, including the amounts of food! This could be on paper or using an app like MyFitness Pal or something similar. Then, look up the foods you are eating and determine if they have a low glycemic index or glycemic load. The glycemic index measures the impact food has on how fast it raises blood sugar. The glycemic load determines how likely a serving of food will probably increase levels.
| Low | Medium | High | |
| Glycemic Index | <55 | 59-69 | 70+ |
| Glycemic Load | <10 | 11-19 | 20+ |
Then either use this site developed by the University of Sydney or download and app like the Glycemic Index Load Net Carbs app.
Eat Strategically and Incorporate Functional Foods
You may ask yourself what exactly it means to eat strategically and incorporate functional foods. Don’t worry; it is also pretty simple, but don’t take my word for it. Let’s take an example.
I want you to think for a moment about how you feel when you have a soda, a glass of juice, a muffin, cookie, cake, or even candy. Some of my clients call it a sugar rush; that is just what it is. Given the sugar content of most of the foods I just named, when you eat them, your body doesn’t really have to do much before absorbing them into your system and makes your blood glucose rise. These are what I would refer to as simple carbohydrates. However, if you eat an apple, oats or whole grain bread, you might feel energized, but it wouldn’t be as fast because your body is more slowly breaking this food down because of the starch and fiber content. The ideal goal is then when you eat higher carbohydrate foods, you focus on those like beans, whole wheat grains, and low glycemic fruits and vegetables in smaller servings.
Fiber: Key to for Insulin Resistance and Lowering CholesterolFiber: Key to for Insulin Resistance and Lowering CholesterolFiber: Key to for Insulin Resistance and Lowering CholesterolThe second element, besides incorporating fiber in your meals, is to make sure you are not just eating the carbohydrates by themselves. If you eat fiber, protein, and fat with your carbohydrate, you will help reduce how high your blood sugar spikes are and stabilize blood sugar.
Next, incorporate functional foods where possible. These are foods or ingredients that impart health benefits beyond basic nutrition. Here are a few (cite):
- Cinnamon- sprinkled on food or in coffee (may help lower blood sugar and cholesterol) (3,4)
- Unsweetened plain yogurt (2 cups over a week)- eat as a breakfast with some berries, chia seeds and nuts (5,6)
- Apple Cider Vinegar- drizzle on a salad or vegetables (7)
Incorporate Lifestyle Changes
Other things can positively and negatively impact blood sugar, including exercise, sleep, and stressors. While continued exercise is excellent for managing blood sugar and cholesterol, excessive exercise may negatively affect blood sugar levels in the short term if it overstresses the body. Instead, try things like yoga and walking which reduce blood sugar (8). Even breaking up sedentary time with three-minute breaks is helpful. (9) Lack of sleep and everyday stress can also negatively impact blood sugar levels.
Final Thoughts
This is such a popular issue that I must include some final thoughts. The way I look at it, a “pre-diabetes diet” is simply a healthy diet. A healthy diet focuses on eating predominantly whole foods, foods low in sugar or things that readily convert to sugar, and foods high in fiber. It sounds simple, and in many ways, it is. But also, quitting sugar is hard because it gives our brain positive signals and energy and makes us feel good. Does this mean that you can NEVER EVER have any sugar again? For most of us, that answer is no. Instead, try minimizing eating those sugary treats to an occasional event rather than something you seek after dinner or to satisfy an afternoon energy crash. If you eat less sugary or sweetened things, you might also crave them less. If you are looking for more support and are a “do-it-yourself” person, I encourage you to check out my course on inflammation. I dive deeper into this topic and everything that drives up inflammation with my Healthy Integrative Program.
Citations
- Rippe, J. M., & Angelopoulos, T. J. (2016). Relationship between Added Sugars Consumption and Chronic Disease Risk Factors: Current Understanding. Nutrients, 8(11), 697. https://doi.org/10.3390/nu8110697
- Excessive intake of sugar: An accomplice of inflammation—PMC. (n.d.). Retrieved April 11, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9471313/
- Cinnamon extract lowers glucose, insulin and cholesterol in people with elevated serum glucose—PMC. (n.d.). Retrieved April 11, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5067830/
- Effect of cinnamon spice on continuously monitored glycemic response in adults with prediabetes: A 4-week randomized controlled crossover trial—ScienceDirect. (n.d.). Retrieved April 11, 2024, from https://www.sciencedirect.com/science/article/pii/S000291652400008X
- Nutrition, C. for F. S. and A. (2024). FDA Announces Qualified Health Claim for Yogurt and Reduced Risk of Type 2 Diabetes. FDA. https://www.fda.gov/food/cfsan-constituent-updates/fda-announces-qualified-health-claim-yogurt-and-reduced-risk-type-2-diabetes
- Chen, M., Sun, Q., Giovannucci, E., Mozaffarian, D., Manson, J. E., Willett, W. C., & Hu, F. B. (2014). Dairy consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. BMC Medicine, 12(1), 215. https://doi.org/10.1186/s12916-014-0215-1
- Jafarirad S, Elahi MR, Mansoori A, Khanzadeh A, Haghighizadeh MH. The improvement effect of apple cider vinegar as a functional food on anthropometric indices, blood glucose and lipid profile in diabetic patients: a randomized controlled clinical trial. Front Clin Diabetes Healthc. 2023 Nov 13;4:1288786. doi: 10.3389/fcdhc.2023.1288786. PMID: 38028980; PMCID: PMC10679383.
- Dhali, B., Chatterjee, S., Sundar Das, S., & Cruz, M. D. (2023). Effect of Yoga and Walking on Glycemic Control for the Management of Type 2 Diabetes: A Systematic Review and Meta-analysis. Journal of the ASEAN Federation of Endocrine Societies, 38(2), 113–122. https://doi.org/10.15605/jafes.038.02.20
- Gale, J. T., Wei, D. L., Haszard, J. J., Brown, R. C., Taylor, R. W., & Peddie, M. C. (2023). Breaking Up Evening Sitting with Resistance Activity Improves Postprandial Glycemic Response: A Randomized Crossover Study. Medicine & Science in Sports & Exercise, 55(8), 1471. https://doi.org/10.1249/MSS.0000000000003166