For so long we’ve been told that weight gain or weight loss is a simple energy balance equation. That if we want to lose weight we need to ‘eat less and more more’, and if you want the reverse, to do the opposite.
I love how Prof Grant Schofield & Dr Caryn Zinn explain this in their book, ‘What the Fast’. They call this a ‘truism’. That is to say, “anything that gains weight must be taking on more energy than it expends.”
But what’s missing from this truism is insight. Insight in to the complex hormonal and neural feedback mechanisms behind why this actually happens, and then in turn, how to actually solve the problem. It explains why the elephant entered the room, but doesn’t tell us how it got there and how to get rid of it.
If I had a dollar for every women who has been told to just ‘eat less, and move more’, I would be able to retire. It is actually cruel to tell an overweight person to do that. It attributes blame where there is none. It adds even more guilt and shame on top of what the person is already feeling. And if you’re a practitioner still telling people to do this, then shame on you. There is simply no excuse not to be educated on the hormonal reasons of weight gain, and then how to help patients reverse it through lifestyle changes.
What we know is that some foods have a profoundly different effect on the body and its feedback systems than others. It turns out that sugar and starch (what we know as dietary carbohydrates) raise blood sugar the quickest. These two images pretty much sum up what carbs do in the blood, and why calories in calories out isn’t helpful.
Insulin, or what some call our ‘king hormone’, is the main hormone (messenger) the body uses to normalise blood sugar. Blood sugar increases with eating, and also from a stress response in the body for energy to ‘fight or flight’. When our blood sugar goes up, insulin quickly sends instructions back to the body to shut down fat-burning, and go in to storage mode. If our insulin is always high (a condition known as hyperinsulinaemia) it affects our physiology and our behaviours, which are all aimed at storage (aka weight gain). High insulin drives fatty liver, high blood pressure, heart disease, inflammation, cancer, diabetes, alzheimers to name just a few. When it isn’t working well (what is known as insulin resistance), the flow on affect to our other hormones is also seen. For example our satiety hormone leptin that tells us when we’re full, becomes resistant too.
When we understand the physiology of our bodies, it all makes a lot more sense. If it’s carbs that are driving insulin resistance and hyperinsulinaemia leading to weight gain and poor metabolic health, then reducing the carbs and increasing our fat makes sense to reverse it. That is what I’ve done over the past 7 years, and there is no denying the evidence out there that this is the way to both reverse metabolic ill health, and prevent it happening in the first place. Of course ‘experts’ who have a vested interest in the high carb food pyramid will tell you that is not the case, but as I said, look at the physiology and it all makes complete sense.
How well our insulin is working is tightly linked to how our blood sugars react. This means that when we can see how our blood sugar levels are working, we can see how our insulin is working, and get a really good picture of our metabolic health (and how close to type 2 diabetes we are).
I’ve been experimenting this week with a CGM (continuous glucose monitor), which stays on your arm for 2 weeks and monitors blood sugar levels for the entire time. Having been eating a ketogenic lifestyle for 7 years now, I know I am metabolically healthy and my insulin is working fine, so I didn’t expect too much to happen during this first week. I eat 1-2 meals a day, I train fasted, and I am very in tune with my body and what it needs. However, next week things might be a little different. I will be eating a SAD (Standard Australian Diet) that any non lchf dietitan would put me on to be healthy. It will contain ‘healthy’ wholegrains, be low in fat and be predominately plant based. It will be mentally hard (and I’ve no doubt my body will not like it), but it will be interesting to see how my blood sugars react.
So what are the messages we are looking for with blood sugars?
While there is a big range of what is ‘normal’ blood sugar, there are some general guidelines that you can follow. If you suspect your blood sugar isn’t working well, see your doctor straight away (preferably a low carb GP who can help you reverse this without drugs). I have found in my experiment that my blood sugars are overall quite low, which makes sense given I am ‘fat adapted’, and my body is burning predominately fat for fuel. It would therefore make sense that my blood sugars will be on the lower side (I certainly don’t experience any of the typical symptoms of low blood sugar).
According to dietdoctor.com, an overall guide, a normal fasting blood sugar level in someone who doesn’t have diabetes is 3.9-5.6 mmol/L (70-100mg/dL)
Fasting blood sugar that consistently falls in the range of 5.6-6.9 mmol/L (100-125mg/dL) is considered to be pre diabetes (impaired fasting glucose), and if fasting blood sugar is above 7.00 mmol/L (above 126 mg/dL) on 2 separate occasions, then you may have diabetes.
Checking your blood sugar early in the morning you will experience what’s called the Dawn Phenomenon, which is a natural spike in blood sugar levels due to a complex hormonal response helping us to get out of bed. It should only be a little bit higher than your normal fasted level, and should normalise pretty quickly.
Checking your levels 1 hour after eating, and again 2 hours after eating should see levels return back to your baseline. If it doesn’t, then it could indicate there is an issue.
How much and how quickly your blood sugar levels increases after eating is mainly determined by your body’s ability to handle carbohydrates. In people who don’t have diabetes, blood sugar levels typically peaks about an hour after starting a meal. However in those with type 2, blood sugar typically peaks about 2 hours after starting a meal. If your blood sugar is consistently between 7.8mmol/L – 11.1 mmol/L when measured 2 hours after beginning a meal, you may have prediabetes or impaired glucose tolerance. If consistently over 11.1mmol/L two hours after beginning a meal, you likely have diabetes.
Data tells us a story. Is it everything? Probably not, but it’s a pretty good picture if done continuously over 2 weeks. If you’re curious to see how your insulin is working, then I encourage you to experiment on yourself. You can also ask your doctor to test your HBA1C, which is a 3 month average of your sugar levels. Although this doesn’t tell you how insulin is responding overall (for that you need to ask for a fasting insulin test).
Insulin is so important to keep working well, because as Dr Peter Brukner and Professor Tim Noakes say,
“Insulin Resistance is the pre curser to all modern diseases.”
Resources:
To find a LCHF supportive practitioner, go here: https://lowcarbdownunder.com.au/resources/
To read the article from diet doctor that goes a lot more indepth with the numbers, go here: https://www.dietdoctor.com/blood-sugar
What the Fast? by Prof Grant Schofield, Dr Caryn Zinn, Craig Rodger