What You Can Do: Lifestyle Actions That Improve Glycemic Response to Foods by Jill Goldring, MNSP
No matter who you are, eating a donut is likely to cause a pretty big spike in your blood sugar, but the magnitude of that spike will be different for each of us. Studies indicate that people with better metabolic health have better overall blood sugar control. By modifying your diet and lifestyle, you can reduce large blood sugar swings even without a Continuous Glucose Monitor (CGM). Focusing on the key concepts below, you can begin to reduce your blood sugar fluctuations. Later, if you choose to try a CGM-based technology, you can experiment with these concepts to make further refinements based on your own biology.
Increase your intake of whole foods
Use food's natural packaging to slow glucose release. Whole foods are foods that are still in their natural form. Fruits, vegetables, legumes (beans, lentils), nuts, seeds and whole grains are whole foods. These foods are still in the packaging nature provided, and they must be broken down during digestion to release glucose and other nutrients. Because this process takes time, the glucose gets released into your blood more slowly than when processed versions of the same food are digested. Whole food carbohydrates also contain many other nutrients that are good for you, including fiber, protein, healthy fats, vitamins, minerals and other beneficial compounds that can get stripped away in the processing before you eat them.
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Reduce/eliminate processed foods
The more processed a food is, the more of nature's packaging (and thus the nutrients and fiber) is removed. Processed foods will rapidly release sugar/glucose into the bloodstream and cause spikes in blood sugar—and potentially, an equally rapid drop once insulin is released. Highly processed foods include packaged treats, home-baked goods made with white flour, table and baking sugars, white rice flour—and all the products made from these ingredients. Even a little bit of processing can cause a significant change in glucose release. For example, an orange eaten whole has about 12 grams of sugar, surrounded by 5 grams of fiber that needs to be broken down to get to the sugar. By contrast, an 8-ounce glass of orange juice has 22 grams of sugar and less than ½ grams of fiber. The juice has almost twice the sugar, with almost no fiber to slow the glucose release.
Pair carbohydrates with healthy fats, protein and high-fiber foods to slow the glucose release
Eating whole foods or minimally processed carbohydrates will help slow the release of glucose into the blood. You can lower the impact still more by combining carbohydrate foods with good fats and proteins. Fats and proteins take more time to digest than carbohydrates and therefore help slow the sugar absorption of carbohydrates eaten in the same meal. For instance, if you pair whole-grain toast with avocado (a healthy form of fat), the fat will help slow the release of glucose into your blood. A rule to follow is not to eat your carbs by themselves.
Eat carbohydrates last
The order in which you eat the foods on your plate can change how a meal affects your glucose levels. Eat the foods that take a longer time to digest first to slow down the overall digestion of the meal. Start your meal with non-starchy vegetables, then move to proteins (such as beans, meat or nuts) and healthy fats (dairy, nuts, avocados, lean meats). Eat high-carbohydrate foods such as grains or starchy vegetables (potatoes, pasta, rice, tortillas, bread) last.
Exercise signals your muscles that they need to take up glucose for energy. This signal does not require insulin, so if someone is insulin resistant or has a decreased ability to make insulin, this is an especially great tool. If you do light to moderate exercise directly after a meal, such as a brisk walk, your muscles will take up some of the glucose coming from your meal and reduce the impact on your blood glucose.
Note: If you are using a CGM, you may notice that exercise, especially vigorous exercise, may increase your blood sugar as your body's way of keeping fuel available for your muscles, but this should not raise it to an unhealthy level like after a high-carbohydrate meal. An exercise-induced rise in blood sugar may be observed for even light to moderate exercise if the body is in a fasting state; this is a normal physiological response.
Add more vinegar and cinnamon to your diet
Regular cinnamon and vinegar intake have been shown to lower fasting glucose and HbA1c, and vinegar may directly lower post-meal glucose levels from high-carbohydrate meals.
While the exact physiological processes are not fully understood, many studies in both human and animal models have shown that regular cinnamon consumption can lower fasting glucose levels and HbA1c. That said, the addition of cinnamon to a meal does not appear to have a direct effect on post-meal glucose levels. So, while you might not see the effect register on a CGM, adding cinnamon regularly to your diet can have a positive impact on your metabolic health.
Like cinnamon, regular vinegar intake has been shown to lower fasting glucose and HbA1c, and it has also been shown to directly lower post-meal glucose rise when meals are high in carbohydrates. Some caution should be taken when adding vinegar to your diet because of its acidic nature. Vinegar lowers the PH of the mouth, which can both demineralize teeth and create an environment where bad bacteria can thrive. To counter this effect, vinegar should be diluted in water or followed by water to rinse the teeth.
Lifestyle actions you can take today to improve your glucose response
Eat whole foods
Eat more fruits, vegetables, legumes (beans, lentils), nuts, seeds.
Replace processed snacks with fruit, nuts, or veggies and dip.
Swap refined grains for whole grains like brown rice, whole wheat or barley.
Eliminate/reduce processed foods
Eliminate/reduce processed foods like sugary drinks, fruit juices, packaged snacks, white breads, white rice and treats made with refined ingredients.
When cooking at home, swap highly processed ingredients for whole foods or ones with lower processing, such as whole-grain flours or brown rice flour.
Look for recipes that use applesauce or dates/date paste to add sweetness.
Pair carbohydrates/save them for last
Pair carbohydrates with good fats such as nuts, nut butters (low sugar) or proteins such as beans, bean spreads or lean meats. Pair carbohydrates with small amounts of dairy such as plain yogurt or low-processed cheeses.
Eat fruits or vegetable snacks with hummus or nut butter. For example, you can pair peanut butter with an apple or a banana, hummus with carrots, peppers or celery, or guacamole or bean dip with chips. Add fruit to plain yogurt or slices of apple with cheese instead of crackers.
When eating a full meal, eat your vegetables, proteins and fats first, followed by your grains or starches (bread, rice, barley, potatoes, tortillas).
Take a brisk walk after meals. Try 10 minutes at first and then increase it by five minutes each day to see a bigger effect.
Try 15–30 minutes of gentle yoga after meals.
Make cinnamon and vinegar part of your regular routine
Try adding ½-1 tsp of cinnamon to coffee, tea, oatmeal or other daily food.
Use vinegar-based dressings on salads eaten before a meal.
Take an ounce of vinegar in water before a meal with a moderate- to high-carbohydrate content.
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Jill Goldring, MNSP, MSIE
Jill Goldring is a nutritionist, engineer, avid gardener, beekeeper and healthy food enthusiast. Nutrition is a second career for Jill after a successful Silicon Valley career managing high-tech projects. Jill is interested in the intersection of diet, glycemic response, microbiome and metabolic health outcomes. Her goal is to make positive changes to food systems and services that provide healthy food, nutrition education and nutrition technology to underserved communities.
She is a volunteer with the Samaritan House San Mateo. She manages a pilot program that pairs nutrition education focused on glycemic response and CGM (continuous glucose monitor) technology for the free medical clinic's food pharmacy for diabetic patients.
She has a Master's in Nutrition Science and Policy from Tufts University Friedman School of Nutrition Science and Policy, a BS in Industrial and Systems Engineering from USC and an MS in Industrial Engineering from Stanford University.