Why Metabolic Health Matters and How You Can Take Advantage of Personalized Nutrition
Personalized Medicine is the Heart of My Practice
The ability to individualize and tailor treatment plans is at the heart of functional medicine. The most rewarding part of running a small private practice is knowing each of my patients and their needs individually.
Personalized medicine has become a bit of a buzzword because of the general frustration with our current medical model in treating chronic diseases and optimizing individual well being. The traditional model compares you to the “average patient,” which many of us are nothing like.
As functional medicine doctors, we counter the traditional model by gathering more data and treating the root cause of symptoms. When it comes to optimizing metabolism, we can utilize an at-home test kit, a blood draw at LapCorp, or a continuous glucose monitor to gather valuable information. This allows us to formulate a plan that's specific to your needs and your goals.
I’m excited about a new tool I’ve been using recently to provide even more personalized guidance to my patients. A tool that allows us to understand how your unique body responds to food and create a personalized nutrition plan that will better support you.
Whether you’re trying to optimize your current health and mood, improve your sleep and energy levels, age gracefully, or heal from a chronic disease, understanding how your body responds to food is a crucial step.
In the past, continuous glucose monitors (CGMs) were reserved for patients with diabetes. Thanks in large part to the work of Dr. Kasey Means and the Levels team, this 20-year-old medical device is now readily available for those looking to optimize their blood glucose levels and health.
So I’m going to cover how I think of metabolic health, and why I went from not loving wearable health devices to making a concession for the incredible data you’ll gain from using a CGM.
Why Should You Care About Balanced Blood Sugar?
We broadly describe how well your body produces and uses energy (such as glucose or fat) as metabolic health. Poor metabolic health, or metabolic dysfunction, is clearly increasing among Americans and is associated with a number of conditions from cardiovascular disease and cognitive decline, to depression and chronic pain.[1] [2] [3]
Blood glucose (i.e., blood sugar) and insulin levels (or even more specifically insulin sensitivity), are two of the best ways to understand your metabolic health. While insulin resistance is harmful to your health, insulin sensitivity is beneficial. Insulin resistance occurs when your cells stop responding to the hormone insulin. This causes higher insulin and higher blood sugar levels.
CGMs measure your glucose level every minute, providing the most detailed insight as to how foods, movement, and stress affect your glucose levels.
While we can't directly measure where you fall on the scale of insulin sensitivity to insulin resistance, seeing how your body responds to carbohydrates, both simple sugars and even complex carbohydrates, gives us a lot of insight into this crucial piece of your metabolic health.
Conditions Associated with Metabolic Dysfunction:
Obesity
Type 2 Diabetes (an extreme form of insulin resistance)
Fatigue
Cardiovascular disease
Cognitive decline or Alzheimer's
Hormonal imbalances and infertility
Depression
Anxiety
Chronic pain
How do we go upstream and better understand individual blood sugar patterns?
Getting Started With a CGM
We’re all looking for ways to feel our best. You might already track your steps, heart rate, or sleep. I’m not typically enthusiastic about wearable devices, but I am admittedly obsessed with wearing a CGM and pairing it with Levels, a new app currently in beta testing.
Levels pairs with the Freestyle Libre CGM. The CGM collects your glucose levels every minute, resulting in a huge amount of data. Levels takes this data and effectively chunks this information into useful feedback.
With Levels, you input your meals, add your exercise, and make other notes that might be helpful (like time in a sauna, which really spikes glucose for a short time).
Levels then organizes this data and provides an assessment of how each meal or activity affected your glucose.
What Does Optimal Glucose Look Like?
According to the research from Levels, healthy blood sugar should fall between these ranges:
Optimal blood sugar should range between 72-110 mg/dl
Glucose should not rise above 140 mg/dl, and preferably not even that high
Glucose levels should return to a pre-meal baseline within two hours after eating
A Functional Medicine Doctor’s Experience
Previously, I believed that as women we needed carbohydrates, perhaps even more so than men, for hormone balance. I never hesitated to include sweet potatoes, plantains, or some legumes in my meals, knowing the health benefits of these complex carbohydrates. But then I started using Levels.
This was eye opening!
I was certain that I ate a healthy diet, with no added sugars and only moderate amounts of low-sugar fruits, but my blood sugar climbed to 156 mg/dl after a meal that included beans, vegetables, an egg, and a cassava tortilla.
By all accounts this was a healthy meal, but clearly not the best for my body.
While my own blood sugar responses to complex carbohydrates are not universal, and I suspect I have some predisposition to insulin resistance (which means my blood sugar doesn’t go down very quickly), I’ve learned that I actually do better on a pretty low carbohydrate diet, despite my previously held beliefs.
I would have quickly rejected this idea without seeing the data myself. My glucose is now more stable, my energy feels even, and I can comfortably eat three times most days without feeling a need to snack.
Here’s an idea of my updated meals (thanks to Levels):
Breakfast:
One avocado, sprinkled with Celtic sea salt and some minced cilantro, enjoyed with freshly sliced radishes, a few Flackers (flax seed crackers), and a slice of aged goat cheese.
Go-to options for Lunch:
Cooked veggies with two scrambled or soft boiled eggs, topped with olive oil and wrapped into coconut wraps.
or
Fresh arugula, canned lemon caper mackerel from Patagonia Provisions, either as a salad or wrapped into coconut wraps. Most often with a small handful of walnuts for a little crunch.
While sometimes it feels a little unfair to watch a friend enjoy a chocolate chip cookie after lunch and her blood sugar only rises to 125 mg/dl, I’m glad to have insight into how my body does best with different foods.
Eating For Optimal Metabolic Health
This is where personalized nutrition really comes in. Above, you have a few ideas of how I eat to improve and support my own metabolic health, so here are a few general steps so you can get started.
Choose healthy fats like olive oil and olives, avocado, nuts and seeds, coconut oil and ghee to include with every meal.
Include ample dietary fiber, whether from flax seed crackers, beans in moderation (if tolerated), or generous servings of vegetables.
Make vegetables the center of your meal, choose a healthy source of protein, and include a small to moderate serving of complex carbohydrates, like sweet potatoes, beans, or cassava tortillas depending on your activity level for the day.
Note that it takes time to transition your diet, and there's no hurry. So have fun finding foods you enjoy and that help you feel your best.
Besides avoiding those obvious culprits that lead to blood sugar spikes (like cookies, tropical fruits or pasta), there are some fun strategies even if you do want to chow down on some delicious in-season fruit or homemade gluten-free cookies!
Tips For Balancing Your Blood Sugar:
Food Pairing - Eating carbs without a good source of fat or protein has a more detrimental effect on your blood sugar. But pairing that apple with some almond butter or nuts can blunt the glucose spike you might otherwise see.
Food Timing - Skip snacks and aim for just three meals daily. Every time you eat, blood sugar, and then insulin, increase. The fewer times you eat, the fewer times you will see glucose and insulin spikes. It's the constant exposure to insulin that causes insulin resistance and diabetes.
Food Sequencing - A case for the salad before a meal and not the bread basket! Try eating your carbs later in the meal as opposed to the beginning. Eating fat and vegetables before carbohydrates leads to lower post-meal glucose levels.[4]
Movement - For one of the biggest impacts on your blood sugar after eating, try moving. Whether doing your evening chores after dinner, taking a 15 minute walk around your neighborhood, playing with your dog, or even enjoying a fun online class (I like Peloton’s 10 min arms and light weights classes with a good playlist). Getting your muscles contracting will move glucose out of your blood and into your muscles.
Stress and Sleep’s Impact on Metabolic Health
You might not always be able to control your night's sleep or stressful experiences, but there are some smart ways you can minimize the elevated glucose levels that can accompany these events. Maybe you’ve noticed you really crave a bagel the morning after a rough night’s sleep, or a gluten free pizza after a stressful day at work. During these times it's especially important to choose a balanced meal that will get you off of the glucose (and insulin) roller coaster, and bring you more balance.
Breathwork may even be helpful in lowering blood glucose levels (more specifically, lowering your stress hormone, cortisol, whose job it is to keep glucose around). [5] Try incorporating box breathing after a stressful conversation. Breathe in for 4 counts, hold for 4 counts, release your breath for 4 counts, and hold at the bottom for 4 counts.
Optimizing sleep hygiene and finding a daily mindfulness practice you enjoy are great foundational pieces for feeling your best. Using a CGM will show you how these simple habits can impact your health for the better.
Feel Your Best with Balanced Blood Sugar
You might have noticed these are all really simple (albeit not always easy) recommendations:
Enjoy healthy fats, like avocados and olive oil
Get moving (and have fun with it)
Prioritize sleep
Explore different practices to help manage and lower your stress
This is something I love about functional medicine. When you treat the root cause of symptoms, simple habits consistently performed over time can make all the difference.
Understanding your own blood sugar response is a crucial tool to prevent or reverse chronic disease and ensure you feel your absolute best.
CGMs typically last 14 days (even holding up through saunas), and the insights you’ll gain in that short time will help you take advantage of personalized nutrition. And I’m happy to work with you to better understand your data and how to make changes that support you.
Book your functional medicine appointment here
I recommend that you give it a try, and I’d love to hear what you learn! You can gain access to the Levels community through my Early Access Code.
While I’m a big proponent of giving Levels a try, prioritizing these simple actions can make a world of a difference in reaching your own health goals.