How to control blood sugar spikes

Biochemist Jessie Inchauspe heads into work one morning at a genetics lab in California. During the morning meeting, management offer staff the chance to self-test a new medical device. Jessie accepts. 

She couldn’t have known this device would take her on a journey of discovery to reshape her health and help countless others do the same.  

The device was a continuous blood sugar monitor, and it was this — combined with her academic background and a remarkable willingness to use herself as a lab rat — that began a journey of discovery into how blood sugar affects our health. 

In today’s episode, Jonathan is joined by two leading experts on the topic.

Jessie Inchauspe is a biochemist, bestselling author, and founder of the Glucose Goddess movement, who’s helped hundreds of thousands of people improve their health by making cutting-edge science accessible.

Dr. Sarah Berry is one of the world's leading experts on human nutrition, who has personally run over 20 randomized clinical trials looking at how humans respond to different fats.

If you want to uncover the right foods for your body, head to joinZOE.com/podcast and get 10% off your personalized nutrition program.

Transcript

[00:00:00] Jonathan Wolf: Welcome to ZOE science and nutrition, where world-leading scientists, explain how their research can improve your health.

Biochemist, Jessie Inchauspe, heads into work one morning at a genetics lab in California. During the morning meeting, management offers staff the chance to self-test a new medical device. Jessie accepts. Unusual, sure, but not entirely out of the ordinary where she worked, but Jessie couldn't have known this device would take her on a journey of discovery to reshape her health and help countless others do the same. The device was a continuous blood sugar monitor, and it was this, combined with her academic background and a remarkable willingness to use herself as a lab rat that led her to a realization. Much of the food she was eating, was creating havoc with her blood sugar. She should stop worrying about calories and start understanding how her body responded to the food. She ate.

In today's episode, I'm joined by Jessie and Dr. Sarah Berry, who has carried out dozens of clinical trials, looking at blood sugar responses to different meals. Together, we will explore how blood sugar impacts our health. We'll also discover Jessie's simple hacks to control blood sugar spikes and crashes and find out the real reason why breakfast might be the most important meal of the day for your health.

Jessie and Sarah, thank you for joining me today. And why don't we start with our usual quickfire round of questions from our listeners? So Sarah, do blood sugar spikes and dips matter for our long-term health. 

[00:01:42] Sarah Berry: Yes. 

[00:01:43] Jonathan Wolf: If you've had a diet high in sugar and you're in midlife, can you reverse the damage?

[00:01:49] Sarah Berry: Partially. 

[00:01:50] Jonathan Wolf: Could I react very differently to you to cereal, for example, for breakfast? 

[00:01:56] Sarah Berry: Absolutely. By about a tenfold difference, possibly. 

[00:02:00] Jonathan Wolf: Amazing. And Jessie is sugar a poison to the body. 

[00:02:04] Jessie Inchauspe: Yes. 

[00:02:06] Jonathan Wolf: Controversial, we'll discuss that some more. Has understanding your blood sugar changed how you eat?

[00:02:12] Jessie Inchauspe: 100%. Absolutely.

[00:02:14] Jonathan Wolf: If we eat our food in a different order, does it change our blood sugar responses? 

[00:02:19] Jessie Inchauspe: It can change it by up to 75%. 

[00:02:22] Jonathan Wolf: Amazing! So Jessie, what's the biggest misconception surrounding blood sugar? 

[00:02:28] Jessie Inchauspe: That in order to have steady blood sugar, you have to give up eating all starches and all sweets. 

[00:02:34] Jonathan Wolf: Brilliant. And I'm sure we're gonna talk quite a lot about this. All right. Why don't we start at the beginning? Sarah, can you explain what is blood sugar? 

[00:02:42] Sarah Berry: Yeah so, blood sugar typically refers to the level of glucose that circulates in our blood. And this is mainly determined by the foods that we eat. So when we consume foods or meals containing carbohydrates, they're broken down into very simple molecules called glucose, and we tend to use the term blood sugar when we're talking about blood glucose.

And so when you consume a meal containing carbohydrates, what happens is that after about 30 minutes, you get this quite big increase in circulating blood sugar that returns to baseline around two hours. And so imagine how we typically eat, where we consume multiple meals and multiple snacks throughout the day. This means that your blood sugar levels are going up and down and oscillating all around throughout the day. 

[00:03:29] Jonathan Wolf: And Sarah helps us understand what it's for. Why do we have blood sugar? Why are we even bothering to have a podcast to talk about it? 

[00:03:35] Sarah Berry: Obviously we eat. And most of us eat foods that contain carbohydrates. So every person every day is experiencing these oscillations, these peaks, and troughs in blood glucose. So this is relevant to everyone listening. And the reason that it's particularly important. This is because we also know that these increases and these dips in glucose play quite a large role in disease.

We know that if you have excessive peaks, it causes whole downstream effects of oxidative stress inflammation, for example. And so not only does it increase our risk of type two diabetes, which most people associate blood sugar with, but it also increases our risk of any disease that's underpinned by inflammation, and this can include cardiovascular disease, some cancers as well, for example.

[00:04:26] Jonathan Wolf: And so why do we have blood sugar at all, Sarah? I've heard all of these bad things about it. So should I get rid of blood sugar? 

[00:04:33] Sarah Berry: No so you have it, like I said, because obviously from the food that you eat, but you also need sugar in your blood to provide fuel for your muscles to function for your tissues, for your organs to function. So it does have a role to play where the problem comes in my opinion where you have excessive spikes. You have these excessive peaks and these excessive dips in blood sugar. So what we don't want to do is encourage everyone to flatline, but it's when it becomes uncontrolled. 

[00:05:01] Jonathan Wolf: Just to help us understand Sarah, could I function if there was no blood sugar in my body?

[00:05:07] Sarah Berry: No, you need a certain amount of it. And particularly for brain function.

[00:05:12] Jonathan Wolf: Got it. So like no blood sugar. I die. 

[00:05:15] Sarah Berry: Yes. 

[00:05:15] Jonathan Wolf: Okay. So we need it. So that sounds good. And then we talk about maybe sometimes too much of it might be bad and I think that's what we're going to explore now. Thank you, Sarah.

One way we can explore this is there's this new sort of blood sugar monitoring device, right, Jessie? That you can wear at home that can measure your blood sugar every five minutes. Could you tell us about it and your own experiences with it? 

[00:05:37] Jessie Inchauspe: Yeah, absolutely. So the first time I wore a continuous glucose monitor was about 4 years ago and it completely changed my life because I realized Jonathan, that glucose spikes, so these rapid increases in your blood sugar concentration after we eat were actually one of the triggers for my difficult mental health episodes that I had been experiencing since I was a teenager. So I finally had found a cause or a trigger for something that had been plaguing me for a really long time.

And with this glucose monitor, I was able to see how what I ate, how I moved, how I slept and all of these other variables were impacting my glucose spikes. And it's pretty cool, you know, on your phone to be able to see that your blood sugar levels are responding to how you're living. And to me, it was a bit like finally being able to communicate with my body.

Finally feeling like I had a channel, it was open communication. There was a dialogue. I could see what was happening underneath my skin. And so it really fascinated me, firstly, because I wanted to heal myself and not experience these mental health problems anymore. So I dove into the research and I actually discovered that I wasn't alone that about 80 to 90% of the population experiences glucose spikes every day. And then. I discovered these really easy tips that allowed me to avoid these spikes, feel better without giving up carbs, and eat sugar and pasta, which I love. 

[00:07:06] Jonathan Wolf: So it sort of gave you suddenly this insight into something that was going on inside your body, which previously you were feeling these results, but you had no idea what was going on.

[00:07:13] Jessie Inchauspe: Yeah, it was a bit of a black box. I didn't understand how what I was eating and what I was doing was impacting how I was feeling. So it was really a light bulb moment for me. It completely changed my life. 

[00:07:22] Jonathan Wolf: And you've talked about your particular experience about how it links to mental health, but maybe we just step back and talk more broadly about how blood sugar affects our health. So I think we've already established that if you have no blood sugar, you're dead. So that's not a good place. What about the other side?

[00:07:37] Jessie Inchauspe: I think there's an easy image we can use. Imagine that you're a plant. If we give a plant too little water, the plant dies. That's what Sarah was saying. No blood sugar, you die.

But if you give a plant too much water, the plant drowns. So it's about finding the right middle ground and for humans, it's the same thing. Yes, we need glucose. Every single one of our cells uses glucose for energy for performance function. But if we give ourselves too much glucose, then problems start arising.

And there's a wide array of symptoms that you might feel if your glucose levels are imbalanced. If you're experiencing these glucose spikes on a daily basis, and the most common ones are experiencing cravings, becoming hungry very quickly, after a meal, so within 90 minutes or 2 hours feeling like you really need to eat again, having energy dips throughout the day.

So, you know, feeling a bit controlled by this sort of rollercoaster, you eat something high in carbs, then you crash and you're hungry. You have cravings, you're tired and sort of staying on that rollercoaster, and in my own experience and in my community, those are the most common symptoms that anybody can feel and anybody can relate to even without wearing a glucose monitor.

And then if you look a bit more medium term and long term, you know, glucose spikes have been associated with hormonal dysfunction, conditions like polycystic ovarian syndrome. And Sarah, I know you did a lot of research into menopause. Acne, poor sleep. There's a correlation between weight gain right there, and then the long-term, of course, type two diabetes.

And as Sarah mentioned, because glucose spikes lead to inflammation, they really create a very favorable terrain for all chronic diseases to develop.

[00:09:12] Jonathan Wolf: I just wanted to ask about flat blood sugar. So, because I think one of the natural consequences, I think if you're listening to this is okay, this all sounds bad. So presumably my ambition is to have completely flat blood sugar throughout the day. Is that the right takeaway? 

[00:09:28] Jessie Inchauspe: So no, because you can actually have a very flat blood sugar while eating things that are really unhealthy. So let me give you an example. If you add a lot of alcohol to your diet, it's gonna flatten your glucose curves.

If you add a glass of wine to your meal, it's gonna flatten the glucose spike of that meal. Similarly, if you add a lot of fat to a meal and this can be, you know, very unhealthy fat like trans fat, that's also gonna flatten the curve of the meal. But that does not mean that you're actually helping your body be healthier.

So in my mind, it's not about trying to reach for this perfectly flat line because that's an objective that can be abused. Really, what we're looking at Jonathan is trying to just reduce this roller coaster sort of flats in the spikes. Minimize the dips as well by using simple hacks. And we don't need to be super anal about it and go for something incredibly flat.

We just need to think, okay, based on how I feel today, could I feel better? And if the answer to that is yes, you can start applying these hacks flat in your glucose curves and start getting the benefits. 

[00:10:32] Sarah Berry: Yeah, I mean, I want to kind of second that, because I think this is one thing that worries me about this explosion in healthy individuals using continuous glucose monitoring, which I think is highly valuable, but I think that people need to use them in an informed way.

And what thing that I worry about is people being obsessed with flat lining and exactly as Jessie said, Jonathan is then selecting these very unhealthy, highly processed high-fat foods and going into keto diets, which are based on incredibly unhealthy aspects of a keto diet. And I think that's really important that people make sure they still consume a balanced diet.

They can still consume carbohydrates, but there are ways. And I think Jessie can talk about this in a lot more detail. There are ways that you can do this in a way that doesn't have downstream unfavorable health effects. 

[00:11:21] Jonathan Wolf: I guess the message is, if you just think about one thing and then you don't think about what you're switching to, you could easily go from something that is actually worse than where you were before. And I guess if you're not eating any carbohydrates, you have to eat fats. And if you're not eating really healthy fats, you're potentially in the worst place.

[00:11:39] Jessie Inchauspe: And something else. Jonathan, when I first wore a glucose monitor, so I was noticing that you know, alcohol and high-fat foods were keeping my glucose levels, steadier and flatter.

And I also noticed that exercise created glucose spikes. So if I had just focused on keeping my glucose levels steady, I would've stopped working out and started drinking heavily and eating a lot of fat. 

[00:11:59] Jonathan Wolf: It sounds like, no, I think this is a diet that many people would love to follow Jessie. You're not recommending it?

[00:12:03] Jessie Inchauspe: No, absolutely not! So I completely agree, Sarah, we really need information, And, you know, that's what I've spent the past several years of my life trying to do is like distill the useful parts of using glucose to make informed food decisions while also nuancing, giving context. And there's a chapter in my book, it's one of the first ones and it says what not to take away from your glucose levels. It's incredibly important and it's a complex subject. And if you're just thrown into it and you get a glucose monitor and you haven't read anything about this topic, you might be very confused. It's quite difficult data to interpret, and you might start, you know, drawing conclusions that are actually not good for your health.

So if you wanna wear a glucose monitor, check out my work, you know, I have lots of stuff for free on Instagram. I also have a book, but that'll give you context so that you can go into it armed with the right information. 

[00:12:52] Sarah Berry: Yeah. And just to add to that as well. I think it's also important that people are aware in this context that it's one piece of a big puzzle that it's not the only thing that drives our health.

It's not the only thing that will determine our cardiovascular type two diabetes, or obesity risk. It's an important piece of the puzzle and it interacts with the other important pieces of the puzzle. So it interacts with our blood fat control. It interacts with our microbiome, for example, but we also need to consider the bigger picture as well.

And what's great about, you know, wearing a CGM and being able to monitor your glucose is you can do that in real time and you can have some control yet, a lot of the other risk factors you can't measure and monitor and modify it in the same way. But I think it's really important. People know it's one piece of a big puzzle, and I think that's, what's great with, you know, the work that we're doing at ZOE is that unlike what's been done previously in research where we tend to focus on one exposure, you know, so one risk factor, for example, blood glucose, and one outcome. We've been looking at all of the pieces of the puzzle where, and we can see how important the blood sugar is for different individuals, how important your microbiome is and how it all interrelates.

[00:14:03] Jonathan Wolf: So, can we talk a bit about menopause now you were talking about changes in these blood sugar responses?

[00:14:08] Sarah Berry: Yeah. So we've done some great research on the ZOE PREDICT studies, where we've looked at how menopause impacts a whole host of factors. We know that menopause is this state of, you know, great upheaval and causes lots of symptoms that people feel physically, whether it's hot flushes, whether it's lack of sleep, brain fog, et cetera.

But what we also wanted to look at is how menopause impact how we process our carbohydrates. How does it impact our blood glucose levels? And interestingly, we found that postmenopausal women have a really big increase in circulating blood glucose levels compared to premenopausal women, even when we match their age.

And this is really important because this shows it isn't just an age-related change that happens anyway. As we age, sadly, we do all put a bit more weight on, we do increase our blood pressure, et cetera. But what we found is when we matched people for their age, we still found this big difference between the pre and post.

And we also saw this big difference as well as in the peaks. So these peaks that we know are really important in terms of inflammation and oxidative stress. We saw a big difference as well in the dips. The difference in the dips was a lot more pronounced in postmenopausal women than premenopausal women.

[00:15:29] Jonathan Wolf: So if I'm listening to this and that describes me, what does that mean about what I should be doing differently? What does it mean about how my body is gonna be reacting? If I say eating the same food that I was eating for the last 20 years. 

[00:15:41] Sarah Berry: Yeah. And I think this is something, everyone, certain people, my age, I'm the mid-40s and sadly myself, many of my friends are going through this perimenopausal transition.

And it's something that everyone talks about now, thankfully, that we weren't talking about in previous generations and people say exactly what you said, Jonathan, but I was eating exactly the same foods that I've met for the last 20 years, but I'm putting weight on I'm feeling a bit rubbish. And interestingly we have, did actually see from the ZOE PREDICT research that postmenopausal women were tempted to eat more sugar and more carbohydrate, rich foods. But I think what's really interesting with this is that we know that it's the peaks. We know that it's the dips that are changing postmenopausally and we know that there are things that we can do about it, so we can either suggest to people, okay, try and modify the types of food we're having or we can suggest to them the kind of hacks that I think Jessie will talk about a little bit later, that would also be able to modify the peak. So you can say, okay, carry on with the food you're having, but do these hacks as well. So you can attenuate that. So it's just saying you are at higher risk. 

[00:16:44] Jonathan Wolf: So fundamentally Sarah, you're saying, I just wanna make sure that this is clear. I might be eating exactly the same breakfast, say that I was eating 15 years ago. 

[00:16:53] Sarah Berry: Yep. 

[00:16:53] Jonathan Wolf: And before I, wasn't having very big peaks with it. My body could deal with this and now I'm having perimenopause or menopause, and I'm having the same food that I'm having these much bigger peaks. And then these are having the impacts that you were talking about before?

[00:17:06] Sarah Berry: Yeah, absolutely. So basically menopause just is really blooming unkind to us women and it does mean yes, 20 years ago you could have had exactly the same pain au chocolat or whatever, and then you have it post-menopause and you are having a very different response. 

[00:17:22] Jessie Inchauspe: And you're also increasing your cravings for the same food, right?

You're eating the same food, but your dips are now bigger probably. And this also, we see this, even in people who are still menstruating the week before their period, your glucose control is not as good. So the same food that you had just a week ago is gonna create a bigger spike and likely a bigger crash. So the same usual food is just creating cravings, where it wasn't creating them before. 

[00:17:47] Sarah Berry: That's really interesting, Jessie because new research that's very hot off the press, Jonathan. We only crunched the numbers yesterday that we've done from our ZOE health studies data, where we had hundreds of thousands of pre and postmenopausal women telling us about their diet and telling us about their menopause symptoms.

And what we found is that people that had higher intakes of sugar-sweetened beverages, so basically sugary drinks had a lot worse symptoms. And so you are getting these cravings that you said Jessie, it's craving them. People are having cravings to have more sugar-sweetened beverages, and then that's acting to then just make their symptoms worse.

And the kind of symptoms it was making worse were the ones that people find most burdensome things like the brain fog, the hot flashes, the anxiety, for example.

[00:18:32] Jonathan Wolf: And so are you suggesting that if you switch what you're eating then potentially, and I know you're not saying this is proven from the, say this, but potentially that can impact your symptoms?.

[00:18:40] Sarah Berry: Yes, based on the research that we looked at or the data that we looked at yesterday, there's a really strong association between the foods that you are eating and the severity of your symptoms. And this is the first data or first study to ever look at that, which is super exciting. 

[00:18:57] Jonathan Wolf: That's amazing. And not yet peer reviewed and published, I guess we should add in that case, Sarah.

[00:19:01] Sarah Berry: No, these numbers were literally crunched yesterday. So this is a real kind of preview. 

[00:19:07] Jonathan Wolf: We're getting a preview. 

[00:19:08] Jessie Inchauspe: I feel so VIP right now.

[00:19:09] Jonathan Wolf: That's good. Well, I know scientists are normally rather cautious, about what they talk about. 

[00:19:14] Sarah Berry: Not when it's this exciting, Jonathan, 

[00:19:16] Jonathan Wolf: Not when it's this exciting? No, that means Sarah feels very confident. 

[00:19:19] Sarah Berry: Yes. 

[00:19:19] Jonathan Wolf: And other than menopause, do we also see a lot of personalization elsewhere, or is this specific to that situation? 

[00:19:27] Sarah Berry: So we see huge differences in individuals. And I touched on this at the beginning, that from the PREDICT program of research, one of the key aims is actually looking at how different are people.

So in nutritional research and population-based guidelines, we typically have a kind of one size fits all approach. And what we're trying to do at ZOE is move beyond that one size fits all because we know that we're all individual. We have, all of our thousands of biochemical processes are slightly different.

And when we look at people's blood glucose responses in our PREDICT studies to identical meals, again, in this very tightly controlled setting that I mentioned, Jessie earlier, we see there's a huge difference. We see probably, you know, more than a tenfold difference between individuals and these are healthy individuals that we recruited into this study consuming exactly the same breakfast.

And I think what I find particularly fascinating as well as the size of the variability in responses to the same meals is that the variability is real, so much greater in this, what we call a postprandial phase. So it's so much greater in the 2 hours. After consuming the meal compared to fasting. And the reason I think this is really interesting is that what this allows us to do is for people like myself and Jessie, for example, might have exactly the same fasting glucose.

Exactly the same HbA1c, which is a measure that is often used clinically to look at people's blood glucose control. But if we were to consume exactly the same breakfast, Jessie might have a really high response and I might have a really low response. Now we wouldn't have seen that by just measuring fasting levels.

And this is what I think excites me a lot about the blood glucose variability that we see from the PREDICT studies, that we see so much bigger variability in the postprandial, so this 2-hour, post-eating the meal phase. So it allows us to discriminate long before anything's played out in that fasting state. So it gives us a real peek into the future also of someone's long-term health, I think. 

[00:21:30] Jessie Inchauspe: It's very cool. And, you know, you mentioned Sarah, if we both had the same breakfast, we would probably see very different responses. And I think that's really interesting and it's fascinating and it's really cool once you're able to get into that phase of sort of personalization. And I would also say for people who do not have access or the ability to see their own glucose spikes and how they might relate to like their friends or their partners, or, you know, yours, Sarah of mine, there are hacks that everybody can use.

Regardless of what the height of your spike would be, if you used one of the hacks, your spike would be smaller. So Sarah, if you and I both had cereal for breakfast and I had a much bigger spike than you, if we both used, let's say the hack of having vegetables first, both of our spikes would be smaller. So in my mind, people often ask me, how much of this is personalized? How different am I really? And do we have general principles that can apply to everybody? And I believe the answer is yes, you have a baseline of like easy principles and then you can get into the personalization. I don't know how you feel about that, Sarah.

[00:22:34] Sarah Berry: Yeah. I mean, this is what I think's really exciting that traditionally, I think people have always thought it's all about what you eat. So the foods that you are eating are what determine your response. That's it, it's all set in our genes. You know, I was a child growing up in the 70s where my mom said, well, everything's predetermined by your genes, and what our research shows, which is really exciting is that your blood glucose response is not just about who you are, but it's also about how you eat. And I think some of your hacks are great on this, and it's also about what you eat. So it's who, how and what, and I think that's really empowering for people because there will be people that don't want to change the food they're eating so they can adapt how they're eating it, for example. 

[00:23:14] Jonathan Wolf: And I think it's a brilliant point, actually. So let's talk about that. We like talking about actionable advice on this podcast. So what can we do to control our blood sugar? And maybe let's start with what we eat because I think that is the most obvious Sarah. And then let's talk about all those other things that we can do after that.

[00:23:30] Sarah Berry: So I think Jessie, you are best placed to maybe talk about this. And what I'd love to do is also jump in Jessie on a few examples where we've actually applied your hacks within our PREDICT studies. So we have some mini protocols in our PREDICT studies and some of the results that I think would be interesting to let you know again, hot off the press.

[00:23:49] Jessie Inchauspe: Nice. Oh my God. This is so exciting! I didn't know I was gonna get all this cool data. Okay. So I think, the easiest hack, which is very simple for people who actually don't wanna change what they're eating, cuz that can feel a bit daunting in the beginning is actually simply looking at the order in which you're eating the constituents of a meal.

So in the studies. They found that just by eating your food in the right order, during a meal, you can reduce the glucose spike of that meal by up to 75% while still eating the exact same foods. And this has a tremendous impact on your physical and your mental health. And so the correct order is, during a meal, vegetables first. Proteins and fats second, and then starches and sugars last. And one of the main reasons this works in reducing the glucose spike of the meal is thanks to the effect of the fiber that is in the vegetables and that fiber will reduce the speed and the quantity of glucose absorbed for later on in the meal and then proteins in fat.

Second, we know those also slow down gastric emptying and digestion speed. And so overall, if you're eating your meal in that correct order, you'll have a smaller glucose spike. And that means fewer cravings being less hungry or a few hours later, fewer energy dips, and then whatever symptoms you're contending with, you know, maybe it's difficult menopause symptoms. Maybe it's like acne, maybe it's just generalized inflammation. Those will also be able to be reduced when you use the food order hack. And Sarah, is that a hack, you guys have been testing? Because I'm so curious. 

[00:25:20] Sarah Berry: That is a hack we've been testing. So we've had lots of our participants who have tried the food ordering hack, where they have cheese, they wait 15 minutes and then they have white bread and this is fasted. So it's a little bit controlled. And then the next day. They just have the cheese on the bread. So they have exactly the same food, but they don't have that 15-minute break. And we do see a significant reduction in their blood sugar, and blood glucose response. 

[00:25:47] Jessie Inchauspe: Nice. And for those listening, you don't have to wait 15 minutes, even if you just reorder and have veggies first and carbs last you'll still see an improvement in the glucose response. Cause I think for most people waiting 15 minutes would be pretty impractical. 

[00:26:00] Sarah Berry: Yeah. I mean, we were doing this to really kind of show the proof of principle. And that was a question I wanted to ask is, could I have my mixed meal where maybe I have my bit of pasta or rice, some chicken and some vegetables. Can I literally just eat my vegetables and then straight away the next minute, start onto my protein, my chicken, or whatever. And then straight away, start on the pasta? 

[00:26:22] Jessie Inchauspe: Absolutely. So, you know, it's a spectrum. So if you were to wait 15 minutes between each constituent, you would see a greater effect, but also if you just eat them one after the other, you will still see a pretty good effect as opposed to eating them all together or starting with the carbohydrates. So it's always a spectrum. You can always do a bit worse for your glucose and a bit better for your glucose, but if you just reorder and eat everything in sequence, you will still see a pretty big impact.

[00:26:47] Sarah Berry: So let's say we're out in a restaurant and we're having a starter. If I was to consume maybe a starter that was either vegetable-based or protein based. And then I was to have, as typically would happen. It would be about 15 minutes later that your main course would come when I'm consuming that main course. Could I consume everything kind of all mixed in at once having at least before that having had either my vegetable, my high fiber, or my high protein and fat starter?

[00:27:15] Jessie Inchauspe: So you don't need to do anything. You can decide how much you wanna use the food order hack. 

[00:27:22] Sarah Berry: But would that work still? 

[00:27:24] Jessie Inchauspe: Yes, it would work. Absolutely. 

[00:27:25] Sarah Berry: Okay.

[00:27:25] Jessie Inchauspe: And your example of adding, I just wanna mention, because sometimes people can feel like, oh, does this mean I have to separate out every single dish, you know, deconstruct every sandwich and no, that's not the point. The point is using this information. Easy. And so Sarah, the fact that you mentioned the starter is actually the hack I was about to talk about. So we're just super connected. The other hack just adds a starter that is built around vegetables and vegetable-based starters to all of your meals and then eats your regular meal as you would usually. That's just another way to use that same principle of fiber first to impact your glucose curve. And so let me give you an example. If you're having like a mixed dish, let's say you're having, you know, pasta with chicken in it and maybe, you know, parmesan and some cauliflower you can just add a veggie starter, like a green salad, maybe some vinegar at the beginning of the meal, and then eat the mixed main dish and still get a really big impact. And that'll be better than not having the vegetable starter. And you can compose with it as you wish. Does that make sense? 

[00:28:26] Sarah Berry: Yeah, absolutely. Thank you. 

[00:28:28] Jessie Inchauspe: Yeah, of course. Of course, of course. 

[00:28:31] Jonathan Wolf: So what other than food orders, can we do Jessie? 

[00:28:33] Jessie Inchauspe: I want to mention vinegar because this was quite shocking to me when I saw the clinical studies that were looking at the impact of vinegar on your meals, glucose spike.

So if you have a tablespoon of vinegar, it can be any type of vinegar. Avoid balsamic glaze, because that has a bunch of sugar in it. If you have a tablespoon of vinegar before a meal, either in a tall glass of water and you drink it, or as a dressing on your starter, for example, you can curb the glucose spike of that meal by up to 30% without changing anything of what you're eating during the meal.

So you're just adding this vinegar ingredient. And the way it works is because vinegar contains a magical molecule called acetic acid that has a few impacts on the body. One, it slows down the breakdown of starch into glucose, and two, it encourages your muscles to uptake more glucose as it arrives in your bloodstream.

And so, as a result, the glucose spike of your meal is smaller, but you didn't change anything about what you were eating and there are some really early studies that show, for example, the impact of just adding two vinegar drinks a day on glucose levels on diabetes markers, also on polycystic ovarian syndrome symptoms.

And they seem to have a pretty good effect, small studies of course, for these specific diseases. But overall, we understand the mechanism and it's really easy. And personally, this has helped me hugely with my cravings. If I have a vinegar drink before a meal, I know I'm gonna be curbing those sugar, and chocolate cravings that usually happen for me an hour and a half after meals.

And something else that I find really cool about this topic is that vinegar has been used for millennia in many cultures around the world, for example, in Iran and people know, culturally that it's a healthy thing to have in our diets, but they didn't understand why. And now we have some clues that it has something to do with glucose levels.

[00:30:29] Jonathan Wolf: And Sarah, this sounds a little controversial. What are your thoughts on vinegar as the magic solution for our blood sugar? 

[00:30:34] Sarah Berry: So I must say I was very skeptical. I thought, oh my gosh, this is one of those quacky food things. So yeah, I did go and check out the research and I have to admit I was wrong in my opinion.

And yeah, the evidence seems quite good on this. So I think it's a great hack. If you'd asked me two weeks ago, I wouldn't have said that. 

[00:30:58] Jonathan Wolf: And are there at this point, are there any randomized control trials actually showing sort of the long-term impact? Cause I guess this is always the question, which is you can see an impact on your blood sugar, but you don't actually know what the long-term health impact. Have they reached this at this point or is this sort of upcoming? 

[00:31:13] Jessie Inchauspe: There are a few like six-month-long studies, but I think those are the longest ones.

[00:31:18] Sarah Berry: While we're on vinegar. I think something to ask, and this is more for something I don't know about for people that they want to go away and do this and want to have a tablespoon of vinegar before every single meal. And let's say they're consuming a typical kind of the UK eating style where it's 3 main meals, you know, in 3 snacks, you're having 6 eating events throughout the day.

If they were to have then 6 tablespoons every day before a meal, are there any possible side effects to this? So I'm just being cautious because I know that people will take these recommendations. And I don't know the answer, and I know, because you've researched this a lot, hopefully, you will have the answer. 

[00:31:56] Jessie Inchauspe: Of course. So there are a few key things to keep in mind. One, always dilute the vinegar in water. Two, you can use a straw because that'll be better for the enamel of your teeth. So, in the literature I was looking at, are there any side effects? Can you overdose on vinegar? Like what's the situation. And the only thing I found is a woman who was consuming, I believe 30 tablespoons of straight vinegar for a few years and started having potassium deficiencies. So that's the only thing I have found and vinegar, it's just another food. And, it seems there are no real side effects of having it several times a day. Of course, listen to your body. If it doesn't agree with you, you know, stop. Personally, I do very well, if I have it 3 times a day, you don't need to have it before every single meal. For example, you know, I'll have some vinegar. If I see it on my counter, in my kitchen, and I remember to do it, or if I'm like, Hmm, I could have a little vinegar drink right now, but how much you apply it to your life is really a function of how you're feeling, how much you think you have glucose spikes happening all the time, and then how much you enjoy it, because if it's stressful and you don't like the taste, like don't even force it. But from a pure health perspective, that don't seem to be any side effects of having vinegar multiple times a day. 

[00:33:11] Sarah Berry: Okay. And one more question on this topic. Are you talking about the kind of table vinegar that in the UK, for example, we would put on our fish and chips, or are you talking about a different kind of vinegar?

[00:33:21] Jessie Inchauspe: Very simple, like table vinegar that you buy, that you put in the salad dressings that you put on your chips. Definitely do not buy the vinegar that's with the cleaning products, in your supermarket. That's 6% acetic acid and that's too strong. You're just looking for the regular vinegar that you might see on the table at the restaurant that you might use when you're cooking.

[00:33:41] Sarah Berry: So like a white wine vinegar, red wine vinegar.

[00:33:43] Jessie Inchauspe: Absolutely. 

[00:33:43] Sarah Berry: Okay. 

[00:33:43] Jessie Inchauspe: White wine vinegar, red wine vinegar, cherry vinegar, apple cider vinegar. 

[00:33:48] Sarah Berry: Yeah. 

[00:33:48] Jessie Inchauspe: Any type of vinegar, rice vinegar, plum vinegar. It's really about the acetic acid and it's present in all types of vinegar. So you're fine. 

[00:33:57] Sarah Berry: Well, I've got a great idea for our next research, Jonathan. That all of these hacks, I think we should try and see how it affects glucose dips.

[00:34:05] Jessie Inchauspe: Oh my God. Yes, please. Let's do it. 

[00:34:08] Jonathan Wolf: You heard it here first for sure. 

[00:34:09] Jessie Inchauspe: You heard it here first! 

[00:34:09] Jonathan Wolf: You heard it here first, for sure. So just before we go to the next hack, I'm conscious that there'll be people listening here saying, okay, but I'm open to changing what I eat and I'm actually not at all clear what foods really affect my blood sugar.

So could we sort of address that also for a minute? What should I be eating, if I want to reduce these spikes? I am maybe concerned, I feel like I'm having these. What's causing it? What could I shift to?

[00:34:32] Jessie Inchauspe: Yeah, absolutely. So the 2 main types of food that contain glucose are starchy and sweet foods. So put very simply, if you reduce the quantity of those in your diet, so if you reduce, you know, bread, pasta, rice potatoes, and you reduce also sweet foods, desserts, sugar, you know, fruit juices, fruit products, you're gonna reduce the glucose spikes in your body, but then it's really important to not, sort of replace those with unhealthy processed foods that might keep your glucose level steady, but are really high in fat, for example.

So the one place Jonathan that I think is actually really, really valuable and important to change what you're eating. And this is the place with the biggest bang for its buck is breakfast. So at breakfast, if you're able to switch from eating sweet and starchy foods to eating, savory foods based on protein, this is going to have a humongous impact on how you feel for the rest of the day. As Sarah mentioned, it's gonna control your glucose dips and spikes for the rest of the day as well. So that's the only hack where I really encourage people to truly change what they're eating, going from sweet to savory.

[00:35:40] Sarah Berry: Jessie, some of what you are suggesting here is at odds with what people are told about whether they have their carbohydrates in the morning or afternoon. So I just love your opinion on this. So we've seen again in our ZOE PREDICT studies, but also there's been other published research on this that shows that you have better glycemic control in the morning.

And so, you know, many people might be aware that if you do want to have carbohydrates, have it in the morning. Because we see a lower blood sugar response in the morning compared to if you consume it later in the day. And we see this with our own research, although it's very variable between individuals.

And so this is something I often advise people who are worried about, but now that's so odds with that. So how do we not give contradictory advice? 

[00:36:27] Jessie Inchauspe: I think one of the problems with that is that you're looking at it in a vacuum, right? So you're looking at cookie at 9:00 AM versus cookie at 6:00 PM. And it says, oh, 9:00 AM cookie is better. But you're not necessarily thinking about what the impact of a 9:00 AM cookie is gonna have on the rest of your day. And that the 9:00 AM cookie is gonna create an 11:00 AM crash and an 11:00 AM craving, and you're gonna be hungrier for the rest of the day. So I believe that the benefits of eating, you know, your carbs earlier in the day, do not outweigh the benefits of having a savory breakfast.

So I personally have seen it, I recommend it. You have a savory breakfast, and if you do wanna eat carbs actually, or something very sweet, for example, a cookie best time to do that is as dessert after lunch or dinner, because I believe the 9:00 AM 6:00 PM, time of day thing is just less impactful than using the food order and having a savory breakfast.

But there are a lot of different pieces of advice and it can be confusing to put them all together for sure. 

[00:37:25] Sarah Berry: Yeah. That's why I just want to get your opinion on that. I think that's really helpful because I want to make sure, you know, we do other podcasts where we'll talk about the time of day. So it's really important we make sure that we are giving unified advice. 

[00:37:38] Jonathan Wolf: So I think we have time for one final hack, Jessie, which you touched on a little bit, which is about exercise.

[00:37:43] Jessie Inchauspe: Mm. Yes. Okay. So Sarah mentioned at the beginning of the podcast that, you know, glucose is your body's source of energy and your muscles specifically are really happy to use glucose if you need them to contract. So a very simple hack is after your meals, use your muscles for 10 minutes, this can be walking, it can be dancing. It can be whatever. Folding your laundry, cleaning your apartment, whatever you wanna do for 10 minutes. Because as you exercise and contract your muscles, they will soak up glucose from your bloodstream to power themselves.

And as a result, the glucose won't accumulate as much in your bloodstream, but rather will be used for energy directly. So within an hour, After the end of a meal, just get up. Move for 10 minutes. You'll see a big impact on your glucose levels and on how you feel. 

[00:38:32] Sarah Berry: Jonathan, there's one other hack that we did in our ZOE PREDICT studies, that is actually one that Jessie has as well in her book. So I would quite like to mention that, and this is about food combinations. So we had individuals on one day having just white bread for breakfast. Then on another day, layering onto their white, red, some cheese, and some spread. And so each day they were consuming an identical amount of carbohydrates.

But one day they had the added fat and protein, and we saw a significantly lower increase in blood glucose levels when they layered on the fat and protein. And I know this is something that you talk about as well, Jessie, and about how you combine your foods. 

[00:39:15] Jessie Inchauspe: Yeah, I talk about don't leave your carbs naked. So always put some clothing on your carbs.

So protein, fat, or fiber. And so anytime you're eating something starchy, like white bread or something, sweet, make sure you add protein, fat, or fiber, because that way the glucose from the starchy, the sweet food, won't hit your bloodstream as quickly. And as a result, you'll get a smaller spike. Now there's a little caveat to this because, you know, we mentioned just adding some fat to your carbs. Don't add 2 pounds of butter to a piece of white bread, because that might cause you to know, other downstream consequences. So the best clothing is really fiber. Then second, best I would say is protein and third best and make sure it's a healthy fat, will be the fat. 

[00:39:56] Jonathan Wolf: I think we can keep talking about hacks for the rest of the day, but I think we better wrap this up.

So let me try and quickly summarize what was a very wide-ranging conversation. So to start with big blood sugar spikes over and over a bad, a lot of processed food, in particular, can cause these high blood sugar spikes. That said blood sugar is just one of the things that matter when we think about our diet. We shouldn't be trying to aim for flat blood sugar, otherwise, we would have the all-butter diet, and we'd have no blood sugar spikes. And no one that I've met so far says that the all-butter diet is, is a healthy diet.

[00:40:29] Jessie Inchauspe: All butter and all alcohol. 

[00:40:31] Jonathan Wolf: All butter and all alcohol, Jessie, yes. So, we'll call that the Jessie diet now 

[00:40:35] Jessie Inchauspe: No!

[00:40:37] Jonathan Wolf: So definitely something that we can't do. Menopause is one of the points in our lives where we can see a huge change in blood sugar responses, as well as other responses that Sarah talked about. More broadly, there's a lot of personalization. So some people have very high responses like me, other people, much lower. So that clearly affects how much you care about it.

And then we talked about some fantastic hacks for trying to manage your blood sugar better. And that breakfast is a place where you can really make a big change and have probably a big impact on your total blood sugar, throughout the day. We talked about a tablespoon of vinegar and it sounds like the full verdict is not yet in.

And then we talked about 2 vital hacks. I think one is to use your muscles for 10 minutes after eating. Go for a little walk, for example, do something in your apartment or your house. And finally, we talked about food combinations, so you can take whatever you wanted to eat. The piece of bread, add some high quality, fat, and protein to it, and actually, sort of improve the quality of that, you know, and, and lower the blood sugar spike.

Did I capture the hacks, Jessie?

[00:41:39] Jessie Inchauspe: Jonathan you're officially a glucose Goddess. 

[00:41:43] Jonathan Wolf: No one has ever said that to me. That's amazing. So just before we go, I've got a final listener question, from Gemma, on Instagram for you, Jessie. And she said, very simply, how do I stop craving so much sugar? 

[00:41:57] Jessie Inchauspe: Mm, well, Gemma, I think you'll find something quite interesting is that often when we crave sugar, we are actually being the victims of these blood sugar spikes and dips we're on this blood sugar rollercoaster.

And often the response to a craving is feeling shame about it, feeling guilty, or trying to apply willpower to sort of overcome it. And so what I would say Gemma, is looking at the root cause. See if using the hacks is something that you can easily do in your life. Because if you do, you'll be able to reduce your glucose roller coaster, and naturally your cravings should dissipate.

And what happened for me is that when I studied my glucose levels, my relationship to things I used to crave really changed instead of feeling this impulse, instead of feeling controlled by my cravings, I now could decide with joy and pleasure to eat the chocolate cake, the chocolate ice cream, the Nutella crepe, without feeling controlled by it. So hopefully as you balance your glucose levels, the cravings will dissipate and you'll change your relationship with sugar. 

[00:43:02] Jonathan Wolf: Amazing. Thank you both so much, Jessie and Sarah, I really enjoyed that and I think our audience will have had a lot to take away from this conversation. I hope we'll be talking again soon. 

[00:43:12] Jessie Inchauspe: Thank you both. Can't wait for my studies. 

[00:43:14] Sarah Berry: Fabulous. Thanks, Jessie. Great to chat with you. 

[00:43:17] Jonathan Wolf: Thank you. 

Thank you to Jessie and Sarah for joining me on ZOE science and nutrition today. We hope you enjoy today's episode. If you did, please be sure to subscribe and leave us a review, as we love reading your feedback.

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