July 10, 2020
Our research, published in Nature Medicine, has demonstrated that our responses to food are all unique and that a one-size-fits-all solution is unlikely to be the best approach for better understanding what are the right foods for your body. We believe that the answer lies in understanding your unique biology and retraining it through diet.
But where is the best place to start when it comes to understanding what your body needs?
We spoke to Melissa Groves Azzaro, RDN, owner of The Hormone Dietitian and author of A Balanced Approach to PCOS, to learn more about what she observes with her clients on a day to day basis. She works closely with women to help them gain control of their hormones naturally using a personalized, food-first approach.
Blood sugar levels rise and fall after every meal or snack we eat that contains carbohydrates. Our body breaks down these carbohydrates into simple sugar molecules, including glucose. Glucose is absorbed by the gut into our bloodstream, which results in increased blood sugar levels.
When this happens, our bodies should be able to handle it in such a way that blood sugar levels don’t end up being either too high or low.
Insulin is one of the main hormones involved in maintaining healthy blood sugar levels. It is secreted by the pancreas in response to elevated blood sugar levels and helps to facilitate the movement of glucose from the bloodstream into cells to be used for energy and storage (it acts like a key that ‘unlocks’ the door to your body’s cells).
A healthy blood sugar response is one where blood sugar levels don’t spike and can come down again fairly quickly after eating. Whilst an ‘unhealthy’ blood sugar response is characterized by a rapid spike in blood sugar followed by a dip below baseline levels, known as a blood sugar crash.
Some foods will cause a large rise in blood sugar and fat levels after a meal, whilst others will have a very small effect. There is also a huge variation in how different people respond to the same foods, which our research has shown to be influenced by a variety of different factors.
So there’s no question about it: balancing blood sugar is critical for many aspects of your health. Excessive, repeated blood sugar spikes and crashes can overwhelm your body's normal, healthy responses, and lead to harmful dietary inflammation which can negatively impact your overall health. But without a continuous glucose monitor, how can you tell if your blood sugar is out of whack?
In the short-term, a blood sugar crash can leave us feeling tired, irritable, and hungry.
“A big tell-tale sign is noticing a blood sugar crash, usually an hour or two after eating a meal high in carbohydrates. This happens when your blood glucose rises too high too fast and your insulin overcompensates, causing your blood sugar to drop rapidly.
You may feel sweaty, shaky, light-headed, or experience ‘brain fog’. Another sign is strong carbohydrate cravings, especially in the afternoon or evening — it’s usually a sign that you haven’t properly fueled your body throughout the day.”
Repeated often enough, blood sugar peaks and dips can result in a cascade of inflammatory responses, insulin resistance, and weight gain, which are associated with an increased risk of developing type 2 diabetes and cardiovascular disease.
Melissa often encounters the knock-on effects of poor blood sugar control in her clients, which can impact levels of cortisol (a hormone that regulates several critical processes throughout the body, including metabolism and the immune response), adding unnecessary stress to the body.
“Constantly riding the “blood sugar rollercoaster” can make you moody and tired and leave you craving carbs. When blood sugar is chronically high, it can also lead to high insulin levels, which can drive up testosterone levels, as is seen in the case of many of my clients that have PCOS”, she explains.
Our research has also shown that the huge variability in blood sugar responses is also associated with the types of microbes in our gut, with ‘good’ gut microbes being associated with lower dietary inflammation (which includes healthier blood sugar responses).
One of the hottest debates in the world of nutrition (including plenty of people on social media) at the moment is between those who believe that low-carbohydrate diets are key to balancing blood sugar, reversing insulin resistance, and losing weight and those who favor other approaches.
But does this advice work for Melissa’s clients?
“It depends”, she shares. “For men and menopausal women, lowering carb consumption may be beneficial. But I don’t recommend it for women of reproductive age, because eating too low carb puts stress on the adrenals and lowers sex hormone production. I find when my clients aren’t eating enough carbs, they’re irritable, anxious, not sleeping well, and wired but tired.”
"Carb tolerance is different for everyone - some people need a little more, some people need a little less. Some people do better with eating more of their carbs earlier in the day, some people do better with eating more low-carb throughout the day and including some slow carbs at dinner."
The reality is that different people can have very different results, even if they have the same diet. There is no one-size-fits-all approach here: what works for one person’s body may not work for yours.
Your genes aren’t to blame for most of these differences either, as data from our PREDICT 1 study suggests. Even identical twins – who share all their genes and much of their environment – can experience vastly different blood sugar responses when they eat the same meal.
Your responses to food may be unique, but they aren’t random. Our research has shown that your body’s response to the same food is similar each time you eat it under the same conditions (i.e. time of day, physical activity).
In her practice, Melissa finds that making sure a meal or snack is well-balanced (with protein, fiber, carbohydrates, and healthy fats) goes a long way in helping her clients maintain stable blood sugar levels.
“...most people aren't’ eating enough protein, especially for breakfast, which sets the tone for the day. You also want to make sure you’re getting plenty of fiber in the form of fruits, veggies, and whole grains to slow the rate the carbs get absorbed into your bloodstream. And finally, you want to add enough fat to keep you satisfied. My one nutrition “rule” is don’t eat carbs alone.”
So one of the best ways to improve blood sugar control is by eating foods that have the smallest impact on your blood glucose levels (or pairing them with other foods that minimize their impact).
This is a great place to start, but are there any ways you could go one step further to better understand how different foods affect your body?
"Currently the only way to know is to play around and experiment with what works best for you, gives you the most stable energy, keeps you satisfied. Which is why I'm so excited that soon there will be a test like the one ZOE has to offer that will help us get those answers faster, without all the trial and error."