Podcast

Sugar Is Making Us Fat, Tired, and Sick (Minisode #22) on Broken Brain with Dhru Purohit

Episode introduction

We’ve all heard about wine pairings, but what about food pairings? It turns out that when it comes to our body’s ability to digest food and manage glucose, there are data-back tips and tricks that can help you reach peak performance and energy. Dr. Casey Means of Levels helped develop Levels’ continuous glucose monitor, which helps individuals actively tracks these things in real time. As a guest on the Broken Brain Podcast, she shared advice on when to eat, when to fast, how to time your intake of carbohydrates, and how understanding your body’s response to food can change your life for the better.

Show Notes

Key Takeaways

16:35 – A finely-tuned diet

Even a plant-based diet can cause glucose spikes in the body. With a CGM, you can modify a diet you love to keep it from causing damage.

“I’ve chosen to be on a whole foods plant-based diet because it just achieves a lot of the things I want in my body for getting me the substrates that are going to lead to optimal biologic cellular function in my body. So it gives me the antioxidants I need. I get tons of fiber to help my microbiome be healthy. I’m getting lots of phytonutrients. I get Omega threes from nuts and seeds, etc. And so to me, it’s just what helps me feel great and helps me really optimize what I know about cellular biology. But the reality is that even with a diet that feels very, very healthy and whole, there can be collateral damage. And what I mean by that is you might be eating lots of healthy foods, but they still might be causing massive glucose spikes in your body. And so for me, glucose monitoring has helped me just really tailor this diet that I love and adore and make it not have that collateral damage and just make it as finely tuned for me.”

18:31 – Finding the proper food pairings

You could eat 200+ grams of carbs and still not suffer from a glucose spike when you understand how to pair your food properly. A CGM can help you understand what food pairings work best for you.

“I’m definitely choosing my fruits really carefully. And I’ve found a number of fruits that don’t spike my glucose at all. I tend to eat less ripe fruits now. So instead of eating a super ripe, juicy pear or peach, I’ll eat a less ripe version of it. And that tends to do a lot better. And then I always pair my fruit with fat and fiber. So it’s always going to have almond butter and chia seeds on it, or I’m going to put it with some fat, you know, full fat cashew milk, yogurt, or something like that. So what it’s done for me has helped me figure out how to pair foods properly and just really not eat carbs all by themselves. And for me, that allows me to eat 200+ grams of carbs per day, and barely ever have a glucose elevation. It’s pretty much just generally flat and stable all the time, but that’s been quite a bit of experimentation.”

19:28 – When you eat also matters

We process carbohydrates better in the morning than later in the day. Condensing the eating window also gives your body a break. Choosing the right eating window is therefore critical.

“I’m also really thinking a lot about food timing. So I’ve definitely condensed my eating window during the day so that I can give my body and my pancreas a break from insulin production. I try to eat earlier in the day. We tend to process carbohydrates better earlier in the morning and in the early afternoon as compared to evening time, because at night our body produces melatonin from the pineal gland to help us go to sleep and gets tired, but that also affects the pancreas and actually makes us secrete less insulin. And so for the same amount of carbohydrates, you’re going to be less quick to bring them into the cells at night as you are in the morning. So that’s something interesting to experiment with.”

 

 

20:49 – Science is catching up with traditional wisdom

Many cultures have a tradition of fasting, a practice that is now possible to back with science. Research shows it’s best to start fasting earlier in the evening than at later night.

“It’s also really interesting to see how the science now is catching up with the traditional wisdom. We’re actually now being able to show molecularly what a lot of these traditions have been saying forever. And I agree with that firmly. If you’re going to fast, I tell people, don’t stop eating at 9:00 PM. And then just your fasting means that you’re not eating until 1:00 PM the next day. That’s going to be, in my opinion, a lot less effective than stopping eating at 5:00 PM and then just starting eating earlier in the morning the next day, because of the hormonal cascade that’s happening at night with melatonin.”

 

 

21:27 – Don’t eat carbohydrates at night

High carbs at night can spike your glucose levels. It’s better to eat carbs in the morning and stick to a higher fat and protein-based meals in the evening.

“When we eat carbohydrates late at night, we’re basically setting ourselves up to not sleep well. High carbohydrate meals late in the evening are associated with insomnia, and many of our customers have seen that when they eat something high carb late at night, like a dinner with bread and then a dessert, they’ll just see their glucose bouncing around all night. Ben Bikman has written about this that when that happens, it actually elevates our body temperature. So when our glucose is bouncing around, it has an effect on our blood vessels and makes it harder for us to release heat and actually raises our body temperature at night. And that is associated with poor sleep quality. So definite life hack, just don’t eat your carbohydrates at night, eat them in the earlier part of the day and stick to a higher fat higher protein meal in the evening.”

22:21 – Eat on time, move your body, and get sleep

Plan your meals around the times when your body can process glucose best. This means eating before or after a physical activity, followed up with adequate sleep.

“Make sure that you’re eating during times when your body’s primed to process glucose properly. And that means when you’re not under stress, ideally if you’ve moved before or after the meal. So a walk before or after the meal or an exercise close to the mealtime and ideally eating higher carb meals on days that you’ve gotten good sleep. One poor night of sleep can make us more insulin resistant. There’s a study that looked at healthy young men who for six days got four hours of sleep per night. And they went from healthy glucose to just pre-diabetic in that amount of time. So you just don’t want to be eating your big carb meals on days when you haven’t gotten good sleep.”

24:11 – Glucose levels are dynamic

We measure metabolic condition with a one-time test. However, glucose changes throughout the day depending on what we eat and do. Therefore, it needs continuous monitoring to help us make better choices.

“So many factors go into how we control glucose. It actually becomes a biofeedback tool for so much more than just food. It’s actually a biofeedback tool for all these other factors like stress, exercise, and sleep. And to your point about your morning glucose being much higher, I think because of the way that metabolic conditions are diagnosed in our country – you go and you get a finger stick glucose, and if your blood glucose is above a certain level, they say you’re pre-diabetic. And if it’s above a higher level, you’re in the diabetes category. But I think what people don’t realize is that that number can bounce around massively day-to-day based on what we’re doing. I’ve had indulgent Saturdays where my average glucose is 10 points higher than on the day before and including my fasting glucose. And so you can imagine if you’re doing that type of day, day after day after day, you’re going to move in that direction. But being able to see how much variability there is with just certain choices, like eating carbs late at night, it’s really empowering. Because you’re like, oh, I can just change that and get things lower.”

 

26:20 – We don’t need to eat every 2 hours

When we are metabolically fit, our body can switch from burning glucose to burning fat. Then we won’t feel the urge to eat every two hours.

“You know, we don’t actually need to eat every two hours. People have gone 30, 40 days not eating. Valter Longo’s work looks into this. It’s very much a physiologic sort of addictive response that we have. And we’re trying to sort of fill up the tank very quickly because we’re not metabolically flexible, and we’re not able to get that energy we need from fat where we’re running out of glucose, and our bodies kind of panic. And so the more that we can train our bodies to be what I like to call metabolically fit, the more we can just balance out those peaks and valleys throughout the day. And I think what is under-recognized is that our glucose swings that are happening all day long, up and down, up and down, up and down with the standard American diet, that projects directly onto our up and downs in our day. Subjectively it maps onto our energy fluctuations, our mood fluctuations, our brain fog fluctuations. Like you’ll start to see as you track this stuff that, oh, I can actually have a much more stable day subjectively and psychologically and energy-wise if I keep things stable. And that’s amazing because I think that’s what we all want. We want to feel in control and we want to feel stable. And that starts with keeping our glucose under control.”

Episode Transcript

Dhru Purohit: [00:00:00] Coming up on this week’s mini episode of the Broken Brain podcast.

Dr. Benjamin Bikman: [00:00:04] So insulin resistance is this, it really is an epidemic that is the single most common health disorder in the world. In the U S alone it affects potentially up to 88% of adults. So this is a problem that is just phenomenally relevant.

Dhru Purohit: [00:00:19] Hi everyone, this episode of the podcast is brought to you by my new venture and our newest protein powder- the Pegan Shake. One of the best ways to boost your brain power is with the best nutrition. This is why Dr. Mark Hyman and I teamed up to create the perfect shake to start your morning off right and set your brain and body up for vitality and success. The shake is called the Pegan Shake and it features a combination of grassfed collagen, organic pumpkin, and organic pea protein powder with healthy fats from MCT oil and avocado oil, which, by the way are great for fat burning and fueling brain power as well. A little bonus, the Pegan Shake also features organic acacia fiber, which is great for gut motility and digestion. See, the shake was created to support healthy blood sugar and healthy energy levels. In fact, one of the most common reasons for mood imbalances and brain challenges come from unbalanced blood sugar. Have you ever felt anxious, tired, and wired and then ate something and felt better? Well, when your blood sugar goes through major fluctuations throughout the day, you literally can feel crazy. I know so many people can relate. So the Pegan Shake supports your blood sugar by feeding your body the right information from this perfect combination of macro nutrients.

I’ve been using the pig and shake for months, and I feel full, satisfied, satiated, focused, and most importantly, I avoid those energy slumps that come in the late afternoon too. I think you’re going to love the shake, Dr. Hyman and I teamed up to make it because we literally couldn’t find a shake mix that we loved. So we decided to create it ourself. Check it out at getfarmacy.com/peganshake. You can find the link in the show notes. That’s getfarmacy, farmacy with an F. F A R M A C Y.com/peganshake. Now, onto today’s episode.

Hi, everyone Dhru Purohit here, host of the Broken Brain podcast. Most of us hear the term metabolic health and we think it only applies to our ability to burn food and manage our weight. And while those things are certainly big pieces of metabolic health, it also is so much bigger than that. Metabolic health impacts everything from our cardiovascular health, to our cognition and brain health, our mood infertility, and so much more. That’s because our metabolism is actually our body’s ability to fundamentally create and use energy. And if there’s dysfunction there, that can lead to a whole host of chronic inflammation and ultimately chronic disease. If our energy production in the brain is hindered we could have memory loss. If it’s not functioning properly in the muscle cells we may see chronic pain and the list goes on. My guest on today’s mini episode is Dr. Benjamin Bikman and Dr. Casey Means, and they talk to us about why insulin resistance has become so prevalent and what makes us insulin resistant in the first place. They discuss how our lifestyle and our diet have fundamentally changed the way that greatly impacts how we regulate blood sugar and how this whole process is wreaking havoc on our metabolic health. They’re all connected! They also talk about how to reverse and prevent insulin resistance through specific dietary and lifestyle modifications and how we can use a continuous glucose monitor to dramatically improve our health. I’ve been using one and it’s been fantastic. Let’s listen in starting with my interview with Dr. Benjamin Bikman, a renowned metabolic health research scientist and a popular speaker on human metabolism and nutrition. He’s the author of the newly released book “Why We Get Sick” which offers a thought provoking yet real solution to insulin resistance and how to reverse pre-diabetes, improve brain function, shed fat, and even prevent diabetes.

Dr. Benjamin Bikman: [00:04:25] So insulin resistance is this, it really is an epidemic that is the single most common health disorder in the world. In the U S alone it affects potentially up to 88% of adults. So this is a problem that is just phenomenally relevant and it is very close levels, in some places even worse, in virtually all of the countries in the Middle East and North Africa they have worst metabolic health than adults do in the U.S. China and India are very close to this. This is a problem that is just spreading around the world as what was once a so-called Western diet is really becoming the global diet unfortunately. So insulin, so just to help people appreciate just how widespread this is, insulin resistance is really, let’s go back to that glucose insulin paradigm. So someone who’s constantly spiking their glucose is constantly spiking their insulin and the insulin will lag behind. So you and I are wearing our continuous glucose monitors we’ll see our glucose come up and down. Let’s just say it goes back to normal within two hours, insulin doesn’t come down that quickly, it’s effects will linger and it will then slowly come down after the glucose. So, eventually the person gets to a state where this incessant stimulus with insulin starts to make the body resistant to insulin, because that is a fundamental principle of biology, too much of something will result in a resistance to that something.

So as the body is swimming in a sea of insulin, insulin is always elevated, it starts to need more and more insulin to get the same effect. But then we get to this paradigm, that I said I’d come back to, where the person has normal glucose levels but they have vastly elevated insulin. This right here is the perfect kind of textbook state of insulin resistance. Insulin is working well enough, despite needing several times more than we had before, to keep the glucose at a normal level. Unfortunately, because we look at metabolic health almost strictly through the lens of glucose control, we have the patient coming in year after year and we see that their glucose is normal. “Glucose is normal, so you’re fine. You don’t have any metabolic problems.”. But if we shifted this paradigm away from the glucose centric model to appreciate the relevance of insulin, we would have detected 10 or 20 years earlier that the insulin is several times higher than it should be. But then we only detect the problem once the body has become so resistant to its own insulin, that insulin can no longer keep glucose in check. And now the glucose starts to climb. Now we detect the problem clinically. Now we diagnose them as having some metabolic problem, like type 2 diabetes. So the tragedy in continuing to focus on glucose as the primary metabolic marker is that we diagnose the problem, the true problem, far, years, even decades later than we could have.

But that same glucose centric paradigm also causes us to treat problems worse. We aren’t addressing the true problem. So for example, back to this paradigm of the glucose being low and insulin high, eventually the glucose is climbing, now we detect the problem. And conventional medicine would say, “Well, let’s just lower your glucose by any means.”, including pushing your insulin up to even higher levels than you could get on your own. And so we give the type 2 diabetic insulin therapy or drugs that stimulate even greater release of insulin from the pancreas. So we push the insulin up to super physiological levels and now we drive the glucose down to normal. The evidence, the proof that that paradigm is so problematic is in the fact that when we do that with a type 2 diabetic, despite the excellent glucose control they get fatter and sicker and die faster than they did before. And I mean it, their risk of Alzheimer’s goes up by double relevant to the brain, their risk of heart disease mortality triples, their risk of cancer mortality doubles, to the same degree that Alzheimer’s doubles.

So we are making them fatter and sicker than before. And we’re doing it in the midst of much better glucose control. Because it’s not the glucose, it’s the insulin. So insulin resistance, again, to define it maybe more explicitly, is that insulin isn’t working normally at all the various cells in the body. And insulin levels themselves are elevated. That is an essential aspect of true insulin resistance. Insulin is high, but it’s not working the same way that it used to. Those were sort of the two pillars of insulin resistance. And then the effects are myriad, it’s far beyond just being relevant to type 2 diabetes.

Dhru Purohit: [00:09:13] A whole host of things, inside of the book, that insulin can be connected to. Because I think, again, people are listening to this, they’re like, “Well, I’m not really worried about type 2 diabetes. And I feel like I’m pretty healthy.”. But you talk about erectile dysfunction, you talk about migraines, right? Let’s just take those two as categories of things that a lot of people suffer from. How could insulin resistance be connected to those 2, as an example?

Dr. Benjamin Bikman: [00:09:41] Yeah. Yeah. I love that you bring those up. In fact, there was a manuscript that mentions in the title, that is something like “Is erectile dysfunction, the earliest symptom of insulin resistance in men?”. And this is a function of a failure of insulin to regulate blood vessel control as well as it could before. So normally insulin will flow across a capillary, these teeniest of the blood vessels, and tell the blood vessels to dilate, it’ll tell them to get bigger. Of course, that is essential for male fertility. We have to have that insulin induced vasodilation for a man to be able to be fertile. The failure of insulin, so as those capillaries, those little blood vessels become insulin resistant, now the blood vessels can’t dilate, it can’t increase blood flow. And now the man fails at fertility, his most essential event with his human physiology, his erection, he’s no longer capable of it. But if we extend that same blood vessel observation throughout the body, we also can explain why insulin resistance is the single most common explanation for hypertension. So someone is coming into the clinic with normal glucose levels yet insulin resistance, and the physician indicates that the person has high blood pressure or hypertension, they will just give the person a blood pressure medication. Which will control blood pressure, but it’s not addressing the fundamental cause of the problem, which is the insulin resistance.

If that physician, having detected hypertension, asked “I wonder what the insulin levels are?” he or she would detect elevated insulin, sign of insulin resistance, and then say, “Let’s address the insulin resistance.”. And that will correct the hypertension. And of course, consequently, correct the erectile dysfunction. But even in women, I won’t elaborate any more beyond this, the most common infertility in women is polycystic ovarian syndrome. And at its core is a disease of insulin resistance. It is a metabolic problem at her ovaries, preventing the ovaries from making the normal amount of female, of estrogens, preventing ovulation. So infertility in men and women is fundamentally rooted in insulin resistance. And then with migraines, as we move up to the brain, this is actually the case in migraines, in epilepsy, and in Alzheimer’s disease. In all three of those seemingly totally unrelated neurological disorders, central nervous system problems, is an energy deficit. Briefly, the brain has, as we noted earlier, a very high energy demand. It is an energy hog all the time. Even when we’re sleeping, the brain has a surprisingly high energy demand. Because of the average diet, the global diet being high in carbohydrates and high insulin, the brain is forced to get all of its energy from glucose, virtually 100%.

And we can come back to this idea later, with the alternative fuel not being available and that’s ketones, but that’s a bit of a shift in topic. But the brain has a high energy demand and because of conventional eating glucose is the only viable fuel for the brain. Some of the brain’s glucose uptake will be mediated by insulin. Not all of it, but insulin facilitates some of the glucose that will get to the brain to meet the brain’s energy demands. But as the brain starts to become insulin resistant, that demand, that actual glucose availability is deficient. We have a little energetic gap. The brain can’t meet all of its energetic needs from glucose and thus a pathology starts to present itself, Alzheimer’s disease, we can detect this, and this is like truly detectable in humans. We can detect in Alzheimer’s, epilepsy, and migraines, the brain isn’t getting the same amount of glucose as we see the brain getting in a control human, who doesn’t have one of those pathologies. And so, as the brain become insulin resistant, it’s preventing again, the brain from getting its energy from glucose. And now we have a problem manifesting but that is why if we can improve insulin sensitivity at the brain, by dietary manipulation we start to correct that problem.

In the case of migraines, there are studies from the 1920s for heaven sakes! I mean, we’re talking like almost a hundred years ago. We have evidence of a physician putting patients with migraine headaches onto low carbohydrate diets. And it is profound what this physician noted in this manuscript, highlighting the effect that each individual subject, something that just doesn’t really happen these days. And almost all of them, it said, upon entering ketosis, which is the state that I’ve been alluding to and haven’t really defined yet, but basically a low carb diet, upon adopting a low carbohydrate diet, which is the best way to improve insulin sensitivity, the migraines cease entirely. And that’s a common phenomenon, where a person will go, either they stop having migraines completely, or they go down by like a 10th of what they were before. And I’ve seen this even right here in my department, at my university. I had a colleague who heard me elaborating on the, on this phenomenon. And he went from having 2 serious migraines a week to having about 2 a year. And it’s almost always because he indulges in something, spikes his glucose levels to a high level and then has the migraine kind of returning. So with migraine headaches, as we see with other neurological disorders, it’s likely at least part of it, part of it is at least explained by an energetic deficit. There is a gap in energy that the brain can’t make up for in an insulin resistant state, that once we address the insulin resistance, we start to address that energetic gap. And then the disorder starts to improve.

Dhru Purohit: [00:15:41] My next guest, Dr. Casey Means is a Stanford trained physician, chief medical officer and co-founder of the metabolic health company Levels and associate editor of the International Journal of Disease, Reversal, and Prevention. Her mission is to maximize human potential and reverse the epidemic of preventable chronic diseases by empowering individuals with tech enabled tools that can inform smart, personalized, and sustainable dietary and lifestyle choices. Dr. Means talks to us about the concept of continuous blood glucose monitoring, which I’m a huge fan of, something that Dr. Means is pioneering with her company Levels, to make more accessible for the mass market. And how we can use that data to truly, truly personalize our diet and lifestyle for optimal health. Let’s listen in.

Dr. Casey Means: [00:16:35] For me, I’ve chosen to be on a whole foods plant-based diet because it just achieves a lot of the things I want in my body, for getting me the substrates that are going to lead to optimal biologic cellular function in my body. So it gives me the antioxidants I need, I get tons of fiber to help my microbiome be healthy, I’m getting lots of phytonutrients. I get Omega 3s from nuts and seeds, etc. And so, to me, it’s just what helps me feel great and helps me really optimize what I know about cellular biology. But the reality is is that even with a diet that feels very, very healthy and whole there can be collateral damage. And what I mean by that is you might be eating lots of healthy foods, but they still might be causing massive glucose spikes in your body. And so for me, glucose monitoring has helped me just really tailor this diet that I love and adore and make it not have that collateral damage and just make it as finely tuned for me.

And so what that looks like personally, is that I’ve been wearing a continuous glucose monitor for about 18 months, and I’ve been using them in my patients for a couple of years at this point. For me it’s means there are certain foods that I’m kind of eliminating, so I really don’t eat a lot of grains. They just spike me so high, I don’t eat oatmeal. I’ve minimized some of the big spikers for me, which are grapes, corn, sweet potatoes, and rice. And I’m getting a lot more fat, protein, and fiber. So I eat a lot of beans and when I do I put extra fat and fiber and protein on them, so I’ll put beans with like tahini and chia seeds and flax seeds and things like that.

I’m eating a lot of nuts and seeds and green leafy vegetables. I’m minimizing sort of the starchy vegetables and I’m definitely choosing my fruits really carefully. And I’ve found a number of fruits that don’t spike my glucose at all. I tend to eat less ripe fruits now. So instead of eating a super ripe, juicy pear or peach, I’ll eat sort of a less ripe version of it and that tends to do a lot better. And then I always pair my fruit with fat and fiber. So it’s always going to have almond butter and chia seeds on it, or I’m going to put it with some you know, full fat cashew milk, yogurt, or something like that. So what it’s done for me has helped me figure out how to pair foods properly. And just really not eat carbs, like all by themselves. And for me, that allows me to eat, you know, 200 plus grams of carbs per day and barely ever have a glucose elevation. It’s pretty much just generally flat and stable all the time, but that’s been quite a bit of experimentation.

And then I would say the second thing is, aside from just food pairing and learning how to mix carbs and fats and proteins and fibers, I’m also really thinking a lot about food timing. So I’ve definitely condensed my sort of eating window during the day so that I can give my body and my pancreas a break from insulin production. I try to eat earlier in the day, we tend to process carbohydrates better earlier in the morning and in the early afternoon, as compared to evening time. Because at night our body produces melatonin from the pineal gland to help us go to sleep and, you know, get tired, but that also affects the pancreas and actually makes us secrete less insulin. And so for the same amount of carbohydrates, you’re going to be less quick to bring them into the cells at night, as you are in the morning. So that’s something interesting to experiment with.

Dhru Purohit: [00:20:06] To project on that point, it’s also reminiscent of the fact that growing up, I was around people that fasted all the time in my tradition. It was part of the Hindu, and my mom’s from the Jain tradition. A big part of those traditions is fasting. And interestingly enough, a lot of the fasting that people would do would be in the evening. Here in the U.S. we sort of have this culture of fasting in the morning,that’s become a thing. But, you know, talking with Valter Longo and his team, they were like, “Well, most of the cultures around the world, they actually fast later on at night.” because they need that healthy fat and maybe some of those carbs in the morning to power their brain and then they do better. You know, it’s just interesting to see the different patterns out there.

Dr. Casey Means: [00:20:49] It’s so interesting. And it’s also really interesting to see how the science now is catching up with the traditional wisdom. You know, we’re actually now being able to show molecularly what a lot of these traditions have been saying forever. And I agree with that firmly. If you’re going to fast, I tell people, don’t stop eating at 9:00 PM and then just, your fasting means that you’re not eating until 1:00 PM the next day. That’s going to be, in my opinion, a lot less effective as stopping eating at 5:00 PM and then just starting eating earlier in the morning, the next day, because of the hormonal cascade that’s happening at night with melatonin. And another point there, is that when we eat carbohydrates late at night and we’re basically setting ourselves up to not sleep well. So high carbohydrate meals late in the evening are associated with insomnia and many of our customers have seen that when they eat something high carb late at night, like a dinner with bread and then a dessert, they’ll just see their glucose bouncing around all night. And we know, and actually Ben Bikman’s written about this, that when that happens it actually elevates our our body temperature. So when our glucose is bouncing around, it has an effect on our blood vessels and makes it harder for us to release heat and actually raises our body temperature at night. And that is associated with poor sleep quality. So yeah, definite life hack, you know, just don’t eat your carbohydrates at night, eat them in the earlier part of the day and stick to a higher fat, higher protein meal in the evening, if you’re going to eat later for sure. So, that’s a big one and then you know, just making sure that you’re eating during times when your body’s primed to process glucose properly. And that means when you’re not under stress. Ideally if you’ve moved before or after the meal, so a walk before or after the meal, or an exercise close to the meal time. And ideally, eating higher carb meals on days that you’ve gotten good sleep. One poor night of sleep can make us more insulin resistant. You can take healthy populations of people and deprive them of sleep for just a few days, there’s a study that looked at healthy young men, who for 6 days got 4 hours of sleep per night, and they went from healthy glucose to just pre-diabetic in that amount of time. So, you just don’t want to be eating your big carb meals on days when you haven’t gotten good sleep. So all of those learnings, yeah…

Dhru Purohit: [00:23:11] I have one more point to that, sorry to interrupt, but just to solidify that point, I didn’t sleep well last night and I woke up this morning I checked my levels and my meter and it was at the highest all week of where my morning blood sugar was. I was hot, I ate my carbs a little bit too late last night, and I was tossing and turning a little bit. And I’m trying this experiment where I had my air filter off in my room and through a whole host of things, I woke up with the highest starting blood sugar that I had when I started in the morning.

Dr. Casey Means: [00:23:49] That is so interesting. And yeah, and not that super surprising, those carbs late at night can just send us on a total rollercoaster. But yeah, so long story short, those are all the things that have helped me figure out how to do vegan and do plant-based without this collateral damage of the glucose spikes and it is very holistic. And I really love about this tool, that because so many factors go into how we control glucose, it actually becomes a biofeedback tool for so much more than just food. It’s actually a biofeedback tool for all these other factors like stress, exercise, and sleep. And I think to your point, about your morning glucose being much higher, I think we kind of think because of the way that metabolic conditions are diagnosed in our country, you know, you go and you get a finger stick glucose, and if your blood glucose is above a certain level, they say you’re pre-diabetic. And if it’s above a higher level, you’re in the diabetes category. But I think what people don’t realize is that that actually, that number can bounce around massively day-to-day based on what we’re doing.

I’ve had indulgent Saturdays where my average glucose is 10 points higher than on the day before and including my fasting glucose. And so you can imagine if you’re doing that type of day, day after day after day, you’re going to move in that direction. But being able to see how much variability there is with just certain choices, like eating carbs late at night, it’s really empowering because you’re like, “Oh, I can just change that” and, you know,  get things lower. So that’s super interesting that you notice that.

Dhru Purohit: [00:25:17] And then also map it out to how you feel, because everybody’s used to the fact of, especially if you were traditionally working in the office environment or, you know, that three o’clock time period where you feel like your energy starts to crash, you can’t focus the same way. People in let’s say corporate America start reaching for sweets, right? And even people that are not working that are working at home, taking care of kids, other stuff, running around, doing all the things that they need to do, especially in this day and age with COVID and homeschooling. And then you get to that three o’clock time period, if you have not managed your blood sugar well, and your glucose well, you hit these patterns where you’re just like, “I just feel like shit. I don’t like the way that I can focus right now.”. And now, you know, are you craving things or are you artificially boosting yourself back up to get, to almost in a way, medicate. Right? So how much of your cravings are just you actually miss foods and how much of them are driven by biological needs, where your body is tricking you to reach for that sweet or that thing that maybe isn’t the best for you?

Dr. Casey Means: [00:26:19] Yeah, I think it’s absolutely the latter. You know, we don’t, we don’t actually need to eat every 2 hours. You know, people have gone 30, 40 days not eating! Valter Longo’s work like looks into this, you know, and we don’t need it. It’s very much a physiologic sort of addictive response that we have and we’re trying to sort of fill up the tank very quickly because we’re not metabolically flexible, and we’re not able to get that energy we need  fat. Where we’re running out of glucose, and our bodies kind of panic. And so, the more that we can train our bodies to, what I like to call the metabolically fit, the more we can just sort of balance out those peaks and valleys throughout the day. And I think what is under-recognized is that our glucose swings that are happening all day long, up and down, up and down, up and down, with the standard American diet, that projects directly onto our up and downs in our day subjectively. It maps on to our energy fluctuations, our mood fluctuations, our brain fog fluctuations. Like, you’ll start to see as you track this stuff that, “Oh, I can actually have a much more stable day subjectively and psychologically and energy wise if I keep things stable.”. And that’s amazing because I think that’s what we all want. We want to feel in control and we want to feel stable. And that starts with keeping our glucose under control.

Dhru Purohit: [00:27:38] There is no perfect diet for everyone. We’ve often talked about this on the show, and even healthy foods like sweet potato or too much cassava, or a lot of the healthyish foods that we see in the aisles of Whole Foods and other natural grocers may cause a blood sugar spike in one person but maybe not in someone else. Seeing this information in real time, lets us make better decisions with immediate payoff for how we feel as well as long-term protection against chronic disease. Thanks for tuning in for this week’s mini episode of the Broken Brain podcast, we’ll  see you next week.

Hi everyone, I hope you enjoyed the interview, just a reminder, this podcast is for educational purposes only. This podcast is not, I repeat, it’s not a substitute for professional care by a doctor or otherwise qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you’re looking for help in your journey, seek out a qualified medical practitioner. If you’re looking for a functional medicine practitioner, you can visit IFM.org and search their find a provider database. It’s important that you have somebody in your corner that’s qualified, that’s trained, that’s a licensed healthcare practitioner, helping you make changes, especially when it comes to your health.