Carb Connection to Prediabetes & Type 2

Transcript:

KARA: Welcome to Dishing Up Nutrition. Today's show is brought to you by Nutritional Weight and Wellness. We're a company specializing in life changing nutrition education and counseling. You know, with technology, all the different ways to be informed these days, it's great that we're able to reach listeners worldwide. So we want to welcome you, whether you're hearing us live. Maybe you're listening to a podcast with Apple or Spotify.

I want you to think for a moment. Have you recently been to the doctor and been told that your fasting blood sugar numbers started creeping up a little too high? Maybe your doctor said you have prediabetes, or perhaps you received a diagnosis of type two diabetes. If not, chances are you know several people who are at least talking about that they have prediabetes or diabetes. According to a study in JAMA, which is Journal of American Medical Association, more than half of the American adult population has diabetes or prediabetes.

My cohost and I are going to start our show explaining the different types of diabetes. Then we'll dive into the science of what's going on in the body that creates these out of control blood sugars. Of course, we're going to also give lots of tips on what you and your loved ones can do nutritionally to bring those glucose numbers down. So I'd like to introduce my two awesome cohosts. First, Leah Kleinschrodt is a registered and licensed dietitian. She sees clients in Woodbury and she also teaches classes. And we all think of Leah as our go to research expert.

LEAH: Oh, well, that's very kind you Kara. I appreciate that. Well and good morning to all of our listeners and good morning, Kara. Good morning, Kristi. It's great to be here-both of you in studio live. It's been a while since I've seen your faces. And Kristi, we'll get to introducing you in just a moment, but on our topic this morning of blood sugars, prediabetes, diabetes, I just wanted to bring in a little of that research. So I came across this bit of research preparing for today's show, and this was in a journal called Cardiology. This study was back in 2018. So the last couple of years. The title of the study was “Sex Difference in the Effect of the Fasting Serum Glucose Level on the Risk of Coronary Heart Disease”. So that's kind of a mouthful. These resource studies tend to do that, but really what they were looking at is whether or not elevated glucose levels were a greater risk factor for heart disease in men or women.

What this study found was that having a fasting glucose of 110 milligrams per deciliter in women created a greater risk for these women of being diagnosed with coronary artery disease. We'll talk a little bit later in the show about why it's important to take a diagnosis of prediabetes very seriously. And also what are those numbers? What are those thresholds that we're looking at of what crosses us into prediabetes and type two diabetes?

KARA: And Kristi Kalinsky: I'm excited to introduce her next as the third cohost. She's also a registered and licensed dietitian. Kristi sees clients in Maple Grove and teaches classes. And she worked for several years in a transitional care unit. And Kristi and I have chatted. I know a lot of her patients suffered from complications that were occurring because of their high blood sugar numbers and their diabetes. And maybe you could just chat for just a moment about that.

KRISTI: Sure. Well, good morning Kara and Leah. It's great to be here with you guys today and good morning to all of our listeners out there. Yes, that's right. I did work at St. Therese in their transitional care unit which is a section of their nursing home. Many of my patients were affected by diabetes. What I did notice if their diabetes was undiagnosed or ignored over time, they would have various complications.

And just to give you some examples of maybe what I would see with that uncontrolled diabetes: they sometimes would suffer strokes. They would have cardiovascular disease. They would sometimes be diagnosed with Alzheimer's. A lot of them had foot or leg problems, like on sores that wouldn't heal. You know, eventual amputations of their toes, their feet, or even their lower legs. Some of them had vision issues. I even had a couple that were blind because of diabetes. And kidney disease: kidney disease particularly was very prevalent with that diabetic population I worked with.

LEAH: Wow.

KRISTI: Yeah.

KARA: I mean, those are very, very serious, serious complications. Well, today's topic: it is really important. You can tell it's going to be an important one because the rates of prediabetes and diabetes just keep going up every year. And although there is a small genetic component to having higher blood glucose levels, most of it is under our control and can be improved or even completely reversed by making certain nutritional and some lifestyle changes. But I want to emphasize most of this is what we're, what we're putting in our mouth day in and day out.

Excess carbs and sugar are main cause of prediabetes and diabetes

KRISTI: Right, exactly. The official title of our show today is called: The Carb Connections to Prediabetes and Diabetes. And the title pretty much says it all. The main reason over half of Americans are prediabetic or diabetic is largely due to the excess of carbs and sugar they're eating. I'm just going to say that again. I think that's staggering. Half of Americans are prediabetic or diabetic right now. That number is just so incredibly high and it they're getting these diagnosis: a lot of times it's from eating those processed foods. You know, it's the foods that you find in boxes at the grocery store. They might be in your freezer. They're in bags, or you can find them at the drive through. Those are the things that are really contributing to those prediabetes and diabetes diagnoses that we're seeing.

LEAH: Yeah, absolutely. So just building off of what Kristi just said. So more specific examples of those carbs that tend to be the biggest culprits behind insulin resistance, higher blood sugar. So some of these are, are the things that we think of as sugary, the sugary treats and the sugary drinks. So things like the cookies, candy, cakes, soda, the sweetened coffee drinks and things like that. But we also have to remember those carbohydrates that turn into a lot of sugar in the body, but may not necessarily taste sweet when you put them on your tongue. So this would be things like your breads, chips, pasta, bagels, crackers, muffins, pizza, French fries. It's again, all these carbohydrates-they pack quite a, a carb punch and turn into a lot of glucose in the body, whether they taste sweet or not.

KARA: And it's not the one piece of birthday cake you had at a birthday party a few weeks ago that caused chronic high blood sugar numbers. It's really the daily and weekly habits that build up over time. It's the vanilla latte at the coffee shop every morning on the way to work. It's the cold cereal with milk for breakfast or the sandwich, chips and lunch and soda that get brought in your office for lunch.

Explaining the 4 different types of diabetes

KRISTI: Yep. All of those things definitely add up over time. I just want to briefly explain: there's four different types of diabetes. That's right: Four. there's type one diabetes, type two diabetes, gestational diabetes, which happens during pregnancy. And then there's a condition known as prediabetes. What prediabetes is, is when someone has higher than normal blood glucose or blood sugar levels, but not quite high enough to qualify as that type two diabetes diagnosis.

LEAH: Right. Absolutely. So let's, we just want to spend a few minutes here breaking down, going a little into depth into each type of that those diabetes or each type of those blood sugar dysregulation conditions. So let's start with type one. This is not the focus of our show today, but I just wanted to do a little background on what type one diabetes is. So type one diabetes: it used to be called when I was learning about it juvenile onset diabetes, because this used to be the type of diabetes that was most commonly diagnosed in children or younger adults.

Nowadays, really it can appear at any age. And type one diabetes is an autoimmune condition, which means that the immune system, for whatever reason, kind of got primed to attack and destroy the cells in the pancreas that make insulin. So that means these people, these individuals cannot, they do not make their own insulin and they rely on insulin every single day just to stay alive. So again, I just want to clarify. For today's show, we're not focusing on type one diabetes. Really this is the minority of diabetes. It's only about 5% of all diabetes cases are type one. So it is less common, but we just wanted to give that little bit of background, cause we know people would ask.

KARA: Right. And gestational diabetes develops in some women when they are pregnant. Most of the time, this type of diabetes goes away after the baby is born. Those with gestational diabetes, they do have a greater chance of developing type two diabetes later in life. So if you're listening and you either have gestational diabetes or maybe you did in the past during a pregnancy, the information in today's show on how to prevent future diabetes will apply to you.

Well, I can't believe it's already time for our first break here. You're listening to Dishing Up Nutrition. Today's topic is The Carb Connection to Prediabetes and Type 2 Diabetes. When researching for the show, I wanted to know more about this. The common foods we eat today, they're just not what people were eating 50 or more years ago. I found research on PubMed. It was a meta-analysis done at Yale University that included data from 25 different studies. So there were almost a total of 200,000 participants, mostly women in the studies. The studies looked at what foods were most addictive. I'm just going to throw out the top 10. Not a lot of surprises here: chocolate, chips, cookies, ice cream, French fries, cheeseburgers, regular soda with sugar, cake, cheese. Think about it, listeners. Almost all of those foods are high sugar, high carb. And if consumed on a regular basis, I could see how those would certainly lead to higher blood sugars. So stay tuned for more about this. We'll be right back.

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LEAH: Welcome back to Dishing Up Nutrition. I'm Leah Kleinschrodt, Licensed and Registered Dietitian. And my cohosts are Kristi Kalinsky, also a Registered and Licensed Dietitian and Kara Carper, Licensed Nutritionist. Oh, tongue tie there; Certified Nutrition Specialist. Before break Kara was just mentioning some published research that she found on PubMed from Yale University that included almost 200,000 people.

So really in study land, this is a really big study, which means there was a lot of data to look at, look at. And they identified the top 10 most addictive foods. And so I won't hash through all of them, but they're very common things. Most of us would identify with them. Things like ice cream, pizza, French fries, chips, et cetera. All of them are on the list of foods that we would really suggest reducing or avoiding for some people if you want to lower your blood sugar numbers. Because big food manufacturers want to make money and are not looking out for your health, you listeners are the ones that need to be aware of this and the ones that to take control of your own health.

It was rare to eat these top 10 most addictive foods even 50 to 60 years ago. Now these addictive foods are overly available. They're in your face everywhere you turn, which when we talk about protecting our environments, that can make it really difficult to know where to start, how to make those healthier choices or how not to be kind of led astray and down that sugar road. It is not your fault if you feel addicted to certain foods or beverages. You are not alone. We talk to clients about this day in and day out. Many people need that support of a nutritionist or a dietitian or that class community support to get them started on a better path. We are here to help and you can call us at (651) 699-3438 to chat with our wonderful front desk staff about all the ways that we can support you.

Now coming back into our topic of carbohydrates, blood sugars, diabetes, Kara you had mentioned, you had just kind of given us an overview of what gestational diabetes is. I just wanted to share, so personally, I had gestational diabetes with my most recent pregnancy, my pregnancy with my daughter. And again, I'm a dietitian. And this wasn't anything that I had done wrong. It wasn't because I was eating poorly or anything like that. I just wanted to highlight that gestational diabetes, because of the hormones that this is something that sometimes it just happens in a pregnant woman's body.

I found this out because I failed my Glucola challenge and I opted to just manage my blood sugars, test my blood sugars several times a day for the remainder of my pregnancy. So I didn't mind doing that so much. I actually learned a lot about how foods affect my blood sugars, but just know that, and I know now, actually, and Kara, you mentioned this, that down the road, five, 10 years down the road, I am at a higher risk for having blood sugar issues kind of later on in life. So that for me is a huge motivation to continue eating well, eating and balance, and really still watching those blood sugars very carefully.

KRISTI: Thanks Leah, for sharing that, you know, that's a great story and, and a good one for our listeners to hear. You know, even though you are a dietitian eating and balance, you knew what to eat. You know, you still ended up with that diagnosis. And it just goes to show, I mean, even dietitians that are, you know, eating well are susceptible, you know, to this as well.

LEAH: Yeah. Absolutely.

KRISTI: Yeah. Well, we're going to switch here and talk a little bit more about type two diabetes. Type two diabetes: What happens in your body? It's either you're not making insulin or you're not using it very efficiently. I know Leah mentioned that the type one diabetes used to be called juvenile onset. Type two diabetes used to be called adult onset diabetes. They actually don't call it that anymore. That's because we're seeing younger and younger people getting diagnosed with this type two diabetes, even in childhood.

It is more common to see it more in that middle age and those older individuals, but it can come on at earlier ages. Type two is definitely the most common type of diabetes of those four that I mentioned earlier. It is a progressive disease. This doesn't happen overnight. The main cause of developing this type two diabetes, it's usually from years of poor eating habits. Again, it's those high sugar foods, the high carbohydrate foods and those sugary drinks that are contributing to this diagnosis. 90 to 95% of all diabetes cases fall under the type two category.

KARA: So really, I mean, that's what we're, that's what we're really talking about today is the type two. And Kristi, you had mentioned earlier the definition for prediabetes. We're also discussing that today. Prediabetes, just to just to repeat that: it's when someone has higher than normal blood glucose levels, but not quite high enough to qualify as type two diabetes. We'll talk about those specific numbers and kind of the ranges for glucose or blood sugar levels.

The importance of addressing prediabetes

First I have a comment about the term prediabetes, excuse me, prediabetes. It can be very misleading for many people who receive the diagnosis. I can't tell you how many clients I've met with over the years, and even some people in my circle of family and friends who say, “My doctor said I have prediabetes and we should just keep an eye on the numbers just to make sure it doesn't turn into full blown type two diabetes.” So that's a very common misconception that it's okay to have prediabetes as long as it doesn't progress into type two.

LEAH: Mm-Hmm. Yeah. That's kind of mind boggling to me. I mean, I think of that as being like, it's like saying, oh, I have one flat tire on my car, but I don't need to do anything about it just yet. I'll wait until I have three flat tires on my car before I actually take it in to get it serviced. Like nobody would do that. And your car would not drive very well in that meantime anyway. So why would we take that prediabetes diagnosis and just sit on it or wait until it got so severe that now we need medications or now we really need to do something drastic to get those blood sugars under control?

So research from the Mayo Clinic shows that having prediabetes, even prediabetes, so not even diagnosed type two diabetes, that prediabetes has been linked with long term damage to the heart, blood vessels and kidneys even if it hasn't progressed into type two diabetes. Prediabetes is also linked to unrecognized or what we call silent heart attacks.

KRISTI: Getting that diagnosis of prediabetes should, it should be a definite wake up call and not something to ignore, like Leah mentioned. I like your analogy of the flat tires. That's a great way to look at it. It's a, it's a really serious condition and it's nothing to be taken lightly. So if someone with prediabetes doesn't change their habits, research actually has shown that 50% of those diagnosed with prediabetes will progress to type two diabetes within five years. Then the complications can be even more serious and life threatening.

KARA: A better way to think about prediabetes is take the letters pre: p-r-e; just change that in your mind, change that to p-r-e for prevent. Let's prevent diabetes.

KRISTI: That's great.

KARA: I didn't make that up. I read that. Getting the diagnosis: it's a great opportunity to make changes to prevent complications. You're listening to Dishing Up Nutrition. Today, we have three licensed dietitians and nutritionists giving tips on how to prevent diabetes or even reverse and heal prediabetes or type two. We will be right back.

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KRISTI: Welcome back. You're listening to Dishing Up Nutrition. I'm Kristi Kalinski. And we are here today talking about how excess carbs and sugar in the diet over time can lead to prediabetes or type two diabetes. Nutritional Weight and Wellness is on Instagram. And if you want to see some fun posts about grocery store finds, meal planning tips, what our nutritionists are eating and upcoming classes, check us out. You can find us at our handle: nutritionalweightwellness.

LEAH: Yeah. I, I follow Nutritional Weight and Wellness on Instagram. I think the grocery store finds are my favorite thing. Kristi, like you were just saying a moment ago, I love seeing what other people are buying or just getting new ideas because how many of us buy the same thing day in and day out or every time we go to the store?

KRISTI: Yep. You get in that rut.

LEAH: Yeah. You get in the rut, which is fine, which is good. We need some of those good go-tos to, to make it simple for us, but just branching out, getting some different ideas. I, I just like, that's one of my favorite posts that we do on Instagram.

KRISTI: Me too.

LEAH: Yeah. All right. Great. So Kara, before we went to break you, I love what you just said. So we hear that term prediabetes. It's like, okay, we're kind of flirting with that edge of type two diabetes, but let's flip that on its head and say, let's take that and say, prevent diabetes instead of prediabetes or almost there. So I just want to give our listeners, okay. If you are looking at your lab results, what are we looking for and where do we need to start putting those prevention measures into place?

Lab ranges of what to shoot for

So before we get into carbs and how they affect our blood sugar, let's just talk about the ranges of what is normal: prediabetic, type two diabetic. Everyone should know these numbers and it's a very simple blood test. Honestly, you're probably getting these labs run, whether you truly know it or not. So to get a fasting glucose, this is typically on a metabolic panel. You need to fast or just not eat for about 12 hours before this test. So this is an indication of how much sugar is still floating around in your blood after you haven't eaten for at least 12 hours. Most people like to schedule this particular test in the morning, just so that they can fast overnight, and so hopefully you're sleeping for a majority of it. Normal fasting glucose is 99 milligrams per deciliter or less.

KRISTI: So if you have a diagnosis of prediabetes, you're going to see your fasting glucose or that fasting blood sugar; the range is about 100 to 125. Type two diabetes is considered a fasting glucose at 126 or higher. According to the Center for Disease Control, about 96 million Americans or one in three have prediabetes, which is pretty astounding. Of that 96 million, 80% are walking around with prediabetes and are undiagnosed. They don't even know that they have it. Isn't that astounding?

KARA: That really is. 80% don't know.

KRISTI: Right. And just a little interesting side note here with a client that I have. I started seeing her back in February. She was part of our Nutrition for Weight Loss program. Her main goal was to, you know, lose weight. So when I saw her initially that was the one thing she had in mind.

She had eaten too many sweets over during COVID. The weight gain had, had snuck up on her like many of us. She also loved to bake. So that also made a recipe for disaster for her. After I saw her the first time I suggested why don't we just run some baseline labs? Just so we have an idea of what's going on internally in your body. Well, low and behold, her A1C came back at 5.8%, which we will be talking about. That's actually considered prediabetes. She was completely shocked. She had no idea. She didn't have any symptoms of, you know, the typical diabetic person and what they might have.

KARA: And a lot of people don't with prediabetes.

KRISTI: Nope. Exactly. So what I did with her, we really worked with her sugar cravings and we got those under control. She was starting her day out with having a Fair Life chocolate shake. And that was to feed those cravings. The first thing she woke up in the morning, she was already craving chocolate. That was a good way to satisfy. It was also very easy. Little, did she know though all the artificial sugars and the artificial ingredients in there was pretty much setting her up for roller coaster ride all day long.

So I suggested to her: start with a balanced breakfast, you know, some eggs with some butter, some avocado. I had her make her own protein shake, limiting, you know, the fruit to half a cup, getting some good protein powder in there and some healthy fats. You know, she was still worried though. She still said, ah, Kristi, I still don't think I can control my sugar cravings during the day.

So I also put her on Crave Control which really, really helped curb her cravings for sugar and low and behold, that was in February that I had her do her A1C. Fast forward four months of eating, you know, less processed foods, less sugar, getting things under control. Her A1C dropped to 5.6% in July.

KARA: Where, where it should be.

KRISTI: And that's exactly where, where it should be. So not only was weight loss a goal of hers, she wanted to get out of that prediabetic range. And now she has within four months, which is pretty amazing.

KARA: Wow. Four months. So yeah, if you, if you're listening to that story, you know, it's possible to turn things around. Sometimes even more quickly than that, but four months is really quick. So that is thank you for sharing that story. That's very powerful.

KRISTI: Yeah.

KARA: And just like, we've been saying, you know, this hour, type two diabetes is very preventable. So getting into your doctor, like Kristi’s client, getting those labs checked, it's very important because, you know, I just mentioned this, unfortunately prediabetes often does not have a lot of obvious signs and symptoms. That is why 80% go undiagnosed, you know, and Leah, you had even mentioned, some people might have gotten tested and maybe they just didn't know what they were, didn't know what the labs meant.

LEAH: Right.

KARA: They didn't look at the results.

LEAH: Yep, absolutely. So, yeah. So let's, let's chat about that A1C. We've thrown that term out a couple of times. So we talked about the fasting glucose number, which is just a quick snapshot of what's going on in your blood at that point. What is your blood sugar? Now that hemoglobin A1C: this is an average blood sugar reading. This is an average over about three months. All right. So this is now we're getting a little higher up more of like that 30,000 foot view of what those blood sugars are doing. Normal hemoglobin A1C should be 5.7% or lower. An A1C between 5.7 to 6.4 means prediabetes. So exactly what you said, Kristi, that 5.8 that your client had experienced. She was right in that prediabetes range. Then anything over 6.5% or higher indicates type two diabetes.

KARA: And another lab that's often part of a cholesterol panel, or you may have heard of that as a lipid panel: it's triglycerides. So since you're already going in for labs, it's, another, it’s a very easy one to get, and just you'll have to request that. High triglycerides can be a sign that you have prediabetes or diabetes. So it's just another good marker to know where you're at. Having high triglycerides is a sign that the process of turning food into energy in your body isn't working properly.

LEAH: Right. So in that lipid panel, when you're looking at that triglyceride number, the, the cutoff is 150 milligrams per deciliter. So, and I even have my clients, I say like, let's keep it under a hundred if we can. Let's keep it the number in the double digits instead of the triple digits. So under 150 milligrams per deciliter for sure is where we want to be. Borderline is between 150 to 199. And anything over 200 milligrams per deciliter is considered high. I mean, I have definitely seen clients who have those numbers of 400, 500, 600 milligrams per deciliter. That is, those are very high numbers.

KRISTI: You know, like many general lab range recommendations, the ones for prediabetes and type two diabetes can be too broad. You know, people will look at them and then they've got that false sense of confidence as far as where their health is currently at.

KARA: I agree with you, you know, here's an example. If a client came to one of our dietitians or nutritionists, they had just come from the doctor and they had their labs and they said, my fasting glucose it's in the normal range. It's 95. Now, remember that technically anything under 100 for glucose, fasting glucose, it's considered normal, at least on paper, but I know that our dietitians and nutritionists would see that 95 reading. And that would be a red flag. For optimal health and to prevent further complications down the road related to heart, kidney function, memory, vision, we like to see fasting glucose ideally 70 to 85.

LEAH: Right. Yes. And same thing applies when it comes to that hemoglobin A1C. Again, 5.7 or less is considered normal, but I like to tell my clients, you know, if we are starting to see 5.5 or 5.6, like let's not even flirt with that line. Like let's try to give us a good amount of buffer so that we know that those blood sugars are under control most of the time. So a more optimal range would be 5%, 5.2%, 5.3%, kind of a more in that range. This would show that insulin is able to do its job to carry glucose into the cells really efficiently. And then that glucose can easily be shuttled into our cells when our cells are able to access that energy source really well. There's just this lower risk of all kinds of things, which include cancer, heart disease, even Alzheimer's disease.

So this, I had a client, oh, that I met with for the first time a couple of years ago. And she and I still have, you know, she still comes in and touches base every now and again. But when she originally came in kind of like your client Kristi, she did want weight loss, but she was also very upset or just very frightened that her A1C was getting close to that prediabetes range. Her A1C was 5.6%. And this was frightening to her.

This was something that she really wanted to change because she, her dad had a lot of health conditions and really a lot of them stemmed from his uncontrolled diabetes. So she was scared that she was kind of going down that same path. So we put together this great eating plan. She was all on board. She committed a hundred percent. She jumped in with both feet. The next A1C check, and I don't remember how long it was before she had that, that check again, but she dropped it to 5.1%. So she even, yes, again, even we're not even flirting with that line anymore. She really dropped it dramatically. And she just, she did wonderful. She was so ecstatic that she was kind of out of more of that danger zone.

KRISTI: Oh, that's great. Yeah. It just goes to show right, when you change how you eat, it really can affect your, your lab numbers in a positive way.

LEAH: Yeah, absolutely.

KRISTI: You know, and just to circle back with the triglycerides we had talked about earlier, we definitely don't want those creeping even up towards 150 even though, you know, under 150 is considered normal. We as dietitians and nutritionists, you know, we really like to see those healthier triglyceride readings closer to a hundred and even less than a hundred is better.

KARA: And I had a relative who was diagnosed with prediabetes and you know, her healthcare providers, weren't really making a big deal about the urgency of it to get that fasting glucose number down. So of course she didn't feel that urgency. And so, you know, she was just kind of keeping it between her glucose between 105, 110, 115. That should have been, like we say, a red flag, but unfortunately nobody was, was telling her to get the number down. It was just like, let's prevent it from going into full blown diabetes. So that's what we don't want to see.

KRISTI: Exactly.

LEAH: Yep. So, you know, we've gone over the optimal lab ranges and, and what to look for with that blood work. On the other side of break, we do want to get into just again, how do foods break down: carbohydrates, protein, fats? How do those affect our blood sugar?

KARA: So you are listening to Dishing Up Nutrition. I'm Kara Carper here with Kristi Kalinsky and Leah Kleinschrodt. If you're struggling with weight loss, prediabetes, diabetes, high blood pressure, high cholesterol, just a variety of health conditions, we invite you to join us for an eye-opening series of classes. It's called Nutrition for Weight Loss series. We're very excited to announce that our Nutrition for Weight Loss series will be held in person again starting in a couple of weeks.

During the pandemic, we were facilitating most of them, I think all of them via Zoom. And we are still offering a Zoom class. So, and of course we always have our online prerecorded Nutrition for Weight Loss series, but the in person classes and the one Zoom class will start the week of September 19th. This 12-week series meets one time per week. It's an hour long each week at all of our offices: Wayzata, St. Paul, Maple Grove, North Oaks, and Eagan. And they are 6:30 to 7:30 PM. Our nutrition educators will motivate you to make lifelong behavior changes. So you can accomplish both your health and your weight loss goals. There's also an early bird special. So if you sign up soon, you will get that special. And we'll share more about that after break.

Sign Up for Nutrition 4 Weight Loss!

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LEAH: Welcome back to Dishing Up Nutrition. Kara was talking about our signature series called Nutrition for Weight loss, our 12-week series. Not only will you receive the groundbreaking nutrition information in all 12 of those classes, but there is also a 90-minute one-on-one nutrition consultation included in the series. You get to meet with one of us nutritionists and dietitians to just take that information from class and personalize it more for you. And to kind of get into the nitty gritty of what's going to help you the most.

Classes are being launched at all of our offices starting September 19th. And we have a fantastic early bird special. I love it when we're able to offer these discounts for people. If you register before September 12th, there is a promotion for $50 off. So go to our website, weightandwellness.com for more information, or if you have additional questions and you just want to talk to somebody, call our offices at (651) 699-3438.

KARA: Great time to sign up for that too. Kind of the back to school, get back into the routine time of year.

LEAH: Absolutely. I, I feel like I've been a broken record talking with clients about that this past week or so of just using that transition time of, okay. Maybe this is a great time to evaluate some of those old habits that we've had and how, like, what do we want new habits to look like? What do we want that new school year to look like? And, and how can we set ourselves up for success going forward this school year?

What happens biochemically in our body when we eat carbohydrates?

Yes. So we, you know, before break, we went over all the lab ranges, what to look for, how do you know if your blood sugars are kind of suffering? So now let's take that information and, and just set it aside for a moment. Let's talk about how this actually works biochemically in our bodies. When we eat carbohydrates, our blood sugar, those glucose levels go up. Our bodies do just fine with a moderate amount of carbohydrates. So we don't need to cut out carbohydrates entirely. We'll dive a little bit more into like what exactly moderate amounts of carbohydrates looks like. But the ideal amount, just to give you kind of this picture is 25 to 30 grams of carbohydrates in a meal.

So picture a large leafy green salad with a few different vegetables on it. And then you eat a small, like maybe medium sized apple on the side of that salad. That's going to get you in that ballpark range of 25 to 30 grams of carbohydrates. Once the blood sugar goes up after eating now, the pancreas produces insulin. We've mentioned insulin a few times. Now this is that hormone and that insulin's job is to help get that blood sugar into your cells. That gives your cells energy. This is an example of everything working well and not going overboard and eating those excessive carbohydrates.

KRISTI: You know, so let's talk about, you know, maybe what a typical American breakfast looks like or at least what I hear from some of my clients. You know, they're grabbing the cereal box in the morning, probably eating, you know, about two cups of cereal in their bowl. And then they're pouring milk over the top of that. And then on the side, you know, they're probably having maybe a glass of orange juice. So the cereal, if you have two cups of cereal and the milk, that's about 68 grams of carbs, and then you add the orange juice on top of it. That's an additional 24 grams of carbs. So if you add those together, 92 grams of carbohydrates. That's just at breakfast. No one, no one needs 92 grams of carbs with a meal, not even an endurance athlete.

So after this type of meal, what's going to happen, right? Your blood sugar or your glucose-it skyrockets way too high. And then your pancreas produces insulin. Cause it's trying to get that blood sugar out of the bloodstream and into the cells to be used for energy. But guess what happens? It's too much sugar. You know, your cells don't need that much sugar to function. So what happens instead is the rest of that blood sugar is removed from the bloodstream and it gets stored as body fat.

KARA: And if you ate two cups of cereal with milk, a glass of OJ, if you did that a couple times this past summer, but the rest of your breakfast were more like eggs with veggies cooked in butter, or perhaps you had whole milk plain yogurt with berries and some nuts, your body can recover from eating cereal and milk and juice a couple of times. So it's those day in and day out high carbohydrate habits that over time, you know, over weeks, months and years lead to first insulin resistance and prediabetes and sometimes type two.

LEAH: Right. So over time, if those cells are just being bombarded with high sugar at every meal day in and day out, high carb meals, snacks, we're drinking those liquid sugars, not only is the body storing more and more fat, but this is where insulin starts to work less and less well. So we still might be making that insulin, but now it's just not able to function the way that it should. Picture all that excess sugar just circulating in your blood. And what happens is it eventually kind of forms this hard crust or a coating over our cells. That's what we mean when we talk about insulin resistance. So now insulin cannot get that proper signaling to the cells. And this is now those blood sugars start to become consistently high. This is where we think of insulin resistance, prediabetes. And that's why that fasting blood sugar number often starts to go up just from all that excess sugar floating around in the blood.

KARA: We gave the example of a salad and an apple and how that amount of carbohydrates, 25 to 30 grams with a meal, that's normal and healthy. Insulin is able to do its job, versus the daily cereal, milk and juice habit that over time prevents insulin from being able to do its job. So let's talk about how other types of foods affect blood sugars and insulin. Cause I bet people would like to know that.

Eating in balance to balance the blood sugar

LEAH: Mm-hmm yeah. Great point. So out of our three macronutrients, we've got proteins, carbohydrates, fats. We talk about those on the show all the time. We know carbohydrates raise blood sugars the most, and of course there's nuance there. Like there's different quantities, portions, types of carbohydrates matter, but the carbohydrates are the things that affect blood sugar the most. But for fats and oils, those don't have any effect on our blood sugar or insulin. And that's super interesting.

KARA: What Leah's saying is if you had, if you ate a half of an avocado, your blood sugar would not go up and all fats work like that. It's wonderful: butter, olive oil, coconut oil, avocado oil, nuts, seeds, things like nut butters, guacamole, full fat sour cream, heavy whipping cream. That's just a list of what we call healthy fats that really work to stabilize that blood sugar level.

KRISTI: Right. You know, and then the third macronutrient is protein. That sort of has like a medium effect on our blood sugars. So after we eat those proteins, think eggs, fish, chicken, meat, cottage cheese, your blood sugar goes up a little, which means some insulin’s released in order to help get that blood sugar into the cells. But it's not that big spike that you see from eating carbohydrates.

KARA: So to summarize, we know that carbs raise blood sugars the most and then protein does a little bit and the fat doesn't at all. So that's the main reason that at Nutritional Weight and Wellness here, all of our eating plans start with the same template. Individual meal plans do vary, but the template on how to put these meals and snacks together is really similar. So it's combining a protein, let's just say four ounces of protein with a healthy fat, approximately 15 grams of a healthy fat. And then that carbohydrate really working to keep that between 25 to 30 grams of real food, preferably vegetable carbohydrates, the non-starchy kind. So that is the perfect combination to prevent dramatic blood sugar spikes.

KRISTI: Yeah, it works like magic. You know, that healthy fat and that protein and combination together work like a buffer for those carbohydrates. So then it doesn't let the carbohydrates create such a big spike in our blood sugar. It's the blood sugar fluctuations. You know, we're looking for more of that gentle rolling hill effect with our blood sugar and the protein and the fat help do that. You know, just eating carbohydrates by itself really creates those steep peaks and valleys in our blood sugar.

LEAH: Yep, absolutely. And that's what I think…

KARA: Thanks for listening. Have a great day.