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Blood sugar blues?

A person’s blood sugar level is basically the amount of glucose present in their blood at any given time. You might be wondering why anyone would need to know this?

Well, keeping your blood sugar balanced is one of the most important factors in maintaining good health – in particular, even energy levels and a healthy weight.

How glucose works in the body

Glucose is a simple sugar that is produced by the body from the carbohydrates that we eat. It is necessary for a wide range of critical processes. Most notably, the glucose in your bloodstream is available to your cells to make energy.

Glucose is transported from the intestines or liver to cells via the bloodstream, and is made available for cell absorption via insulin (a hormone produced by the pancreas).

Glucose that is not directly used as an energy source (for instance, because blood sugar levels are too high) is either:

– sent to the liver, adipose tissue and muscle cells, where it is absorbed and stored as glycogen (our temporary fuel store)

– or converted into fat (our long-term fuel store).

Stored glycogen can be converted back into glucose and returned to the bloodstream whenever insulin is low or absent.

Why are balanced blood sugar levels important?

It is estimated that as many as 3 in every 10 people have an impaired ability to keep their blood sugar levels stable – it may go too high and then drop too low.

Blood sugar is normally measured in molecular count (millimoles per litre), or as a weight in grams (milligrams per decilitre).

Normally, the body maintains its blood sugar level at a reference range of between 3.6 and 5.8 mmol/L (or 64.8 and 104.4 mg/dL). The mean normal blood sugar level is around 4 mmol/L (or 72 mg/dL), although it obviously fluctuates throughout the day.

As you might expect, levels tend to be lowest in the morning, before the first meal of the day, and spike for 1 to 2 hours after meals by a few millimolar. However, when it comes to diabetics, blood sugar fluctuates more widely.

Over the years, a continual imbalance in blood sugar levels can result in weight gain (if not obesity), increasing feelings of lethargy and possibly more serious health conditions.

Low blood sugar

When blood sugar levels are too low (referred to as hypoglycemia), a host of symptoms can be experienced. These include everything from irritability, nervousness and depression, to fatigue, headaches and digestive problems.

In particular, when the level of glucose in your blood drops, you feel hungry. This is how blood sugar can have a direct impact on appetite and weight gain.

High blood sugar

Persistently high blood sugar levels are referred to as hyperglycemia. This can involve a suppressed appetite in the short term, with more serious health problems in the longer term.

The bottom line – if you are able to control your blood sugar levels and keep them stable, the result is usually an even weight, healthy body and consistently high energy.

More about the effects on health

As mentioned above, unstable blood sugar levels over a prolonged period can lead to serious health problems or may be indicative of an underlying medical condition, some of which are described below.

Advice should always be sought from a qualified medical practitioner if you have any concerns.

Diabetes

Diabetes is an extreme form of blood sugar imbalance and, possibly, the most well-known – certainly the most common.

According to NHS Choices, in England in 2010, there were approximately 3.1 million people aged 16 or over with diabetes (both diagnosed and undiagnosed). By 2030, this figure is expected to rise to 4.6 million, with 90% of those affected having type 2 diabetes.

It is a lifelong condition which is characterised by persistent hyperglycemia. Early warning signs are similar to those of mild glucose imbalance, but most notable is a sense of raging thirst.

There are two main types of diabetes – type 1 and type 2. Type 1 usually develops before the age of 40 (often in the teenage years), while type 2 tends to be diagnosed in older people.

Type 2 diabetes occurs when the body doesn’t produce enough insulin to function properly, or the body’s cells don’t react to insulin. This is known as insulin resistance (see below).

Type 2 diabetes is far more common than type 1 diabetes, which occurs when the body doesn’t produce any insulin at all. In the UK, about 90% of all adults with diabetes have type 2.

For those with diabetes, it is particularly important to keep blood sugar levels within normal ranges to avoid the development of serious health complications. For instance, kidney disease, nerve disease, eye disease and heart disease.

Insulin resistance

Insulin resistance is a condition where the body fails to recognise the consumption of sugars and carbohydrates, which means that it continues to pump out insulin which is not needed.

If this continues for a prolonged period, the pancreas can shut down and cease to produce insulin altogether.

If care is not taken by those who have this condition to ensure a healthy diet and maintain balanced blood sugar levels, it can eventually lead to Type 2 diabetes.

Keeping your blood sugar levels stables

A wide range of factors can affect a person’s blood sugar levels. For example, it can be temporarily elevated as a result of severe stress (such as trauma, surgery or illness), as a result of medication use or through alcohol intake. However, diet, weight and exercise are key.

The most obvious cause of unstable blood sugar levels is eating too much sugar.

Arguably, the best way to achieve an optimal balance of blood sugar levels is to control the glycemic load (GL) of your diet.

This is widely considered to be a more accurate measure than the glycemic index (GI), as the GL score takes into account both the quality and quantity of the carbohydrate. The GI will only tell you if a food is ‘fast’ or ‘slow’ releasing – it won’t tell you what the particular carbohydrate will do to your blood sugar or waistline.

That’s not to say that the GI isn’t helpful – it is worth understanding that fast-releasing foods provide a quick burst of energy, which then rapidly burns out – leading to the peaks and troughs which can be so damaging. Prime offenders are sugar and sugary foods, sugary soft drinks, white bread, white pasta, potatoes and white rice.

However, the GI can give some misleading results. For example, carrots and chocolates have almost the same GI score, but we all know that carrots are healthier than chocolate. This is because the GI is not taking into account the quantity of carbohydrate – you would have to eat 7 carrots to get the same amount of carbohydrate and the same effect on your weight. The GL score addresses this inconsistency and provides a truer picture.

So, it’s not just about what you eat, it is also about the quantity you eat, the quality of the food (i.e. whether natural or processed), how you prepare the food you eat and what you drink.

Interestingly, neither fat or protein have any appreciable effect on blood sugar. While they can both be converted into fat, this does not happen in the blood.

So, if you are looking for some healthy foods with a good GL score, below are some examples:

– oats
– peas
– beans
– lentils
– berries
– plums
– apples
– pears
– kale
– broccoli
– and spinach.

The fibre content of a food also lowers the GL, so make a conscious effort to include quality sources of dietary fibre in your diet. When you eat carbohydrate foods with a low GL with quality protein foods, you help to stabilise your blood sugar level even more.

As a final tip for keeping those blood sugar levels stable, it is also better to ‘graze’ throughout the day (eating little and often), than to ‘gorge’ on large meals. Opt for natural, whole foods – preferably organic and, whenever possible, raw!


Wheat/Gluten intolerance or coeliac disease?

Wheat/Gluten intolerance or coeliac disease?

Today we  have to ask why are the “free from isles” in the supermarket their quickest and largest growth areas .

These days, it is all too common to hear people saying that they are “intolerant”, “sensitive” or allergic to certain foods. At the top of the list are dairy, lactose, wheat, yeast, sugar, additives and gluten, but there are many others. 

The question is, why is this now so prevalent? Is it that there is actually a higher incidence of these conditions, or rather greater awareness leading to better diagnosis?

The answer is a bit of both.

Our hate – love  relationship with grains

Take our relationship with grains for example. Our eating patterns have changed drastically throughout human evolution.

While primates thrive by running on carbohydrates, and have a naturally “sweet tooth”, humans have learned to isolate and concentrate the sweetness from food, thereby cheating nature and putting pressure on our bodies.

One of the most common ways that we now eat carbohydrates is through grains and, more particularly, wheat. In fact, it is a staple food in the modern diet. This makes it harder to accept that it might not be good for us.

Previously, it was believed that sensitivities to gluten (a protein composite found in wheat and related cereals, including barley and rye) were relatively rare. However, recent research suggests that:

– gluten sensitivity affects as many as 1 in 10 people 

– coeliac disease (a more serious digestive disorder and auto-immune disease caused by intolerance to gluten) affects almost 1 in 100 people.

Why is this? Well, for one thing, our ancestors ate almost no gluten at all. The cultivation of grains started only about 10,000 years ago – a relatively short time in evolutionary terms. Even then, such cultivation was not widespread. In fact, gluten grains were only introduced to the American continent a few hundred years ago. The reality is, many of us have simply not yet genetically adapted to be able to tolerate grains.

Another important factor to note is that modern wheat is very different to that grown and consumed by our distant ancestors. For one thing, gluten now makes up as much as 78% of the total protein found in it. It is now well-understood that gliadin, one of the gluten proteins, is not only an intestinal irritant, but also causes allergic reactions.

Spotting a problem

Aside from the clear role of diet in the modern tendency towards these conditions, it is also true to say that there has been a steady increase in awareness of gluten intolerance and coeliac disease in recent years.

Unfortunately, both conditions can result in ambiguous symptoms which are difficult to diagnose and can be similar to one another, and those suffering with gluten sensitivity often experience no digestive symptoms at all. 

Under-diagnosis is therefore a significant problem – research suggests that around 500,000 people have not yet been diagnosed in the UK. A diagnosis can be made at any age, but the most common age range is currently between 40 and 60 years.

Encouragingly, national public awareness campaigns have led to a new focus on education in this area for doctors, nurses, dietitians and natural health practitioners. Similarly, there have been important developments in food labelling standards and the “free from” food industry.

If you suspect that you might be suffering from a gluten intolerance or coeliac disease, and/or are experiencing unpleasant symptoms when eating foods that contain gluten, it is important to speak to your doctor. If and when diagnosed, you can then take the appropriate dietary measures – including shaping your gluten-free diet.

More about gluten intolerance

A gluten intolerance results in gut symptoms similar to those of coeliac disease, but no associated antibodies are produced by the immune system. 

As already mentioned above, some people have a sensitivity to gluten but don’t experience any symptoms at all. However, many do. These might include feeling tired or depressed. Other common symptoms include:

– upper respiratory tract problems (such as sinusitis)

– problems with nutrient absorption (resulting in, for instance, weight loss, anaemia and fatigue)

– digestive disorders (including diarrhoea, constipation, bloating, Crohn’s disease and diverticulitis).

Research is ongoing into gluten sensitivity and new studies suggest that gluten may not be solely responsible for the symptoms produced by the condition. Instead, it seems likely that a group of short-chain carbohydrates (referred to as FODMAPs), are poorly digested and absorbed in the small intestine and could, therefore, also contribute to symptoms. Wheat, barley and rye (all gluten-containing grains) are all high in FODMAPs.

More about coeliac disease

Coeliac disease is a lifelong autoimmune disease, which is caused by the immune system reacting to gluten – it essentially attacks its own tissues through the production of antibodies, whenever exposed to the allergen.

Unlike a gluten sensitivity, coeliac disease is far more likely to result in inflammation to, and long-term damage of, the lining of the small intestine. 

The main function of the small intestine is the digestion and absorption of the nutrients in food. If coeliac disease goes undiagnosed, and therefore untreated, the cells lining the small intestine can become increasingly inflamed. They can also become flatter, resulting in a surface area that is significantly reduced. 

What this can ultimately mean for the individual, is less efficient nutrient absorption and therefore potentially malnutrition, deficiencies, weight loss, fatigue, digestive disorders and a strained immune system.

It is not entirely understood what causes coeliac disease, but it is now widely accepted that there are three key factors that underlie (or at least contribute to) its development:

– an environmental trigger (i.e. exposure to gluten)

– a genetic susceptibility

– an unusually permeable or ‘leaky’ gut.

In rare cases, stress on the body can also trigger the onset of the condition. For example, following an operation, accident, gut infection or pregnancy.

Just as is the case with gluten sensitivity, the symptoms of coeliac disease vary from person to person and can range from mild to severe. What’s more, symptoms are not restricted to the digestive tract – they can present in other parts of the body.

Some of the most common symptoms include: fatigue, anaemia, diarrhoea, abdominal discomfort, weight loss, vomiting and mouth ulcers. Again, some people may show no symptoms at all.

Living with a gluten sensitivity or coeliac disease

While there is no known “cure” for these conditions, once diagnosed they are relatively easy to address by simply removing all sources of gluten from the diet. This is the primary treatment and is usually very successful.

It is important to note that, where there has been prolonged irritation of the gut and inflammation of the intestinal lining, it can take several months for the improvement of symptoms. The individual will therefore need patience and staying-power.

A gluten-free diet to address sensitivity or coeliac disease is therefore a lifelong commitment. Sticking to it can be difficult, particularly as gluten is present in a wide range of foods that are consumed on an everyday basis (and is also sometimes ‘hidden’ in ingredients). It therefore takes a bit of research and practice.

“Free from” diets such as these can have a tendency to become heavily restricted. While it is perfectly achievable to have a healthy, well-balanced and varied gluten-free diet, it is important to be proactive in your meal planning to ensure this.

Gluten-free supplements, such as nutrients-fortified gluten-free meal replacements, can offer excellent support on a daily basis. With high quality products, you can rest assured that you are accessing a broad spectrum of nutrients, with certainty that you will not be exposed to gluten.

 

 


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