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Dr. MacMillan – Part 2

Last week in this space, Dr. Lucas MacMillan, Naturopathic physician and clinic director at Delbrook Integrative Medicine Clinic in North Vancouver, B.C. talked about increased energy levels and healthy weight control.

Today in part two of our Q & A, Dr. MacMillan advises on how to control sugar intake and the importance of blood sugar testing.

Q: What can blood sugar testing tell us?

A: Two main tests we offer for blood sugar assessment are fasting or random glucose, which speak to how much sugar is in our blood at the moment of the blood draw after fasting eight-plus hours (fasting glucose) or not fasting at all (random glucose).

This is best if done fasting, and gives us an idea of what the blood sugars are doing right now. Another test is called hemoglobin A1c, which tells us your average blood sugars over the past three months. 

Red blood cells live for about three months and this essentially tells us how much of a sugary product is stuck to them so we can calculate the three-month average blood sugar. 

It’s one of the very cool tricks that science and medicine have brought us, and is very useful to give a better picture of blood sugars. 

For example, a person may be very nervous to have their blood drawn, release a high amount of cortisol which increases blood sugars, all of which ends up showing me that their fasting blood glucose is borderline high. 

However, their hemoglobin A1c (blood sugar average over three months) gives a different picture of their blood sugars that may be more accurate to that person’s usual levels. 

Every lab test requires some interpretation, but we can learn a lot by using them and they can help to point out what is getting between us and our health goals.  

Q: How do we control our sugar intake?

A: One important thing to consider is the effects of having high blood sugar on sugar cravings. To understand this, imagine a muscle cell next to a blood vessel. 

The muscle cell requires glucose to do its job, and the blood vessel transports glucose throughout the body. 

Normally, the muscle can easily take glucose out of the blood to be used for energy production in the muscle, but this doesn’t work well when insulin sensitivity concerns arise. 

When insulin works correctly, it opens the door between the muscle cell and blood vessel, which allows glucose to pass into the muscle; when insulin isn’t working correctly (insulin sensitivity goes down), this door won’t open.

Blood sugars go up, largely because they aren’t being absorbed and used by body tissues such as the muscle. 

This leads to abnormally high blood glucose, and just as importantly, low glucose in the muscle. This can make the muscle feel weak and tired, and cause the body to release signals of hunger and sugar cravings. 

This can turn into a negative cycle of craving sugars, and starving tissues and muscles despite high sugar levels in the blood.

I always like to bring that story up as it rightfully shifts part of the blame off of people, and exposes the natural and powerful effects that happen with a decrease in insulin sensitivity. 

The vast majority of people will eat sugars if they crave them long enough. 

That said, here are a few of my favorite tricks for controlling one’s intake of sugar. 

First, make a new rule stating that you can eat a snack or chocolate only if you have a glass of water and a small vegetable first – ex carrot or broccoli and hummus dip. 

This helps to address the hunger that leads many to sugary snacks. Second, pre-plan how much of a sugary snack you are going to have before you dive in, serve yourself that amount, and put the rest away before you eat any. 

This can help to decrease the endless snacking and creates a solid end-point. 

Finally, brainstorm better alternatives that you will actually eat, and keep your house stocked with them. 

Ninety per cent of the diet is planning ahead and sugared snacks are no exception.

I recommend avoiding having the temptations in the house altogether and giving yourself healthy options for when the cravings do arise. 

I personally am a major fan of popcorn or cooked soybeans/edamame with butter and/or nutritional yeast, and I’ll take well-made hummus and raw veggies over almost any treat most days. These are my tricks; you may need to find yours!

Q: If someone is exercising, eating healthy but isn’t losing weight as expected, why would this happen?

A: This is more common than people think. I have patients that struggle to lose weight, and clearly eat well and exercise often. 

My first reaction is to test the big three: iron levels, sugar levels, and thyroid function.

If any of these are out, losing weight becomes an uphill battle, and it simply may not be possible to lose weight without an outright starvation diet – which simply doesn’t work out in the long term, so it is never recommended. 

These tests may reveal minor imbalances in each of these, or major imbalances in one. 

Either way, we either confirm that one or more of these is the problem, or we eliminate them from the list of possibilities. 

It really is surprisingly common for these items to play a role in weight concerns. 

Next, the concept of grazing and constant insulin exposure must be discussed.

Our bodies need a break, though many people aren’t offering their insulin receptors some time off. Some common diet suggestions include constant grazing, and never skipping breakfast. 

I am not a fan of outright claims of one method being right and another wrong, as there are always the patients whose bodies don’t play by the usual rules.

That said I am comfortable noting that I don’t personally believe regular snacking is a necessity, and I think it may be hurting our ability to lose weight, at least for many people. 

It is worth looking at if what you are currently doing isn’t working. 

Thanks to Christine Blanchette for our weekly feature and please follow her on Twitter as well as her Youtube channel.

Stay Safe!!