Diane Sanfilippo & Liz Wolfe | Balanced Bites Podcast | Blood Sugar & Pre-Diabetes

Podcast Episode #311: Blood Sugar & Pre-Diabetes

Diane Sanfilippo Featured, Paleo and Primal, Podcast Episodes 16 Comments

Diane Sanfilippo & Liz Wolfe | Balanced Bites Podcast | Blood Sugar & Pre-DiabetesTopics

  1. News and updates from Diane & Liz [1:41]
  2. What we're digging lately [3:27]
  3. Pre-diabetes and blood sugar [7:56]
  4. Blood sugar and hormones [10:20]
  5. Foundational points [15:09]
  6. Proper testing technique [20:34]
  7. How to handle it [26:35]
  8. Movement snacks [29:23]
  9. Closing thoughts [33:05]


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Diane Sanfilippo & Liz Wolfe | Balanced Bites Podcast | Blood Sugar & Pre-Diabetes Diane Sanfilippo & Liz Wolfe | Balanced Bites Podcast | Blood Sugar & Pre-Diabetes Diane Sanfilippo & Liz Wolfe | Balanced Bites Podcast | Blood Sugar & Pre-Diabetes

You’re listening to the Balanced Bites podcast episode 311.

Diane Sanfilippo: Welcome to the Balanced Bites podcast. I’m Diane; a certified nutrition consultant, and the New York Times bestselling author of Practical Paleo and The 21-Day Sugar Detox. I live in San Francisco with my husband and fur kids.

Liz Wolfe: I’m Liz; a nutritional therapy practitioner, and author of the Wall Street Journal best-seller Eat the Yolks; The Purely Primal Skincare Guide; and the online program Baby Making and Beyond. I live on a farm in the mystical land of the Midwest, outside of Kansas City.

We’re the co-creators of the Balanced Bites Master Class, and we’ve been bringing you this award-winning podcast for nearly 6 years. We’re here to share our take on modern paleo living, answer your questions, and chat with leading health and wellness experts. Enjoy this week’s episode, and submit your questions at http://blog.balancedbites.com or watch the Balanced Bites podcast Instagram account for our weekly calls for questions. You can ask us anything in the comments.

Remember our disclaimer: The materials and content within this podcast are intended as general information only, and are not to be considered a substitute for professional medical advice, diagnosis, or treatment.

Before we get started, let’s hear from one of our sponsors.

Liz Wolfe: Today’s podcast is sponsored by Vital Choice seafood and organics. Purveyor of premium sustainably sourced seafood and a certified B corporation. Vital choice offers a wide range of fish, shellfish, humanely raised meat, protein rich bone broths, and paleo friendly snacks like organic dark chocolate, super antioxidant trail mix, and bison jerky. As the days get longer and the grilling season heats up, www.vitalchoice.com is your source for real food.

1. News and updates from Diane & Liz [1:41]

Liz Wolfe: Ok my friend. My friend, Diane Sanfilippo.

Diane Sanfilippo: That’s me.

Liz Wolfe: What’s up with you this week?

Diane Sanfilippo: Well. Just kind of plugging away on edits for the new book, the 21-Day Sugar Detox Daily Guide. Some recipe development, photography, all that good stuff. I’m kind of excited about the different approach we’re taking with the new book. Where it’s a little bit less of independent recipes. Like, just make this one thing and that’s all you get out of it. It’s a little more of how to; I don’t know if I would say batch cook. But let’s just say you're roasting a chicken; I’m going to give you two different things to do with the chicken from after you roast it. So stuff like that that’s a little more; I don’t know. Maybe a little more practical. Or just how I actually cook.

So I think that will be really fun for people. And it’s a fully guided daily approach. So I’m holding your hand the whole way through. I’m kind of excited about. I mean, I’m not kind of excited. I’m very excited about it. It’s harder to be excited while you're editing. Because, you know, it’s kind of stressful. But it’s fun, and I’m excited to have something new for people. What’s up with you?

Liz Wolfe: Not a lot. Just trudging through the month of August, trying to keep my head above water. We have a ton going on just in life, and in toddlerhood. And you know, my mom’s a teacher and she’s been helping me this summer. And of course, she’s gone back to work. So just trying to patch things together and stay sane. That’s about all I’ve got right now.

Diane Sanfilippo: Well, I think we’ll be talking about all of that in an upcoming episode.

Liz Wolfe: Yes.

Diane Sanfilippo: Just kind of life and balancing all that stuff. So alright.

2. What we’re digging lately [3:27]

Diane Sanfilippo: Alright, let’s talk about stuff we’re digging right now. It doesn’t have to be a new thing.

Liz Wolfe: Ok.

Diane Sanfilippo: So this is kind of the way we’re approaching the segment. Ok, let’s see. Stuff we’re digging right now. I am totally digging. Well, I feel like I’m always digging eating my food in bowls. Do you eat food out of bowls a lot?

Liz Wolfe: {laughs}

Diane Sanfilippo: {laughs} You seem to use plates. Look, this is a serious topic.

Liz Wolfe: I just don’t have any bowls that photograph well. Not that anything I do photographs well.

Diane Sanfilippo: I’m sorry, that’s the criteria?

Liz Wolfe: I find that my plates are better. I don’t know. I’m trying to not have a heinous Instagram, since I’m focusing on Instagram a lot more now. I don’t really know how to photograph stuff in bowls. {laughs} But that’s not why. It’s also because I just don’t think about my vessels for food all that much.

Diane Sanfilippo: I think about it so much that my poor husband will take a plate out for me, or a bowl. Or a plate bowl, as I sometimes call them. He’ll literally take one out.

Liz Wolfe: A plowl. A blate? What is it?

Diane Sanfilippo: {laughs} Yeah, I don’t know. It’s not like spork where there’s a name for it. But he’ll take one out of the cabinet, basically knowing that I will pick a different one. He just knows.

Liz Wolfe: But he still tries.

Diane Sanfilippo: He still tries.

Liz Wolfe: That’s a good man.

Diane Sanfilippo: I feel badly whenever I do pick a different one. But I’m very particular and I just have my ways, ok. I’m really old person who just has my ways. So anyway. I like to eat my food in bowls because it doesn’t spill off the edge. {laughs} Maybe it’s just because I’m a messy eater. I feel like it’s easier to stab at my stuff. So anyway, I’m really into…

Liz Wolfe: Uggh!

Diane Sanfilippo: What.

Liz Wolfe: I’m losing it over here. “I’m Diane, and I like to eat my food in bowls because.”

Diane Sanfilippo: I do. I just do. I’m not the only one! You guys have to come tell us if you're into it.

Liz Wolfe: There are people nodding their heads vigorously, and shaking their heads vigorously. This is like, team bowl/team plate. This is ridiculous.

Diane Sanfilippo: I’m just saying. Anyway. I get a lot of them from World Market, if anyone is wondering where they’re from. And I’m into it. So anyway. That’s something I’m totally into right now. And I’m into Michelle Tam’s new cookbook, Ready or Not.

Liz Wolfe: Yes!

Diane Sanfilippo: I actually am reading it! Like, I’m reading the little captions. And I think it’s kind of fun. So what are you digging right now?

Liz Wolfe: I’m digging. Oh shoot. I think they’re called Nelly’s. They’re like, you can’t say healthy Almond Joys. I feel like I’ve talked about these before.

Diane Sanfilippo: You can say that. You just did say that. {laughs}

Liz Wolfe: I just did say that. I can say that. Should I say that? I don’t know. So I think it’s Nelly’s. And they have them at Sprouts, which is fairly new to Lee Summit, Missouri. So sometimes we make the trek to Sprouts. And they’re always out of stock. Always! They have all these Nelly’s bars in this little refrigerated section. And they’re almost like candy bars, reimagined without the crap. And I used to love Mound’s bars. Just the coconut and dark chocolate. And they have this one that’s just coconut with this perfect shell of dark chocolate around it. And the ingredients are fairly clean. I mean, they’re not perfect. Obviously, there’s some refined I think agave in there. But it is such a good treat. And I love how the dark chocolate just kind of crunches when you bite into it.

Diane Sanfilippo: {laughs} Oh.

Liz Wolfe: And I found an entire full box of them at Sprouts the other day. And I hoarded that, you better believe it. I don’t even know how much it costs. It was a terrible, terrible financial decision. But I did it. And they’re so good.

Diane Sanfilippo: I approve of this message. {laughing} I would totally do that.

Liz Wolfe: The Balanced Bites podcast is sponsored in part by the Nutritional Therapy Association. The NTA trains and certifies nutritional therapy practitioners and consultants (including me; I’m an NTP), emphasizing bio-individuality and the range of dietary strategies that support wellness. The NTA emphasizes local, whole, properly prepared nutrient dense foods as the key to restoring balance and enhancing the body’s ability to heal. Nutritional therapy practitioners and consultants learn a wide range of tools and techniques to assess and correct nutritional imbalances. To learn lots more about the nutritional therapy program, go to http://www.NutritionalTherapy.com. There are workshop venues in the US, Canada, and Australia, so chances are you’ll be able to find a venue that works for you.

3. Pre-diabetes and blood sugar [7:56]

Diane Sanfilippo: Ok. So today we’re talking about a listener comment on blood sugar and pre-diabetes that we both found really interesting. Do you want to read the comment/question?

Liz Wolfe: Yes. This was one where we know we can make a podcast out of this answer, because you and I talked about it for like an hour behind the scenes. This is really interesting to us. So we thought this would be a good one.

Emily says, “Can we talk about blood sugar for a second. As in, what’s actually normal and what’s not. Recently after finding out that a very thin and seemingly-healthy friend of mine was diagnosed as pre-diabetic by her OB/GYN, I decided to start testing my own at home with a glucometer. I’ve been testing about an hour or two after meals to see how my body reacts to different foods and what I’m finding is kind of scary. Most diabetes and health websites out there say that your blood sugar, if you're healthy/normal, should never go above 140 after a meal. But there have been several times that my blood sugar has hit as high as 170. For example, after a burrito bowl from Chipotle. And last week, I woke up to a fasting blood sugar of 101.

The thing is, I consider myself to be a pretty healthy person. I’m 5’3”, and 110 pounds. And I exercise every day. I don’t drink very much caffeine or alcohol, or eat refined carbs. And my dessert every night is herbal tea with a few squares of 85% dark chocolate. Yet my blood sugar readings continue to surprise me in a negative way. I’m just confused, and I really don’t want to have to give up all carbs. Just FYI; my doctor testing my hemoglobin A1c about 4 months ago, and it was 5.2 so she wasn’t worried. But my numbers still seem high to me. Am I wrong? And if not, what is there to do besides going carb free? I guess I really just want to talk about this because my friend and I are both seeing pre-diabetic numbers. I have a feeling a lot more people are walking around with pre-diabetes and have no idea. Thank you for any insight you can give.”

Extra info. “I’m not paleo, but I definitely try to eat in a way that makes me feel good. Lots of veggies, whole grains, some fruit, nuts, seeds, and beans. I struggle with estrogen dominance so I’m very much trying to limit alcohol. But I don’t always succeed. I probably have, on average, one to two drinks per week. I do have a sweet tooth, probably as a result of an eating disorder I went through in high school where I didn’t allow myself anything sweet. But dark chocolate usually does the trick.”

Diane Sanfilippo: Such an interesting question.

Liz Wolfe: I know! My gosh, I have so many thoughts.

Diane Sanfilippo: Well, do you want to throw some things in.

Liz Wolfe: Yes.

Diane Sanfilippo: Or do you want me to just lay some foundation? Which? How do you want to do this?

4. Blood sugar and hormones [10:20]

Liz Wolfe: Let me throw a couple of things down before I forget them, because I will forget them. First of all, I’m curious, just on an individual level how she knows she’s struggling with estrogen dominance. Whether it’s physical symptoms, or whether it’s something she’s confirmed. Has she done the Dutch test. Those things. Because sometimes we think we’re dealing with estrogen dominance, when what we’re really dealing with is cortisol dominance. And that is not a clinical term.

But the whole elevated cortisol loop, which is intimately tied to stress is estrogenic. In that it kind of promotes the physiology that promotes estrogen, and it suppresses the physiology that promotes progesterone. And so when a lot of folks think it’s just about the hormones; and of course, I think estrogen dominance is probably associated fairly tightly with a downgrade in insulin sensitivity. But my curiosity is whether this is kind of self-diagnosed or whether it’s practitioner diagnosed, and she’s really sure it’s just about the estrogen or whether this is actually about the cortisol.

And the reason my mind went straight to cortisol, is because when you're waking up with high blood sugar, you have this physiology that happens that basically wakes many of us up in the morning where you have this dip in blood sugar, cortisol and stress hormones spike and recruit stored glucose from your body to kind of compensate for that end of the sleep period dip in your blood sugar. Not that it’s normal to wake up to high fasting blood sugar, but I think it’s really, really relevant to address the stress and the cortisol situation, because that is absolutely going to affect where your blood sugar is day to day. So it’s not always just about the carbs that you're eating.

The other thing that really came to mind. Ok, first I’ll say this and then I’ll kind of loop back to hormones quickly. But the other thing that came to mind is a lot of times we think it’s just about the carbs. And I don’t know that that’s true. I think the first shift; and this is something I feel like I learned from you, Diane. The first shift you make is choosing the right carbs for you. A lot of times people are so quick just to hack carbs completely out of the diet. I think particularly for women, this can be a negative thing to do. And can kind of have some negative rebound effects that we don’t necessarily want. But what we really want to do is have a reasonable amount of carbohydrate, for you, and your level of activity and your hormonal state and where you are in your reproductive journey. But we want to teach your body also how to properly use carbohydrates.

There are a lot of things involved with that. Some of that is balancing hormones. Some of that is getting the right nutrients in. A lot of that is probably sleep and stress. But it’s not just about hacking out carbs when, as we say all the time. There are almost always deeper stress related, sleep related, issues.

The other thing I wanted to talk about. And of course, this really piqued my curiosity. This first paragraph where she was talking about this “seemingly healthy friend of mine was diagnosed as pre-diabetic by her OB/GYN.” What’s really interesting that I think a lot of people, even practitioners, don’t realize. Which is weird, because it’s all over the medical literature. Is that it’s not just pregnancy that is kind of; particularly the third trimester, that is a naturally insulin-resistant state. I think that third trimester has up to maybe a 50% decline in insulin sensitivity.

But it’s also women who are not pregnant will have reduced insulin sensitivity in their luteal phase. I have no idea what the biochemistry is. I think progesterone suppresses some kind of pathway that is involved with insulin sensitivity. But depending on when you're testing in your cycle; we just can’t away from this as women. We just cannot get away from our cycle and the ebb and flow of our hormones. Which are affected by sleep, and stress, and food, and yadda-yadda-yadda. We can’t get away from how different our physiology is at different points in our cycle. So depending on when your testing your blood glucose in your cycle, you might come up with something different. And that’s one of those things, whether you're pregnant or not, would be something really interesting to track if you have the wherewithal to do it.

But not only was I wondering whether her friend was pregnant, and diagnosed as pre-diabetic. Or I guess she didn’t say gestational diabetes, but you never know, exactly what is going on in the doctor’s office. But where her friend is in her cycle, where she is in her cycle. Particularly whether either one of them tends to lower levels of progesterone just based on lifestyle stress and things like that. That’s really kind of all the things that were swirling around in my head when I was listening to this question. Now I’m done.

5. Foundational points [15:09]

Diane Sanfilippo: I was nodding along. I was muted so that I didn’t interrupt you with weird noises, or the cat interrupting. But I was totally nodding along. To address some of the things that she was talking about here in her question. A few of them. And first of all, I really just like the way she, “Can we talk about blood sugar for a second?” {laughs} I like the way she worded that.

Liz Wolfe: {laughing}

Diane Sanfilippo: I’m curious how old she is. She says that she exercises every day. I’m just curious a little bit more of the picture. So maybe she’ll come back and comment on the blog post and fill in a little bit more there for us. Because it does make a difference, I think, if she’s in her 20s, 30s, 40s, etc., because of that hormone balance that you were talking about.

But a couple of just kind of; I don’t know, foundational points for folks to hear and know whether or not her situation or she and her friend’s situation is relevant to you. Just the idea of pre-diabetes and all of that. There’s just a few things to note. One is, what is pre-diabetes? It’s just before there’s a diagnosed medical condition where either something like metformin, which is a regulator. It’s to help you regulate blood sugar, help insulin sensitivity, but it’s not insulin. That’s usually prescribed before insulin would be prescribed. And it’s very, very commonly prescribed in type 2 diabetes.

So this is basically seeing numbers that are just inching closer to that diagnostic range that your doctor has. And in standard medical practice, numbers for fasting glucose under 99 would be considered normal, and in the 100 to 125 range could be considered pre-diabetes. But in a healthy person, optimally, we’d probably be looking more like under 90, under 87 or so for that fasting glucose number.

Now, here’s where we’re going to throw a wrench in the works. And she definitely says that she does eat things like whole grains, and fruit, etc. Which is fine. This is no longer a, “if you're not paleo, be paleo” podcast. {laughs}

Liz Wolfe: {laughs} If you're not paleo, be paleo.

Diane Sanfilippo: Be paleo. Like here, that will fix it. I mean we’ve kind of never said that that was the way to be.

Liz Wolfe: I probably did. You probably didn’t. {laughs}

Diane Sanfilippo: I don’t know. Anyway. What I was going to say is, for people who are eating low carb you might expect to find some higher faster glucose, and that seems strange. But kind of what you were talking about with women in the luteal phase. Folks who are eating low-carb may be slightly insulin resistant as time goes on, because the body is downregulating how much insulin we need to use all the time if we are eating low carb. I’m saying we, although I’m not eating that way currently.

But it’s a non-disease state of some insulin resistance. And we’ve talked about this on the podcast many times. We’ve talked about it on any episodes where we talked about keto. So you guys can go back and listen to those. But I’m just pointing that out for folks who may have this experience who are eating lower carb. It doesn’t sound like she’s doing that, so I just kind of wanted to put it out there.

And a couple of other things about her glucose testing. One, your glucometer. If you bought it on Amazon, and it’s not a super expensive device that’s extremely accurate, what you're getting from it is the plus or minus standard deviation of what that measure may be could be off by several points. So I just want to point out that noticing trends is more valid and accurate than the exact number. So I know that’s frustrating, but you could be measuring your fasting glucose at 100, and it really could be 95 if it were measured otherwise. So it’s really tough to say exactly what your fasting glucose is with a home-based monitor.

The other thing about that is, and I’ve heard this from several RNs who have commented to us on multiple different posts, or blog posts, etc. You want to wipe away the first drop of blood. Because that reading sometimes is really, really off. I don’t know why. Maybe it has a higher concentration in it. Or something is going on. So if you are using a home glucometer, wipe away the first one or two drops of blood, and use one after that.

Liz Wolfe: I think it might be because of what’s on your skin, or something.

Diane Sanfilippo: That could be, as well. Where you're just picking things up. So, get rid of that. Of course you want to wash your hands before you're doing it, as well. So just some different things about the testing and how first and foremost your test could be off. And not to just be so tied to the exact number, because it’s more about watching patterns. So over the years, if you're going back to your general practitioner or your OB/GYN, and they’re doing this type of testing.

Did she have a fasting test done at her OB/GYN? She said her blood sugar. Did she say it was fasting, of her friend? I don’t know how common it is that someone’s getting that type of blood work done with their OB/GYN. But perhaps if she was doing some fertility work. That could have come in. So just some other thoughts on that. Because all of those things can throw those numbers off.


Diane Sanfilippo: So, my question too about her post-prandial, or her after meal testing for Emily, was how long after did she test it? Because she just said, after a meal it hit as high as 170. Well, we don’t want you to test it like 10 minutes after you eat. We want you to test it an hour after you eat. So I don’t know when she was testing that. And the number that she was saying, not over 140, that’s an hour later. So if you're testing it inside of that one-hour window, give your body a chance to deal with what you just ate. Because your blood circulating glucose will be higher in that time. But what you want to see the marker for is one hour later and then two hours later. Did your body do a good job of bringing that blood sugar down?

And I think that’s really important to note. Because I could see someone finishing a meal, and then *prick* let me just see what’s happening; 10-15 minutes later, 20 minutes later. But just give your body a chance. So there’s all of that.

I think, also what I mentioned about folks who are eating low-carb or keto, and that causing some of this insulin resistance. Again, it’s a non-pathogenic, non-disease state of insulin resistance. It’s not the same as something like type 2 diabetes. But on that note, as you mentioned, Liz. This isn’t a situation where I want folks to give up carbohydrates in order to improve their blood sugar. Because I don’t think we’re dealing with someone who is honestly pre-diabetic at this point.

Liz Wolfe: Mmm.

Diane Sanfilippo: But, you really never know. If somebody looks healthy from the outside, you just don’t know the mechanisms in their body that are handling their nutrition in different ways, and it may not have as much to do purely with the food. Her friend who, she said something about her being thin and seemingly-healthy. I mean; you just don’t know what’s happening metabolically with anybody. You don’t know what she’s eating.

If she’s eating poor quality food, maybe the body fat is not accumulating, but are her triglycerides high? I wouldn’t be surprised. I’ve definitely known folks in the past who have looked healthy from the outside. And inside their blood markers are really telling the story. So we’re actually luckier if we accumulate more body fat, because we can see the evidence of something happening versus someone who has it just going on in their blood.

So, all of that. The “But I’m healthy.” And “How could this be happening?” We don’t know exactly why one person may have issues like that. There can be so many factors. It can be hormonal. It can be an issue of stress and hormone detox. Absolutely, Liz, I’m totally with you on the cortisol issue. When she says estrogen dominance, I see that as; this is something that I struggle with, too. Where I’m like, “I think it’s my female hormones, but it’s probably not.”

Liz Wolfe: Yeah.

Diane Sanfilippo: It’s probably other hormones that are then having this effect downstream. So should she be worried about being pre-diabetic? Probably not. And if she is eating a super high amount of carbohydrate that is poor-nutrient carbohydrate, then that would be something to consider. But just not eating carbs isn’t a solution. The only time that is a “solution” is as a therapeutic intervention for someone who is struggling with type 2 diabetes or legitimately pre-diabetic. And you know they're eating poor quality food.

So what’s happening there is the body doesn’t have the nutrition that it needs to process this stuff. Because if you're eating nutrient-poor foods and they’re high carbohydrate, high refined seed oil fats, high refined sugars, sodas, crackers and cookies and breads. All kinds of things that are just not supporting the body and properly metabolizing carbohydrate, that can happen. That can cause a state where we are pre-diabetic, and it’s more and more common to happen in younger people who maybe aren’t overweight. But it’s just some kind of malfunction with blood sugar.

It’s always possible that, depending on how long she’s been eating healthier, it’s always possible that her past had a metabolic effect on her. She said something about struggling with an eating disorder. We don’t really know the effects of some really tricky choices we’ve made in our lives. You and I will never know the effects of just how much the spaghetti-o’s affected us in the long-term. At least for me. Or drinking Red Bull when you were in college. Or whatever it is. We think we can rebound from all of that very quickly. And maybe we can. But maybe some of it is affecting us all differently.

I think, unfortunately, the high blood sugar story gets an answer of “reduce your carbs” very quickly, and I just don’t think it’s always that simple. I know that maybe that doesn’t give a lot of answers, but I think it’s more about what else could be going on here. What are factors that affect this, and just knowing that it’s not about just giving up carbs. Even if you think you're pre-diabetic. I don’t know; I’m hoping that makes sense.

I mean, even for someone that does get diagnosed with type 2; I would not say to them, “You need to eat low-carb or keto for the rest of your life.” I would say, “This is a way to eat to start to get your body to heal.” And I still wouldn’t have them avoid carbs altogether. Because I don’t want them to be more insulin resistant than they need to be. I want them to have good quality carb in some small amounts, at the very least, to keep their body working properly with all of their hormones and appetite signaling. But it’s just not a one-size fits all answer. We know there are people who eat that way, and they’re just not seeing the results that they would expect to see.

7. How to handle it [26:35]

Diane Sanfilippo: So how best to handle it? I would definitely be cautious about the way you're testing and assumptions about how accurate the tests are. It is really important to watch this stuff, if you're concerned about things like heart disease and you're concerned about fertility. Watching your blood sugar is definitely not a bad idea. But I would not freak out. {laughs} For sure, I would not freak out about it.

And if it is something that you’re really, really more concerned about; I would have your fasting glucose tested every three months, or so, as part of a normal blood panel rather than testing it just at home. Because I do think that you’ll get more accurate readings, and you’ll see a trend of what’s happening, and you can keep track of how you’ve been eating, how you’ve been exercising, what your stress is like, and see what’s happening there. But I think in an otherwise healthy individual; I just don’t want people to freak out about it. You know?

Liz Wolfe: Mm-hmm.

Diane Sanfilippo: It’s a delicate balance there of awareness, which we love. And awareness that causes a freak out, if that makes sense.

Liz Wolfe: It does. And I think in the medical model. Which of course, is an important part of our ability be healthy in the modern world. There is this focus on, I don’t think there’s a really good understanding of the fact that test results, whether it be cortisol, hormones, blood glucose; you cannot just go on one days’ measure. You can’t get an entire picture about somebody’s life and overall state of health by one test one day, one number gleaned from that test.

Diane Sanfilippo: Yes, exactly.

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8. Movement snacks [29:23]

Liz Wolfe: Alright. Let’s talk about something entirely different. Let’s talk about what we are doing; you and me, Diane, to move each day. What are your daily movement snacks?

Diane Sanfilippo: {laughs} Movement snacks. Well, I would say I am not as good at this as I would like to be. So we’ll just throw that out there. I took a couple of months off from working out for various reasons. And luckily, we have a garage that has space for a home gym. So we’ve finally put together a home gym, and that’s kind of my new, exciting, I can just go down there, change my clothes, get 30 minutes. Change my clothes when I come back, no big deal. So that’s kind of my new thing. We’ve got a barbell. A nice barbell for me. Some dumbbells, and some mats, and a whiteboard, and lots of stuff we’re kind of putting together. So I’m excited about that.

I’m trying to do little; what are they, time-lapsed videos while I’m down there. I’m not trying to show you what I’m doing all the time, because I’m just not a trainer. I don’t need to be instructing everyone on everything I’m doing fitness-wise. But I like a little bit of that accountability. So I’m trying to film it and be like, “Hey, this is what I did today if you want to check it out.” So you guys can see that on my Instagram stories usually, because they’re messy little videos.

But yeah, I’m not as good at the movement snacks. I do try to go with Scott in the morning to walk the dog, and if it’s nice out in the evening for like a sunset walk too. So those are good days when I can get that in. What about you? I feel like you’re a little better at this.

Liz Wolfe: Are you kidding me? You're crazy. I take long walks when I can. That’s going to rapidly come to an end when I don’t have my mom helping us out and often staying with us to watch the kiddo. I’m not big on putting the kid in a stroller and taking a really long walk. Although, I guess if it’s; I don’t know. I struggle with this because I don’t know. Should I get my movement time and put the kid in a stroller and take a long walk at my pace? Or do we both; do I let her get her proper movement, and I just fit it where I can? That’s a big debate for me.

Because we can walk. My kid will walk. And she will walk a long ways. But it is very slow. It’s not that really active, good vigorous walk that I kind of crave. So that’s an ongoing struggle. My life is so hard, I can’t decide whether to walk or use a stroller.

Diane Sanfilippo: {laughing}

Liz Wolfe: But one thing I have done when I’m feeling like I need to get a little movement in my day, is I’ll just do whatever my kid does. So she’ll walk, and she’ll squat, so I’ll squat. Or she’ll run, and she’ll fall. And I’ll run and do a burpee. That type of thing.

Diane Sanfilippo: No you will not.

Liz Wolfe: Oh I totally will. I’m not going to fall.

Diane Sanfilippo: You’ll do a burpee?

Liz Wolfe: I’m not going to throw myself on the ground.

Diane Sanfilippo: By choice?

Liz Wolfe: Well, if she’s running. It turns out to be a burpee. But if she’s running in the grass and she falls down, I’ll run and I’ll kind of pop down and then pop back up. Which is kind of a burpee, I guess. Right?

Diane Sanfilippo: Yes.

Liz Wolfe: But I’ll just kind of follow her movement patterns to remind my body of what it’s like to not only stand with your hips jutted out with the weight on the front of your foot instead of your weight through the heel. Or remind my body what it’s like to squat instead of bend at the waist.

Diane Sanfilippo: So what you're saying is, your toddler is your personal trainer. {laughs}

Liz Wolfe: Pretty much.

Diane Sanfilippo: I like it. I like it a lot.

Liz Wolfe: I do too.

9. Closing thoughts [33:05]

Diane Sanfilippo: Liz, why don’t you give us some closing thoughts?

Liz Wolfe: My closing thoughts are that it’s never whatever it happens to be. Whether it is high fasted blood sugar, or hormonal imbalance, or stress. Whatever we’re dealing with is almost as never straightforward as what we think it is. So it’s not just about the number that you see on your blood tests or on the scale. It’s always something a little bit deeper. So when you're dealing with sugar stuff, let’s not just think about cutting out the problem. Let’s think about how to teach your body to work better, and then see where you are once you’ve done that.

So for almost everyone, no matter what you're dealing with, it’s going to come down to, what can I do with my sleep? What can I do with my stress levels? What can I fit into my day? Like a minute of meditation. It doesn’t have to be perfect. We talk about this a little bit in the podcast I think that’s upcoming with Dr. Hanscomb, about how you don’t have to do things perfectly. But you can do a little bit of meditation. You can do a little bit of stress relief and build those things into your day. You can do some expressive writing; you can play a little bit. Those types of things. So really look at yourself as a whole person. And see what you can do with that whole person to see how that moves the needles with the things that you're concerned about.

Alright, that’s it for this week, friends. You can find me, Liz, at http://realfoodliz.com/ and you can find Diane at http://dianesanfilippo.com. Join our email lists for free goodies and updates that you don’t find anywhere else on our website or on the podcast. While you’re on the internet, please leave us an iTunes review. See you next week.

Comments 16

  1. Hey guys! Emily here. First off, thank you SO much for answering my question! I’m no longer freaking out about my blood sugar readings, which is a nice sort of freedom. In response to your questions, I wanted to provide a little more info:

    I’m 25 years old, I exercise for about an hour every day (walking/yoga/pilates/strength training), and I sleep like a baby for 8 hours a night. I don’t have any kids or a super demanding job, so my life is as stress-less as it’s ever going to be. I do, however, love my iced coffee habit—but only treat myself 2-3 times a week. I was diagnosed with low progesterone last year (and just assumed this meant that I was also estrogen dominant), and since have been tinkering with natural supplements such as DIM, Calcium D-Glucarate, cod liver oil, and N-A-C. My biggest health complaint is my acne-prone skin, which I’ve struggled with since I was a pre-teen.

    As far as my blood sugar numbers go, I always test at least 1 hour after I eat. What I’ve noticed over the last few months is that my readings get worse as the day goes on. For example, my breakfasts of avocado toast or greek yogurt with nuts and granola usually result in lower numbers somewhere between 85-120 after an hour or so, but if I eat the same thing for lunch or dinner, my levels will sometimes soar to the 140-150s even by the 2-hour mark. The incident that surprised me the most was after eating a Chipotle burrito bowl for lunch (of brown rice, pinto beans, chicken, romaine, fajita veggies, & spicy salsa), when I saw a reading of 171 an hour and a half later. Just a few days ago, after indulging in 1/2 cup of Luna & Larry’s coconut bliss ice cream, my blood sugar was 144 after two hours(!).

    I guess my biggest fear is one day becoming diabetic if I don’t change something about my eating habits/lifestyle. I don’t like to restrict my eating because I’ve been there/done that, and it was a miserable way to live. It’s been about 3-4 years since I began eating intuitively and I’ve never been happier with myself. My diet includes a variety of food (gluten and dairy sparingly), some caffeine and alcohol, and the occasional sweet treat.

    Again, I appreciate you addressing my concerns and helping a sister out! I know everyone’s body is different, but I’m still trying to figure mine out. 🙂

    Oh! And my friend is 27, is not pregnant, and also struggles with hormonal imbalances (such as PCOS). I’m not sure how her doctor determined that she was pre-diabetic, but my guess would be fasting blood glucose or hemoglobin A1C.

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      Hey Emily- you may find Robb Wolf’s carb test helpful! You could be having these experiences in response to different types of carbs, or, for you, also at different times of day. His test may help you figure out which are better/worse for you and which to avoid all together. You may find that a banana works great but then rice doesn’t – for example. Check out his book, “Wired to Eat” for the details! We also chatted on a past episode you may find helpful.

      1. Thanks, Diane! I actually have read “Wired to Eat” and loved it! I might give the carb test a try at some point, just out of curiosity, but I already am kind of have a clue of what foods don’t sit well with my body. (Rice definitely being one of them!) Thanks again for all of your input—I will definitely check out the podcast with Robb!

  2. Hey gals, I was very interested in this episode, because I am in a similar situation, though in my case, I can fill in the details you didn’t know about Emily.

    I am a 55 yr old man. Been eating Paleo since 2011. Had let probably too much hard cider and “treats” in to my diet earlier this year, but in the past month to 6 weeks really cut that back. Body composition is pretty good (I can see every alcoholic drink show up in belly flab, which then goes away in a couple of days). I work out pretty sensibly — weights 2x/week, run 4-5x/week at a nice easy pace, do yoga 2x/week. My energy is fine, although this year I’ve had a lot more trouble waking up very early than ever before (never have trouble falling asleep).

    My fasting blood glucose (lab tests) however, has been consistently way high for someone eating Paleo. 100-115. It dipped down to 95 in June, but just last week I had another test and it was 110. My HbA1c was tested in June at 5.60 and was 5.50 back in March. Also, I have a family history of high cholesterol and mine skyrocketed (LDL particles over 3000) but has now fallen back into an acceptable range, though my triglycerides are still high (154 in June).

    Like Emily, my knee-jerk reaction is to cut out all carbs. For me, this would have to mean going Keto because my carb intake these days is around 90-125grams a day (fat is around 95grams, and protein varies from 120-ish to sometimes very high at 160-180grams). But maybe the protein is the problem? My energy is good. I generally feel great, but my worry is the whole “ticking time bomb” syndrome.

    My big question is — where should I be looking for the cause of this? Should I be looking at carb intake? Or gluconeogenesis? Or cortisol? Or something else?

    What do you think?

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      Hi Seth-

      Honestly, I don’t think tweaking your diet is the answer here. I would work with a naturopath and get some other bloodwork done to see what’s going on under the hood. You will get a better picture if you see things like hormone status, micronutrients, perhaps gut issues (stool test), etc. I would also for sure start with lifestyle factors that impact your health like stress and sleep. I think my biggest takeaway for most people is that even if lowering carbs does help in the short term, the longer term solution/root cause is often something else. We know carbs themselves aren’t causing a disease state, but we don’t know what *is* for each person, and it may not be so cut and dry!

  3. Hi ladies, thank you, thank you, thank you for doing a podcast on blood sugar! I have a family history of diabetes (father), and noticed last year that my fasting blood sugar was too high (blood test). I realized that I had been having spikes after lunch sometimes, with (dangerously) low drops after. I tested my A1C and it was a little high for my ND (5.6). I did end up lowering it by cutting carbs (bye bye coconut ice cream), and my number dropped to 5.2. I still don’t feel like I have the full picture. While visiting my dad, I noticed that my blood sugar was relatively low. We figured out that the test strips I have been using are “too cheap” and may be giving me a false reading. Like your other listener, I too have excess “bad” estrogen (blood test confirmed). I also have hypothyroidism and a history of Lyme Disease…so many things are at play. I’ve also heard that food sensitivities can cause blood sugar issues. This is so complicated, I almost think there could be a part two. Thank you for all you do!

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  4. Hi ladies! As I was listening to this podcast I was so glad Diane talked about the accuracy of the at home glucose meter. I took my glucose multiple times per day while pregnant instead of taking the glucose tollereance test. My blood glucose values were a bit higher on my meter than I was used to seeing in my regular blood work. I started to not trust my meter. Luckily, I work in a lab where I could test multiple sample on my meter and with a reference lab level glucose test.
    My meter was 15-20% higher on every sample!!! Basically if A blood sample was measuring 100 on the home meter, it was 85 with the reference method!!
    There is a way to calibrate the in home meters If you look in the user manual, or may you just need a new one.

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  5. I am a few days late but just wanted to check in for Team Bowl; I am with you, Diane! If it’s not a steak or porkchop, it’s going in a bowl. It’s so much easier to scoop (or shovel) food into my mouth than it is to place each bite on a fork 🙂

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  6. I just listened to the podcast yesterday and have some insights that may be helpful from my own Type 2 Diabetes. I was diagnosed three years ago after I chose to get a general check up. Ironically this is after I started to listen to Paleo podcasts. The determination was made from My A1C test results. I had a previous result from two years before that was normal, so it was pretty clear I was Diabetic, specifically Insulin Resistant. At 44 I didn’t expect to be like this due to my family history. I am also overweight.

    What I have learned is the glucose testing is not necessarily good for general testing. I had started with Metformin and progressed to three drugs to lower my A1C. However I have had issues losing the excess pounds. I found that I had to follow my own plan to manage my health. One mistake people make is listening to other people about their Diabetes and how they manage. I have a friend that believes in the eat to maintain blood sugar method, which she may need to do, but I don’t have that problem. Through your podcast, reading and a lot of experimentation I am finally losing weight and hopefully working to get off the drugs.

    I believe that self discovery and working with my general practitioner doctor have been the best. I had to figure out what worked for me as far as food. Everyone is different.

    Thanks for all your podcasts they have helped me over the years.


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  7. Hi Diane! Am I going crazy? I thought that you or Scott posted a blog post about your garage gym gear but I have searched both of your sites high and low and I cannot find anything. Please help! Thanks! 🙂

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  8. I was just reading through this and I wanted to share in response to Liz’s statement about being insulin resistance during the luteal phase…she says, “I think progesterone suppresses some kind of pathway that is involved with insulin sensitivity.” My understanding is that estrogen is linked to insulin sensitivity, so having low estrogen during your luteal phase would make you more insulin resistant. Just thought she might like to know the mechanism for that…or not 🙂 (also couldn’t find a post for this podcast on her blog or I totally would have posted this there.)

    Thanks for all you ladies do!!

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