Comprehensive Naturopathic Weight Loss Part One: Stabilize Blood Sugar and Improve Insulin Sensitivity

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Dr. Pamela Frank, BSc (Hons), ND

As the phrase implies, blood sugar or blood glucose is a reflection of the sugar level in your blood stream. Its variable throughout the day depending on what you eat, how often you eat and how much you eat. If you eat something sugary or starchy, your blood sugar level will rise, prompting the release of insulin to bring the blood sugar back to normal or a happy medium. Insulin allows sugar to flow from the blood into muscle and other tissues where it can be used for fuel. However, if you have a sedentary lifestyle and you aren’t physically active, once in the tissue, that sugar will be turned into fat. Insulin’s other job is to turn on the fat production factory.

People vary in how well their bodies listen to insulin. If your body responds readily to insulin, you have good insulin sensitivity. If your body does not respond well to insulin you are deemed insulin resistant. How would you know if you are insulin resistant? You wouldn’t without certain specific blood tests, it’s not something you could feel or be aware of other than if you are struggling with weight.

Blood Tests for Blood Sugar and Insulin Sensitivity

Fasting Blood Glucose or Fasting Blood Sugar – As the name implies, this test is measuring the amount of sugar in your blood after you have been fasting for at least 8-12 hours. The level should be between 70 and 100 milligrams per deciliter (mg/dL). Fasting glucose levels of 100 to 125 mg/dL indicate prediabetes.

Fasting Insulin – This test is also done after an 8-12 hour fast and measures the amount of insulin in your blood. After not eating anything for a prolonged period of time, there should be a fairly low level of insulin. An ideal fasting insulin level should be between 2-6 uIU/mL.

Postprandial (After Eating) Glucose – It`s all well and good if your blood sugar is normal after you haven`t eaten anything for 8-12 hours, but the reality is that you eat at least 2-3 times per day. It`s important to know what your blood sugar is like after eating, especially if your diet consists of a fair bit of starch and sugar. A level of < 140 mg/dL (7.8 mmol/l) 90 minutes after a meal is a normal postprandial glucose.

Glucose Tolerance Test – a Glucose Tolerance Test measures how well your body deals with being challenged with glucose, how well does your body manage it. A fasting blood sugar is collected and then a standardized dose of glucose is given and then blood is drawn either ½ hour, 1 hour and 2 hours after drinking it, or just 2 hours after drinking it. Normally blood sugar will spike up and then return to normal within those 2 hours. For people with insulin resistance, blood sugar may remain high 2 hours after drinking the glucose drink because the body isn’t listening and responding to glucose properly.

HbA1c – HbA1c stands for glycosylated or glycated hemoglobin. Hemoglobin is a protein that carries oxygen around to your tissues. Hemoglobin has a life span in your circulation of about 3 months. Glycated hemoglobin is hemoglobin with sugar stuck to it. Measuring this level can give an indication of whether blood sugar levels have been consistently high over the last 3 months. A normal HbA1c is less than 5.7%, 5.7-6.4% is prediabetes and above 6.4% is diabetes. Optimal for HbA1c is less than 5.2%.

Diet Tips to Stabilize Blood Sugar

  1. Limit or avoid sugary drinks. Water and unsweetened herbal teas are ideal to drink. Diluted fruit juice is ok on occasion.
  2. Cut back on bread, pasta, cereal, rice and potatoes. These provide little in the way of nutrition and pack a big blood sugar spike.
  3. Eat protein with each meal. Whether you choose plant or animal protein, try to have a little with each meal. Too much can cause problems too, but a little protein helps keep blood sugar stable. Choose lean, preferably naturally raised beef, chicken, fish, lamb, turkey etc about the size of the palm of your hand or tofu, beans, legumes, nuts and seeds.
  4. Eat lots of fiber. Fruits, vegetables, beans and legumes help provide fiber that helps you feel full and slows down digestion. Broccoli is great for fiber and supplies dietary chromium that can help with blood sugar and insulin, so eat your broccoli!
  5. Eat foods that are low glycemic index and low glycemic load. My favorite list to check these is http://www.mendosa.com/gilists.htm.   Look for foods that have a glycemic index of less than 55 and glycemic load of less than 10.

Diet Tips to Reduce Insulin

  1. Follow the tips above to reduce spikes in blood sugar.
  2. Cinnamon!1 Use cinnamon liberally! You can sprinkle it over your food or add it to your tea, either way, cinnamon helps improve insulin sensitivity.
  3. Consume more zinc containing foods.2 Zinc is another good insulin sensitizer. Good food sources of zinc include: egg yolks, pumpkin seeds, Brazil nuts, beef and shellfish.

Lifestyle Changes to Reduce Insulin

  1. Exercise! Exercise helps improve insulin sensitivity, so that even if your blood sugar does spike, you don’t need to make as much insulin to lower it back to normal. Exercise is also a great stress buster and helps manage blood sugar better. High Intensity Interval Training (HIIT) works particularly well to lower blood sugar levels.3 HIIT workouts involve short bursts of intense activity interspersed with an active rest, for example a 30 second sprint followed by a 60 second jog, continuing this pattern for 20 minutes.
  2. Reduce your stress level. You may be eating well and exercising regularly, but if stress levels are high, you’ll experience blood sugar spikes anyway. In the extreme case of people suffering from post-traumatic stress disorder (PTSD), there is a higher incidence of insulin resistance and type II diabetes.4 Exercise, try yoga, breathing exercises, meditation, read a book, take a walk, get a pet, have a bath, anything that helps you relax and unwind.
  3. Spend more time outside to increase your Vitamin D. Studies have shown that vitamin D can improve glucose tolerance and insulin sensitivity.5 You can also take 2000 – 3000 IU of vitamin D3 per day.

Supplements to Improve Blood Sugar

  1. Chromium – Chromium is a trace mineral normally found in a wide range of meats, fruits and vegetables including broccoli, turkey, beef and apples and has been shown to improve insulin sensitivity.6 Supplements can contain 50-200 mcg of chromium. 100-200 mcg of chromium picolinate per day is a typical supplement dose.
  2. Vanadium – Vanadium is another trace mineral that can help with blood sugar and insulin levels.7 The best food sources for vanadium include mushrooms, shellfish, black pepper, parsley, dill weed. A typical supplement dose would be 30-100 mcg per day. High doses may be toxic, best to consult a naturopathic doctor before taking any supplements.
  3. Banaba Leaf8 – In one small, randomized clinical trial involving type 2 diabetic patients, researchers found that dosages of 32 and 48 mg of a banaba extract standardized to 1% corosolic acid taken for 2 weeks significantly reduced blood glucose levels.
  4. Gymnema sylvestre9 – This herb is used to manage blood glucose levels. Clinical studies investigating antidiabetic effects have typically used 200 or 400 mg extract daily standardized to contain 25% gymnemic acids.
  5. Alpha Lipoic Acid9 – Alpha lipoic acid is a vitamin like chemical naturally found in Yeast,liver, kidney, spinach and broccoli. There is research showing that it helps lower blood sugar levels and also that it can help with weight loss. One study found significant weight loss with 1200 mg of ALA per day for 10 weeks.10 There is one case report of fatal alpha lipoic acid overdose, consult a naturopathic physician before use.11
  6. Fenugreek9 – One study measured glucose levels after eating 50 grams of rice or white bread and jam with and without 5.5 grams of fenugreek seeds. Glucose levels after the carb meal with fenugreek seeds were significantly lower than the same meal without the seeds.12

Supplements to Improve Insulin Sensitivity

  1. Cinnamon – Cassia cinnamon has been shown to help with blood sugar and insulin levels in diabetics.6 Doses range from 1-6 grams per day for up to 4 months. One teaspoon of cinnamon equals about 4.75 grams, but is usually a blend of other types besides cassia.
  2. Inositol – Myo-inositol has had a number of positive studies relating to improving insulin sensitivity, particularly in women with PCOS and gestational diabetes.13 The typical dose for this purpose Is 4 grams per day.

Stable blood sugar means fewer carb cravings and more control over what you eat. Stable blood sugar and lower insulin means less fat production and greater ability to burn body fat for fuel.

References:

  1. Sartorius T, Peter A, Schulz N, Drescher A, Bergheim I, Machann J, Schick F, Siegel-Axel D, Schürmann A, Weigert C, Häring HU, Hennige AM. Cinnamon extract improves insulin sensitivity in the brain and lowers liver fat in mouse models of obesity. PLoS One. 2014 Mar 18;9(3):e92358.
  2. Ahn BI, Kim MJ, Koo HS, Seo N, Joo NS, Kim YS. Serum zinc concentration is inversely associated with insulin resistance but not related with metabolic syndrome in nondiabetic Korean adults. Biol Trace Elem Res. 2014 Aug;160(2):169-75.
  3. Little JP, Francois ME. High-intensity interval training for improving postprandial hyperglycemia. Res Q Exerc Sport. 2014 Dec;85(4):451-6.
  4. Rao MN, Chau A, Madden E, Inslicht S, Talbot L, Richards A, O’Donovan A, Ruoff L, Grunfeld C, Neylan TC. Hyperinsulinemic response to oral glucose challenge in individuals with posttraumatic stress disorder. Psychoneuroendocrinology. 2014 Nov;49:171-81.
  5. Peterson CA, Tosh AK, Belenchia AM. Vitamin D insufficiency and insulin resistance in obese adolescents.Ther Adv Endocrinol Metab. 2014 Dec;5(6):166-89.
  6. Anderson RA. Chromium and polyphenols from cinnamon improve insulin sensitivity. Proc Nutr Soc. 2008 Feb;67(1):48-53.
  7. Gruzewska K, Michno A, Pawelczyk T, Bielarczyk H. Essentiality and toxicity of vanadium supplements in health and pathology. J Physiol Pharmacol. 2014 Oct;65(5):603-11.
  8. Stohs SJ, Miller H, Kaats GR. A review of the efficacy and safety of banaba (Lagerstroemia speciosa L.) and corosolic acid. Phytother Res. 2012 Mar;26(3):317-24
  9. Smith JD, Clinard VB.. Natural products for the management of type 2 diabetes mellitus and comorbid conditions. J Am Pharm Assoc (2003). 2014 Sep-Oct;54(5):e304-18.
  10. Ratliff JC, Palmese LB, Reutenauer EL, Tek C.Clin Schizophr Relat Psychoses. An open-label pilot trial of alpha-lipoic acid for weight loss in patients with schizophrenia without diabetes. 2013 Mar 7:1-13.
  11. Hadzik B, Grass H, Mayatepek E, Daldrup T, Hoehn T. Fatal non-accidental alpha-lipoic acid intoxication in an adolescent girl. Klin Padiatr. 2014 Sep;226(5):292-4.
  12. Robert SD, Ismail AA, Wan Rosli WI. Trigonella foenum-graecum seeds lowers postprandial blood glucose in overweight and obese individuals. J Nutr Metab. 2014;2014:964873.
  13. Corrado F1, D’Anna R, Di Vieste G, Giordano D, Pintaudi B, Santamaria A, Di Benedetto A. The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes. Diabet Med. 2011 Aug;28(8):972-5.

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Pamela-2013-retouched_resizedPamela Frank, BSc(Hons), ND has been in practice as an ND since 1999 and previously worked for 20 years as a
medical laboratory technologist. She is Clinic Director of Forces of Nature Wellness in Toronto and was twice voted “Best Naturopath in Toronto”. Pamela maintains a busy, diverse practice with particular expertise in naturopathic treatment of PCOS, PMS, menopause, acne, infertility, uterine fibroids and endometriosis. Pamela’s interests include fitness, triathlons, yoga, healthy cooking, tennis and volleyball.

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