by Dr. Will Cole
Chances are that you—or anyone else walking around today—has a serious blood sugar problem. Chances are also good that if you do, you don’t even know it. Yes, it’s true: 50 percent of adults living in the United States today have diabetes or prediabetes. Even more have some other type of health problem related to blood sugar imbalance or insulin resistance, such as PCOS or metabolic syndrome. What’s worse, the problem isn’t getting any better. The American Diabetes Association (ADA) estimates that up to 50 percent of people with insulin resistance and prediabetes will end up with full-blown type 2 diabetes if they don’t make significant lifestyle changes.
Blood sugar balance basics.
You probably already know that what you eat directly affects your blood sugar. It’s a pretty simple formula: The more sugar you eat, whether it is in the form of carbohydrates, artificial sweeteners, sugar, or fruit, the more likely your blood sugar is to be elevated. When you eat a food high in carbohydrates, especially without much fiber or fat, that food is quickly converted into glucose in your bloodstream, triggering the release of insulin to take the sugar out of your blood and send it to where you can use it, like in your muscles, or in short-term storage in your liver. But you only need so much glucose and if you eat a lot of sugar-rich and carb-rich foods all the time, your insulin may have trouble keeping up and your blood sugar may stay too high for too long. This puts you on the path to diabetes and other metabolic health problems.
So what does all this have to do with your gut? You’ve probably heard what the father of medicine, Hippocrates, said, “All disease begins in the gut.” He could not have been more right. Your gut is home to a huge population of microbes, also referred to as your microbiome, that includes bacteria and fungi, that live inside your gastrointestinal tract (mostly in your colon) and work with you to perform many necessary functions that benefit you. A hot area of current research focuses on the link between your microbiome and a wide range of diseases, from depression to lupus and even blood sugar problems. Although these problems may not seem related to what’s going on in your gut, you don’t have to have typical gut symptoms to have gut problems.
The gut health-blood sugar connection.
Food is fuel for you—the way it affects blood sugar relates to the way it provides your body with fuel. But food doesn’t just feed you. It also feeds your microbiome. Your microbiome’s nutritional needs are, perhaps surprisingly, similar to yours. Many of the same foods that are good for you help to increase the beneficial microbes in your microbiome, while many of the same foods that spike blood sugar also have a harmful effect on your microbiome. For example, artificial sweeteners have been implicated for years in poor microbiome health and bacterial imbalances in the gut—specifically in ways that impair blood sugar control.
Because of the link between these two systems, focusing on healing your gut and optimizing your microbiome should also help to rebalance your blood sugar. That’s exactly what the latest research suggests.
The science connecting blood sugar and microbiome health.
It makes sense that diet is connected to microbiome health, and it also makes sense that diet is connected to blood sugar. But is the microbiome directly connected to blood sugar? A recent scientific study, published in the journal mSphere, looked at Acarbose—a drug for type-2 diabetes—and how it changes animals’ microbiome composition to favor bacteria that play a role in controlling blood sugar. Even when those animals ate a higher-starch diet while on this medication, their microbiomes still contained higher levels of the beneficial bacteria Bacteroidaceae and Bifidobacteriaceae and lower levels of the bad bacteria Verruocomicorbiacea and Bacteroidales S24-7. However, once the medication was stopped, the positive microbiome features reverted.
Another study from the Center for Individualized Medicine at the Mayo Clinic followed a group of 300 people over the course of six days. The researchers tracked glycemic responses to foods and found that they could only accurately predict blood sugar between 32 and 40 percent of the time when considering what foods the subjects ate and how many calories they consumed. But when the scientists factored in the specific composition of the microbiomes of each individual, they were able to accurately predict blood sugar response 62 percent of the time.
Other studies also support the blood sugar-microbiome connection. Those who are overweight or struggle with weight loss resistance—a symptom of underlying metabolic problems—tend to have lower microbiome diversity with lower numbers of beneficial microbes and higher numbers of harmful bacteria and fungi. In another fascinating study, scientists were able to transplant the microbiome of diabetic mice into healthy mice to make them diabetic as well, without changing their diets. It seems like our microbiomes are in charge of a lot more about our health than we once realized.
To tackle blood sugar and heal the microbiome, go keto.
Diet seems to be the ultimate key to modulating both the microbiome and blood sugar. Consider the research surrounding the increasingly popular ketogenic diet. One of the biggest health benefits of this high-fat, moderate protein, low-carb diet is its ability to reduce inflammation, lower insulin levels, and improve insulin receptor site sensitivity. This diet is so good at controlling blood sugar that it can reverse symptoms of type 2 diabetes in just 10 weeks! But the ketogenic diet works on multiple areas at the same time—it’s been shown to change the microbiome in beneficial ways, too. It’s no coincidence that diets high in sugar—the opposite of a ketogenic diet—can contribute to the overgrowth of the yeast Candida, which is also linked to blood sugar problems and an overgrowth of bad bacteria. On the other hand, diets rich in protein and fat specifically reduce Candida populations, minimizing this fungus’s effect on blood sugar balance.
While we need to do more research to fully understand exactly how the microbiome influences blood sugar, we can’t deny that it plays a significant role. And as long as we are taking Hippocrates’ words to heart, consider another one of his gems: “Let food be thy medicine and medicine thy food.” Many systems in our complex bodies are connected, but food is the one common element that seems to connect them all, so it should be one of the very first steps in managing not just blood sugar but microbiome balance.
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