Hello, health enthusiasts, and welcome to Rev Up Health, your go-to podcast for all things wellness. I'm Dr. Mark Hechler, and I'm Tandi Hechler. Together we're here to fuel your health journey with the best of functional medicine and holistic well-being. Each episode, we'll dive deep into topics that matter to your health, bringing you the latest insights, research, and inspiring stories. Whether you're on a quest for vibrant health or just looking for daily health tips, we've got you covered. So let's embark on this journey together and transform the way you live. So, Tandi, what's on our wellness radar for today?
Hello, hello, and welcome to the Rev Up Health Podcast. We're so glad you've joined us today. I'm Tandi, and I'm Dr. Mark. I'm going to share a quick little story about Dr. Mark. He is a researcher, and oftentimes I'll find him deep in a book or on the computer, and I'll just ask, "What are you doing over there?" And typically I'll get an answer like, "Just getting educated." This is one of the reasons we're so excited about doing this podcast for you all — it gives us an opportunity to share some of what we've learned so that you can get educated too. So that's our invitation today: let's get educated.
What Is Blood Glucose?
Today we're going to take a closer look at blood glucose, commonly known as blood sugar. Glucose is a simple carbohydrate, and it's the main sugar found in our body. It's your body's primary source of energy, and it comes from the food we eat. Your body breaks down most of that food into glucose and releases it into your bloodstream. Insulin is then released to aid in the absorption of that glucose into various cells, like the muscle or the brain.
There are four main types of sugars. The first is glucose, a simple sugar and simple carbohydrate. Then there's fructose, which you find in fruits, honey, and some vegetables — this is also where high-fructose corn syrup, made from corn, comes into play, and we can talk more about that in another podcast. Then we have sucrose, which is common table sugar — that's glucose and fructose together. And finally lactose, which is from milk and is made up of glucose and galactose.
The main source of sugar in the American diet comes from sugary drinks, desserts, and snacks like cakes, cookies, and candies.
How Much Sugar Are We Eating?
Recently there's been a big push around what our recommended allowances are. The USDA says the average American eats 34 teaspoons of added sugar daily, and they're now coming out with a new recommendation that says we don't need more than 12 teaspoons daily. It's great that they're coming down, but ultimately we don't need added sugar at all — we can get the sugar we need from the food we eat. And did you know the American Heart Association recommends women consume no more than six teaspoons and men no more than nine teaspoons daily?
That's crazy. Can you imagine 34 teaspoons of added sugar on average in a day? That's hard to imagine. But it doesn't necessarily have to come from sugar, either — it can come from carbohydrates too, which is even worse, because those will also elevate our blood sugar. The truth is the human body really doesn't even need added sugar at all. We actually get more glucose than we need from our highly processed foods and starches.
Why Blood Sugar Matters
So why is blood sugar important? The goal is to keep a very stable glucose level, because the spikes in your glucose are what contribute to inflammation and insulin resistance. Eighty percent of people who are pre-diabetic don't even know they're pre-diabetic, and that's a real shame, because if they knew, they could start taking steps to reverse it before it actually becomes diabetes.
Traditional medicine is typically only going to draw a fasting glucose. They usually don't order a hemoglobin A1c unless the glucose is out of range, because sometimes insurance won't even pay for it. But the crazy thing is that your fasting glucose is the last thing that will change as the disease progresses.
The Labs We Look At
So how do we take a closer look? We're going to look at fasting insulin, which is newly getting popular; a hemoglobin A1c; and your fasting blood glucose. There's also a calculation that takes your insulin and your glucose and gives us a marker called HOMA-IR. Fasting insulin is a great test because it's one of the first things that will change when your pancreas is having to work extra hard over time to keep up with all the sugar that you're eating.
We're going to talk a little bit about normal versus optimal right now — this is something we'll educate more about later, but just so you know:
A normal fasting glucose is considered between 85 and 100, and our thought is that we want you under 85.
A normal fasting insulin is between 7 and 10, and we'd say optimal is less than 7.
A normal hemoglobin A1c falls into the 5 to 5.7 range, and optimal, where we'd like to see folks, is less than 5.
A normal HOMA-IR is less than 2.0, and optimal is less than 1.
Mark's Story: An Elevated A1c
Knowing those numbers, we'd like to share a little story about part of what really got us going down this path. We went and got labs drawn, and Mark found out that his fasting glucose was fine — it had always been fine — but in our new, deeper lab draw, he found out that his hemoglobin A1c was actually 5.7, on the high end. I'll let him tell a little more about that.
As you all know, if you know me, I'm a very active person. I like to do a lot of activity and exercise — I run multiple marathons a year, so for me exercise is a way of life, a lifestyle, a necessity. To have that kind of active lifestyle, you need an intake of nutrients good enough to keep going, to rebuild muscle, stay energized, and keep running down the road. After I got these labs, I started to think, okay, I need to look at this a little differently. With my elevated A1c — but a normal glucose level — it made me start to think, where am I going wrong, what is going on? I spend a lot of energy, so you'd think I'm burning off all these calories and don't have to worry about being overweight, because I wasn't overweight. And yet my glucose markers were elevated.
So I started looking at what it was in my lifestyle, my daily foods, and my intake of liquids that was making this elevated. Well, I happened to have a really cool nugget ice machine in my new kitchen — if you've had Sonic ice, you know what I'm talking about, that ice is primo. I used to take that ice, pour my Mountain Dew over it, and I'd have probably two cans of Mountain Dew every evening after running and after dinner. I'd think, "Yeah, I just ran five or six miles, I've got to replenish my system a little bit." Plus I'd have candy throughout the day, because I'd frequently get bored sitting around or have to take breaks between patients, so I'd grab a Hot Tamale or a handful of Skittles and just eat them. This was an ongoing, continuous process on a daily basis. And I wouldn't get overweight, so, yeah, I figured I can eat all I want. Well, my labs told me different.
That's where I turned around and decided I needed to do something about it. I slowly got off all my sodas and moved into sweet tea, thinking, well, that's okay, that's not near as bad as soda. Well, no, it's not — but it's still sugar. So then I had to go a little further and finally got off the sweet tea, and I got rid of my candies. I slowly weaned myself off them, and the way I had to do it was to literally throw it away and not have it around the house. As time went on, I also decided to watch the carbohydrate intake and increase the protein, and started a new — I hate the word "diet" — a new lifestyle improvement to reduce my glucose and carbohydrate intake. I was able to take my A1c, which had been around 5.7, and bring it down to 5. My fasting insulin had been around eight or nine, and now it's lower — it dropped on my last draw not too recently. And of course my glucose levels remained the same. So it just goes to show that this glucose revolution being shoved in our faces constantly on television ads certainly makes a difference in your life.
Understanding Hemoglobin A1c
I want to go back and explain a little of what hemoglobin A1c is. We know what fasting glucose means — it's what your blood sugar level is when you haven't had anything to eat. Your hemoglobin A1c basically takes an average of what your glucose has been over the last three months. That's why you get so much better insight into where your blood sugar really is, because it's taking an average. So even though Mark woke up with a nice stable glucose before eating, that wasn't catching all the spikes he was having throughout the day, or throughout the weeks, when he'd have those sodas or sugary snacks.
What You Can Do — Without a Prescription
So what can you do when you find out your hemoglobin A1c is elevated, or your fasting insulin is elevated? There is so much you can do without the help of a prescription — without a doctor at all.
First thing on the list: lifestyle. Change your lifestyle. I tell everybody the two main medications you can take to improve your health are diet and exercise. You need to move more. The more you move, the more muscle you build — and we're talking about the big muscle groups, legs and back. The more big muscles you build, the quicker they're going to eat the glucose, and the more they'll give you a smoother spike if you keep eating the same way.
Snacking is also a really bad thing. You really need to do more of an intermittent fasting approach with feeding windows — we'll talk more about that in a later podcast, because that's a whole topic in and of itself. You have to limit your simple sugars and carbs. The key is to really focus on your protein, good fat, and fiber. If you make protein and fiber the first priority of your meal, you're actually going to lose weight, because they're very satiating — they help fill your stomach and give you a better sense of fullness, so you're not going to fill up on all the carbs.
There's even apple cider vinegar and things like that you can do before meals. I'm not into that because I really don't like apple cider vinegar — Tandi does, though. Go for a walk and do some exercise after you eat. Anything you can do to improve your gut health will ultimately make a difference in your glucose levels and your overall sense of well-being and hormone balance. And sleep — goodness, where does that end? Seven or eight hours of sleep should be the average, and if you need more, get more. That's how your body repairs, and that's how you reduce stress, which is a big problem too: stress management is a big one for folks.
Change the Order You Eat
One other thing you can do, just in your habits, is change the order in which you eat your food. If you start your meal with your proteins, fats, and fiber, you can withstand some sneaky foods that are usually really bad for glucose — bananas, grapes, oats, oat milk — all of those are pretty well-known sugar spikers.
Continuous Glucose Monitors
One way to tell how foods affect you is to wear a continuous glucose monitor. There's a lot of talk right now about CGMs and using them to see where you're at. We've both worn continuous glucose monitors, and it's extremely insightful. It lasts for about two weeks, so you can put the monitor on, eat normally for a couple of days to see how that affects you, and then start doing some experiments — like changing the order in which you eat your food and seeing how that changes things.
I know for sure that when I go to breakfast, if I eat my eggs and veggies first, I can have a few breakfast potatoes or even a piece of toast with jelly on it, and my glucose will not spike, because I ate the fat and protein first. You can also experiment with apple cider vinegar and see if it helps you — take it before a meal and see how it changes your spike. It's pretty interesting and cool to see.
One thing we noticed is that we could eat the exact same thing and it would affect one of us differently than the other. So it's very, very personal. That's one of the things we talk about a lot in our practice: everybody is unique. And just like some nutrition plans work better for some bodies, it's the same here — everybody is different.
That's right, Tandi, everybody has a different body. But these CGMs — I can tell you, you think, okay, I'm eating oatmeal, it's very heart-healthy, but you're going to see such a spike from that oatmeal that it'll probably scare you away from it. Bananas, along with that oatmeal, are just big spikers for our glucose levels.
Why the Spikes Matter
It's these spikes that we don't want, because that's where you start seeing the surges in your insulin. That'll cause free fatty acids to be released from the liver, and then you start seeing these inflammatory cytokine markers get released, and they go out to create havoc — whether it's within the brain, within the heart, all over. Then, if you have these glucose spikes, you may get deposition of glucose into the fat, so now you start creating other problems, and we start seeing visceral fat increasing in size. There are a lot of things we can do to curb those spikes, which we'll talk about in other podcasts.
Medications and Supplements
From a medication or supplement standpoint, there are things we can do. Everyone's heard of metformin. There's also berberine, there are probiotics, and then there are GLP-1 agonists — that's kind of the new fad right now, with folks getting shots and taking pills to help control and curb their blood sugar.
The Bottom Line
Too much sugar over time is a driver of metabolic disease, and this may put you at risk for heart disease, obesity, metabolic syndrome, type 2 diabetes, cancer, and the dreaded neurodegenerative diseases like Alzheimer's.
So if you need help navigating your health, visit us at revelationhealthandwellbeing.com, and we hope to hear from you. If you have any questions or thoughts, or want to hear something special on the podcast, just reach out to us. If you want to learn more about how we can help you with your health, contact us at revelationhealthandwellbeing.com. Have a great day.
Thank you for tuning in to another episode of Rev Up Health. We hope you're leaving with some valuable insights to supercharge your health journey. Don't forget to follow or subscribe to Rev Up Health wherever you listen to your podcasts, and if you enjoyed today's episode, please leave us a rating and review. Have a topic you want us to explore? Reach out to us on our social media channels — we love hearing from our wellness community. Until next time, keep thriving, and remember: your journey to health is a journey to a better you. Stay well, and we'll connect with you again soon. This is Tandi, and this is Dr. Mark, signing off from Rev Up Health. Take care.
The information provided in this podcast is for educational purposes only and is not intended as medical advice. The content is designed to support, not replace, the relationship that exists between a patient and their healthcare provider. Always consult with a qualified healthcare professional before making any changes to your healthcare regimen, including diet, exercise, or treatment plans. The views and opinions expressed in this podcast are those of the hosts and guests and do not necessarily reflect the official policy or position of Revelation Health and Wellbeing.