The World Health Organization (WHO) has declared obesity a major public health problem and global epidemic. In 2016, it was estimated that 39% of adults, 18% of adolescents, and 41 million children were overweight or obese.
The health risks of being overweight or obese are well established. They include an increased probability of several chronic health conditions like type 2 diabetes, heart disease, stroke, sleep apnea, fatty liver disease, osteoarthritis, kidney disease, and some types of cancers. These concerns are not country-specific as the prevalence of obesity has increased worldwide – tripling between 1975 and 2016.
What Causes Obesity?
According to the WHO, overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. The cause of obesity, in its simplest sense, is when the body gains fat as it stores excess energy. This extra energy arises from consuming more food energy than is used in physiological metabolism.
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While multiple factors can come into play, including genetics, in most cases, obesity arises from living in an ‘obesogenic’ environment. An obesogenic environment is one that allows and encourages low levels of physical activity, sedentary lifestyles, and abundant consumption of energy-rich food. Many dietary and lifestyle influences can lead to weight gain or weight loss, but is high blood sugar one of them?
How Does Blood Sugar Fit Into Weight Management?
Research has found that consuming a diet high in added sugars, such as sweetened beverages, candy, baked goods, and cereals, contributes to weight gain and obesity. There are multiple ways excessive sugar intake can lead to weight gain. First, foods high in sugar, such as those just listed, often provide lots of calories while offering nothing else of nutritional value. Therefore, people often refer to these foods as “empty calories.”
Because these foods lack other essential nutrients such as fat, protein, fiber, vitamins, and minerals, they often do not stimulate feelings of fullness and satiety. Therefore, they are often consumed in addition to a full day of meals, which ultimately leads to a greater intake of calories than the body needs.
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Additionally, sugar intake directly influences our hormone responses. It’s well known that eating sugary foods raises blood sugar (blood glucose). Occasional intake of high amounts of sweetened foods isn’t likely to cause harm, but excessive intake over a long time can lead to chronically high levels of blood glucose (hyperglycemia). Our body responds to chronic hyperglycemia by dumping hormones into the blood to regulate high blood sugar levels. This is where it can get complicated.
Blood Sugar and Insulin Basics
Insulin is a key hormone involved in regulating blood sugar, fat storage, and weight management. In short, as glucose rises in the bloodstream after consuming sugary foods, the pancreas begins to release insulin in proportion to the rise in blood glucose. Insulin is an anabolic hormone and acts like a key that unlocks and opens the doors to our cells so that glucose can enter. The more glucose in your blood, the more keys (insulin) you need to allow for its movement into the cells.
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Glucose that enters the cells can be used to meet energy demands. However, when more glucose is in the blood than the cells need, insulin signals the liver and muscles to store the excess. Once those storage spaces are full, any blood glucose left over is converted to fat (triglycerides) and stored in the fat cells around the body for later use. This mechanism is how we survive. However, this finely tuned system can also fall out of whack.
Hyperglycemia and Weight Gain
If blood sugar is chronically high, the pancreas will be working overtime to produce more insulin. When this happens, the cells may eventually stop responding to insulin. Think of it like an old, overused door lock that gets worn out, and the key will no longer work to unlock it. This is called insulin resistance. When your cells stop responding to insulin, your body pumps out even more in an attempt to get glucose out of the bloodstream. This leads to higher baseline insulin levels, which can directly counter weight loss efforts. Evidence does show that prolonged hyperglycemia can cause weight gain and other harmful effects on health.
Moreover, research has found that high insulin levels also lead to “leptin resistance.” Leptin is a hormone secreted into the bloodstream by fat cells (adipocytes) and is required to maintain energy and body weight balance. Leptin interacts with the central nervous system and conveys information about body energy storage and availability to the brain.
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Leptin pretty much tells the brain, “Hey, there is enough energy storage here, we don’t need more food right now; we’re good,” which can help control our perceptions of appetite. However, in most cases, circulating leptin levels are abnormally higher in obese individuals, and it’s believed they have developed leptin resistance.
Leptin resistance is defined by the reduced ability of leptin to suppress appetite and weight gains. Therefore, it may be harder for us to feel satiated and more likely to consume more calories than our body requires. Leptin resistance has been associated with increased body fat and high sugar diets.
Does Lowering Blood Sugar Help with Weight Loss?
Managing healthy blood sugar levels can help stave off diabetes and manage body weight. We now understand how high blood sugar leads to weight gain, so as Missy Elliott would say, back it up, flip it and reverse it.
If high blood glucose levels lead to increased insulin levels, which leads to the storage of glucose in our muscles, liver, and fat cells, then decreasing blood glucose levels will lead to reduced insulin levels, which will signal to our body to use the stored energy (in our fat, liver, and muscle cells) to meet our energy needs. Ultimately, lower insulin levels are essential to utilize (burn) fat that has been stored. And the best way to keep our insulin low is to control and manage our blood sugar.
Dietary Sugar Demystified
To control our blood sugar levels, we must better understand dietary sugar. First, sugar is not innately “bad.” Sugar is a good thing; it gives our bodies the energy to play with our kids, run marathons, and feel energized throughout the day. Research even shows that our brains consume around 20% of our blood glucose just to function.
However, sugar is a generic term for a much more complicated concept. The simplest way to approach this topic is to understand the difference between complex carbohydrates (aka complex sugars), simple carbohydrates (aka simple sugars), and added sugars.
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Complex carbohydrates are critical to a long and healthy life. Complex carbs occur naturally in nature and include foods like fruits, starchy vegetables, beans, and whole grains. They are called complex carbs because they contain starch (a long chain of numerous glucose units joined by chemical bonds) and fiber (a type of carbohydrate that our bodies cannot digest completely). In addition to starch and fiber, they also contain essential nutrients that support our health, like vitamins and minerals. The fiber and long chains of sugar found in complex carbohydrates allow the food to be digested slowly, making them more filling and allowing slower absorption of and rise of blood sugar.
Simple carbohydrates, or simple sugars, can also occur naturally in foods such as raw sugar, honey, and milk or be added to foods (added sugars) such as sodas, baked treats, cookies, breakfast cereals, and fruit juice. Simple sugars are short chains (2 sugar molecules) or single sugar molecules.
Because of their simple chemical structure and lack of fiber, simple sugars are digested and absorbed quickly and significantly impact blood sugar. They also tend to lack other nutrients that support health, such as fiber, vitamins, and minerals. All forms of carbohydrates, complex or simple, will be broken down into single glucose units that enter the bloodstream. The main difference is how quickly and abruptly they influence blood sugar and what other nutritional value you are gaining from them.
5 Natural Ways to Manage Your Blood Sugar:
- Choose complex carbohydrates (aka low-glycemic foods) as your primary source of sugar. By choosing complex carbohydrates, you will receive various health-promoting nutrients such as fiber, vitamins, and minerals and long chains of glucose (starch) to provide your body with the energy it needs. More information about carbohydrates, blood sugar, and the glycemic index can be found here.
- Cut out sugar-sweetened beverages. Several studies indicate that sugar-sweetened beverages are the primary source of added sugars in the American diet. Sugar-sweetened beverages contribute to weight gain due to their high amounts of added sugar content yet low satiety and nutritional status. They are often consumed in addition to a typical day’s worth of calories, increasing energy intake overall and driving up insulin. Items like soda, sweet teas, sweetened lemonades, sports drinks, fruit juice, etc., should be limited or cut out to help manage blood sugar levels.
- Don’t skip meals. Skipping meals can lead to poor dietary choices later due to extreme hunger. Additionally, skipping meals can lead to blood sugar levels that are too low. Low blood sugar, or hypoglycemia, can cause symptoms like shakiness, sweating, headache, fatigue, irritability, or dizziness. When extreme, it can even lead to confusion, loss of coordination, or loss of consciousness.
- Exercise regularly. Studies have found that exercising increases insulin sensitivity of the muscles and physically trained individuals have higher insulin sensitivity than untrained individuals. With regular exercise, your cells will be more responsive to insulin; therefore, less insulin will be needed to lower blood sugar levels when they become elevated. Moreover, muscle contraction that occurs during exercise stimulates more GLUT4 transporters, the gates through which glucose enters the muscle cells from the blood, to come to the surface of the cells. This means that exercise alone has insulin-like actions and can drop blood sugar levels without insulin even being present.
- Know your blood glucose levels by testing HbA1C. It all starts with blood glucose levels; if they are elevated, insulin will be elevated too. HbA1c is a simple blood test that measures your average blood sugar over the past three months. By knowing your HbA1c, you can understand your blood sugar trends and make appropriate lifestyle changes to get them within a healthy range. To learn more about HbA1c, check out this article