How to Manage Blood Sugar for Insulin Resistance & Perimenopause: A Gentle Nutrition Guide
My first true nutrition “a-ha moment” was learning about the blood sugar rollercoaster in a group nutrition class. It felt like the secret to fix my body, the one I was hoping to learn my dietetics undergraduate program, but didn’t. When I started eating to stabilize blood sugar, I almost immediately felt less anxious, slept better, and had more energy.
I learned blood sugar can impact everything from your energy levels to your mood and is particularly relevant for those with insulin resistance, Type 2 diabetes, PCOS, or those navigating perimenopause.
Suddenly so many things made sense to me, including:
Why eating an apple as a snack left me feeling hungrier than not eating at all
The moodiness and irritability (aka hanger) I experienced when I waited too long to eat
The intense cravings for all.the.carbs.
Waking up on the regular in the middle of the night and struggling to get back to sleep
Being overly focused on blood sugar management can be a slippery slope to diet culture. I should know: this group nutrition class that reignited my interest in nutrition was also the thing that kicked-off several years of orthorexia, or my obsession with eating healthy foods.
And, of course managing blood sugar levels didn’t “fix” my body (aka make me lose a bunch of weight), but I did enjoy reduced anxiety, more stable moods, and better understanding of my body.
I strongly believe applying the concepts of blood sugar management in an anti-diet, gentle nutrition way can help most people feel more regulated in terms of energy, hunger and cravings, mood, concentration, and sleep.
Understanding The Blood Sugar Rollercoaster
Glucose is a simple sugar that is abundantly available in carbohydrate-rich foods like bread, fruit, and beans and is the body’s primary and preferred source of energy. Almost all of the carbohydrate foods we eat are broken down in the digestive system into sugar. (The main exception is fiber, more on that in a bit).
Because glucose, or blood sugar, is so important to the body, and especially the brain, it is very tightly regulated. The body has safeguards built-in anytime blood sugar gets higher or lower than the target amount.
When blood sugar gets too low, the body releases a hormone called glucagon that stimulates the liver to release glycogen, the storage form of glucose, for use in the body. The body also releases hormones that make us feel hungry. Sometimes low blood sugar can also fuel cravings for foods that are high in sugar or refined carbohydrates because they give a quick boost of energy to the body.
When blood sugar levels get too high, the pancreas releases the hormone insulin to help move the glucose from the blood stream into cells where it can be used for energy.
If you've ever felt an energy crash after a sugary afternoon snack or hungry again just an hour after eating a bowl of cereal with skim milk, a banana, and a glass of orange juice (you know, the Platonic ideal of breakfast in the 80s and 90s), you've likely experienced the blood sugar rollercoaster.
When you consume foods that are high in carbohydrates alone, they can be quickly digested and broken down into sugar and absorbed into the blood stream. This causes your blood sugar levels to rise quickly, like going up hill on a rollercoaster. The body senses this quick increase and tends to respond with a large release of insulin which causes your blood sugar to drop quickly too, like going downhill on a roller coaster.
This is the essence of the blood sugar rollercoaster—a continuous cycle of spikes and crashes that leaves you feeling out of control.
Insulin Resistance
You can think of insulin as knock that opens the door to your cells to let glucose in, where it can be used for energy.
If you have chronically elevated levels of insulin, your cells can become less responsive to the knocking. They stop opening the door.
The body responds by making even more insulin, to make the knocking louder and harder to ignore. It might work for a while, but eventually the cells can adapt to the louder knocking and ignore that too. If this pattern continues long-term it can lead to type 2 diabetes.
When glucose can't get into the cells for energy, it gets stored as fat instead which can leave you feeling hungry and tired even if you just ate.
This “always hungry” feeling is common in people with a history of restricted dieting. Blood sugar is an important factor to consider but may not be enough by itself to reverse the hungry feeling. Intuitive Eating helps to address the mental, emotional, and psychological factors that also contribute to skewed hunger cues.
So, how do we get off the rollercoaster, break the cycle, and begin to feel more regulated?
A Gentle Approach to Stable Blood Sugar
Our goal is to keep our blood sugar more stable, like rolling hills, instead of the erratic like a rollercoaster. This doesn't mean skipping meals, which can also cause low blood sugar and increase cravings. It also doesn’t mean skipping carbs. Carbohydrates are an important nutrient for energy, cognitive function, metabolic regulation, and satiety.
The gentle nutrition approach to balancing blood sugar is to eat most carbohydrate-rich foods in combination with protein, fat, and/or fiber.
This combination keeps your blood sugar from spiking too quickly after eating and helps stabilize it for a few hours, which can help with hunger and cravings.
This approach is about moving toward a moderate, sustainable dietary pattern rather than something extreme or eliminating entire food groups. The goal is eating a combination of foods most of the time. Perfection is not required.
Why Protein, Fat, and Fiber are Key to Blood Sugar Balance
While carbohydrates have the biggest impact on blood sugar levels, protein, fat and fiber play a crucial role in stabilizing it.
Protein: Protein has little to no impact on blood sugar at moderate levels. It takes longer to move through the digestive system than simple carbohydrates which means, when eaten in combination with carbs, it can help slow the release of glucose into the bloodstream. In addition, protein contributes to feeling full and satisfied. This is why paring your apple with sharp cheddar cheese can make a huge difference in how full and energized you feel.
Fat: Fat doesn’t contain glucose, however fat slows digestion which helps stabilize blood sugar. Fat is also satiating and makes food taste good. Think of how a piece of toast spread with peanut butter is more filling and helps prevent the crash you might feel from a plain piece of bread or one topped with a sweet jam.
Fiber: Fiber is a carbohydrate your body doesn’t digest. Like fat and protein it also slows digestion which helps to minimize the rapid digestion and uptake of glucose into the blood stream. This is a great reason to skip the juice and eat the whole fruit instead, since the fiber in the fruit helps slow the absorption of the naturally occurring sugars.
Any one of these paired with carbohydrates can help keep blood sugar more stable, but the combination of all 3 is even better.
Example Blood Sugar-Balancing Meals
Here are a few examples of meals and snacks that combine protein, fat, fiber, and carbs to keep your blood sugar stable throughout the day:
Breakfast: Seeded Sourdough toast topped with smashed avocado, eggs, everything bagel seasoning and hot sauce with a bowl of berries.
This meal works because it combines carbohydrates and fiber in the seeded sourdough bread and berries with fat from avocado and protein from eggs. Together this slows the digestion of the carbohydrates for more stable energy to start the day. Condiments like hot sauce and everything bagel seasoning boost the flavor and enhance enjoyment.
Lunch: Beef Chili topped with cheese and sour cream and a side of tortilla chips and carrot sticks.
This chili is a great example of a balanced meal. The beans provide fiber, and the beef and cheese offer protein and while sour cream adds some fat, which helps stabilize your blood sugar. The whole grain corn chips and carrots add extra fiber and satisfying crunch, while the colorful veggies in the chili provide a boost of antioxidants and some additional carbs.
Snack: Turkey meat stick, an apple, peanut butter and dark chocolate.
This snack is an ideal combination of balance and deliciousness. The turkey meat stick is a great source of protein, the apple provides fiber and carbohydrates, and the peanut butter and dark chocolate contribute fat for satiety. The mix helps prevent the energy spike and crash you might get from eating a piece of fruit or chocolate on its own.
Dinner: Lemon Pepper Parmesan Salmon with olive oil roasted potatoes and broccoli.
This dinner is a delicious blood sugar-balancing meal. The salmon and yogurt provide plenty of protein, while the olive oil contributes healthy fat. By leaving the peels on the roasted potatoes and eating the broccoli, you get a good dose of fiber along with carbohydrates to help keep your blood sugar steady.
Supportive Habits for Blood Sugar Management
Beyond what you eat, certain lifestyle habits are also key to managing blood sugar:
Movement: Exercise stimulates insulin receptors on muscle cells, allowing glucose to move into them for energy production without needing insulin. In fact, as little as 2 minutes of light-intensity walking after eating can have a positive impact on your blood sugar levels.
Sleep: It is not unusual for clients to report more cravings and hunger after a poor night of sleep. Studies show that sleep deprivation is linked to reduced insulin sensitivity and blood glucose disturbances—this is why a restless night can leave you feeling hungrier and craving more carbs the next day. Strive to go to bed and wake up at about the same time each day, and aim for 7-9 hours of sleep each night.
Stress Management: The stress hormone cortisol raises blood sugar by triggering the release of stored glucose from the liver so you have the energy to fight or flee. Find a way to manage stress that works for you, whether it's deep breathing, meditation, or yoga, to support more stable blood sugar.
It is possible to manage blood sugar and move toward better energy, a more stable mood, and overall better health without the side of diet culture (or orthorexia).
If you're in the messy middle of figuring all of this out and have questions or doubts about this new path, I'm here to help. Learn more about one-on-one nutrition counseling or set the groundwork for a better relationship with food and your body while supporting mental, physical and emotional health in the self-paced Intuitive Eating for Skeptics program.
The information provided is for educational and informational purposes only. It is not intended to be medical advice or to diagnosis, treat, cure or prevent any disease. This information does not replace a one-on-one relationship with a physician or healthcare professional. Dietary changes and/or the taking of nutritional supplements may have differing effects on individuals.
To learn more about how working with a nutritionist could help you, schedule a free 15-minute call.