Chapter 1: Enter the Cockpit: Why Glucose Is So Important

1 ENTER THE COCKPIT Why Glucose Is So Important
Navigating our health sometimes feels like glancing into an airplane cockpit on the way to our seat. We see complicated stuff everywhere: screens, dials, flashing lights, knobs, switches, levers… buttons to the left, buttons to the right, buttons on the ceiling (no, but really, why do they have buttons on the ceiling?). We look away feeling grateful that the pilots know what they are doing. As passengers, all we care about is whether or not the plane stays in the air.

When it comes to our bodies, we are the clueless passengers, but—plot twist—we’re also the pilots. And if we don’t know how our bodies work, it’s as if we’re flying blind.

We know how we want to feel. We want to wake up with a smile, feeling energized and excited for the day. We want to have a skip in our step, feel pain free. We want to spend quality time with our loved ones, feeling positive and grateful. But it can be challenging to know how to get there. We’re overwhelmed by all the buttons. What to do? Where to start?

We should start with glucose. Why? Because it’s the lever in the cockpit with the biggest bang for its buck. It’s the easiest to learn about (thanks to continuous glucose monitors), it affects how we feel instantaneously (because it influences our hunger and mood), and many things fall into place once we get it under control.

If our glucose levels are out of balance, dials flash and alarms go off. We put on weight, our hormones get out of whack, we feel tired, we crave sugar, our skin breaks out, our hearts suffer. We inch closer and closer to type 2 diabetes. If our body is the plane, the symptoms are the pitch, roll, and yaw of a machine out of control. And these strongly indicate that we need to rectify something to avoid a crash. To get back into ideal cruising mode, we need to flatten our glucose curves.

How do we move this lever? Very easily—with what’s on our plate.
YES, THIS BOOK IS FOR YOU
A recent study showed that only 12 percent of Americans are metabolically healthy, which means that only 12 percent of Americans have a perfectly functioning body—including healthy glucose levels. Odds are that you, and nine out of the ten people closest to you, are on a glucose roller coaster without knowing it.

Here are some questions to ask yourself to find out if your glucose levels are dysregulated.

• Have you been told by a doctor that you need to lose weight?
• Are you trying to lose weight but finding it difficult?
• Is your waist size (or pant size) above 40 inches if you are a man or above 35 inches if you are a woman? (Waist size is better for predicting underlying disease than BMI is.)
• Do you have extreme hunger pangs during the day?
• Do you feel agitated or angry when you are hungry, aka hangry?
• Do you need to eat every few hours?
• Do you feel shaky, lightheaded, or dizzy if meals are delayed?
• Do you crave sweet things?
• Do you feel sleepy midmorning or midafternoon or are you tired all the time?
• Do you need caffeine to keep you going throughout the day?
• Do you have trouble sleeping or wake up with heart palpitations?
• Do you have energy crashes where you break out in a sweat or get nauseous?
• Do you suffer from acne, inflammation, or other skin conditions?
• Do you experience anxiety, depression, or mood disorders?
• Do you experience brain fog?
• Is your mood variable?
• Do you frequently get colds?
• Do you experience acid reflux or gastritis?
• Do you have hormonal imbalances, missed periods, PMS, infertility, or PCOS?
• Have you ever been told that your glucose levels are elevated?
• Do you have insulin resistance?
• Do you have prediabetes or type 2 diabetes?
• Do you have nonalcoholic fatty liver disease?
• Do you have heart disease?
• Do you have difficulty managing gestational diabetes?
• Do you have difficulty managing type 1 diabetes?

And most important: Do you think you could feel better than you currently do? If the answer is yes, keep reading.
WHAT THIS BOOK SAYS—AND WHAT IT DOESN’T
Before we dive in, it’s important to know which conclusions not to draw from this book. Let me explain.

As a teenager, I went on a vegan diet. It was a bad vegan diet—instead of cooking nutrient-rich chickpea stews and loading up on crispy baked tofu and steamed edamame, I chose (vegan) Oreos and (vegan) pasta. All I ate was poor-quality, glucose-spiking food. My skin broke out in pimples, and I was constantly tired.

As a young adult I went on a keto diet. It was a bad keto diet. I had hoped to lose weight; instead I gained weight because in the process of removing all carbohydrates from my diet, all I ate was cheese. I stressed my hormonal system so much that my period stopped.

The more I’ve learned, the more I’ve realized that there is no benefit to extreme diets—especially because dogmas can easily be abused (there is very unhealthy vegan food, and there is very unhealthy keto food). The “diets” that work are the ones that flatten our glucose, fructose, and insulin curves. When vegan and keto are done well, they both do this. And when any diet is done well—meaning that it helps you reverse disease or lose excess weight—it’s for that same reason. Really, we should be looking for sustainable lifestyles, not diets, and there is space on all our plates for a little bit of everything—including sugar. Knowing how glucose works has helped me understand that better than ever.

On the topic of being moderate, I want to note three important things to keep in mind as you read this book.

First, glucose isn’t everything.

Some foods will keep your glucose levels completely steady but aren’t great for your health. For instance, industrial processed oils and trans fats age, inflame, and hurt our organs, but they don’t cause glucose spikes. Alcohol is another example—it doesn’t spike our glucose levels, but that doesn’t mean it’s good for us, either.

Glucose isn’t everything. There are other factors that determine our health: sleep, stress, exercise, emotional connection, medical care, and more. Beyond glucose, we should pay attention to fat, to fructose, and to insulin, too. I’ll get to these later in this book. But both fructose and insulin levels are hard to monitor continuously. Glucose levels are the only measure we can track from the comfort of our couch, and the good news is that when we flatten our glucose curves, we also flatten our fructose and insulin curves. This is because fructose exists only hand in hand with glucose in foods and because insulin is released by our pancreas in response to glucose. When the numbers on insulin are available in the scientific studies (insulin is often measured continuously in clinical settings), I describe the effect of the hacks on them, too.

Second, context is key. My mother often sends me a photo of something she is debating buying at the supermarket. “Good or bad?” she texts. I always respond, “It depends—what would you eat instead?”

We can’t say whether a food is good or bad in a vacuum—everything is relative. High-fiber pasta is “good” compared to regular pasta but “bad” compared to veggies. An oatmeal cookie is “bad” in relation to almonds but “good” in relation to a can of Coca-Cola. You see the conundrum. You cannot look at a single food’s glucose curve and determine whether it is “good” or “bad.” You must compare it to its alternative.

Finally, the recommendations here are always based on evidence. Every glucose graph in this book is here to illustrate scientific discoveries that I reference and cite. I do not draw generalized conclusions from a single person’s glucose experiments or indeed from my own personal experiments. First, I do the research: I find scientific studies that explain how a certain habit flattens glucose curves—for example, a paper that finds that 10 minutes of moderate physical activity after a meal reduces the glucose spike of that meal. In these studies, the experiment has been run on a large group of people and the scientists have come to a generalized conclusion that statistically holds true. All I want to do is make a visual example of what they have found. So I pick a popular food that spikes glucose levels when eaten alone, such as a bag of chips. Then I eat the bag of chips on its own one morning, measure the resulting glucose curve, and do the same thing the next morning—but then go for a 10-minute walk. The second spike is smaller, just as the paper explains. That’s what I show to people to illustrate that walking after any meal reduces the glucose spike of that meal. Sometimes it’s not me but someone else from the Glucose Goddess community who contributes the illustrative test.

So if your body is a plane and you’re both the pilot and the passenger, consider these three caveats your safety lesson. Now that you know that flattening your glucose curves is the place to start to get your body back to cruising altitude, buckle up: it’s time to begin this journey by learning where glucose comes from.