Episode 25: Blood Sugar, Diabetes, and the Metabolism with Isaac Pohlman, Registered Dietitian and Fellow T1D
In case you are thinking that an episode about blood sugar doesn’t apply to you because you don’t have diabetes, think again! Isaac Pohlman, a dietitian and type one diabetic himself, brings such clarity and simplicity to what can feel like a complex subject. In this conversation, Isaac breaks down some of the most common questions surrounding blood sugar and makes a compelling case for why all of us should be concerned with balancing our blood sugar. Whether you are living with a diabetes diagnosis or not, we hope this discussion on blood sugar regulation from a metabolically supportive standpoint helps you take the next step in your healing journey.
Join us as we discuss the following:
The health challenges Isaac experienced that led him to his path of healing and helping others do the same
Why all of us should take interest in our blood sugar even if we don’t have a diabetes diagnosis
How blood sugar spikes and drops cause stress on the body
The case for why blood sugar is a core foundation of health
A simple analogy for understanding what insulin resistance is and why it matters
Five areas you can look for symptoms to assess whether your blood sugar needs some attention
Conventional approaches to blood sugar regulation that may fail to take into account the health of the whole body
What to consider if you have diabetes and you want to embrace a pro-metabolic way of eating
The surprising factor that could be contributing to the prevalence of diabetes today
The connection between what you eat and how your skin reacts to the sun
Practical steps you can take if your fasting blood sugar is higher than you want it to be
Who should begin tracking blood sugar numbers and how to do it
Three practices you can begin implementing today to balance your blood sugar
Gestational diabetes and the glucose tolerance test
What it looks like for someone to start off with a lower carb introduction to pro-metabolic eating
About Isaac:
Isaac is a dietitian originally from a small rural town in the Upper Peninsula of Michigan and am currently residing in Chicago.
During his formal education in undergrad and grad school, he studied human physiology and nutritional sciences and has since gone through a series of trainings, including internships to become a Registered Dietitian, mentorship programs under Josh Rubin and Morley Robbins, and independent research.
Despite his formal education, his personal experiences with health and working with clients 1:1 have been just as if not more valuable to his work. He was inspired to pursue nutrition after developing a series of health issues, including hypothyroidism, low testosterone, fatigue, cystic acne, and type 1 diabetes, during his high school and early college days.
Isaac currently helps adults with type 1, type 2, and pre-diabetes improve their health, blood sugar control, and stress by eating carbohydrates, in his coaching program, The Balanced Blood Sugar Roadmap.
Resources mentioned:
5 Steps to Lower Insulin Resistance (Free Report)
Schedule a Free Call with Isaac
Connect:
Isaac Pohlman | Instagram | Facebook | Facebook Group
“It’s easy to fall for health philosophies that have one big benefit and forget about everything else with your health. It makes no sense to go one step forward and ten steps back. We want to find philosophies that support your health as a whole. I think monitoring biofeedback is a great place to start with that.”
Transcript
Kori Meloy [00:00:16] Welcome to The Freely Rooted Podcast, where we are passionate about helping women reclaim their metabolisms, restore their youthful vitality, and rediscover God's original design for motherhood and wellness.
Fallon Lee [00:00:35] We are your hosts, Fallon and Kori, and we're so glad you're joining us for season four. If you're new here, be sure to listen to our previous episodes where we talk through many of our favorite foundational topics. Now grab your favorite nourishing drink and join us as we continue discussing simple, attainable, and life-changing approaches to wellness.
Kori Meloy [00:01:02] Isaac, welcome. Thank you so much for being here. I would love for you to start our audience out with your own personal health story, how you found yourself in the line of work that you're in now. And yeah, just give us the full story.
Isaac Pohlman [00:01:16] Yeah. Thank you, Kori and Fallon, for the invite. I really appreciate it. It's great to spend time for a few hours here with you guys. And yeah, how it came to be for myself— I grew up in a very rural area in northern Michigan, Upper Peninsula to be exact. And at that time, during high school was when I started to experience a lot of different health issues. And at that time in particular, I was very much into activity and sports. And I remember at that time especially I was experiencing a lot of stress because it was my sophomore year of high school. There was a lot of pressure to get good grades and good ACT scores for college. And I was getting notice for college soccer as well. So getting recruiters on board with the skills that I had, I think, was a lot of pressure for me at that time, and I really internalized that. And as a result, I basically burned myself out through exercise. And at that time as well, I started to notice the results or the consequences of that. And one of them being the first signs was Gastroparesis. And I'm not sure how familiar you guys are with that, but it's basically the delayed stomach emptying, so essentially you feel very full, very quickly. So that was one of the first signs. And I lost a ton of weight. I was already very skinny at that period of time, probably like about 100 pounds, and I lost 15, so I was like 85, 5'6" or something like that. So just rail skinny.
Kori Meloy [00:02:48] Oh, my gosh.
Isaac Pohlman [00:02:48] And it forced me to quit a lot of sports because as a result, I had a lot of fatigue. So that was kind of the start of it. And as I got into college, I ended up pursuing college soccer and it just was a huge burden on me. And not only with a lot of the pre-med classes I was taking at the time, but also college soccer being one step up from high school. So that's where I started to experience a lot of hormonal imbalances, low testosterone, low thyroid, lots of food sensitivities and allergies, just all sorts of things coming up for me. And that's where I started diving into things on my own because I don't know about you guys, but I had a lot of well-meaning doctors trying to support me. And well-meaning but weren't really able to do that, to find that solution for me, and that's why I really started to advocate for myself and started to see some results. And as a result of feeling better, of looking better, of finally getting some muscle, getting some weight, people started asking me, "Hey, Isaac, what are you doing?" And I started to give them some of the tips and tricks that I was using, and that's where that work stemmed from. I pursued human physiology study in undergrad, then went on to grad school where I studied more of the nutritional sciences piece of that because it was such a big piece for my recovery. And unfortunately, that wasn't the end of it for me. And in grad school, I kind of continued the same patterns. I'd fall back into a lot of the things I was doing in high school, and not saying that that was the only thing, but as a result, at the end of grad school, I ended up with a type one diabetes diagnosis. So that just adds another layer on to that. And in a sense, I hope I finally have learned to manage things, but it's certainly something that has been a trend of mine in history. And as a result, I started working with people especially within the diabetes realm— type one, type two, pre-diabetes, because I've seen such significant results for myself, but also I have such a personal experience with it as well.
Kori Meloy [00:04:47] So cool.
Fallon Lee [00:04:48] Yeah. Thank you for sharing that story of yours. I would love to kick us off with you letting us know why is it that everybody should be concerned about blood sugar regulation? Because I can say for myself, one of my closest friends is a type one diabetic. So I have this sort of general framework for the blood sugar conversation for years and years. But when I put together that I needed to be concerned about it for myself, it was kind of this shocking moment. Like, I had no idea that as a non-diabetic that blood sugar was even something I needed to worry about. And I think a lot of our audience probably feels that way too—mine and Kori's audience, that is—that they don't really understand that they need to be concerned about it, even as someone who doesn't have a diabetic diagnosis. So can you explain why is it that all of us need to be concerned regardless of our current health state?
Isaac Pohlman [00:05:37] Yeah, yeah, absolutely. You're exactly right, Fallon. You know, balancing blood sugar is often thought to be a thing for just people with diabetes and monitoring the numbers. And there's some truth to that. You know, I wouldn't recommend someone without diabetes to be tracking that. I think that's a little bit excessive. But that doesn't mean that that shouldn't be a focus of theirs, because if you look at the function of blood sugar, what is that? Well, you can almost view blood sugar, in a sense, as the fuel or the gas tank that we need on a day to day basis to feel our best, both mentally and physically. Right? And if that were to be out of balance— right? Let's just say blood sugar jumped up to a thousand or blood sugar dropped to zero. Essentially that would be a threat to our survival. Right? And as a result of that, if there are some level of imbalances that occur, the body's going to respond accordingly because it views that as a threat to its survival, which it can be in excessive amounts. And as a result, if blood sugar does get imbalanced, it's going to employ symptoms to say, "Hey, Isaac, something's off here," to get our attention, essentially. So when it comes to those that are without diabetes and wanting to better their health, blood sugar can be a great way to do that because it's the foundation of how we feel our best. And it's a foundation of how we—at the end of the day—produce energy or improve our metabolism because it has such a vital piece into the symptoms that we may or we may not feel as a result. So let's just say, for example, that blood sugar dropped. We have a deficiency in the blood. We don't have enough carbohydrates. Well, the body views that as a stress. Right? So what happens? Well, it employs stress hormones that break down our own body tissues—things like fats and glycogen or stored carbohydrates in our muscle—to basically fuel ourselves. Right? And if it's at an extreme, we might start to feel a little bit dizzy and we might start to feel a little bit more lightheaded or weak or lethargic. Right? And that's a sign to us that, hey, something's off. Maybe I need to eat. And you start to learn that, right? If you have experience with blood sugars, you eat and all of a sudden, hey, you feel better because your body is getting what it needs. It's not in that deficient state. Right? And on the other side of things, too, let's just say it's high, for example. Well, we have an excess in the bloodstream. But we're not getting enough at the cell level. It's not getting it there. There's some discrepancy. Right? And as a result, it's very similar to a low. We have all this energy in the bloodstream, but not enough at the cell level. So it still views that as a stress. And as a result, we're breaking down our fat stores or breaking down muscle to inevitably help to get that fuel over to the cell site. Right? So as a result, you might feel a little bit more lethargic. You might feel less energetic, a little bit more of headaches. Frequent headaches are often one of the things that happens most when it comes to feeling your best. And then even things like urine frequency. If you're noticing, hey, I'm having to use the bathroom a lot, especially after meals, that can be a big sign that something's off. So when I talk about blood sugar regulation, I'm always talking about biofeedback. At its extreme, it can relate to diabetes, but it can certainly relate to everybody because it's the way that we all derive energy. It's the way that we all can feel our best mentally and physically. And one example of this—and I'll wrap it up with this—is that I don't know if you guys have seen those Snickers commercials, like way back in the day, maybe like ten years ago, that they talked about like you're not you when you're hungry. Right? And one of the videos that popped up was like Betty White playing football. The guy was like, hey, you're playing football like Betty White. And then he eats a Snickers and all of a sudden he feels better. And it's the same thing with blood sugar. Like, if it's off, you're not going to feel your best. And that's exactly what that points to. So that's really the key behind blood sugar balance. And when you do that, all of a sudden you improve your metabolism. All of a sudden you improve thyroid labs. All of a sudden you can improve things like cholesterol, energy, sleep. So it's really, in my view, the foundation of health.
Kori Meloy [00:09:54] That's so good. I mean, I can think of my own personal health—and probably Fallon, too—I mean, my younger brother and I for many, many, many years dealt with blood sugar dysregulation, but didn't really have the tools to bring ourselves out of that. It's so funny because we're like, "We're so shaky whenever we go six hours without eating," but never thinking maybe we should eat like earlier, not go six hours without eating. Anyways, but headaches, frequent urination— I was dealing with all of that, and it's awesome to see how even just simple principles to balance my blood sugar have improved things so much. And I think for our listeners, a lot of people come in who have either gotten a PCOS diagnosis or some sort of diagnosis where insulin resistance is a part of the conversation. So Isaac, could you define insulin resistance and what that means? I think if we hear that from maybe a doctor, there's this fear spiral of the unknown of what that is, but can you kind of break down for us what insulin is? What insulin resistance is? And kind of simplify that to our audience.
Isaac Pohlman [00:11:04] Yeah. Yeah, absolutely. And Kori, I think this is a really complex term that gets thrown out there, and a lot of us may not know exactly what that means entirely. So the way that I like to do it is use analogies, too. I think that can be very helpful, and just break down the term insulin resistance. And I think the great place to start is what is insulin, right? Well, insulin is this hormone that's produced by the pancreas and allows us to regulate blood sugar. You can almost think about it like a mailman or mailwoman. Right? What are the jobs of a mailwoman or mailman? Well, they take mail from the postal service. Right? They gather it up and they deliver it to the individual mailboxes— people like us. And as a result, the mail gets distributed. It doesn't build up, in a sense. And that's exactly what insulin does. It basically carries carbohydrates instead of mail and delivers it to the individual cells instead of mailboxes. So it's very similar. Right? So that's what insulin does. It helps to manage the blood sugar, helps it keep it within balance. Right? And that's what the body loves. It loves homeostasis. It loves when things are within balance. But enter something like insulin resistance. Well, that's an inability to use that insulin. So as a result, blood sugar tends to rise. Right? And so what does that essentially look like? Well, when insulin resistance occurs, typically there's some sort of insult. So that could be something like stress. That could be something like a lack of sleep. That could be mineral imbalances. That could be lack of movement, whatever that is. And typically it's a few of those different factors, in my experience. But whatever it is, blood sugar just tends to go up essentially. And the body being this adapting machine that it is, it's going to adapt. So what does it do when blood sugar goes up? Well, it's going to increase the amount of insulin that it produces. It'll help compensate. So as a result, blood sugar gets back in range. But the more of these stressors or insults that we have placed on ourselves, the higher that blood sugar, the higher that insulin production is going to be. And at its extreme, that's where you see something like hypoglycemia or that's where you see something like Hyperinsulinemia that those with PCOS might experience as well because you're producing so much insulin that, as a result, you have a tendency to drop, especially when you're not eating in a frequent way or regular way. So as a result of that, you might experience Hyperinsulinemia drops throughout the day. Or some people that I work with, too, experience reactive hypoglycemia which is when they drop after eating a meal as well which can be very scary. I think a lot of the clients that I work with, that's one of the things they fear the most are those drops in blood sugar. So that's essentially what's happening is we're producing all this insulin. And this is a long story to say that the more that we're producing excessive amounts of insulin, the more that cells are going to be resistant to that. Right? And you can almost think about going back to the mailman postal service example. It's almost like you have so many mailmen, so much mail being delivered to these mailboxes that they're so full. There's no way you can fit in more packages. There's no way you can fit in more mail. So they're going to be super overwhelmed, resistant. Hey, I can't put this mail anywhere. And that's exactly what the cells are feeling. They become desensitized, in a way. They're not going to accept that. And as a result, the insulin isn't going to work properly. We're not going to get those carbohydrates delivered to the cells, and blood sugar tends to rise as a result. So that's essentially the core of insulin resistance. It starts off as we're producing too much, and as a result, cells become resistant to that.
Fallon Lee [00:14:52] Thank you. That was a fantastic breakdown. The mail analogy was incredibly helpful. You mentioned some symptoms in kind of your own story and in talking about why it's important for everyone to be aware of blood sugar regulation. Let's come back to that and give it kind of some focused attention. What are some classic signs that our blood sugar needs attention? So I don't know if you want to categorize by maybe high blood sugar versus low blood sugar and how that can differentiate. But how can our audience know, okay, maybe my blood sugar needs some attention?
Isaac Pohlman [00:15:25] Yeah, yeah, absolutely. And I think this is a good question because a lot of times for each person, it's going to differ a little bit depending on how these things might show up. And the thing that I have all my clients focus in on is what's called biofeedback. And it's essentially how your body is feeling in a variety of different areas. So the things that I typically like to measure are things like energy, and hunger, and digestion, sleep, and stress. So with focusing on those, typically those are the things I see affected the most. Right? And when your blood sugar is off, essentially your energy is going to be affected. Typically, you're going to feel more tired. You're going to feel more exhausted at the end of the day. You're going to feel more lethargic or sleepy, particularly after meals. And then typically another trend that I tend to notice, too, is that you might feel tired during the parts of the day where you actually need energy. So during that— especially that midday where you're trying to be productive but you just don't have the energy, and then at night you actually have more. It's almost in a way that it's flipped where the times where you should be having energy, you don't, and the times where you should feel more or less tired, you actually are feeling hyped up and feel like you could exercise. So that's where I see things being particularly off from an energy perspective. Now, when it's high or low— high blood sugar, typically you're going to feel it particularly after meals. So very lethargic and sleepy sort of feeling versus if it's low, typically more on the weaker side of things. Like you just don't have that strength and more so exhaustion, less of that sleepy feeling. So that's one I look at in particular, because energy is the biggest symptom that I think tends to come up for most people. I'd say the second one would be hunger, right? And Snickers commercials big on this— you aren't you when you're hungry. And that's the same thing with blood sugar. If you can't go long hours without eating or are feeling hangry, in a sense— like angry when you can't have a meal. If you feel really put off by not having food nearby, typically that speaks to a blood sugar issue, right? So a lot of my clients have some experiences with that where they feel almost tied to the kitchen, like they're always having to eat in order to feel like themselves. And over time, as we work on things related to blood sugar regulation—I'm sure more the topics that we get into today—they can start to feel like they can go longer hours without eating and don't have to have a meal every hour or every two hours to feel like themselves. So that one is particularly affected as well. I'd say another one would be digestion, particularly when it comes to carbs, because we talked about how blood sugar imbalances can lead to stress. And that's the same thing. It very much relates to digestion because if we think about digestion, what kind of state that we do we need to be in to digest things properly? We need to be in what's called a parasympathetic rest and digest sort of state. But if we're not eating, if we're not living in a way that's balancing our blood sugar, we're going to be more stressed. Now as a result, we're going to be sympathetic or a fight or flight type of response. So when we're in that sort of chronic stress state, we're not going to be able to digest things properly. We're not going to be producing things like digestive enzymes or hydrochloric acid, which are needed in order to digest foods properly. And that's why a lot of times when you start to introduce carbs to someone who hasn't had them a lot, they're going to have all sorts of bloating and gas and all sorts of digestive issues because of that stress, because of the state that their body is in, essentially. So that's a big one as well. Digestion. Another one would be sleep. And Kori, I think you mentioned this as well, that whenever we're not regulating our blood sugar during the day, that's going to expose itself at night, in particular. It's going to be a very vulnerable state. So I've had clients— even if I look at myself in the past, what has happened when I wasn't regulating my blood sugar, wasn't eating in a way or living in a way that's supportive— that I would wake up like five or six times during the night to use the bathroom. Right? And it was just this constant cycle of having to use a bathroom, wake up. And I was so used to that. I just thought it was normal, but it's really not. We should be able to sleep throughout the whole night and not have to wake up to use the bathroom. So that's a big key. Another one would be if you're waking up feeling hungry. If you're starving in the middle of the night, that also points to, hey, you're probably not fueling yourself early on in the day to ultimately support your health. Right? And that's going to show up in sleep. Right? And then that last one, too, would be stress. So a lot of times we think of stress to be the external thing, like this person cut me off in traffic or my boss is being really hard on me or my kids are being annoying or whatever that external stress is. A lot of time, we think that, hey, that's external. But we also need to understand that we can create an internal environment that can help us cope with stress, and blood sugar regulation can certainly do that. So even if I look back on myself and the clients that I work with, when we're not eating frequently, we're going to be more moody, we're going to feel more stress, we're going to feel more anxious, right? So the way that we show up in the world is a direct reflection of how we're living, and blood sugar regulation can be a huge sign of that.
Kori Meloy [00:21:05] That's so good. Yeah, I completely agree. And it's interesting to see how—with the last point you just made—even just behavior and how we are, as a culture, maybe even quick to label people as like—I don't know—bad people or whatever, when there could be some serious imbalances at the root of just how they're feeding their bodies on a cellular level that are showing up in the way that they even behave in the world. So anyways, yeah, I love this conversation because—especially with what you're talking about with sleep—it's so funny now the way that I approach sleep. This idea of even "insomnia". I'm putting quotation marks because in college I was like, "I have insomnia for sure." And now I look back and I'm like, "You were not feeding yourself." I would lay wide awake— everything that you just said. So wired, so jittered because I went to the gym at 10 PM to go workout. Our gym was open 24 hours. And it's bizarre to me to look back on that now, and then look at my life now, and I'm able to pinpoint— if I am having a hard time falling asleep, I'm able to pinpoint, "Oh, that's because you went—" you know, like it's just easier to see the building blocks of what you're cultivating as far as sleep at night. So I would love to talk about just more of the conventional approaches to blood sugar dysregulation or regulating your blood sugar that you don't necessarily use in your work, but you're able to recognize as hm, maybe that's not really hitting the mark. So what are some of the more conventional approaches to blood sugar regulation that might not be addressing the root cause?
Isaac Pohlman [00:22:54] Mm hmm. Mm hmm. Yeah, absolutely. Absolutely. And I think this is another great question, because I think a lot of the listeners and a lot of my clients have some direct experience with these philosophies that may, in a sense, target the blood sugar, but forget about everything else with their health. And I'm sure you guys have seen these over and over, but with the clients that I work with, typically they've used some sort of ketogenic diet or some sort of carnivore diet or low carb diet to address that, essentially cutting off a whole food group. And I'm not here to bash any sort of those lifestyles, because if it gives some someone a place to start with their health, great. The concern that I have would be more so the long-term. So it typically advertises maybe one big benefit, whatever that might be. Maybe it's weight loss, maybe it's blood sugar balance, maybe it's more energy, maybe it's a cleanse. So they're looking at one big benefit. But typically what happens is you take one step forward and maybe ten steps back, in a sense. So while maybe blood sugar might improve, maybe your energy doesn't. Maybe you start to feel more stressed and more anxious. Maybe you can't sleep at night, right? It's all these domino effects that tend to occur with these philosophies that have one big benefit. And that's why—whenever I'm approaching any sort of philosophy—I want to make sure that it's improving all of these different aspects, not just blood sugar—right?—that they're targeting or whatever that one benefit that you're searching for. And that's why I'm so big on biofeedback because you can see that. You can see, hey, is my stress improving? Is my sleep improving? Is my appetite or digestion improving? Right? And for those of us that have diabetes or are checking blood sugars, is my blood sugar improving? Because it's so easy to fall for these things that have that one big benefit and forget about everything else with your health, because at the end of the day, all those things do matter. To me, it makes no sense to go one step forward and ten steps back. Right? We want to find philosophies that go into supporting your health as a whole. And I think monitoring biofeedback can be a great place to start with that. So whatever philosophy that you follow, that can be a great place to start. How can you monitor your hunger or stress or energy or digestion, right? Is there a way for you to do that? And can you be honest with yourself? Can you create that awareness? And a lot of my clients do food logs and lifestyle logs to be able to create that awareness and give them that objective perspective because sometimes it's hard to see. And my clients say that a lot. When they see their symptoms improve, they're like, "Wow, I didn't even know that was connected to blood sugar." Right? They have no idea. And it's not talked about enough. So that's why I think a lot of those philosophies do go off base is they're focusing on that one big benefit without understanding that health is a conglomeration of everything. It's not just your blood sugar, it's how you feel mentally and physically as well.
Fallon Lee [00:25:51] It's interesting to me how much of my own journey I see in this conversation. Kori, you've said this too, but I came from a long background of lower carb dieting. I was AIP for probably five years, and so it's inadvertently very low carbohydrate. And so when I transitioned to pursuing more of a balanced approach and healing my metabolism, I was one of those people that wrestled with that persistent state of low blood sugar for the longest time, and I would have to eat every one to two hours. And you mentioned this earlier, Isaac, but that has evened out so much over the course of two or three years of pursuing this, and now my body is resilient enough to go longer stretches. But I mean, I feel like I'm a walking example of how lower carb can be really dysregulating to your body, even though I wasn't approaching it in light of wanting to regulate my blood sugar. I was doing it for different reasons, and then my blood sugar really struggled as I transitioned to kind of a more bioenergetic approach. So yeah, it just is so interesting how everything you're talking about— Kori, you said this too, but I'm like, yes, yes, yes, yes. The insomnia, the hangry state. I just have been in all of that and now have seen such healing from that. And on that note, Isaac, I would love for you to cover anything in kind of the—again, put quotes around this—the "pro-metabolic diet" because I think probably all of us sort of function off this framework that we don't want to call it a diet. It's a lifestyle. It's a methodology. It is not a list of foods and a yes and no type black and white approach. But is there anything in the— we'll say the pro-metabolic approach that somebody with diagnosed diabetes or blood sugar issues of any kind should be cautious or aware of? I know that the adrenal cocktail conversation comes up a lot that some people just can't handle eight ounces of orange juice at a time, and they need kind of a different approach to balancing their minerals. Things like that. What are some things in the pro-metabolic approach that you would sort of offer caution around for those who do have blood sugar issues of some kind?
Isaac Pohlman [00:28:05] Yeah, absolutely. And this is such a hot topic. I made a post about this maybe a year ago on this exact, exact topic because I get it so often. And I think the way that I like to frame this conversation is typically where you start doesn't mean that's where you're going to end, right? So what might be supportive to you now typically won't as your body becomes less stressed and as you balance your minerals and as you balance your blood sugar a little bit more, right? So for those that are just starting out, it's easy especially if you come from a mindset of being very restrictive with carbohydrates and you're on keto or you're on low carb, that, oh, you see this whole new world open up for you that carbs are good and they help to boost metabolism and have all these different benefits and when people see that that door opens to them, it's like the floodgates. And it's easy to go just hog wild on carbohydrates, and symptoms that I typically see is people's blood sugar spikes totally out of control and they gain a ton of weight as a result because their body just isn't used to that. And it's one thing about the physical side of that— you see the blood sugar, you see the weight gain, but also the mental side of this, too. It basically drives home that carbs are bad and I should be fearful of carbs because this is what they did to my blood sugar. Now understanding the context of, hey, your body is probably really stressed. You probably have a lot of mineral imbalances. Let's keep things in context here. Your body probably isn't used to processing carbohydrates just yet at that stage. So let's keep the context. But it's hard to see that when you see the direct result of holy crap, I just saw my blood sugar skyrocket 100 points and I just gained 20 pounds in a matter of a few months. Right? So that's where I see starting off very slow being very helpful not only from a mental perspective but also physical as well. Because, like I said, where we start might not be where we finish. So typically if you have a diagnosis of diabetes—whatever that might be, type one or type two—typically what I find just starting to get used to a level of carbohydrates on the lower side of things can typically be a little bit easier to handle mentally and physically because it doesn't initiate that fear, in a sense. You're not seeing your blood sugar skyrocket; you just kind of getting used to it. So it actually— say, in this stage of the game, eating kind of a lower carbohydrate diet wouldn't be the worst idea because it allows you to get stabilized, which we want to do with those with diabetes, first and foremost, is get things within balance even if that's a higher baseline for them. You know, let's get you within balance so things can be a little bit more stabilized for you. And then we can work on kind of getting it back into a good range. And starting off with kind of lower end of carbohydrates is typically a good way to do that. The other thing that would be helpful to keep in mind, too, is the types of carbohydrates that you're consuming because we know that not all carbohydrates are the same. Each one might have a different glycemic or blood sugar response. All right? We know something like a bowl of rice is different than maybe a piece of fruit, or a root vegetable is different than a bowl of oatmeal. Right? So identifying those carbohydrate sources that you feel confident with. Right? And there's things like fruits that can be very supportive as a carbohydrate to start off on. Not to say that's the only carbohydrate that you can have, but they contain something known as fructose. So, you know, what is fructose? Well, it's this carbohydrate that can basically be absorbed independently of insulin. And we talked about that insulin resistance before. Right? That pathway is kind of disrupted. Well, fructose can kind of take a detour around it, in a sense. It's not utilizing the insulin pathway. It's absorbed through other ways. And essentially, we can have our carbs while still balancing our blood sugar. So the type of carbs that you're eating should be something that you take into account, too, because outside of the pro-metabolic space, there's a lot of emphasis on complex carbohydrates. I mean, you see this as— you know, I'm a classically trained dietitian, and that's what most people in diabetes clinics will recommend is complex carbohydrates. But those are starchy, very much starchy. And they contain a carbohydrate known as glucose, which is something that requires insulin to be absorbed. So for the people that have insulin deficiencies or that have insulin resistance, they're going to experience a lot more challenges with that type of carbohydrate versus something that has a little bit of fructose in it. Right? Yet the fructose, the sugar, the fruits are the things that we're told to avoid, essentially. So that's what I would look at. Number two is the source of those carbohydrates. Right? The next one that I would look at, too, is the meal frequency. So there is a balance with eating frequent, but also grazing. Right? So for someone that has diabetes, they want to make sure that they have enough space between their meals to make sure that blood sugar trends down, but also not too much where they're not fueling their bodies in a way that's supportive. So I can give you an example here. I have some clients that might start off with eating three meals a day—right?—to kind of give them that space to process those carbohydrates. And then they might add in a snack or two as they get a little bit more proficient with digesting carbohydrates. Right? So meal frequency comes into play to make sure that you have enough space, but not so much that you're not actually supporting your body. Now, where this becomes a problem is if you're avoiding meals because it "spikes your blood sugar". Right? I have some clients that come in very fearful and are actually avoidant of snacks or avoidant of meals. They might skip breakfast, they might have a small lunch, and then they might have a large dinner, for example. So that's where kind of the mental side of things comes into play. And kind of looking at, hey, food isn't the only thing that impacts blood sugar. There's so many different things like sleep and movement and stress that go into impacting blood sugar as well. And the more that we avoid something, that's not going to address the problem because how many times have we avoided something in our life and things have improved? So, essentially, we want to meet the body where it's at, but we also want to make sure that we're not just simply avoiding the issue altogether. So from a pro-metabolic standpoint, there's a certain balance. There's types of carbs, there's a balance between meal frequency. So eating enough, but not too much to the point where you can't get your blood sugar down and starting at a place where you feel comfortable. And that's both from a physical standpoint to make sure blood sugar stays within a good range, but also mental because there's a lot of fear with blood sugars and consequences and complications as a result. So that's where working with that client and making sure that you have kind of that mutual agreement can be something to keep in mind.
Fallon Lee [00:35:23] Yeah, that was great. Thank you so much for all of those details. I do also want to ask, too— we have just this prevalence of diabetes in our modern society, both type one and type two in particular seems to have just really increased in how common it is. And I'm curious what you would say is kind of the wind in the sails for this jump in diabetes that we've seen. Are we right in blaming the carbs or is there something else that's contributing? What is your opinion on why is this happening so much right now?
Isaac Pohlman [00:35:59] Absolutely. Yeah. That's the million dollar question—right?—Fallon, is what is contributing to these increases in diabetes rates that we're seeing that are kind of exploding, in a sense? And I have a few ideas of where that might be stemming from, and I think there's a certain hierarchy with it, too. The one that I would look at, first and foremost, is the category of stress. And when I say stress, I don't just mean emotional or demand stress. I'm talking about nutritional; I'm talking about minerals; I'm talking about sleep. So all these external things— how you're living your fulfillment at work, relationships at home. All of these things go into that. And the reason why I put this first is because stress can make such a big impact on blood sugars. Right? And if we go back to that mailman example, talking about the insulin, when stress is on board, when we're chronically stressed—whatever that might be; often is a series of things—that's going to inhibit that mailman from delivering those carbohydrates. Right? And as a result, blood sugar tends to rise. And we have that mechanism going on, so we know blood sugar tends to rise when we're stressed. But we also know that when stress occurs, it depletes vitamins and minerals. Right? So I don't know about you, Kori and Fallon, if you have had these stressful experiences where you had to give a presentation or something really nerve wracking for you, and all of a sudden you have to use the bathroom more frequently. I know that was the case for me a few years back when I was giving my thesis. And what we know about stress is what happens— it's a diuretic, so it causes us to have to urinate more frequently. Right? Well, what comes along with more of that urine production? Well, all the water soluble vitamins and minerals, so things like magnesium and potassium and B vitamins. Right? Calcium. And what do all those have in common? Well they help to manage blood sugar. Right? So there's this huge connection. And the way that I like to present this as an analogy is in order for us to achieve the best health and best quality of blood sugars, we have to, in a sense, fill up our bucket. And you can almost compare this to filling up a bucket with holes in the bottom. So you're trying to fill up this bucket of water with a bunch of holes at the bottom, and the water is essentially leaking through it. You try to fill it up, it's not going to fill up. Right? But if you address the stressors and major things in your life that are causing you stress, you essentially plug those holes. Right? But if we don't do that, if we're just taking all these different supplements and trying all these different diets and drinks or whatever that is the case, we're not really addressing that stress. So to plug the holes, we need to do that first in order for us to actually hold on to all those minerals and vitamins, all those great quality foods that we're eating. And when we do that, we can actually fill up that bucket. We can actually achieve good health. We can actually achieve good blood sugars. Right? So in my view, it starts with that is addressing the stress. And what could that stress be? Well, it could be a lack of minerals. It could be imbalanced minerals. And the one in particular that I see coming up for those with diabetes is iron. And iron, I think, is shown around a lot in the pro-metabolic space. And it's not to say that iron is bad. I want to preface this conversation. It's not to say that iron is bad. We actually need it. We need to produce red blood cells all throughout the body. But it's to say when it's out of balance with these other minerals, it's going to cause us issues. Right? And the reason why that's the case is because, in excess, iron is what's called a pro-oxidant. And what does that mean? Well, it means that it's the complete opposite of an antioxidant. So the exact thing that we use as good quality foods or in supplements to help with inflammation, essentially. Right? So if you have too much iron on board, which can be a result of just frankly consuming too much, or not taking enough supportive copper and vitamin A or other minerals, or we're super stressed—right?—we're going to hold on to more of that iron. And as a result, that's going to lead to more of those pro-oxidants. And, in excess, that can lead to inflammation. Right? Which, when we look at inflammation, it's something that underlies poor blood sugar control. So as inflammation goes up, so does blood sugars. So that can be a big piece to look at is iron. And it's actually been proven, especially within the type two space, is that when we have too much iron stored away, it increases the amount of glucose output from the liver. Right? And if you think about type two diabetes and you think about the mechanisms involved, something like metformin. Metformin is a classic medication that's used for people with type two diabetes, some with type one as well. They have a level of insulin resistance. But essentially what metformin does is it prevents the release of glucose or carbohydrates from the liver because that is going on excessively, and that's what's contributing to those rises in blood sugar. And as a result, when they take metformin, it knocks that out. All of a sudden their blood sugars start to stabilize. Right? And guess what's behind that? Well, one of the things that's behind that is iron. We know that iron— when we have too much on board, it's causing an excess release of blood sugar or carbohydrates, and it's spiking your blood sugar up. So if we are able to manage iron a little bit better, we're going to be able to manage our type two diabetes a little bit better, too, because of that. Right? And with something like metformin—and this is not to be medication bashing or anything—we know that it chelates something called copper. Right? So you'll notice for those that do have to take metformin, they actually tend to be more and more metformin to produce the same result. And that's a result of wasting that copper mineral, which—I can go into this later—but it actually helps to manage iron. It's a huge piece of that. So it's kind of a double whammy, in a sense. So iron can be such a huge piece to type two diabetes or any sort of insulin resistance. Another one would be what's called polyunsaturated fats. Those are a big one in the pro-metabolic space. And I want to preface this conversation, too, that it's not that polyunsaturated fats are bad. And I think, you know, in the pro-metabolic space or Ray Peat space, I think they are very much tracked and trying to create as little as possible with diets, which I think is a little bit overboard. But with polyunsaturated fats, they can certainly be something that can cause some havoc, especially when we're talking about type two diabetes and blood sugars. Right? And the reason why that's the case is because it's very similar to iron in the fact when we have them in excess,—when we're eating them excessively or we have them stored away excessively—they're going to have more pro-oxidants, essentially. There are going to be more pro-oxidants. And very similar to iron, they're going to put a strain on our antioxidant system. And why is that the case? Why is this type of fat different than others? Well, if you look at the structure—and this is diving a little bit into the science here—polyunsaturated fats, we break down the term. Poly, meaning many or more than one, essentially. There's more than one double bonds. And those double bonds within the chemical structure of those unsaturated fats are reactive to heat, light, and oxygen. Well, if we look at unsaturated fats, what do they encounter when they're produced? Well, they probably interact with the sun, they probably interact with the oxygen rich environment that we have. Right? And they probably interact with some sort of heat. So those three elements are encountered before we even eat those fats. But also, if you look at us as humans—right?—a healthy body is 98.6 degrees Fahrenheit. We're very warm, and we're very oxygen rich. Right? So it's a perfect recipe for fats that don't so much align with our system and put a strain on the antioxidant system that we have. And for those of us— even those of us without diabetes, we already probably have an antioxidant problem, meaning that we're not producing enough. And if we add something like a ton of unsaturated fats, PUFAs into place, then that's going to cause even more issues for ourselves because of that reason. Because of the elements that those unsaturated fats interact with outside of us eating them and then when we put those into our bodies as well. Right? And the thing with fats— it kind of goes by the old notion "you are what you eat", essentially, because the fats that we do eat inevitably become a part of our own adipose tissue. So when we are experiencing more stress or when we're not eating as frequently that we'd like, we actually break those fat stores down and then we essentially release some of those pro-oxidants again, again, and again. So that's where it can become, in a sense, damaging if we are consuming a lot of those. Right? And the key word is excess. It's not so much the chicken or the ham necessarily, the small amount of PUFAs that can come into play, but more of the excess. So, you know, nuts, seeds and especially vegetable oils, particularly. So that one, in particular, I see being one of the biggest changes in our food supply. If you look at disease rates when we didn't have so much type two diabetes, versus when we do now, that is one of the things that has steadily increased versus more saturated sources like butter has actually steadily decreased. Right? So that's another big area to kind of look at. The other area might be, too, is not only an excess of maybe the wrong kind of minerals, but a deficiency of maybe the minerals that can be of good support. So the first thing that comes to my mind when I think about good quality minerals that a lot of people do need is something like potassium. Right? If you look at the needs for potassium, it's something like 4700 milligrams. And I know for a fact even— you know, I have a lot of dietician friends. I know for a fact that lot of them—being some of the most educated people when it comes to nutrition—they're not getting that amount of potassium in. They're not meeting those 4700 milligrams that you need. And what does potassium do? Well, it is a big factor when it comes to carbohydrate metabolism, meaning it plays a big role in assisting that conversion between carbohydrates to energy. So essentially, it helps to lower blood sugar. So for a lot of folks that I see that do have blood sugar problems, they tend to be not consuming very much potassium. And that's such a big player. And we talked about the adrenal cocktail, and there's other lower carb forms of adrenal cocktail, but that's one of the reasons why that can be so supportive. If you find maybe a lower carb one that you could have, that's going to lead to a lot more blood sugar stability because of that potassium. Right? So that's what I look at, too: supportive forms of minerals. And then last one would just be kind of lifestyle. So we know that sleep— if you're not getting enough sleep— and that can go back to how you're living throughout the day, too. But even things like sleep hygiene. If you aren't going to bed before midnight or before 1 a.m., that those kinds of things— you're going to have more insulin resistance in the morning. Your blood sugar is generally going to be higher. So that's a key piece. Movement as well. We know— during the pandemic, especially— I have a lot of clients that have more desk jobs now. They're not moving as much. And as a result, our insulin sensitivity goes down, insulin resistance rises. And more chronic basis, the more stressors that we have on our body, that's going to have even more of an impact. And that's where you see things like pre-diabetes, type two often come into play.
Kori Meloy [00:48:15] Isaac, that was so good. And to circle back to what you were talking about with you are what you eat and changing even like your fat tissue, I'm curious if you had any changes as far as your skin's sensitivity to the sun and developing sunburns or being more resistant to sunburn, like just from your changing of the kind of fats that you eat.
Isaac Pohlman [00:48:39] Yeah, I love this question because this comes up a lot during the summertime. And absolutely. I think a lot of times, we— even government sites or wherever you want to look at— is blaming external things like the sun as being the problem, which, in excess, I think anything can probably give us some problems. But at the core of it, if we're looking at the sun and it interacting with our skin which has maybe a bunch of unsaturated fats, and we know that unsaturated fats interact with the sun and can oxidize as a result, then yeah, we're going to burn more easily. And that's something that I saw. I grew up constantly burning from the sun. I would never get tanned or whatever, and then I think that's the reason why is like I would essentially go from pale light-skinned to burnt. Those would be the stages: one, two. And as I started to understand why that was the case, I was like, yeah, I'm actually getting a tan here and not just skipping that stage, essentially. Which I think from a visual perspective looks a lot better, but also just the frustration with summertime, I think, can come into play, too. So it's definitely the case. You are what you eat. And that can very much be influenced between whether you get tan or actually just go straight to that burning stage.
Kori Meloy [00:50:04] Yeah, the sunburn thing has been fascinating in my own life. And also just like the direct visual representation. If there is a meal that's like really high in those oils and then seeing how my skin's more sensitive to the sun even that day is interesting. And I have a highlight on my Instagram called sunburns, I think, where if you guys haven't gone through that, you can see— I think I have maybe like 50 or 70 different stories and testimony of people who have kind of changed what they eat and then become incredibly resistant to sunburn. So it's really cool to see that in real life and not just be this whimsical thing that we're talking about, but like it actually is happening, and it's incredible to see that and especially with this volume of people who are not afraid of the sun. And you talked about like in the summer, it's kind of annoying to be thinking so much about like, I can't even enjoy this day or this time in front of me because I have to be worrying about getting a sunburn, you know? So it's pretty freeing in that way.
Isaac Pohlman [00:51:08] Oh, yeah, absolutely. And it suggests that it's not just a one on one. Like you said, you have a lot of people suggesting those same things. And I've heard it from my clients, too, that as they reduce kind of their nut and seed intake or their vegetable oil intake and have graduated to more of those saturated sources, they're seeing the benefits of that when it comes to skin health. And I think that just points to everything is connected. You know, I think we like to pigeonhole things as being like a blood sugar conversation or hormone conversation or a PCOS conversation. But when you look at supporting your body, you know, all these things can certainly apply. So I think that brings it all together, in a sense.
Fallon Lee [00:51:48] I want to talk a little bit about high fasting blood sugar, but I have kind of a cool personal story on this first because I had done a full monty iron panel maybe a couple of months ago. And no surprise, I have a lot of oxidative stress happening— too much iron, and trying to figure out how to address that. In hindsight, I can see how iron overload would have happened over the course of my journey. But it's just not something I was aware of at the time. The cool bit of this is I did decide to start testing my own blood sugars at home several months back because I just like research. I like to have a data point, and I like to have something to kind of monitor and share. And my post-meal readings would be fantastic, like always perfectly in range, but I noticed that my morning fasting blood sugar would occasionally be— I mean, not high even per se, but probably 10 to 15 points/numbers higher than what I probably would have liked to see. And after donating blood and testing my levels again, they've gotten better, which is just wild to me. I know that's not always the missing piece for everybody. But for me, starting to address that oxidative stress has actually been really crucial in changing my fasting blood sugars. And on that note, Isaac, I would love to hear from you. How would you encourage somebody to address fasting blood sugar? Because I know that this was a question that came up really frequently when I announced on Instagram that you'd be coming on. I think a lot of people that are pursuing healing their metabolism are having the same issue where they're seeing fantastic post-meal blood sugar readings, but their fasting blood sugar, for whatever reason, is just maybe 10 to 20 numbers higher than they'd like for it to be. So what would you tell someone to do in that situation?
Isaac Pohlman [00:53:39] Mm hmm. Yeah. That's a great question. And I think this is the most common blood sugar trend that I see is higher fastings regardless of who that person is. And you're certainly right, the blood donation that you experienced there, Fallon, there's all sorts of research on that that can improve insulin sensitivity, and that goes back to the ion piece, and we can talk about that in relation to this too. But I think just from a simple perspective, I find that a lot of people that have this fasting blood sugar, a lot of their eating patterns might be a little bit switched up or a little bit backwards, right? So I'll give you an example. I have a lot of clients that start off with me and might not be skipping breakfast or might delay their breakfast maybe two or three hours. Right? They're not feeling totally hungry in the morning. And as a result, they end up kind of chasing their hunger in a sense. Right? They start to feel hunger later on the day, and maybe during the evening, they're just totally ravenous and starving. And maybe they have the bulk of their calories at that particular time. Well, when we have the bulk of our calories at that particular time, we're a little bit less active. Right? We're kind of winding down for bed typically and getting in that rest and digest sort of mode. And as a result, their blood sugars tend to be a little bit higher during the evening versus if we flip that, if we slowly started sort of to introduce food earlier on in the day, maybe they're eating breakfast a little bit earlier, maybe within 30 minutes or so, because it's been proven that the earlier that you can have breakfast, the more likely you can stop that stress hormone production that is required for us to wake up, to create that alertness. But the earlier we can have that, the less stress that we're going to have, essentially, and the better that we're going to be able to manage our blood sugars for the rest of the day. And that's especially true since we are able to fit in more food during that morning/afternoon period of time versus at the end of day, because we know, typically, we're going to be more active towards that early afternoon/morning period of time. So essentially we can kind of use those calories, in a sense, rather than us just kind of feasting on this huge meal and then just not being as active. And that's one of the big issues that could come into play for those of us with insulin resistance. We're going to struggle if we're having a bulk of our calories towards the end of the day. So that can be a simple change is just kind of slowly starting to look at, hey, is there a way that you can kind of flip that cycle if this is occurring for you? Can you start to get food a little bit earlier on in the day? Can you incorporate a little bit more to the point where maybe just naturally— you don't have to have a cut-off period. You don't have to say, "Hey, I have to stop eating at 8 p.m." But how can that naturally happen where you're starting to feel a little bit less hungry towards the end of the day? And I'd be curious if that might help with the blood sugars. And I know for a lot of my clients, it has. So that would be one of the first things I'd look at. Another thing that I'd look at, too— and I see this with food logs all the time is that— especially in the pro-metabolic space where a lot of these healthy foods, nutrient dense foods are actually higher in fat, right? And as a result of that increased amount of fat, maybe in excess, really, it's going to decrease our ability to tolerate carbohydrates. And that's essentially what the Randle cycle is referring to— if listeners are familiar with that very sciency term. But basically what it refers to is that the more fat that we consume, the less of a tolerance of carbs that we'll have, essentially. And that's why people that are been consuming a higher fat diet, have been on keto or low carb for a while, they're going to be super reactive to carbs initially, which is one of the reasons why those of us that have been on keto is not something I recommend to just introduce a bunch of carbs at once because of that insulin resistance that they're having and that Randle cycle that's occurring. So looking at how much fat that you're consuming— is it in excess? Are you eating more fat than you are protein or more fat than you are eating of carbohydrates? If you are, are there ways that you can kind of balance it out? Can you incorporate some more leaner options into your day? Can you incorporate some more leaner proteins or utilize a little bit less cooking fat with some of that? And I'd be curious if that might help with some of those fasting sugars. So that might be another one to kind of look at as well. The other one would be the iron piece that you touched on, Fallon. So we know that when we're not eating, that our liver is going to put out glucose just naturally. That happens for those of us with normal fasting readings, that happens for us for fasting readings or high fasting readings. But if it's high, that suggests that when we're sleeping, our liver's putting out excess into the bloodstream, and iron is a big piece of that. So is there ways that you can go about managing iron? And there are a few different ways. One of them being is just looking at ways that you can opt for choices that don't have iron fortified foods. Like here in the U.S. that has been going on for— I don't know, almost— I think it was in the 1940s that they introduced that. So almost about like 80 years or so. So that's a huge iron piece. And if you look at the cereals these days— I'm not sure of your diets growing up, Kori or Fallon, but I know for me, I was eating a lot of cereals that were very enriched in iron. And you talk about iron— these cereals can have up to like 15 milligrams in just like one serving size. And, you know, that wasn't the only thing I ate. I might have had a couple of bowls of cereal. I might have had crackers and breads and pasta, all that are iron fortified. Right? And as a result, if you're doing that on a daily basis, you could accumulate 60 milligrams of iron when the amount that we really need is around one. One milligram of iron to replace daily losses, and that's even for females that are menstruating. I think it's something like 1.3 or something like that, very small figure. But, essentially, we're getting an overload of it. At the same time, we are typically not incorporating a lot of copper, vitamin A rich foods, right? So you can almost compare it to something like this. Like, let's say you have a lot of your favorite clothes in a closet, right? But this closet— you can only access it with the key. So you can think about your favorite clothes as being this iron that's being stored away. It's causing inflammation; it's causing these rises in fasting blood sugars. Right? The only key that we have is a copper and vitamin A key. So if we open that door—that proverbial door—that's going to give us access to that iron so we can put it to use. We can push that into red blood cells. Right? We can push that into other things that our body needs instead of it just sitting there stagnant and causing inflammation and causing higher fasting blood sugars. So that's a huge piece is that mineral dynamic between iron and copper and vitamin A, essentially. Right? The last piece— I should say second to last piece would be magnesium. Right? We know if we have a magnesium deficiency, we know that we're going to be taking out more glucose from the liver as well. And we know that a lot of us are going to have magnesium deficiencies, particularly here in the U.S., because we live a go, go, go lifestyle. We have all sorts of stress placed on our plates. Again, that's not just emotional or work. It could be family, it could be nutritional, could be moves, it could be lack of fulfilling work, or lack of me time, whatever the case that may be that we're going to burn up, essentially, magnesium. When we're stressed, we burn through those minerals like we talked about. We waste those a little bit more. So we're going to have or tend to have a magnesium deficiency. And as a result, our fasting readings are going to be a little bit higher. Right? So good minerals would be another key to that. Another one—and this will be kind of the last one—would be light movement throughout the day. Right? Like I think I mentioned in the earlier question that a lot of the clients that I see have been placed into kind of more desk jobs or more sedentary work because of the pandemic. Right? And as a result, maybe we're not moving enough. Maybe we're not walking to meetings or walking from the parking lot to our office or fitting in walks or exercise during our lunch break, right? And that light movement can be incredibly helpful for somebody with a high fasting blood sugar, particularly if you do it something like even during the evening, right? Maybe you do a walk after dinner or walk with your partner during the evening. And as a result, that's going to increase insulin sensitivity and as a result, typically lower those fasting readings. So don't discount something like a light form of exercise, even if it's a walk, even if it's chores around the house, whatever kind of gets you up and moving in a light sense can be particularly helpful for those fasting readings as well.
Kori Meloy [01:02:50] That's really good. That was really jam packed with practical advice. We appreciate that. And I guess that leads me to the follow-up question. Circling back from what Fallon was talking about earlier, she's more of like a data and numbers person. I remember— and I won't name this brand, but we both got like a tracking device at the same time to track our movement and calories burned throughout the day. And Fallon was like, "I love this stuff. Like this just lights me up." She's like, "How is yours?" And I'm like, "I returned it." I actually returned it like after like two days of use because I'm not so much a data and numbers person. So that brings me to the question of— when you talked about earlier, Isaac, it's not necessarily that it's for everyone as far as tracking your glucose at home, but if you are similar to Fallon, if you find yourself going like, "Actually, I really love data and numbers," and that's something that you want to pay attention to or just because you're self-experimenting and maybe you're about to go offload some iron and you're like, "I want to see what happens before and after," and it being experimental in that way. So if that's you, what would be— Isaac, what would you say is the best way to track glucose at home? Is there an affordable and pretty reliable test that you recommend?
Isaac Pohlman [01:04:09] Mm hmm. Yeah, absolutely. And I think what you mentioned, Kori, is such a great point— that you have to know yourself. Like, if this is going to cause more stress for you, then I'd recommend not doing it, because I have some clients that that just adds another layer for them. But if you're like, "Hey, I love the numbers." You're like Fallon. It really helps you connect the dots and see if your experiments are paying off, then absolutely. What you can pick up is something known as a glucometer, which is a blood sugar meter that those of us with diabetes test with on a regular basis. So you can get one of those. I have some clients as well that do get a continuous glucose monitor as well, so they don't have to do as many finger pricks. In my experience, I think clients like kind of the usability of a continuous glucose monitor, but I think I've had a lot of them experience where they feel like the data isn't as accurate, for whatever reason. I think that might vary brand to brand. So I would suggest getting a very reputable brand. I know Dexcom is kind of the leader when it comes to continuous glucose monitors, and I think the Abbott Freestyle Libre is a good one. But one of those two I think can be a good way to go about it, however you want to do that. Now, if it's somebody without diabetes, when it comes to the numbers, ultimately you would be looking at a range between 70 to 100 pre-meal or fasting. So before you end up eating, kind of looking at that as the target range: 70 to 100. And then one to two hours after a meal, less than 140. Right? So it just depends on how you want to track them. I have some that just simply track the fastings or pre-meals. I have some that want to see how their blood sugar is doing after a specific meal, so they end up checking it maybe two hours afterwards. So that can be a good way to do it and just kind of gain that feedback. And then another thing that you might incorporate this, too, is maybe a few days where you do some sort of food log. So you log the meals that you had, and see how maybe some of those meals might be impacting that, maybe both positively and negatively, in a sense. So give you feedback of what might be contributing to those factors. And then you might put in, hey, I only got like maybe 5 hours of sleep this day or maybe I was really stressed this day. So accounting for those external variables and activities, maybe like a blood donation, like Fallon, like you did. Accounting for those other variables that might change those numbers that you would get can be a great way to create a reference, in a sense. So if you do that for maybe a couple of days a week, that can give you a good idea of whether those experiments are paying off. Right? So that would be for somebody without diabetes. If you're looking at for someone with diabetes, essentially it's a little bit higher. But target range— I believe the ADA sets 70 to 130 pre-meal and fasting and then less than 180 one to two hours after meals. So it's a little bit on the higher side, but that's kind of the target range when it comes to diabetes. So if you're just starting out, that might be a helpful range to use to give you a little bit more flexibility there.
Fallon Lee [01:07:24] As a last thing, Isaac, I would love for you to give our audience your maybe top three functional steps that they can take starting today to help balance their blood sugar. What do you think are the most important things to get started?
Isaac Pohlman [01:07:36] I think, number one, food is the foundation. So dialing in kind of a food frequency, food and meal balance that really works for you. Making sure that you're combining a carb and a protein and a fat all together in one meal, and making sure that you're honoring your hunger signals and trying to eat earlier on in the day. I often find that's helpful because you don't end up chasing your hunger, in a sense, right? So eating early and eating often can certainly be a great way to do that and making sure that those meals are balanced. For those of you that are really struggling with the high blood sugars, you might want to back off just slightly on the carbohydrates and kind of monitor the choices that you have. But essentially, it's still the same recommendation to eat early and making sure that you're fueling yourself early on the day to make sure that you're not feeling starving at the end because the telltale sign that you're not feeling yourself in a way that's supportive is kind of those biofeedback that's off that we talked about earlier. Feeling stressed, more moody, hungry at the end of the evening, I can't sleep, that kind of thing. So that'd be the telltale sign. But in my opinion, it starts with food and that can help to, in a sense, regulate stress. Right? Number two would be looking at, hey, what's the biggest external variable for you? Is it work stress? Is it family stress? Is it mineral stress, like imbalances? Whatever that is for you, is there one way that you can do to increase either your resiliency with that, to take that away, to better cope, whatever that is for you? So maybe it's getting in a little bit more movement, maybe it's going to bed at a decent hour. Maybe it's getting a full monty panel to see where your minerals—or HTMA—to see where your minerals are at. Right? So that would be a little bit more personal. But I think there's a power in reflection—right?—when we tune into ourselves, and that's the way we can kind of personalize it a little bit more. So an external variable, right? And then I would look at some form of support to make it sustainable. So whether that's a partner that's doing it with you, whether that's a friend that's doing it with you, or you're working with a coach, or you're reading things on social media from coaches that you trust, or you're in a Facebook group with others that are doing it themselves, too. I think in any journey there's going to be challenges along the way. There's going to be ups and downs, so the more support that you can get on board— if this is a big issue for you, if you're really struggling, then I think that can really go a long way.
Kori Meloy [01:10:06] That's really good. I do have one more question based on our audience Q&A of just a common question that was rolling in was surrounding gestational diabetes in pregnancy. And also just like this glucose drink, and if that's really setting people up for success as far as test results. And I just wonder if you work with anyone who maybe gets a test result saying, yes, you have gestational diabetes, but you're able to completely manage and maybe even resolve what the root causes are. First of all, the glucose test. I don't know if you're familiar with this test and what you would say about it, but do you feel like this is setting someone up for success as far as like a pretty good indication of maybe what gestational diabetes would be?
Isaac Pohlman [01:10:55] Yeah, yeah. This is a good one, too. I think what's called the glucose tolerance test and the glucose drink that they force patients to drink— in my view, it's a test, but I don't think it's the most accurate or necessarily simulates real life because oftentimes what are we drinking with something that has carbohydrates? We're probably eating something that has maybe a little bit of protein or a little bit of fat in it, too. So I don't necessarily think people are— especially listening to this podcast because everybody in kind of that pro-metabolic space is highly educated. And I just don't think that that's necessarily something that is very applicable to their lives, necessarily. So in my view, it's not necessarily the most accurate test because how often are you necessarily doing that in real life, right? But in the same line of thinking, if someone does get a gestational diabetes diagnosis, we know during pregnancy it adds another layer of stress. Right? You're supporting the growth of another human being. Right? That's a lot. That's a lot. And the mineral environment demand and calorie demand that comes along with that. And I'm obviously not a woman, but I would imagine that's pretty substantial. Right? So we know that if someone—prior to becoming pregnant and having that additional demand—is under a series of stressors, maybe they have a level of mineral balance before they enter pregnancy, or maybe they're not getting enough sleep, or maybe they're not eating as supportive as maybe they would like to. Right? Or maybe they've been taking prenatals for a while that has a big source of iron and doesn't have a compensating source of copper and vitamin A, then that makes them more prone to the stress of pregnancy. It adds another layer, because when you talk about insulin resistance or you talk about gestational diabetes, it's layers upon layers upon layers, right? It's not just one thing. So pregnancy almost in a way, exposes maybe some of those weaker spots. Right? So with pregnancy, looking at kind of the carbohydrate types that you're consuming, is there a way that you can kind of stabilize those? Is there a way that, hey, am I eating more starchy carbohydrates? Is there a way that maybe I can either look at the portion size that I'm using or can I opt for others that might be a little bit more supportive to how I feel in my blood sugars? Right? Am I eating in a way that's balanced? Am I including a good amount of protein? Which I think is very much a common trend that people, especially women, aren't getting enough protein. And maybe you guys have seen that, too, in your clients. But that's a big thing, not simply eating enough. And then when it comes to the mineral side of things, we talked about the prenatals. They might already have an iron overload situation, and then they add in something like a prenatal, which is adding fuel to the fire, in a sense. So that's the other key that I would look at. What does their mineral balance ultimately look like? And is there a way that we can kind of even that out through right foods and making sure that we have enough copper and vitamin A and magnesium and potassium and sodium? Right? So that's the way that I would kind of look at that. But also you might start maybe a little bit on the low-ish carb side of things like we talked about, starting a little bit on that side, and then gradually tapering that up to a place where it's ultimately supportive so that they essentially improve their carbohydrate tolerance, but they're not being shocked with the sheer amount of carbohydrates that they might have in the end.
Fallon Lee [01:14:34] Isaac, this has been such a good interview. I would love to wrap up with a couple of things. I know that our listeners will wonder this, so as part of this question— first, will you define for us what you would consider to be a low carb approach in terms of grams? When you say like, "Hey, you may need to start out with a lower number of carbs," how would you define that? And then as part of that answer to wrap us up, will you also let our audience know— I know that you do one-on-one work, and so we would love to hear what type of clients do you work with? How can we connect with you? We will, of course, put your Instagram handle and link in our notes, but we would love to continue supporting you and your work. I love following you on Instagram. You've got really, really good information, so we'll definitely send people to you. So to cap us off, can you talk about this carbohydrate ranges, and then will you tell us how can we continue to support and possibly work with you?
Isaac Pohlman [01:15:23] Yeah, yeah. Carbohydrate ranges— it's going to be relative to the person, but just in a general sense, it's going to be like less than 120. Less than 120 is generally considered a low carbohydrate diet. Now for someone who's coming from like a ketogenic background, who's maybe consuming maybe 10, 20 carbs, maybe their form of low carbohydrate may be like 50 grams versus maybe someone who's coming from like a lowish carbohydrate diet, maybe they're eating like 50, maybe their low end would be kind of the 80s or 100s, somewhere within there. So I think it's all relative, but everything under 120 would be considered a lower carbohydrate diet. Everything above, you start to get into the moderate/higher forms of carbohydrates, right? So that's what I would look at if you're tracking macros. Now, I don't necessarily believe everybody needs to do that, at least at first. But when you get down to the nitty gritty, that can certainly be helpful just to kind of keep an eye on things, particularly with something as fear mongering as carbohydrates, particularly when you're starting off with someone who's been through a series of diets. So less than less than 120 would kind of be that range. As far as how to kind of work with me or what that looks like— I work with those that have type one diabetes because I myself have type one. And it's something that I'm very passionate about and love working with those individuals because I think there is certainly a lot of support for type two diabetes— well meaning. You know, 95% of people with diabetes have type two. But I think a missing audience often is that type one. So I work with those individuals. I also work with those with type two and then pre-diabetes. So anybody with kind of a blood sugar concern, essentially, I work with. You can include gestational with that. Gestational diabetes as well. So for right now, I do one-on-one coaching, and then am in the process of finishing a book. So by the end of this year, I'll have a book for those with type one diabetes, and then hopefully next year releasing the book on type two as well. So you can go to my website if you want some more information on that: IsaacPohlman.com. I also do have a free Facebook group that you can take part in, too. I go live on there every two weeks and post all sorts of recipe content and ideas in that, too. So feel free to join. And then I have an insulin resistance report. It's a free download that you can get started with a lot of the topics that we discussed today, too.
Kori Meloy [01:17:56] That is fantastic. You've got a lot that you serve your audience with, and I'm excited to connect you guys listening with Isaac and what he's putting out. Isaac, thank you so much for being on and we will see you guys in the next episode.