Blood sugar mindfulness with Elizabeth Hatley

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In this episode, Claire is joined by Flourish nutrition coach and Certified Intuitive Eating Counselor Elizabeth Hatley to discuss the basics of what blood sugar is, how it relates to insulin, insulin resistance, and diabetes, and how much effort we do (or don't) need to devote to managing our blood sugar to feel our best.

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Transcript

Claire Siegel: You're listening to the Flourish podcast. I'm your host Claire Siegel, founder of Flourish. We're on a mission to help women get healthy for good. Join me each week for a new episode that'll help you sustain healthy habits and nourish your body so you can Flourish in life.

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Ok, but in all seriousness, if you're a fan of the podcast, then your exactly who we built this membership for and you're probably ready to start making some major moves. Flourish is the place where women make peace with food, better their body image, and get healthy for good.

Inside the Flourish membership, you'll get unlimited access to credentialed nutrition and mindset coaches, you'll get community support from women who are on the same page as you, and you're also going to get an evidence-based curriculum to help you cut through the clutter and guide your daily actions.

Now, we're still invite-only, but I'm giving friends of the podcast early access. So use code PODCAST to get started with a totally free, no strings attached 30-minute strategy session with one of our coaches, and then spend the next week checking out the rest of the membership totally free. The link to sign up is in the show notes. And again, use code PODCAST to sign up today. Alright, let's get in to the episode.

Claire Siegel: Welcome back to the Flourish podcast! I am absolutely delighted to be joined by a very special guest. Today on the podcast for the very first time we have Elizabeth Hatley, our very own Flourish nutrition coach in the house. Hello, Elizabeth!

Elizabeth Hatley: Hi, Claire! Thanks for having me.

Claire: Thanks for being here!

We are actually in person in Austin. Elizabeth lives in Alabama, but we are in person in Austin this week for the first ever Flourish team retreat, and we are having an amazing time.

And this podcast is the only thing in between us and dinner. So, we're excited to be here, excited to get this thing out to you, and then we're going to go to Emmer & Rye in Austin, which we're delight about.

So, Elizabeth, for our audience members give us a little bit of insight as to what you... how you support our members. What are kind of some common things that you work with our members on?

Elizabeth: Yeah, absolutely. So, as Claire mentioned I am the Flourish nutrition coach, and so I do work with our members not only in group coaching space, but also in a one-on-one coaching space.

And typically topics of conversation include a lot about improving your relationship with food, a lot of talk around improving body image—because as we know body image can be so conflated with how we choose to nourish ourselves. And so really trying to unpack those things, find a lot of clarity, and then pursue a new path that feels less dramatic, I suppose.

Claire: I love that. Our members absolutely love you, Elizabeth. (giggles) And Elizabeth just has such a passion for the work that we're doing, the growth of our members—I mean she really does think about them in between coaching sessions. She wonders what they're up to, helps hold them accountable, all the wonderful things that we could ever want from a nutrition coach.

And Elizabeth just has such a passion for the work that we're doing the growth of our numbers I mean she really does think about them in between coaching sessions. She wants know they're out to help hold them accountable all the the wonderful things that we ever want from a nutrition coach.

Um, and with that I am really curious—I think it'd be helpful for you to share with our listeners here: What got you into this field of nutrition—and specifically working with women on all the things that you work with them on?

Elizabeth: Yeah. So I... I personally had my own history of—and experience with—a lot of dieting, a lot of disordered eating. Just really feeling defeated by my well-intentioned desire to take care of myself, but just how noisy and complicated that got.

And so, that led me to pursue a path in nutrition which honestly made it more complicated until I found the practice of Intuitive Eating back in 2016 and completely fell in love—not just with the concept, but the freedom it brought me personally.

And so it has become my passion to share that freedom hopefully with other people, and so I pursued becoming a Certified Intuitive Eating Counselor and worked with Evelyn Tribole and so now I get to live out that dream. It's amazing.

Claire:I love it. So, if you are not familiar Evelyn Tribole is actually one of the creators of Intuitive Eating, and one of the coolest things I think Elizabeth brings is not only a slew of amazing metaphors and analogies, which I'm sure we're gonna get a taste of in today's episode, but just so much of the research actually behind Intuitive Eating.

It's really important for us at Flourish that everything we do has a really strong evidence base, and Elizabeth does a really beautiful job of making that accessible to our members.

So, today we wanted to bring to you a conversation around blood sugar management, insulin, insulin resistance. This is something that comes up, certainly, you know, for our members as they're, you know, learning more about their bodies and how food works in their bodies.

You know, for some members that looks like managing chronic conditions or preventing chronic conditions, but also blood sugar is just talked about a lot right now, kind of, culturally.

We have a lot of thoughts and expectations around what proper blood sugar  management should look like, and it's why many people go to things like keto or intermittent fasting. Now, more and more we're seeing these like continuous glucose monitor companies coming out for use by non-diabetics. It's just a very, very interesting time.

And, as a nutrition professional, something that I think is really missing is just an understanding of how blood sugar works and why it's important... or maybe why it's less important than maybe we make it out to be.

So I thought this would be a very interesting conversation for us to have with Elizabeth. So, I'm gonna be asking Elizabeth some questions, and y'all will be getting to hear how she so beautifully illustrates them through the answers, through her amazing analogies and such.

So, with that, let's just start with the basics. First of all, what is blood sugar and what is insulin?

Elizabeth: Yeah, so blood sugar is simply pretty self-explanatory. It is the amount of sugar that exists in your blood, which is meant to ebb and flow. It's meant to be higher. It's meant to be lower. But it also is certainly never meant to be without sugar. We are always supposed to have a healthy amount of sugar existing in our blood and ready for our cells, and so that is kind of the concept around that.

And then insulin is the hormone that is responsible for pulling the sugar out of the blood and making it available to enter into the cells so you can create energy and have an excellent mood and do wonderful things.

Claire: That's awesome. I'm gonna take us down like even one step back, I suppose. How does sugar get into our blood? Is it just from eating sugary foods? Is it just from drinking fruit juice? Like, how does the sugar actually get into our blood?

Elizabeth: Yeah. So, whenever we're having any type of carbohydrates source, whether it is a brownie or a sweet potato or a smoothie or, you know, what have you—anything that has existing carbohydrate sources in it are all broken down to the same thing. Something called glucose, which is what it needs to be in form of before it enters our blood.

So, at the end of the day your body really cannot tell the difference whether or not the glucose came from ice cream or whether the glucose came from a sweet potato or brown rice and... what have you, things like that.

And so it really just is... once it's in the glucose form and existing in our blood, then the insulin is present to take it from our blood and put it into our cells so that our cell can create something called ATP.

I think everyone remembers the concept in like seventh grade biology and how many ATPs are made from one molecule of glucose. So, that's what's going on whenever you have lunch, have a snack, anything.

Claire: Yep, yep. So, yeah, so blood glucose is generated from food. Especially, you know, sources of carbohydrate. Although, there are ways for things like protein and fat, right, to be converted into glucose if there is not enough carbohydrate present. Is that correct?

Elizabeth: Yeah, yeah absolutely. If—and I think that a lot the confusion that happens around this is it's talked about that it can be pulled from fat, but it also is simultaneously pulled from protein. So, whether that is digestive protein or protein that exists in form of muscle mass.

So, it can create glucose from those things, and that to me is just a reflection of how desperate our body is for the presence of glucose to function at its best.

Claire: Yep, exactly. So, one of the easiest ways for your body to get the glucose that it needs to run and to create energy and to live your life as Elizabeth said is carbohydrate sources, right?

But, if you are not providing adequate carbohydrate sources for your body, it's going to get it somewhere else. Whether it's kind of getting into your stored glycogen from your muscle or your liver—ah, sorry. Glycogen is just the storage form of glucose. So it'll break down those stores, and, again, if it still doesn't get it, it's going to get it from other places by breaking down actual tissue in your body.

And, again, this just goes to show how important it is to give your body the sugar it needs to run... from, ideally, you know, the most efficient and effective sources. Because your body's going to get it one way or the other. Okay? So that's where, kind of, blood glucose comes from.

We talked about insulin and how insulin is the storage molecule, right? So, it's going to take the glucose in your blood into the cell so you can actually utilize it, right?

Now, a term or phrase that comes up a lot when we talk about insulin is 'insulin resistance.' So, what the heck is that? Do I need to be up all night worried about it? Do I need to not have bread at dinner tonight because I'm worried about insulin resistance? Please give us the lowdown.

Elizabeth: Yes. A hundred percent, not. I fully intend on having bread at dinner tonight. That is my favorite food group is bread.

So, insulin resistance is really just whenever... like we talked about the insulin's job is to pull the glucose from the blood and put it into the cell.

So, when you're experiencing something like insulin resistance, it's more moment by moment, and what's happening is your insulin is linking arms with that glucose molecule, and it's knocking at the door of the cell saying, "Hey, I'm here with your sugar!" And it's knocking, and it's knocking, and it's knocking, and the cell is not responding by allowing that glucose to enter.

So, as a result, the blood sugar stays higher than normal, and your body reads it as: "Oh, we's still need more insulin, we's still need more insulin, we still need more insulin." Until there is enough, finally, until the body reads it as: "Oh, okay. The insulin is here. We can allow the sugar to come in."

And so it is just a resistance to recognizing the presence of and responding appropriately to what it means when insulin's present there with that glucose.

Claire: Okay. And, in what cases does insulin resistance happen? Or, you know, we talk—we hear a lot about insulin resistance as it relates to diabetes and other chronic conditions. So, can you kind of explain that progression or link?

Elizabeth: Yeah, so it's multifaceted I would say. A lot of different long-term behavioral things can impact the way that the cells respond to insulin, and I think that brings more of a conversation of how do we promote insulin sensitivity more so rather than worrying about causing something like insulin resistance.

Because insulin resistance isn't even something that's necessarily like a chronic, diagnosable thing. It's more of something that one experiences. So, if you are concerned about experiencing insulin resistance, then the question there is: Well, how do I improve my insulin sensitivity—so, my cells response to the presence of that insulin."

Claire: Okay, so I've gotta ask. How does one improve their insulin sensitivity?

Elizabeth: So, there certainly is a lot of research talking about responding to initial hunger cues is a great way to improve insulin sensitivity. And that just comes back to a lot of body trust. So, the body knows, you know... hey, I know how to get my needs met through hunger signals, through cravings, through just that really prominent existing connection between mind and body.

And so, trusting those cues, responding to those cues, are certainly things that can promote that insulin sensitivity. As well as movement, right? So being engaged in walking or weight lifting or dance classes or yoga or, you know, whatever feels enjoyable and positive for your body is something that can certainly improve that insulin sensitivity as well.

Claire:Okay, so insulin resistance, blood sugar... a lot of this conversation is brought up in the context of diabetes. So often when I hear people talking about blood sugar, talking about insulin, the kind of chain of thought seems to be: If you eat a lot of sugar, you're going to have high blood sugar, and then you're going to develop insulin resistance, and then you're going to develop diabetes.

Is that how it works or are we like missing some context and nuance? Please, kind of, break this down for us.

Elizabeth: Yes, the good news is that: No, the body does not work in such an A plus B equals C format. It has a lot of functions to keep you safe and to keep you healthy on its own.

What can happen though, and this is not necessarily implying that insulin resistance causes diabetes, but experiencing a high amount of insulin resistance for a chronic period of time can end up reinforcing what might lead to diabetes. And by chronic I mean years and years and years, and months and months and moths, and just time after time after time.

And why that happens is, you know, we are only born with so much insulin that is available to be made by the pancreas. And where there is that extended high blood sugar telling, "Hey, we more insulin because we are not getting into the cell." We end up burning out. And when we experience a burnout of Insulin then that is when diabetes enters into the game.

And so, I think, you know, being careful around any causal language with that would be—like you said—just missing a lot of context. But they certainly can kind of impact each other in more indirect ways as well.

Claire: Mmhmm. Yeah, we certainly work with members who maybe go see a doctor and they hear words or the phrase "insulin resistance" for the first time. and right away they think, "Oh my gosh, I have diabetes." And, this really is a progression that, you know. we're talking about. It isn't something that happens overnight.

And that's why the... having an understanding of how blood sugar it works, how insulin works, what insulin resistance actually is and how you can increase your insulin sensitivity, and if this is something you even need to worry about is so relevant.

Because there's so much fear mongering happening in this space, when, in reality, for the vast majority of us, like, our bodies are there for us. Our bodies are taking the amount of sugar that we, you know, we consume and utilizing it appropriately.

And I think that even in that case, people can really benefit from understanding how blood sugar works, understanding how food affects their bodies.

So, why—you know, from your perspective, Elizabeth—why do you think that, you know, blood sugar management outside of chronic illness management or prevention is important?

Elizabeth: So part of me feels like that answer is kind of multifaceted and, in some ways, the word "management" brings up an implication that you yourself personally have to be monitoring your blood sugar a hundred percent of the time... eating in a way that balances macronutrients to support that, or constantly engaging in those insulin sensitivity promoting behaviors, when that is not entirely the case.

For the most of us, our bodies can manage the natural ebb and flow of our blood sugar completely fine on their own. And so—and I know we've talked about this—it can be almost more of a mindfulness than it is an active management.

So using nutrition information or information about things that just make you feel good to also help reinforce the insulin sensitivity can be a better approach in terms of preventing chronic disease or just how that exists and manifests outside of chronic disease, as well.

Claire: Yeah, so the analogy I think of—it's not even really an analogy. It's, you know, I think a lot of people here at this point who are listening to this podcast in particular probably know that, for example, like lemon juice cleanses and detox programs and charcoal and juice cleanses and all these things—these "detoxes"—are not necessary because you have a liver that detoxes you. Right?

And I get the sense that our blood sugar is really working the same way, right? That you don't have to manage your blood sugar so actively—unless, again, we're talking about someone who's experiencing type 2 diabetes and really does have to be mindful of that. It's a separate conversation.

But for those of us who are... who don't have don't have diabetes and aren't experiencing an insulin resistance, it's more about blood sugar mindfulness, to your point, rather than like active management because our bodies are naturally doing that. Naturally managing our blood sugar for us in a very, certainly, a subconscious way. But that being mindful and having an understanding of how blood sugar works can help you feel your best. Right?

So, I, for example, think about, you know—I mean I don't know if I think of... I don't think about it in terms of blood sugar management or I don't think about it in terms of my blood sugar... but, for example, today for breakfast—we had Franklin's barbecue for lunch. It was pretty epic, but we weren't going to eat probably till like one o'clock, and we started at meeting... started meetings at like nine-thirty.

So, I wanted to eat an earlier breakfast, like 8 o'clock or something, and so I knew putting putting my meal together I wanted to have my source of carbs, my source of fat, and my source of protein. I wanted the carbs to kind of make me feel satisfied and energized right away, and then I wanted that protein and fat to help keep me full until we had Franklin's at lunch.

So, being mindful of how you combine your macronutrients and what you want that food to kind of enable for you. Or what you want that food to sort of allow you to experience in terms of your energy levels, digestion, all these things, can be really powerful and it's not necessarily something you need to worry about a hundred percent of the time because your body is managing your blood sugar for you.

Is that—? Does that kind of summarize what we're getting at, Elizabeth? Would you add anything to that?

Elizabeth: Yeah. I mean I think that also it's just such a beautiful reflection, too, on how powerful our bodies are at communicating what they need. So, for example, my favorite thing to get when I travel—and as Claire mentioned, I am traveling right now—is a chocolate croissant.

And that is what I chose to get at breakfast this morning, knowing full and well that I was going to be pretty hungry and ready for food an hour and a half in. And knowing that that probably wasn't the food choice that was going to be sustaining my blood sugar in a balanced way for the longer period of time, but that was the thing that sounded good to me.

And so, choosing to have that with the knowledge of... I'm probably going to need to have some some more carbs and fat and some protein in the nearer future in between those meetings is the approach that I took.

But, that ended up coming about just because I simply got hungrier and thinking of food at a sooner time than I would have if I had had more food in general, as well as more fat and more protein with my breakfast, too.

Claire: Yeah, yeah.

It's—we're all about utilizing nutrition information in a way that feels—that makes you feel empowered and gives you full agency over your body rather than feeling like the food is controlling you.

And that's really what it's all about.

Elizabeth: Right. And nothing crazy gonna happen because I had a chocolate croissant by itself this morning.

Claire: Right! (giggles) Exactly, you're still here.

Elizabeth: I had my barbecue at lunch, and I moved on with my life, as well as some snacks. And now I'm getting ready to have more bread at dinner.

Claire: More bread at dinner. Oh my gosh, if you haven't been to Emmer & Rye... actually what they're known for is their Cacio e Pepe and that we will be diving into tonight.

Okay, last question before we get out of here. Do I need to count my carbs?

Elizabeth: Unless you are managing diabetes and need to be tracking the amount of insulin that you are nuturing yourself with, I would say generally the answer is no. Do I think it's wrong for every person always to count their carbs? Absolutely not, because I think sometimes knowledge can provide insight which helps you with future decisions.

But majority of people don't have time to sit there and calculate the number of carbs they eat per day. That's exhausting, and honestly it probably creates some hesitation that does block that connection with the body where it does want to communicate to you what it needs. Because just a simple act of questioning and counting keeps you more connected in your mind than it does connected to your body.

So there are certainly pros and cons, but nobody needs to count their carbs. Carbs are beautiful. In fact, our brain alone needs one hundred and thirty grams of carbs per day just by itself. And that's equivalent to eight slices of the bread, which I think is wild.

Claire: You heard it here first. Eight slices of bread. The daily dose.

(laughter)

No, I think that is really well put, and I, of course, appreciate—we always appreciate nuance and context here at Flourish because there really are no absolutes. And I think this is, you know, why personalized coaching is always going to be part of what we do because what's right for one person may not be right for another. It's also what makes producing a podcast about nutrition and food a little bit challenging because we're here talking to, you know, thousands of people.

And my hope for you is if you're sitting here kind of wondering where you fit in this mix that you feel a little bit more open to trusting your body, to eating the carbs that you love, to knowing that, you know, in most cases—again, I don't know you individual listener, where you're at but—that your body is doing its best and it is working with what it's got.

And if you've got questions or concerns about blood sugar or insulin resistance or type 2 diabetes, you know, managing any of these things... I would say, of course, these are things you can talk to your doctor about and this is why we offer personalized coaching inside the Flourish membership.

So that's what I've got for today. Elizabeth, anything to add before we close out?

Elizabeth: No, I don't think so. I think my blood sugar is an appropriately low amount and ready to go up on the rise at dinner. (giggles)

Claire: Same. Okay, we will see you next week. Thanks so much, y'all.