Brigid TitgemeierBeingBrigid Functional Nutrition · Transforming Women's Health Using Food as Medicine

Blood Sugar Spikes Aren’t Always Bad with Ashley Koff

5 May 2026 · 1 min

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In this segment of the interview, Ashley Koff challenges the conventional reliance on fasting glucose and A1C as sole indicators of metabolic health, arguing that they fail to capture the dynamic nature of blood sugar regulation. She advocates for a more nuanced view that values “rolling hills”—natural fluctuations—over flat, constantly low glucose lines, warning against the simplistic “lower is better” mindset often applied to CGM data. Koff explains that during intense exercise, glucose naturally spikes as a stress response, and the goal should be to allow the body to recover rather than suppress the rise. She emphasizes that hunger and weight-regulating hormones act as the initial domino, signaling insulin and glucagon to manage glucose, highlighting the central role of hormonal signaling in metabolic balance.

Chapters

Can you talk about the interconnection between blood sugar and hunger hormones? We had fasting glucose and then we had AM1C, and we have to unlearn that these do not tell us who is in a good or a bad place with their blood sugar. You know, we want more rolling hills, we do not want flat lines. No, but we are not looking for just lower being better. This is like CGMs and have taken us a bit to the statin methodology of like just lower it, lower it, lower it, and that's not what our goal is. As an example, when you're working out, for your workout to be stressful on your body, as a result your blood sugar is going to be elevated, and then we want to, you know, successfully bring it down. But you're weight health hormones are directly related because they're actually the first domino. They're telling insulin and glucagon to go to work.