How Continuous Glucose Monitoring Can Optimize Your Health with Kara Collier

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I'm JJ Virgin PhD dropout. Sorry, mom turned four time New York Times bestselling author. Yes, I'm a certified Nutrition Specialist, Fitness hall of Famer, and I speak at health conferences and trainings around the globe. But I'm driven by my insatiable curiosity and love of science to keep asking questions, digging for answers, and sharing the information I uncover with as many people as I can. And that's why I created the well beyond 40 podcasts to synthesize and simplify the science of health into actionable strategies to help you thrive. In each episode we'll talk about what's working in the world of wellness, from personalized nutrition and healing your metabolism to healthy aging and prescriptive fitness. Join me on the journey to better health so you can love how you look and feel right now and have the energy to play full out at 100. I love to say what you measure and monitor, you can improve. And boy is that for sure with blood sugar. You know when you look at what you can affect to really make a huge difference in your health, blood sugar is right there at the forefront. In fact, there's three things that I really believe that we should be tracking. Blood sugar is one of them by using a continuous glucose monitor. Sleep is the other one by using some kind of sleep tracker. I use my Apple watch and my Oura ring. I do both. And then of course skeletal muscle by using a bioimpedance scale. So today we are going to dig into blood sugar and how to use a continuous glucose monitor, what the information means and then how to optimize it. And I've got Kara Collier, who's a registered dietitian and a founding partner of Nutrisense, where she is the director of Nutrition. I've been wearing a continuous glucose monitor now off and on, it's about a year now. And I used it, got myself really balanced, connected the dots between my lifestyle, my diet and my blood sugar. And now and then if I travel or do anything different, I put it on again. And so we are going to unpack a whole lot of stuff about CGM technology for health optimization here. And super excited to have Kara. She is known as one of the leading authorities now on the use of CGMs. So we are about to unpack this. You are going to want to get one for yourself. And I have a special offer for my listeners to be able to get 25% off their first month. And you'll be able to get that, that@jjvirgin.com Nutrisense and that's n U T R I S e N S e. All righty. I will be right back with Kara. Stay with me.

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Thank you. Excited to be here.

Yeah. And I do want to talk a little bit about the CGM gate as I would talk about it and like that, because I think that it bears some breaking down. But let's just first talk about, like, what's a cgm?

So CGM stands for continuous glucose monitor. So that's exactly what it kind of sounds like. As opposed to maybe what people are more familiar with, which is like a glucose meter, glucometer, or even, you know, a fasting glucose or a hemoglobin A1C lab value that gives you a snapshot in time of your glucose. So think about that as like a picture. Whereas a CGM gives you a movie version of it. It's capturing your glucose levels all the time for a two week period each time you wear one of these devices, usually by just scanning your phone over the device, you get data on your phone that's telling you your gluc levels in real time 24, seven for two weeks straight. So now suddenly you have this movie image. So instead of this random here and there, that requires a finger prick, which means blood, which means pain.

Yeah.

And messy.

And messy, yeah.

Because I actually used one of those that. I think it's a Dario. I was like, okay, I'll start this. And I was like, well, this is no fun at all. Using a little Lancet and then you've got blood. And I'm like, forget it. So it is very fun to be using the CGM Now, I will tell you that. You know, I'm wearing it first of all. Like, you get the weirdest looks with this thing, especially as you're going through, like, airport scanners and stuff. And they're like, are you. Do you have diabetes? And I'm assuming these came from the world of diabetics, right?

Correct.

So I got attacked on Instagram by a bunch of type one diabetics who literally, I was like, watching this whole thing, and this social team's like, what do we do? And I'm like, looking at this going, this is the most ridiculous thing I've ever seen. There's no shortage of CGMs. And they're like, how dare you be using. As if I was using a CGM for vanity. Using a CGM and taking them away from us Type 1 diabetics. My thought process on this is we have an epidemic right now of diabetes and prediabetes and blood sugar issues. And CGMs are a great way to take health in your own hands and really learn the impact of food and lifestyle has on your blood sugar. What would you say to those people that were literally attacking me? Is there a shortage of CGMs? Because I haven't seen it.

There is not a shortage of CGMs. Yeah, we get this a lot as well because we're a company that sells CGMs primarily to non diabetics. And historically speaking for Some context, the CGMs as we mentioned, are medical devices primarily for insulin dependent diabetics, which is mostly type 1 diabetes, but is also, you know, a handful. About a third of type 2 diabetics are wearing CGMs. That number should be a hundred percent, but right now it's really only about a third. And we strongly believe that everybody can benefit from this data, not just diabetics, but it is a life saving tool for diabetics and they 100% should be wearing them. You know, the anger comes when somebody has frustration underneath it and they want somebody to blame. I think the frustration with the type 1 diabetics specifically comes from the fact that a lot of times they still have to pay out of pocket for some of these devices and these medications. There's insurance coverage issues and they are frustrated that a device that literally saves their life they're having to pay for. So I think there is a misunderstanding of why there is costs on their ends and it actually has nothing to do with non diabetics wearing CGMs. That actually will probably drive costs down as we drive demand up. Companies who make the devices are for profit companies and they definitely want to sell as many CGMs as possible. So Abbott and Dexcom being the two most common manufacturers. So there isn't a short, more of an issue of probably some misunderstanding of what is causing those who have the medical condition to, you know, not necessarily have full insurance coverage or more like legal issues in the insurance world.

And I would assume when you said, you know, you're talking about type 2 diabetics that they all should be wearing them. I would assume the reason that they aren't is probably a cost issue at this point too.

It is a cost issue. There's new coverage that is in the almost approved stage where Medicare Medicaid will approve of coverage for type 2 diabetics who are not on insulin therapy to get these devices covered, which would be excellent. And I'm guessing more type 2 diabetics would use them in that instance. It's also an education problem with physicians and you know, because there requires a medical prescription. So you have to have a physician who believes in the power of this tool as well and will give it to their patients. So there's a mismatch sometimes there. And what we're trying to do, there's a huge mismatch in physicians finding the benefit for non diabetics. Much, you know, bigger gap there. And that's the gap we're trying to solve because it's really hard for these people who can have major health improvements from this data to actually get access to the data. So we're trying to provide it to all those other people as well who can really, really gain benefit.

Well, now that we have, and I know the studies pre Pandemic said that 12% of the population was metabolically healthy. And when you look at what really says someone's not metabolically healthy, blood sugar plays a key role in there. Mark Hyman told me it was now like 5%. You look at it and go, oh my gosh, think about how much could change if someone just monitored their blood sugar, they monitored their sleep and they monitored their muscle mass and they optimized each of those. That 12% would probably go to like 90%. I mean, it is that dramatic. So, you know, I look at this and I think this is a tool that can make such a profound change. And the reality is you don't need to wear a CGM for the rest of your life. Right. So I mean, what do you see for someone to really be able to connect the dots between what they're eating, when they're eating, and their lifestyle and their blood sugar response. How long would someone really need to wear one for?

It really depends on how knowledgeable somebody is coming into it and kind of what their health status is. As a general rule of thumb, we really recommend using it for at least three months in that kind of information gathering stage. First, it's all about learning about yourself, figuring out which of your health habits are actually health promoting, which maybe are not as health promoting as you might think, where you really need to focus your attention and then kind of test like trying different things, making some change and seeing how your numbers improve. So for the first three months, you know, one to five months for most people is a time where you're learning a lot about yourself and you're figuring out the routine that best supports your health from a glucose lens.

And then if you change things up like I did, you'd wear it again.

Exactly.

So let's like start walking into this. First of all, someone using a, a cgm, what are the optimal levels they're really trying to get to.

Yeah, there's a few different metrics within glucose you can look at. So if we're looking at just how your day looks overall, we're gonna look at both your fasted glucose levels. And so this is when you know you're without food, when you're sleeping overnight, waking in the morning before you eat. And we really want to see this in a General range between 70 and 90 milligrams per deciliter. Anything below 100 is technically considered healthy, but there's a lot of research to support that. We really want it closer to under 90, which then if we look at that 12% of who's considered metabolically healthy, that's by the traditional standards of under 100 as well.

Yeah. So now it's probably 3%.

We've shrunk that number. Yeah, quite a bit if we're looking at optimal. So that's one metric we'll pay attention to. And the other is how your average glucose is overall. Maybe you are swinging up and down a lot, which we'll get to, and maybe you're not, but your average glucose is still really important and we want to keep that below 105 or less, which again is a little different than maybe the traditional recommendations, a little bit more stringent if we're looking towards optimal. And then that third kind of daily view is those swings. So that's what we call glycemic variability and that's actually something that might be even more determinant of cardiovascular health. Oxidative stress, general inflammation is how much your glucose goes up and down throughout the day. So two people could have the same exact average glucose, but one person is having really high highs, really low lows and going up and down all day and that person is going to have much poorer health outcomes and they're also going to feel worse. You usually feel pretty cruddy when your glucose is going up and down all day. And you can really only know that true glycemic variability if you're seeing that continuous data, you can't really capture that if you're pricking your finger here and there. So those are the three metrics. We want to look from a wide view lens and then if we zoom in, we also want to see what your glucose is doing each time you eat. So we want to see how high does it go and how quickly does it return back to pre meal values. So we really wanna see it below a threshold of 140 for most generally healthy non diabetic individuals. And then we wanna see it come back down to pre meal values about two to three hours after you've eaten.

Is there any difference between men and women on this or adults and kids?

When it comes to the ideal glucose values, we're looking at the same for both men and women. If you're a type 2 diabetic, which we do also work with type 2 diabetics or those who have metabolic dysfunction. If your average glucose is 200, you know, we're not gonna jump straight to hitting the goal of 105. So we might set more realistic goals to work towards over time. But it's the same per gender. The difference might come in how easy it is to obtain that or what strategies you have to do to get there. It's not always unfortunately the same for men and women.

Okay, so let's talk about which things actually impact your blood sugar, either in a good way or in a bad way.

So I always describe how to think about optimizing your glucose values as four legs of a chair, they're equally important. If you take any of those four away, the chair is going to topple over. Because a lot of people first think nutrition, carbohydrates, sugar, and that is part of the picture. But it's only one leg. So one thing we have your diet, what you're eating, but another leg of the chair is physical activity. General fitness level, also super important. And another we have stress. This could be both physical stressors, like illness. It could also be psychological stressors, like what we're more used to thinking about chronic stress. And then the last one we have sleep. Equally important, both quantity and quality of sleep. So if we're really taking that big picture view, what is the 8020 rule? What do I need to focus on? It's those four categories and then usually there's fine tuning. People always want to know about supplements or the newest biohacking tool. Those will also improve your glucose values. Typically. But we have to master the fundamentals first.

Oh, I'm so glad you said that. That is my big argument with biohacking. I'm like, you can't biohack the basics. Like you have to do the foundational stuff first. Then I mean, it's like going to buy a car and not even looking at the engine and the gas mileage or how well it charges. I'm now do all electrical and just solely focusing on the interior. You know, the leather.

Yeah. People are like, what supplement can I take and should I, how often should I be in my cold plunge but they're snacking all day on processed foods and we're like, first, we actually unfortunately have to do that non sexy stuff, which nobody wants to jump to first.

I'm in the cold plunge when I'm eating the french fries.

Yeah.

Doesn't that like counteract it? Okay, so then let's, let's break each of those things down and I'll tell you a funny one. I'd love to talk about sleep and you know, I'm really careful about stopping eating three hours before bed. But one night, you know, every once in a while things go sideways and I was eating late and then I went to bed like an hour later. And I remember waking up the next morning and looking at my oura ring and looking at my CGM report and my blood sugar was higher than normal. And my oura ring literally said, looks like you ate late last night. And I'm like, wow, what is it? Like, is the aura company spying? Do they have a nanny cam? What's going on? So let's talk about what sleep does to your blood sugar levels. Good and bad.

Yeah, absolutely. And that's one of the biggest things for sleep that's going to affect not just glucose, but all of your health metrics is eating late at night. Like if we're seeing someone eating late at night, that's the first thing we're going to try to adjust because it makes such a difference both in your sleep quality and your glucose levels. But sleep and glucose is a bidirectional relationship. So poor glucose levels going into the night of sleep is going to affect your sleep quality. But then also a poor night of sleep is going to affect your glucose levels the next day. So that works together synergistically like that. And so both positive habits and your glucose levels has a positive effect. And same with the negatives. So when it comes to the sleep quality itself, both high quality sleep and enough quantity of sleep are going to really improve your ability to have stable glucose levels the next day. There's lots of research that's been done on non diabetics specifically that shows when we have either fragmented sleep or we just don't get enough sleep, our glucose levels can be almost 25% higher the next day. So you're essentially putting yourself in a pre diabetic or diabetic state the next day if you're not sleeping well.

Wow, that is 25%. And when you say enough sleep, because I know that like I definitely have my opinion on how much sleep and you know, it's, I Fall in much more in the eight hour camp. Which means that if you want eight hours, you can't put aside eight hours because you actually have to give yourself a little time to fall asleep. Are there some numbers in there? Because I know quality, it's not just quantity, it's quality. But you know, in terms of actual number of hours of sleep, what were the studies?

And again it averages where some people might need a little bit more and some people might need a little bit less. But on average it's estimated that anywhere between seven and a half to nine hours of sleep is the optimal for range for most people. And that's actual sleep. Like you're saying like real sleep happening. So it's very, very, very rare. I think it's only like 1% of the population that can only get like six or seven hours of sleep and be have the same optimal outcomes. So some people are like, no, I really don't need that much sleep. Most likely you're actually not falling in that bucket.

I have in now 30 plus years of having clients I have had and you know, thousands of people. I had one of those people, they're rare, who could sleep four hours a night and be totally. And I was like, first of all I was super jealous because think what your life would be like. I was like, oh my gosh, you know, she's up and she's getting all this stuff done. I'm like, darn, that is so great. Okay, so sleep. Love that stress.

Yeah, stress is a huge one. And so essentially, you know, how it works is that everyone's familiar, I think with cortisol, our stress hormone. And so we have a really normal, healthy stress response. It's meant it's built for acute stressors. So think historically getting chased by something or something's happening where you need that quick burst of energy and that stress response, essentially when we get that flood of cortisol, our body releases glucose to fuel whatever we need to do to deal with that stressor. So that's a normal, healthy acute stress response. But the problem is triggering that response all the time now and we don't actually need extra energy for it. And not only are we having more than frequent acute stress responses, we're also having a lot of chronic stress, which is that kind of constant hum of cortisol in the background that's constantly driving glucose levels up. Not as dramatically as an acutely stressful moment, but kind of this constantly elevated baseline glucose levels. So what we typically see is if somebody is really stressed, so maybe they have A really stressful job. There's a lot of family dynamics that are stressful. Maybe they have a long commute that is, you know, really starting their day off on the wrong foot. We'll see those fasted glucose values specifically never really come back down to normal. And if we can't find any other reason, like there's no obvious like 8 light at night or you're eating poorly, you're not moving, it's usually related to stress. And so often if you start to implement a stress management technique that really works for you and you can be consistent with, that's the key, we'll see those glucose values drop right away. For some people, that's meditation. For some it's journaling, you know, reframing strategies, nature, exercise, you gotta find what works best for you. But those stress management techniques, you can actually see your glucose levels improve. It's pretty powerful. For many people who eat really well, sometimes the highest glucose value of their day is during a stressful moment. And so that's always really shocking when somebody sees a glucose spike to 1:40 and it's never from food, but it's from a fight or an argument they're having or, you know, that traffic jam. So stress can be really impactful.

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Before all of this information was out, I used to teach this course for doctors called Overcoming Weight Loss Resistance. And this was like 15 years ago. And one of the areas I would talk about was stress. And the reason that I found this was years of looking at people's labs and I would see people who were eating perfectly and their triglycerides were great, they were like 75, their HDL was great, everything looked perfect except their fasting blood sugar. And you're like, all right, wait a minute, you don't have, you know, you don't have anything else to indicate an issue except this fasting blood sugar. Why do you have everything else looking perfect and your fasting blood sugar is a hundred one hundred five. And so that's when I started to go, what? What is going on here? And that was how I managed to affect it was to find that thing. Because the biggest challenge with stress is, is actually being able to quantify it.

Absolutely. And that's why these wearables, you know, your. Your hrv, or if you're tracking heart rate, HRV with a lot of common wearables as well, you'll also start to be able to quantify this stress effect. And if you combine that with the glucose, it's really hard to deny it.

Right.

Many people, if you're constantly been, you know, chronically stressed all your life, that feels normal. And they're like, no, I'm not that stressed.

I'm good.

Yeah. They're like, I feel fine. But they're just so used to being in that stress state that it's really hard to kind of more objectively look at it and identify it as a real problem. But those are clear warning signs.

Don't you find that for people who are in that first stage of chronic stress, where their stress hormones are up, you know, they're breaking down, they're kind of catabolic, they're getting that blood sugar out, they actually feel pretty, like, wired.

It's like adrenaline.

It's like, it's not till all of a sudden they crash. Like, you never see someone. I never used to have people come in and complain about stress during that time period.

Absolutely. But that's when you want to identify it, because it's much easier to kind of fix it a little bit there than until you've decompensated completely.

Well, you mentioned one thing. You mentioned using exercise to help with stress. And I think it's interesting to talk about exercise because exercise can also give you some data that if you didn't know what you were looking at, you looked at your cgm, you'd go, oh, hold on. How does exercise, like, impact your blood sugar? And how can we use exercise to optimize our blood sugar? But also, how do we understand how to read a CGM when, say, we're at the gym and we're doing some intense training, and all of a sudden we see our CGM shoot up. And if you didn't know what you were looking at, you go, oh, right, yeah, absolutely.

It's always one of the first thing we educate people on is that if your glucose rises while you're exercising, that is not a bad thing. We never, ever want to deter the exercise. So there's two different things to think about here. One is what happens to your glucose while you're exercising. And then the other is what impact exercise is having on your Glucose in the long term. So in the moment, you might see that glucose spike like you mentioned. And you can think about this as a supply and demand. If we're doing something high energy. So hiit workout, sprints, heavy weightlifting, you're more likely to see that glucose spike during that type of exercise. And that's because you're demanding a lot of energy from your body, and then it's supplying it really quickly with that increase in glucose. But the difference between a glucose spike from heavy weightlifting session and drinking a soda and sitting on the couch is that your body is using that energy right away. It's producing it for a reason. It's fueling that exercise. Whereas a glucose spike from food or sugar is not necessarily getting utilized. You know, that's just because we put it in the system and now it doesn't know where to go go. You can think about it in that way. But again, it's totally different. It's not having the same metabolic effect. Whereas something more like steady state cardio or a gentle walk or more low intensity, we typically see glucose pretty even or even decrease a little bit during that because it's not as intense of a demand for energy.

If you did eat some pie, you could go do some pushups or, you know, take a walk after a meal. And that can help lower that blood sugar response. So those. There's some great ways to use exercise, but I think it's important to note because someone might go to the gym and go, holy smokes, what have I done to myself? And it's like, oh, no. That just is a sign you're working out intensely. All right, I saved the big kahuna for last diet, because obviously diets and what we eat and when we eat can play a huge role here. And I think I'll tell you a little funny story. I love to wear CGMs when I'm traveling because it really helps you stay on point, especially with different buffets and situations and also with all the time zone adjusting. And I last year I went. I traveled so much last year, it was crazy. This year I'm like, I want to go anywhere. I went to Dubai, then the Maldives, then Istanbul. And in the Maldives, I was speaking at an event, and I was speaking at an event, and every day we would have this buffet. And of course, they did a lot of things on the buffet to follow my virgin diet and sugar impact diet. But one of the things they had in the buffet was like this big bowl of kiwi fruit. I eat a little bit of blueberries Or a little bit of a slightly green banana every day. I have maybe one or two servings of fruit a day. And it's in conjunction with protein and fat and. But here I remember I was like looking, I saw this kiwi, like across the, across the hall. I was like, oh boy, you know, beelining over for it and because I never eat kiwi at home because it's a pain in the butt, right? Who wants to deal with that fur? And I might have taken like probably two cups of kiwi. I mean, it was a ridiculous amount of kiwi and I ate it before eating anything. I mean, I rule violated everything I know to do. I just was like, I'm gonna have that kiwi. I'm gonna have coffee and kiwi. What a perfect thing. And boy, my blood sugar was like, boop, hijacked up. So it was, it's, it's just really good to be able to see these things and go, which foods work for you, which foods don't? And, and also, you know, foods in isolation where if I'd had a half a cup of kiwi and I'd already had some, you know, eggs or protein and some little bit of healthy fat first, I probably wouldn't have had that spike. So let's talk food. And also I love to talk about coffee and things like that too.

And you were right to save diet and nutrition for the last bucket because it can be the most. Not complicated, but it's the most personalized, where there are a lot of good general rules of thumb that work for everyone. And then there's a lot of good nuance and differences between people with diet. So I always start with, again, master the basics. But then you have to actually see the data to know what works best.

For you, which is why these are so great. Like you wouldn't have any other way. There's, I love connecting the dots between what you're eating and what's going on with your body. And I don't know any other way to do this without wearing one of these. Like, it's so fantastic. Okay, so the big rocks, what are they?

Yeah. So the basics are what I'm sure many people have heard before. Go for as much as possible. Whole foods, least processing as possible. So that includes not only just your typical not packaged foods, but also thinking about, you know, whole fruit versus juice is going to be a lot different. Steel cut oats versus instant oats going to be a lot different. So the least amount of processing as possible. And also really always prioritizing protein, both Overall, throughout your day, but also at each individual meal. As you mentioned, eating foods in isolation. So eating carbohydrates by themselves is going to be a much, much different glucose response than if you had had a few scrambled eggs first and then some kiwi. That protein helps to really blunt that glucose response and also really promote satiety. So we don't overeat too much either. So some basics like that, try not to eat too late at night, thinking about eating most of your meals during daylight hours and then not grazing all day. So really making them meals, not snacks, bites here and there all day long. So those are kind of some of the high level parameters. And then often people want to know, how many carbohydrates should I be eating? I go keto, Do I go low carb, how many high carb? And that's really going to be kind of a personal threshold is what we see for people. People can consume a lot more carbohydrates from healthy, nutrient dense foods and maintain really good glucose levels where other people really, really have to cut back. So that's kind of going to depend on your activity level, how much muscle mass you have. So going back to exercise, building up that skeletal muscle mass really helps you be more flexible when it comes to glucose tolerance. And it's going to depend on a whole host of things, of how many carbohydrates you can really handle while maintaining those great glucose values. But in general with nutrition, we have to focus on the basics. But as you mentioned, you and I could eat the same exact thing. Could both have eggs and kiwi fruit and we'll probably gonna have a different glucose response because we have unique responses. So, you know, we're used to hearing about glycemic index, which is gonna give a prediction of how your glucose levels will respond on average. So that estimates that something like a banana, we're going to have a much higher glucose response than something like berries. But then you, as a unique individual are not necessarily going to fall where the population average falls. You might actually have a better response to bananas than you do to blueberries. But again, you don't know unless you've actually seen the data and tested it out.

Wouldn't that have to do with your genetics, your gut microbiome and then also your lifestyle, like how much muscle mass you have, the, the amount of sleep you had the night before, your stress level, the first meal you had of the day, like all of those things would play a role in it.

Yes, absolutely. Yeah. So some of these are more changeable than others. Research at this point is estimating that those differences are maybe tied up to 50% to our microbiome and a lot of that gut health in general. So that's determining a lot. Another chunk is genetics can't change that too much. But then if there's a whole nother, probably 30 to 40% that is more these, you know, changeable factors such as your general state of health, how much muscle mass you have eating something on an empty stomach versus not an empty stomach, the time of day. So there are some factors in our control that are really helpful to learn and that's part of what the data helps you figure out as well. It actually empowers people to have more flexibility in their diet and nutrition because you learn these tips. You know, okay, I have kiwi fruit when I'm on vacation and I love it, but I know I need to eat some protein first and I should probably go on a walk afterwards. So you learn this strategies that makes it so you can be a little bit more flexible. But that way, you know, you know, this isn't something I should probably do every single day because if I have it every morning at home, that's going to lead to kind of repeated high glucose levels and not set me on a very good trajectory.

One of the things I've looked at is how you start your day and eating, you know, hour or two after you wake up, your cortisol's up, your pancreas is woken back up again, what you eat there really starts to set the tone for the day. You wake up every morning and decide you're going to hit yourself right away with some kiwi fruit, you are going to start a bad cycle for yourself.

Yeah. And often what we see is those swings in glucose too will trigger more hunger. It'll trigger cravings. And so if we start the day off as you're mentioning that even glucose level, we're getting ourselves nice and satisfied with protein, fat and nutrients. And we're having that, that stable energy level then that also decreases cravings and sets you on that better positive flywheel rather than that negative flywheel. We're kind of stuck in this craving cycle all day.

Now, when you talked about the three different things you looked at, because there's spikes and then there's would be area under the curve. And I will just give you an example because this is what I'd love to know. Is it worse to have a quick spike that was say, go up to 160 or 180, but come right Back down or to have a, you know, let's say, or let's go 200, it spikes up, it comes down versus coming up to 160 and hang in there for a bit, which is worse.

I would say it's worse to go to the lower level and hang out there for longer. So it's more indicative that you have a healthy metabolic system if you have that quicker spike and then you go back down to normal, because that's showing us that your body is insulin sensitive. You might have had a big spike, but your body was able to recover it quickly and come back into that normal range. That doesn't mean it's ideal. And if we did that every single day, again, going to the example of now that was your glucose pattern every single morning at your regular breakfast meal, then that's eventually going to cause your body to be less insulin sensitive and you're going to start to see that second response, which is you go to maybe 160 and you hang out there because your body's not able to respond as well. So the goal is that we're not seeing that pattern all the time, but we're going to choose one over the other. We really want to see your ability to go back down to normal fairly quickly.

So I'm just looking now because I mentioned this before I went on air, and I am so thrilled that I decided to wear this cgm, my Nutrisense. When I did this, I decided it would be really fun. And my husband's always like, gung ho. I come up with an idea. He's like, okay, let's do it. I'm looking at my phone and at the Nutrisense app so that I can give you these. These scores because, like, holy smokes. And so what I said was, honey, it would be really fun. Now, I. I don't know if fun was really the right word, but it would be really fun to do a Prolon fasting mimicking diet at the beginning of the year for five days. Trigger autophagy. What a cool way to start the year. He's like, okay. He has no idea what I'm talking about. He's like, okay, I'll do it. Whatever. He doesn't know what he just signed up for. Or I've done this once before because the medical director and Dr. Valter Longo were actually working with me on some other stuff. So I was like, okay, I'll try. Well, the time before that I tried to do it, I, like, totally failed. I forgot that I'd, like, tried this and failed. I ended up having to supplement with a load of bone broth, which just didn't work. But I didn't have a CGM then, so I'm like, you know, I probably didn't give it a fair shot. I'll do it with Tim. It'll be great. So I go on this Prolon fasting mimicking diet, which is super low protein, because what they're trying to do is keep your protein very, very low. They're trying to basically make your body think it's fasting so that you trigger deep cellular cleansing autophagy. Every which way. I take a test, whether it's genetics or gut microbiome. I'm one of those people that. That feels best protein first. And, you know, I. I like, feel best on protein, even if I have to use some of it for fuel. And I don't do well with high, simple carbs or. Or lots of fat, like, either one. This diet, when you look at, is very, very low protein. And then the rest of it's super high glycemic carbs, which I'm not quite sure why, and then fat. So I go on it, and it's very low calorie. The first day is like 1170 in terms of calories, and the next four days, I think, are just around 700 calories. The first day I'm looking, and my blood sugar spikes up at 165 and then spikes up at 165 again. Now I'm used to literally such tight glycemic control. Like, my blood sugar is going to sit somewhere between once I'm up and moving about, it's like 80 to 120. It barely ever goes under that. So I'm like. I just. It's just easy for me. And I'm like, huh, that's interesting. Okay, the next day it goes up to almost 180. I'm like, holy smokes. Whoa. Right? Okay. But the next day it goes up to 2:25. And I'm like, oh, my gosh. And now I'm sitting there, and I'm like, all right, I'm shaking. I have all the hypoglycemic stuff going on. It's not overcorrecting. My blood sugar's not dumping too low, but just the going up and going down. I just feel crappy. And I'm like, this is amazing. I was still sleeping fine. I wasn't stressed. I was doing my exercise, but I wasn't. I wasn't exercising super hard because I couldn't because I had 700 calories. But I get to day four. I make it through day four and I literally look at my husband. I go, listen, I cannot. I'm done. I'm done. I'm going to go out, get a steak. Like, I can't take it. But it took me a day to recover from that too. I still felt crappy the next day when I got up and immediately was like, I'm going to eat protein all today. I'm having three protein rich meals. But it literally took me. That was Sunday. I had protein. What day is today? Today. Monday or Tuesday?

Monday.

Monday. See, it even affected my brain. But my, my blood sugar is back to normal today and I actually did a really hard gym workout today and felt normal, but I just was blown away. And I went online and I was like, okay, what the heck? Like asking into all the AI things. Can Prolon affect your blood sugar levels? But I thought, this is so perfect. We have this interview going on because I'd love to just kind of unpack what the heck happened to me here with this?

There's probably two factors at play here. One is that, you know, we've had a lot of our customers also try Prolon and we have seen that they have pretty high glucose spikes to the food that is provided in, in this diet because as you mentioned, it's really low protein and it's really high in simple sugars and really easily digestible sugars.

Yeah, well, you drink actually a glucose drink, which is when I got. And Tim goes, well, that you were supposed to drink that drink throughout the day. He handed to me, I drank it and so. And therefore I had. I had my own little glucose tolerance test. Yeah, exactly right. That's what happened.

Yeah, well, we'll see. And I don't know their exact rationale for formulating the foods in the way that they do, but I'm guessing they want it really easy to digest and that's why they go with super simple sugars. I'm not completely sure, but we see pretty much across the board that people really big glucose responses to the food that's provided. So that's been a general trend observed. And that's because of really, you know, just the simple sugar and nothing else to stop it. And I'm curious before I give my second hypothesis, if your husband was wearing a CGM or if you have any data on him.

No, darn it, he wasn't. And I was like, oh, I should have put. But here's the thing. I'm actually lower in body fat. Than my husband is. And I have really crazy low body fat for a female. I'm 59 years old and I just did a DEXA at 14 and I've done enough body fat and DEXA scans and I always end up somewhere in the 12 to 14% range. So I mean, that's crazy low for a woman. But that I've been like that for 20, 30 years. Right. So I don't know if that was part like, that was playing a role in it too. He actually has a little higher body fat than me. He was doing fine. I'm like, I dropped five pounds in four days. I'm like, you know, I'm like, you know, my little body was like, like, stop it. Feed us. So I don't know if I just had less margin for error here because.

And that's, that's exactly what I would predict is that most likely your husband probably had more even keeled glucose values. He probably was still spiking during the actual prolonged meals because they've got sugar in them, but he was probably having more stable values. And this is usually what we see with women who are relatively healthy and really lean. If they do a lot of, lot of fasting, we typically see that they have much poorer glucose responses than their male counterparts. So we usually don't see this with just like regular, daily, intermittent fasting, which we consider just kind of healthy eating patterns for most people. Like, not. Yeah, you have to define what fasting is.

I don't think we should call intermittent fast like this. Not eating for 12, you know, 12 to 14 hours is what we should be doing. It's what we actually used to be doing.

We.

And now I was listening to an interview with Sachin Panda who said, you know, the 90% of Americans eat 15 hours a day or more. I'm like, oh my gosh.

But yeah, and during those 15 hours, they're typically eating something at like every hour too.

That is crazy. Well, I still remember when grazing came out and it was during the fat free craze days when you were just starving all the time. What was crazy, I was a personal trainer at the time, like paying my way through grad school. And what was important is I was in our doctoral program. We were doing a lot of different body composition metrics. So I did my body comp. I was 25% body fat. I was working out hours each day. I was always hypoglycemic. And that's when I did all that. I was like, oh, this whole thing is not working. What they're telling us to do.

Yeah, that's when you have the data. That's when you're like oh yeah, this information is invalid.

Yeah, this is bs, you know, like me. Yeah. Right. So clearly this stuff, that, that whole thing didn't work, that whole grazing thing. But I agree, like I don't even think like we shouldn't call intermittent fasting not eating for 12.

So yeah, to make that really clear for the women listening, it's not the you know, eating in a 12 hour window or 16, 8 hour window that we see this negative outcome. Typically we'll see it in when women start to do the one meal a day or longer fasts. So some of this fasting, mimicking dieting like you are doing with the Prolon or like 2 to 3, 4, 5 day fasts we tend to see for the women who are already healthy, already lean, already doing a lot of good healthy stressors like heavy exercise, sometimes you know, sauna, cold therapy that they pushing that body, adding another stressor of that longer fasting time almost fills the cup too much. So we have a cup for our stressors, our healthy hormetic stressors. But female cups are smaller than males cup is how I describe it. So we're more likely to overfill the cup before our male counterpart will. And so often that's what we see and that's that body stress response where I'm having high glucose levels, really feeling the symptoms of it. And that's your body telling you that this is not working well for us.

As you were saying that I went, yes, I went to the gym, I cold plunged and I saunaed. And so I think the takeaway there would have been like okay, do that if you're looking to trigger some extra autophagy but like skip the cold, plunge, sauna and gym during that time.

Yeah, like try to balance out those stressors.

Yeah, I'll just do it all more is better. I love this so much. All of this has been super useful and and you're also going to give everyone a 25% discount. So I'm going to put all of that on a cgm. So that's super exciting. I think your first month of a CGM you can get started and get a 25% discount. So I'm going to put that@jjvirgin.com Nutrisense so you will have exactly how to get a hold of that. Do it. And we'll have all the notes from this as well. So it's really easy for you to see and I've done a couple other great recordings on, you know, what you need to do to balance blood sugar. So we'll put all those resources there too. But I cannot, like, echo enough how much a CGM can help you. Like, I look at three things to track that change your life and it's your sleep. I, you know, wearing, unfortunately I'm wearing like my ninth aura ring in three years. I don't know, like, I don't know if I've got some weird energy field, but I just like keep blowing them out.

They stop working.

Yeah, they just like, all of a sudden I'm like, I did another one. I'm like, what am I, an alien?

I don't hear that often.

So that's, it's like literally nine of them. CGM and OURA ring for sleep tracking. And then really using a biopedance scale or DEXA scan twice a year or in body and really knowing your skeletal muscle and monitoring and improving that and everything fixes. When you fix those things, like, it's amazing.

Focus on the most important and then you're going to have that positive ripple effect is what I always tell people.

Yes, yes, yes. Well, thank you so much, Kara. You're a wealth of information. Thank you for like, unpacking my prolon situation.

Yeah, absolutely. It was a pleasure.

Be sure to join me next time for more tools, tips and techniques you can incorporate into everyday life to ensure you look and feel great and more importantly, that you're built to last.

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Hello listeners, this is Ann Bogle, author, blogger and creator of the podcast what Should I Read next? Since 2016, I've been helping readers bring more joy and delight into their reading lives. Every week, I take all things books and reading with a guest and guide them in discovering their next read. They share three books they love, one book they don't, and what they've been reading lately. And I recommend three titles they may enjoy reading next. Guests have said our conversations are like therapy. Troubleshooting issues that have plagued their reading lives for years and possibly the rest of their lives as well. And of course, recommending books that meet the moment. Whether they are looking for deep introspection to spur or encourage a life change or a frothy page turner to help them escape the stresses of of work, school, everything, you'll learn something about yourself as a reader, and you'll definitely walk away confident to choose your next read, with a whole list of new books and authors to try. So join us each Tuesday for what Should I Read Next? Subscribe now wherever you're listening to this podcast and visit our website what Should I read next podcast.com to find out more.