Intermittent fasting during stress peaks. Understanding sugar spikes

Reading time: 4 min Current evidence shows that stress can potentially lead to serious diabetes-related illnesses. The underlying mechanism proposed to explain the association between stress and glucose levels involves interference with carbohydrate metabolism following various stressors, potentially leading to insulin resistance. By activating the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, stress can result in the release of stress hormones, such as cortisol and epinephrine, which are associated with insulin resistance.

1. What happens when we eat carbohydrates?

To produce Adenosine Triphosphate (ATP), the energy currency of our cells to carry out their functions, several energy substrates are needed, including glucose . Since it does not diffuse through the lipid bilayer, it must be actively transported into the cell via endocytosis. This transport is carried out by two groups of proteins: the SGLT transporters (sodium glucose transporters) and the GLUT transporters (glucose transporters). When we eat foods high in carbohydrates, these will be transformed into glucose that will be absorbed in the small intestine via these transporters to reach the blood. Given this increase in glucose, the pancreas will produce the corresponding insulin to be able to introduce this glucose into the cells, increasing the expression of GLUT transporters and removing glucose from the blood.

2. Can we get energy from other foods?

Definitely. The physiology of the human being is highly complex and its metabolism can adapt to periods of fasting or reduced availability of food. We have two other substrates from which we can obtain ATP: fatty acids and amino acids . Our body uses both substrates at the same time (fatty acids and glucose) to obtain energy, especially when there is a high energy demand. Obtaining energy through amino acids is not convenient for it to occur, since it only occurs in extreme situations of catabolism and tissue destruction. Although more energy is obtained from a gram of fat (9 kcal/g) than from the same amount of carbohydrates (4 kcal/g), the rate of energy release from fat is slower, and therefore for sports where we seek a quick energy demand, the main substrate will be glucose. Fatty acids will be the most used substrate in long-term physical activities, since we have a limited reserve of glucose in the liver and muscle (1,500-2,000 kcal) and a practically unlimited high reserve of fat.

3. What happens if we have a high blood glucose level?

The elevation of glucose and insulin is necessary and essential for multiple physiological processes, however, aberrant and constant glucose levels and/or if glucose consumption is higher than demand (sedentary people) can trigger resistance to insulin. insulin hormone . This pathophysiological situation has multiple effects: tissue damage induced by hyperglycemia, hypertension, advanced glycation products (peripheral neuropathy, cataracts, premature aging...), dyslipidemia, metabolic syndrome and cardiovascular disease.

4. What substances or situations raise blood glucose?

Mainly carbohydrates and stress , although the consumption of protein and fat also increases it, but with totally different effects and in a significantly lower proportion (figure 1). But what many people don't know is that stress raises blood glucose considerably due to the fight/flight reaction, since animals react to stressful situations with a general discharge from the SNS, preparing us to fight or flight and therefore releasing glucose in blood to be able to have enough energy to react. In figure 2 and 3 you can respectively see a glucose peak due to stress without previous consumption of food and after the consumption of a banana, consumption is practically the same. We also know, through recent scientific studies , that glucose load per se does not affect free cortisol levels, but psychosocial stress does induce a greater cortisol response in subjects who after a fasting period (11h) took a high amount of glucose.

5. What can we do to maintain optimal blood glucose levels?

The elevation of glucose and insulin in the blood in itself is not problematic, everything will depend on the context . If you are a sedentary person, with a high percentage of fat and consume high amounts of carbohydrates, you will be susceptible to Insulin Resistance problems. However, if you are an athlete who eats a balanced diet and has a consumption proportional to your spending, the elevation of blood glucose will not be a problem as it will quickly be used as a substrate or stored in muscles and liver without problem. So what are my tips for maintaining stable glucose levels?

5.1. Perform physical exercise

Strength, resistance and cardiovascular training have multiple benefits:

1. It increases brown adipose tissue and reduces white, promoting a much less pro-inflammatory and efficient state to oxidize fat.
2. Increases muscle mass and the number of GLUT transporters, being more efficient when managing the consumed glucose.
3. It has positive effects on the reduction of blood pressure, lipid profile, diabetes mellitus, glucose tolerance and insulin response and increase in basal metabolism, among others.

5.2. Learn to better manage stress

Stress is necessary for our survival, however, sustained and poorly managed stress can trigger problems of chronic fatigue or IR/Diabetes in the long term, therefore having a specialist therapist to help us better manage our emotions is highly recommended. . Rest and contact with nature can be of great help and complementing it with adaptogenic supplementation can help us reduce our response to stressful situations such as 5-HTP , Ashwagandha or CBD .

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5.3. Take an adequate diet to your caloric expenditure

We should not fear carbohydrates, but consume the right amount and adapted to our caloric expenditure. What advice can I give you? Consume low glycemic index carbohydrates such as brown rice, quinoa, buckwheat, or tubers in the form of resistant starch instead of foods such as bread or corn that have a higher glycemic index (figure 4). On rest days we can prioritize a diet high in fat and protein, since we will not need a fast and high energy demand. And the father of medicine already said it, "if we could give each individual the exact amount of food and exercise, neither too much nor too little, we would have found the safest path to health" - Hippocrates (460-280 BC) . Bibliography 1- Peinado, Ana B., Rojo-Tirado, Miguel A., & Benito, Pedro J.. (2013). Sugar and physical exercise: its importance in athletes. Hospital Nutrition, 28(Suppl. 4), 48-56. Retrieved on November 5, 2020, from http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112013001000006&lng=es&tlng=es. 2- Jellinger PS. Metabolic consequences of hyperglycemia and insulin resistance. Clin Cornerstone. 2007;8 Suppl 7:S30-42. doi: 10.1016/s1098-3597(07)80019-6. PMID: 18154189. 3- Capes, SE, Hunt, D., Malmberg, K., Pathak, P. & Gerstein, HC Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients - A systematic overview. Stroke 32, 2426–2432, https://doi.org/10.1161/hs1001.096194 (2001). 4- Guyton, AC & Hall, JE (1996). "Medical Physiology Treatise". 9th Edition. Inter-American-McGraw-Hill. Madrid.