Blood Sugar, Insulin, and Heart Disease (Cardio Metabolic Syndrome)

When you talk about the health of your heart, you can’t separate out the sugar component! Blood sugar imbalance, glucose intolerance, and insulin resistance are the main dietary contributors to heart disease. Abnormal blood sugar levels and troubles with insulin are also key players in heart failure. The bottom line is too much insulin negatively affects your heart + many other tissues, vessels, and organs throughout your body. This is because excess insulin is pro-inflammatory. One nutrition tip is to choose foods based on the glycemic index. High glycemic foods are linked to more inflammation, so stick to low glycemic foods most often. These types of foods also keep you off the blood sugar roller coaster!

Five Ways Blood Sugar Imbalance Affects Heart Health

There are 5 primary ways blood sugar imbalance negatively affects heart health.  

#1: Abdominal Obesity

Insulin causes fat to be stored around the waist. In today’s world, it’s very common for a person’s body to release more insulin than it should. The more insulin the body releases, the less effectively the insulin becomes at transporting glucose from the blood to the tissue or cell where it can be burned as energy. When this isn’t effectively happening, more insulin is released, and ultimately, insulin causes fat to be stored around the waist.

#2: Imbalanced Blood Fats

Insulin is a signaling hormone, and when it gets over released, it sends a signal to the liver to make more cholesterol, and the liver ends up making more LDL cholesterol (bad type), and less of the HDL cholesterol (good type).

#3: Elevated Blood Pressure

Insulin over-release increases the amount of sodium between the cells (interstitial), which causes more water retention. That means the volume of the blood increases, even if the blood vessel size stays the same. If you increase volume with the same size piping, the pressure goes up to get that fluid through that pipe.

#4: Insulin Resistance and Glucose Intolerance

What comes with insulin resistance is a decrease in glucose tolerance. The sugar not getting into the cells: some is converted to trigs, which thickens the blood (it’s fat in the blood). And the sugar that doesn’t get inside the cell can now start to damage healthy tissues (ie: blood vessels, kidneys, eyes, heart) through the process of glycation. Insulin resistance increases the synthesis of advanced glycation end products (AGEs) – those are harmful!

#5: Pro-inflammatory and Pro-thrombotic states 

These two "states" increase inflammation and increase risk of blood clot formation. Excess insulin is pro-inflammatory. It also can cause the blood to thicken, which is a pre-thrombic state. Too much insulin can make platelets sticky, which can increase the risk for thrombosis.

The Two Most Important Lab Values for Assessing Cardiovascular Risk

#1: Triglycerides

Fasting triglyceride readings are a marker for fat in the blood but has more to do with sugar, high-glycemic foods and alcohol in the diet. If a person has high triglycerides, lowering them raises the good HDL and lowers the bad LDL and total cholesterol.

#2: Hemoglobin A1C

Hemoglobin A1C is the standard for measuring a three-month average of your blood sugar levels. Optimal value falls between 4.8% and 5.2%

If a person’s hemoglobin A1C level is high, that means tissue is getting damaged as a result of insulin not doing its job of maintaining normal blood sugar levels. When insulin can’t do its job, it’s called insulin resistant. Once A1C levels decrease, that doesn’t mean the tissue damage is un-done.  

The key to managing blood sugar instability is focusing on re-sensitizing the insulin receptors. The hips, butt, and upper legs have the most insulin receptors, so any type of activity involving the legs lowers insulin requirements, sugar and hemoglobin A1C.

Other Important Labs to Test for Heart Health, Sugar and Insulin

Fasting* Blood Glucose: optimal level of 80 to 90 mg/dL

Fasting* Insulin: optimal level no higher than 5 (the range goes up to 25). An optimal level means you’re not creating a high insulin demand, creating inflammation or promoting fat storage. Your body is producing insulin at optimal levels.

Lipid panel (Cholesterol, HDL, LDL, Triglycerides)

  • Trigs: 60-70 mg/dL
  • Chol: around 200 mg/dL
  • HDL: 40 or greater mg/dL
  • LDL: <130 mg/dL

High sensitivity CRP (HSCRP): optimal level of <1 mg/L

*8-12 hours is fasting

Reasons For an Over-Release of Insulin

It’s important for insulin to maintain normal blood sugar levels, but it’s also important for the body to release the proper amount of insulin. Many people over-release insulin, which is primarily caused by these four factors:

  • The #1 factor is consuming quick-acting carbohydrates.
  • Toxic metals, especially Mercury.
  • An over-response to stress.
  • Chronic inflammation because of the stress it generates.

Higher levels of insulin lower testosterone and increase estrogen. This estradiol increase (once it’s above 40), starts to cause a lowering effect on testosterone, which is crucial for healthy ejection fraction (the amount of oxygenated blood the left ventricle can push out with a single squeeze).

Berberine and Blood Sugar Support

There is an herb used to support blood sugar levels in normal ranges: Berberine! A few of berberine’s other health benefits include:

  • Supports glucose uptake by the cells
  • Assists the body with normal clearance of glucose insulin
  • Supports heart health, particularly triglycerides

Formation of Advanced Glycation End-Products (AGEs)

When there’s too much sugar in the blood, even modest amount, the sugar starts to get sticky because of the warmer body temp and oxygen in the blood. It’s very similar to when you sauté onions. As you cook the onions, they start to stick together and turn brown – that’s what happens in your bloodstream too. Those AGEs start to stick to the protein in the eyes, kidneys, heart, etc. and that’s how they do their damage.

Insulin resistance has a pro-inflammatory effect, and this involves AGEs. You really want to keep insulin at the healthiest levels possible. It is possible to have too much insulin in your bloodstream and still have somewhat normal blood sugar levels, which is why it’s important to test the fasting insulin.

How to Maintain Healthy Blood Sugar and Insulin Levels

The first domino is the over-release of insulin, and the cause of that is your blood sugar level rising too fast. You don’t want to give your blood sugar the opportunity to rise too quickly.

#1: Consume Healthy Fats at Opportune Times

With the goal of minimizing blood sugar spikes, consuming healthy fat is one of the most important ways to do this. When you get up in the morning, you’re going to either gain or lose control of your metabolism as soon as you open your eyes – this includes blood sugar levels. The best way to manage this is, before you do anything else, is take a Tbsp of fish oil or cod liver oil, off the spoon, as soon as you wake up. It’s the single most important thing you can do.

The oil forces the sugar level in your blood to rise slowly. The reason we want the sugar to rise slowly is to train the metabolism to be more steady, stable, and more balanced. If you don’t eat fat, your liver starts releasing sugar and you don’t want to start the day with a blood sugar spike. It’s difficult to get that balance back to where it should be the rest of the day. The oil sets the tone for the waking hours, and that’s how you start to train the high stress pattern and high insulin pattern.

The two most important times of the day to eat fat or oil are upon waking up and right before bed. Those are the times when blood sugar and insulin levels can get most disrupted. You want about 15 grams of oil off the spoon (not capsules) to get the full stabilizing benefit.

I prefer to use the brand Nordic Naturals for myself and my kiddos. In a pinch, I’ll also use organic extra virgin olive oil.

#2: Change Your Diet

  • Include small, low-glycemic snacks – mid-morning and mid-afternoon. People must eat often enough because if you don’t eat, your liver will feed your bloodstream sugar anyway. It doesn’t have to be a lot of food – a small, low-glycemic snack works. Ideas include: some pecans or almonds, a slice of cheese, a few celery sticks, apple with nut butter.
  • Quality Proteins
  • Healthy Fats. Here are the ones your heart loves (and doesn't love)
  • Lots of Vegetables
  • Fruit | When you choose fruit, pick berries and green apples (eat 3-4x more veggies than fruit). Two ways to minimize the negative blood sugar effects from fruit’s natural sugars are: Eat fruit with a protein or fat and//or Eat fruit as a dessert.

#3: Berberine

It’s critical to reduce the negative effect of insulin and the negative effect of blood sugar. I like this nutrient blend supplement that includes berberine and a handful of other ingredients important for blood sugar stability.  

#4: Pump Some Iron

Include weight training that involves the bigger muscles in the lower body (hips, thighs, gluts). The greatest number of insulin receptors are located in those muscles. Any type of exercise or training that has a positive effect on the big muscles in the legs and hips helps to balance both insulin and sugar. The heavier weights work better because more muscle fibers get into play.

Protect that ticker of yours, and don't let mainstream convince you that sugar and refined carbs don't affect your heart and circulation because they do!

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

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