When it comes to heart health, you can’t ignore the impact of blood sugar! Blood sugar imbalance, glucose intolerance, and insulin resistance are major dietary contributors to heart disease and heart failure. These conditions, characterized by abnormal blood sugar levels and insulin troubles, play crucial roles in cardiovascular health.

Excess insulin can harm your heart and other tissues, vessels, and organs due to its pro-inflammatory nature. To manage this, it's essential to choose foods based on their glycemic index. High glycemic foods increase inflammation, so it's best to stick to low glycemic foods. These types of food choices help stabilize blood sugar levels and keep you off the blood sugar roller coaster!

Understanding and managing these factors is key to preventing and addressing cardio metabolic syndrome.

Five Ways Blood Sugar Imbalance Affects Heart Health

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

#1: Abdominal Obesity

Excess insulin leads to fat storage around the waist. In today's world, many people release more insulin than needed. Over time, the body becomes less effective at using insulin to transport glucose from the blood to cells for energy. This inefficiency prompts the release of even more insulin, which ultimately causes more fat to be stored around the waist.

#2: Imbalanced Blood Fats

Excess insulin signals the liver to produce more cholesterol. This results in higher levels of LDL (bad) cholesterol and lower levels of HDL (good) cholesterol.

#3: Elevated Blood Pressure

Excess insulin causes sodium retention, leading to increased water retention. This raises blood volume while blood vessel size remains unchanged. As a result, blood pressure increases to accommodate the higher fluid volume.

#4: Insulin Resistance and Glucose Intolerance

Insulin resistance leads to decreased glucose tolerance. When sugar can't enter cells, some is converted to triglycerides, thickening the blood. Excess sugar damages tissues like blood vessels, kidneys, eyes, and the heart through glycation. Insulin resistance also increases the production of harmful advanced glycation end products (AGEs).

#5: Pro-Inflammatory and Pro-Thrombotic States

Excess insulin promotes inflammation and raises the risk of blood clots. It thickens the blood, creating a pro-thrombotic state, and makes platelets sticky, increasing the likelihood of thrombosis.

The Two Most Important Lab Values for Assessing Cardiovascular Risk

#1: Triglycerides

Fasting triglycerides indicates fat in the blood, and it's primarily influenced by sugar, high-glycemic foods, and alcohol intake. 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 measures a three-month average of blood sugar levels, with optimal values between 4.8% and 5.2%. High A1C levels indicate tissue damage due to insulin resistance, where insulin fails to maintain normal blood sugar levels. Reducing A1C levels doesn't reverse existing tissue damage.

Managing blood sugar instability involves re-sensitizing insulin receptors. Activities engaging the hips, butt, and upper legs, which have the most insulin receptors, can lower insulin requirements, blood sugar, and hemoglobin A1C levels.

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

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

#2: 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.

#3:Lipid panel (Cholesterol, HDL, LDL, Triglycerides)

• Trigs: 60-70 mg/dL
• Chol: around 200 mg/dL
• HDL: 40 or greater mg/dL
• LDL: <100 mg/dL

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

*8-12 hours is fasting

Reasons For an Over-Release of Insulin

Maintaining normal blood sugar levels requires proper insulin release. However, many people over-release insulin due to these primary factors:

1. Consuming Quick-Acting Carbohydrates: The leading cause.
2. Toxic Metals, Especially Mercury: Disrupts insulin regulation.
3. Over-Response to Stress: Triggers excessive insulin release.
4. Chronic Inflammation: Generates stress, increasing insulin output.

Higher insulin levels can lower testosterone and increase estrogen. Elevated estradiol (above 40) further reduces testosterone, which is crucial for a healthy ejection fraction—the amount of oxygenated blood the left ventricle can push out with a single squeeze.

Berberine and Blood Sugar Support

Berberine is an effective herb used to support blood sugar levels in normal ranges. Here are a few of berberine's key health benefits. Read here for more.

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

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 health.

Formation of Advanced Glycation End-Products (AGEs)

When blood sugar levels rise, even moderately, the sugar molecules start to get sticky because of the warmer body temp and oxygen in the blood. This process is very similar to sautéing onions, where they stick together and brown. This is what happens in your bloodstream too. Those AGEs attach to proteins in vital organs like the eyes, kidneys, and heart, causing damage.

Insulin resistance makes inflammation worse, contributing to AGE formation. 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 for comprehensive health assessment.

How to Maintain Healthy Blood Sugar and Insulin Levels

The first step in achieving balanced blood sugar and insulin levels is to prevent the over-release of insulin, typically triggered by rapid increases in blood sugar. To accomplish this:

#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. Upon waking, you’re going to either gain or lose control of your metabolism as soon as you open your eyes – this includes blood sugar levels. Kickstart your metabolism and stabilize blood sugar by immediately taking a tablespoon of fish oil or cod liver oil upon waking up. This practice ensures a gradual rise in blood sugar, promoting metabolic steadiness throughout the day.

The oil forces the sugar level in your blood to rise slowly. This trains your metabolism to be more steady, stable, and balanced. If you don't eat fat, the liver starts releasing sugar, and you don’t want to start the day with a blood sugar spike. 

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: Embrace Strength Training

Incorporate weight training that targets major lower body muscles like the hips, thighs, and glutes. These muscles contain the highest concentration of insulin receptors in the body. Any exercise or regimen that engages these large muscle groups effectively promotes insulin and sugar balance. Using heavier weights engage more muscle fibers, maximizing the benefits of your strength training routine.

Protect that precious heart 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