Blood Glucose Spike and its Prevention

This article is based on an NHK Japan YouTube video about glucose spikes.

A glucose spike or post-prandial hyperglycemia (PPG) is the rise of blood sugar to more than 140 mg/dL after a meal. It can happen after every meal.

Many may unknowingly have glucose spikes, including those with normal fasting blood sugar and slender.

In the video, much to their surprise, a 27-year-old man had a blood sugar of 233, and many Japanese girls in their twenties have glucose spikes.

The Hisayama study showed that glucose spikes are present in 25% of those who are more than 40-year-old age groups.

In a study of 8000 4th-year elementary school students, 14.5% of boys and 13.6% of girls have elevated blood glucose levels (HbA1c).

One reason that glucose spikes happen is that the pancreas does not secrete enough insulin. Insulin is the hormone responsible for making blood glucose or sugar enter the skeletal muscles and the liver.

Another reason is insulin resistance of the skeletal muscles and the liver cells. Muscles use glucose as an energy source. If someone has a low muscle mass or a sedentary lifestyle, their blood sugar tends to build up.

If the blood sugar gets high, the body compensates by producing more insulin, creating a condition called hyperinsulinemia. High insulin levels affect other organs and contribute to disease formation. One of them is dementia which will be described below.

Glucose spike complications

Having a glucose spike does not mean that you have type 2 diabetes. However, the complications of type 2 diabetes, like atherosclerosis, heart attacks, strokes, dementia, and cancer, can also be seen in people with glucose spikes.

Atherosclerosis

High reactive oxygen species (ROS) production is associated with high blood sugar. ROS damages the blood vessels. As the immune system tries to fix the damage, it initiates atherosclerosis and hardens the arteries.

The repeated insult to the blood vessels as glucose spikes recur eventually leads to myocardial infarctions and cerebrovascular accidents. The risk of these conditions is 1.9 times more in people with glucose spikes.

Dementia

People with glucose spikes have 1.6 times more likely to have a cognitive impairment, similar to Alzheimer’s disease. That is due to the build-up of Beta-amyloid protein.

Beta-amyloid is readily broken down in the brain by enzymes. However, if high insulin levels are present, the enzymes will break down the insulin, not the beta-amyloid, leading to its accumulation. Beta-amyloid then accumulates and leads to dementia.

Cancer

The reactive oxygen species can also damage DNA and cause cancer.

Screening for Glucose Spike

Answer the following. The higher the score, the greater the likelihood of a glucose spike.

Gender: Men 4 points, Female: 0
Age
- 44 and under: 0 points
- 45-54: 4 points
- 55-64: 3 points
- 65 and over: 0 points
Are your parents or siblings diabetic?
- Yes: 7 points
- No: 0 points
Are you obese? (waistline) Measure around the belly button. Male: over 90 cm (35.4 in) Female: over 80 cm (31.5 in).
- Yes: 3 points
- No: 0 points
What is your Body Mass Index? Calculate your BMI here.
- 22.9 and under: 0 points
- 23-25.9: 3 points
- 26 and over” 7 points
Do you have high blood pressure?
- Yes: 7 points
- No: 0 points
Do you smoke?
- Ten or more cigarettes /day: 5 points
- Fewer than ten cigarettes/day: 2 points
- No: 0 points
Do you exercise more than three times a week?
- Yes: Subtract five points
- No: 0 points

Risks of glucose spikes

9 points or less: Low
10-19: Middle (consider lifestyle change)
20 points and above: High Risk (have your blood sugar checked in a laboratory)

Lack of Sleep

Melatonin is produced while sleeping. It also makes the pancreas produce insulin and helps the skeletal muscles to absorb glucose.

Lack of sleep decreases melatonin secretion, decreases insulin secretion, and elevates blood sugar. Stress hormones like cortisol and epinephrine also increase when a sleep deficit occurs. Both increase blood sugar levels too.

How to Avoid Glucose Spike

Eat vegetables first during a meal. The dietary fibers coat the lining of the stomach and intestines and delay the absorption of sugar to prevent a rapid rise in blood glucose.

Research from Thailand showed that glucose adheres to the dietary fibers of salad vegetables and inhibits the enzymes (amylase and alpha-glucosidase) that digest carbohydrates. [1]

This reduces the absorption of glucose in the stomach. As food goes to the intestines, digestive enzymes in them can also digest carbohydrates. The result is the elimination of a glucose spike. [1]

Dietary fiber also has a high cholesterol-binding capacity and reduces dietary cholesterol digestion. [1]

In one study, it takes 30 minutes for half the rice to reach the intestines when it is eaten first. If another food is eaten, it takes 80 minutes for the rice to reach the intestines.

Eat meat before the carbs. Meat contains proteins and fat that stimulate incretin release from the intestines.

Incretin slows down the movement of the intestines and the absorption of carbohydrates. Incretin also increases insulin production from the pancreas and lowers blood sugar.

The rise in insulin is also seen in those with a “weak” pancreas that cannot produce enough insulin. Fasting and Exercise for Fatty Pancreas

Walk after a meal. Mild physical activity after a meal redistributes blood away from the gastrointestinal tract and slows the movement of the stomach and intestines.

This results in a decreased rate of food absorption and prevents increased blood sugar.

It would be a challenge to walk if the stomach is 100% full. Eating about 80% is observed by the people in Okinawa, which holds the record for the most centenarians.

A segment of the video talks about glucose spikes occurring if breakfast or lunch is missed, as in intermittent fasting. However, it could be that the meals may have a lot of carbohydrates or the carbs were taken at the beginning of the meal.

For those who want to do intermittent fasting, eating vegetables, meat, or fish then, carbohydrates can prevent glucose spikes.

Take Away Message

Glucose spikes are common and lead to several preventable illnesses. Cardiovascular diseases like strokes and heart attacks, dementia, and cancer are among the top ten causes of death in the entire world.

To prevent a glucose spike, eat vegetables first, then meat or fish, and carbohydrates last. Walk for a few minutes after a meal.

Don’t Get Sick!

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Reference:

NHK World Glucose Spike
Powthong P, Jantrapanukorn B, Suntornthiticharoen P, Luprasong C. An In Vitro Study on the Effects of Selected Natural Dietary Fiber from Salad Vegetables for Lowering Intestinal Glucose and Lipid Absorption. Recent Pat Food Nutr Agric. 2021;12(2):123-133. doi: 10.2174/2212798412666210311163258. PMID: 33719980.

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