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Why continuously monitor our glucose?
Carlee Hayes: NutriSense
BY PETER BOWES | LOS ANGELES | OCTOBER 5, 2021 | 0700 PT
Real-time information about how our bodies respond to food and exercise is transforming preventative healthcare. Wearable technology provides immediate feedback during a workout and can collate and interpret complex data based on our food choices. One of the deepest dives into the inner workings of our metabolism is achieved through continuous glucose monitoring (CGM). Carlee Hayes is the lead dietician at NutriSense, a metabolic health company that uses the latest technology to help its clients optimize their wellbeing through a better understanding of their bodies. In this LLAMA podcast interview, Carlee explains the science behind continuous glucose monitoring and why it provides a valuable insight into our state of health.
Recorded: Sept 14, 2021 | Read a transcript
Analyze in real-time how your blood glucose levels respond to food, exercise, stress, and sleep. Nutri| Sense is offering LLAMA podcast listeners $25 off your first month of subscription. Use code LLAMA at checkout. Affiliation disclosure: This podcast receives a small commission on your purchases from Nutri| Sense. It helps to cover production costs and ensures that our interviews remain free for all to listen.
“One thing that I want people to take from this is your health is in your hands, so don’t wait for someone else to diagnose you or to identify an issue.”Carlee Hayes
- This episode is brought to you in association with Clinique La Prairie, the award-winning spa-clinic – and pioneering health and wellness destination – nestled on the shores of Lake Geneva in Montreux, Switzerland. Combining preventative medicine with bespoke lifestyle and nutrition plans, Clinique La Prairie offers a holistic approach to living fuller, healthier and longer lives.
TRANSCRIPT AND CHAPTERS
Transcribed using AI. Please check against audio recording for absolute accuracy.
- How Nutrisense started
- Developing proactive healthcare
- Why is too much sugar bad for us
- Why continuous monitoring?
- Focusing on personal healthcare
- How does continuous monitoring work?
- Getting a prescription for a CGM
- Too much data?
- What does big data tell us?
- Sleep, circadian rhythms and glucose
- Carlee’s personal experience with CGM
- Understanding the impact of exercise
- Longevity aspirations
Peter Bowes: [00:00:20] Hello again, and welcome to the Live Long and Master Aging podcast. We use the acronym LLAMA. My name is Peter Bowes. This is where explore and stories behind human longevity.
SPONSOR MESSAGE: [00:00:31] This episode is brought to you in association with Clinique La Prairie. The award winning spa clinic and pioneering health and wellness destination nestled on the shores of Lake Geneva in Montreux, Switzerland. Combining preventative medicine with bespoke lifestyle and nutrition plans, Clinique La Prairie offers a holistic approach to living fuller, healthier and longer lives.
Peter Bowes: [00:00:55] Now, I think it’s fair enough to say that we have reached a stage in our understanding of healthy lifestyles where we no longer need to question whether smoking is bad for us. Of course it is. What about a diet rich in processed foods, excessive salt and huge helpings of sugar? I think we know what we need to avoid, but avoid is a vague word when it comes to sugar, and I think we’re all still in need of some help to fully understand its impact on our bodies and how to manage our diet for optimum health. My guest is Carlee Hayes. Carlee is a registered dietitian and nutritionist and the lead dietitian at NutriSense, a metabolic health company that uses continuous glucose monitoring technology to help its clients to monitor their bodies through real time data. Carlee, welcome to the Live Long and Master Aging podcast.
Carlee Hayes: [00:01:44] Thank you so much for having me, Peter. I’m excited to be here.
Peter Bowes: [00:01:47] Yes, me too. It’s good to talk to you before we delve into the data and glucose. Tell me a little bit about Nutrisense, you were one of the original founders, weren’t you?
How Nutrisense started
Carlee Hayes: [00:01:56] Yeah. So I was actually the first dietitian that was brought on the team, so we started at a very with a very, very small team. And when we started taking members and just kind of helping them assess their glucose data, that was September of 2019. I was the first dietitian that was brought on. So I really seen this company grow up from the very bottom, and it’s been a very, very exciting ride. So just a little bit about NutriSense. Like you mentioned, we are a metabolic health company, so we are using really, really cool advanced technologies to help people achieve their healthiest self, right? And one of the ways that we’re doing that is through CGMs or continuous glucose monitors. So I’m sure your audience is pretty familiar with these. But what they are is a little medical device that you insert into your arm and it’s tracking your glucose. twenty-four/seven. So with that data, you’re able to make complex analyzes about what you’re seeing in your metabolism and then use that information to improve your metabolic health. And so as a dietitian on the team, my role is to kind of be that bridge between that, you know, really, really comprehensive, sometimes confusing data and the actionable changes that people can make to be healthier, live longer, age better. So I think that’s been really, really exciting because I get to see that that connection click with people and and really make those changes. The cool thing with CGMs, as you probably can imagine, is that’s that real time data. So not only are you monitoring something that’s really important, but you’re able to see that in real time on your phone. So I think with a lot of health behaviors and a lot of things that we’re trying to achieve, there can be a disconnect from our daily decisions and our choices, which when it comes to food, we we make an average of two hundred plus decisions around food every single day, but we don’t see the impact of those decisions for weeks, months, maybe even years down the road. So there seems to be this lack of really sticky motivational change because of that disconnect. And when you can scan this little CGM in your in your arm and see your data on your phone and say, Oh, this was a good decision for my body or Oh wow, this wasn’t the best decision for my body. Those changes are able to stick and they’re able to be sustainable, and people can use those to improve their health, which is really exciting.
Peter Bowes: [00:04:29] Yeah, it is. It really goes to the heart of what we talk about every week on this podcast, especially when you refer to living long and living well. I’m curious what led you to this? What fueled your interest? You’re a registered dietitian, aren’t you? Tell me a little bit about your background.
Developing proactive healthcare
Carlee Hayes: [00:04:45] Yeah, yeah. So it’s it’s actually interesting. I started in a very, very traditional setting, so different from what I’m doing now, you know, and I always loved food and I loved science. So being a dietitian helped me combine both of those two passions and use those to fill this intrinsic need that I have to help others. So, you know, I started out just in a traditional outpatient counseling sessions. So what would happen is I’d work with doctors and they would, you know, maybe do their annual lab, work with their clients, their patients. And then something was high. If they were diagnosed with diabetes, prediabetes, hypertension, heart disease, then they would make the referral to the dietitian to manage that condition with nutrition, right? And so I loved my job. I loved being able to work with people and kind of help them manage their conditions. But I really got to thinking is, you know, why am I the last referral? Why is nutrition the last piece of the puzzle? And we know that 80 percent of chronic lifestyle related conditions, like the ones that I mentioned, can be prevented or at least delayed with early lifestyle interventions. So when we’re waiting in. All that diagnosis is actually happening, and that disease state is in full effect. We’re kind of missing the mark and we’re we’re doing ourselves a disservice. So I started to to really dig into how I as a professional could help these people in a more meaningful, more proactive way. And that’s when I kind of dove into the research on metabolic health and how that’s so important. What I started to find when I got into the research is at the heart of every single one of those lifestyle conditions is metabolic health, and a big piece of that is glucose, right? And so if we think about, you know, what is metabolic health, I think that’s important to define first and foremost. There’s a study that gets thrown around all the time that 88 eight percent of Americans are not metabolically healthy, right? Which is staggering. But what does that actually mean? What is our metabolism actually do? And so when we think of a healthy metabolism, we think of a couple of different metrics. We think of a normal body weight, normal good control of our glucose, normal cholesterol, normal blood pressure, and then of course, our our waist circumference as well. So we’re doing a good job of monitoring those things, you know, at our doctor’s office. But what we’ve started to see is one finger prick once a year to see your fasting glucose value is just not cutting it right. We’re missing some of those early yellow warnings for signs that something might be going awry. So when it comes to metabolic health and kind of optimizing that glucose is one of the lowest hanging fruits that we can pull out and really make the biggest difference in our metabolic health in general. So that’s kind of what led me here.
Peter Bowes: [00:07:37] Let’s go back to and I think this would be very useful for people. Let’s go back to basics and talk about why too much glucose at any one moment and therefore extrapolating too much sugar in our diets. Why that is bad for us?
Why is too much sugar bad for us
Carlee Hayes: [00:07:51] Yeah, it’s a great question. And I think it’s important to really understand that before going into any of the nuances because this stuff can be really complex. But when it comes to glucose, the way that I like to think of it, as you know, glucose is a window into our metabolism and what our metabolism is doing, just simply put is how are we responding to the different factors in our diet? How are we able to utilize energy coming in and kind of utilize that to fuel our body? Is that process going well? Is there a hang up? Are we efficient at metabolizing those substrates? So when we think of glucose, we need a certain level of glucose in our body at all times, right? There’s our body’s fueled by glucose. That’s our primary source of energy. There’s organs like the brain that really need glucose to function well, and glucose is a part of our natural homeostatic process. So our body is working round the clock twenty four seven to keep glucose in that really tightly controlled range, and that’s part of homeostasis. So when glucose goes a little bit too high or a little bit too low, our body has to go into overdrive to get that back down, to get it back up, whatever it might be. And so monitoring glucose and kind of monitoring that substrate can tell us, is there some sort of issue in that process and what are the things that are driving it up a little bit too high? And so, of course, a little bit of an increase in glucose is normal. That’s healthy. That’s what we want to see. And so when we’re monitoring glucose, I always tell people we like to see kind of rolling hills and glucose. A normal process would be you eat something, your glucose increases a little bit. The pancreas responds by releasing insulin to bring glucose back down. And then you’re kind of at this, this steady range. But when things are driving that glucose up too high or it’s staying there for too long, that can be a sign that we can make a change to get it back into that range. So when it comes to an optimal glucose response, we’re not just looking at the peak, right, we’re looking at how far that’s spiking up. So the amount of shift in glucose and then how quickly it’s coming back down. So that gradual curve versus that huge spike, that’s what we’re looking for. So when glucose is increasing and going to that higher value, that can be a sign of ‘we need to make a change’ and when we think about our normal food environment that we’re all currently living in that can be really challenging. You know, we are not we’re not made to process the types of foods that are currently in our food system today.
Peter Bowes: [00:10:31] That’s fascinating. And of course, these are immensely complicated issues and in some cases, very individualistic. There are some people who might see that spike in their glucose and then the curve goes down, but it doesn’t go back to a normal level. Actually, it slumps dramatically after a major meal. Now that’s not everyone, but for some people, they’re facing very difficult issues.
Why continuous monitoring?
Carlee Hayes: [00:10:54] Oh, definitely. And so we can tell a lot by monitoring this and when we think about traditional glucose monitoring. I mean, I think everyone probably knows someone that’s maybe diabetic or pre-diabetic that does the finger prick device right. They prick their finger in the morning or maybe before they eat or after they eat just to see where they’re at. But that’s just giving you a snapshot in time. That’s kind of telling you what your glucose is at this one moment. So when we think about those meal responses or those postprandial curves as we call them, we’re missing all of that data. And what’s interesting is that there’s really no governing body that’s assessing and monitoring those, the shape of our glucose curves, right? So I think we can tell a lot about our diets, about our lifestyle. So exercise, stress, sleep from monitoring that continuously. And I always use the analogy, you know, if you were buying a home, would you pull it through with that purchase if you saw one picture or one snapshot into what that home looked like? Probably not, right? You need to know more about the foundation. You need to know what’s going on, what’s inside, and that’s what that CGM or that continuous data is going to tell you.If you wanted to assess your response to a meal just using a finger prick device, you would have to check it probably every 15 minutes for three hours. And that’s a lot. That’s not fun. No one wants to prick their finger that much. So that’s where wearing these wearables can be so helpful at seeing the full picture and seeing what changes do you actually need to make to your diet to improve your response? And you made a really good point about the individuality in our glucose responses as well. The way that you respond to a food may be completely different than the way that I respond to a food, right? There’s no one size fits all diet, and there’s a lot of genetic, environmental or microbiome factors that are going to influence the way that we respond to specific foods. And if you’re not testing, you’re not going to know that so many of us follow x diet because this influencer said so or because it worked well for my mom or whatever it is. But the truth is, if you’re not testing and experimenting with your own body, you’re never going to know how to make it run optimally.
Focusing on personal healthcare
Peter Bowes: [00:13:09] I think the analogy that you make with buying a new home is a really good one. A recent guest on the podcast made a similar analogy with people and the amount of research they put into buying their next car, compared with the research they put into their own health, especially looking forward and planning health regimes for the future. Often a huge discrepancy between the amount of attention that we pay to ourselves, as opposed to some of the hardware around us.
Carlee Hayes: [00:13:38] Oh, one hundred percent. You know, I think we all think to some extent that we’re invincible, right? That, Oh, well, you know, I’m young. I don’t need to worry about glucose because my annual lab is fine and I’m doing my due diligence by checking that once a year and following up with my doctor once a year. And I do think that’s great. I don’t want to discourage anyone from doing that, but from seeing thousands of individuals’ glucose data. What I can tell you is we don’t want to wait for an issue to occur before we track it, before we monitor it and before we really take control of what’s going on in our bodies. So by monitoring glucose and you don’t have to do this forever, I always tell people, you know, track it for a month and see how your current lifestyle behaviors affect your glucose. And that’s going to give you data driven strategies to improve your health for an eternity. So I think it’s really important, and I think one thing that I want people to take from this is your health is in your hands, so don’t wait for someone else to diagnose you or to identify an issue. It’s in your hands, and it’s our responsibility to identify things that we can make proactive changes for.
How does continuous monitoring work?
Peter Bowes: [00:14:45] So let’s talk through the practicality of using your device. And as you’ve referred to, glucose monitoring, per say, has been around for a while, from the finger prick to other forms of devices that will give you a moment in time readout. But as you say, this is continuous glucose monitoring, so just talk me through the practicality of using it and what it entails.
Carlee Hayes: [00:15:07] Yeah, definitely. So, yeah, CGM is traditionally a medically prescribed device for individuals with type one diabetes or poorly controlled type two diabetes. So, yes. You still do need to get a prescription from your doctor to use one. I think that’s the big hangup. You know, a lot of these wearables are only for specific conditions, but what we’re finding is that they can be really helpful for preventative health and for being preventative focus versus reaction focused, right? So how it works, it’s kind of like a little it looks like a quarter. It’s about three quarters stacked together in size and you insert it’s into your arm and there’s no needle that stays in your arm. I know that’s always a concern, but you insert it once so versus pricking your finger a couple of times a day. One insertion it sticks to your skin, and it measures the glucose in your interstitial fluid. So the fluid around your cells and what happens is we have an app on our phone that you can scan that device and your glucose will show up in five to 15 minute increments on our app, on your phone. So when I say real time, I mean real time, you know, you scan this and you see what your glucose is right now. So say I eat a meal, right? We expect glucose to increase to that meal, and that’s completely normal. But we can actually monitor it throughout that glucose curve and see how quickly is it increasing and how quickly does that come down, which is really cool. So with our app, we allow the ability to track all those other factors as well. So you log your meal, you log your ingredients, you can log any exercise, any stress or any other factors that might influence glucose. And then you’re able to see how all of those things kind of culminate into the glucose responses that you’re getting so real time data on your phone and you’re able to see everything all in one place, which I think is just convenient. You know, we’re in this society where we need really, really quick results. We need things right away. You know, you go, you need an answer to something. You go to Google, you don’t wait for anything anymore. And I think that’s where technology is taking us and that’s the future of health care. So with that CGM, you’re able to see how your body is responding to all the things that you’re doing for 14 days and then after that 14 days, you pull that off, dispose of it in a regular trash can and you can apply a new one. Or if you are just experimenting, you might not need more than two sensors just to kind of get that baseline. So
Peter Bowes: [00:17:35] And I think listeners to this podcast are probably quite familiar with the kind of device that you’re talking about. For those that are not, is it cumbersome? Does it restrict your daily activity? Can you swim with this device, for example?
Carlee Hayes: [00:17:48] Great questions. And yes, you can do all the things. In fact, I often forget that it’s there, and I’ve accidentally bumped it off because I just forgot that I was wearing it. It feels like nothing. It’s really lightweight. It sticks to your skin. Ninety percent of people that put one on don’t find any pain at all. So one thing that is always scary is the insertion, right? You insert this with a needle into your skin that can be really intimidating, but once it’s in, you kind of forget that it’s there and we do provide or you can purchase adhesive bandages that go over the top. And with that bandage, you’re pretty much good to go. You can exercise, you know, I’ve done kickboxing, I’ve done CrossFit with mine on. And then you can swim up to 30 minutes and up to three feet of water. So it’s not waterproof, but it’s water resistant. And with that bandage, it makes, it lasts a little longer. We have had, you know, Olympic athletes swim for two hours with their CGMs and had no problems at all. So that can be really cool because your body is going to respond to exercise and that can help you determine how am I going to fuel for this exercise? Am I fueling enough? Is my body tolerating this exercise well, and that’s all data and information that that CGM can give you again in real time on your phone. So it’s with you for the long haul and it can kind of just go along with you and your normal life.
Getting a prescription for a CGM
Peter Bowes: [00:19:09] And you say you need a prescription from your doctor. How close are we to anyone being able to use this device? Because I see a potential issue here clearly to go to your doctor and get a prescription. There has to be an issue. So you probably need it because you have health problems. And surely the goal must be to use a device like this to prevent those health problems occurring in the first place. But if we can’t get one because we haven’t got a prescription, because we haven’t got a problem, is it kind of a vicious circle there isn’t there.
Carlee Hayes: [00:19:39] One hundred percent, and that’s definitely the barrier that we’ve come across and why we have our own team of physicians on staff that review, you know, everyone that signs up for the program has to fill out a health questionnaire. And then once approved, you know, you get that prescription and we’re able to send you that CGM without you having to go through all those hurdles. I do think that we are working towards a future where maybe these things will be available without a prescription or it won’t be so tedious to get that prescription. But we’re just not there yet. And I think the more data that we have that this is actually helpful for prevention, the more we’re going to be able to kind of sell that case. And so, you know, I’ve seen this in my own data. I’ve seen this in thousands of our members data. This is a powerful tool, and I think the more that information gets out there and we can see if someone has a CGM, even for this short amount of time, we’re able to see X, Y and Z improvements in their longevity. Then we’re able to kind of have that be accessible for more people early on.
Peter Bowes: [00:20:37] I’m just curious to know what the barrier is. The reason for this delay, because it seems as a preventative measure, it seems to make so much sense for those who are inclined to have a and to use a device like this. Just perhaps curious, perhaps they’re aware that their diet isn’t optimum and there could be issues, but they’re not feeling any sort of outward symptoms that a doctor could recognize. But looking ahead, it could save their lives.
Carlee Hayes: [00:21:03] Yeah, and I think that’s I know a barrier that we get in a lot of different areas of medicine right now, where again, we’re reactive, we’re not proactive. So you could go to your doctor and tell them, hey, I really, you know, I listen to this podcast and I heard that glucose was really important and they would probably test your fasting glucose and they would test your hemoglobin A1C, which is a measure of your average glucose over the course of about three months. And don’t get me wrong, those are important metrics. Those are great to test and everyone should be getting those regularly, but they have their barriers and they fall a little bit short. So fasting glucose, if you go to your doctor and tell them that you want to measure your fasting glucose, they’re going to look for less than one hundred as a good measurement. But we know from really diving into the research that optimal values are between 70 to 90 while you’re fasting for at least eight hours. So it’s typically first thing in the morning. And again, you could go to your doctor and have a fasting glucose of ninety four and they might not say anything. You’re good, you don’t have diabetes, you don’t have prediabetes, you’re good to go. But again, we know from diving into the research that elevated fasting glucose can be an early sign of an increased cardiovascular risk. So by keeping it into those optimal values and again identifying that little yellow flag, saying, Hey, I’m four points higher, like what’s going on here? We can make that early change and kind of assess it before a real problem arises. But again, so could be missed by certain medical standards.
Too much data?
Peter Bowes: [00:22:37] Is there a danger that for some people, it could be too much data that could be misinterpreted by the individual and actually cause them to panic and to worry unnecessarily about a moment in time reading that maybe doesn’t look good? But bigger picture is probably OK.
Carlee Hayes: [00:22:55] Oh, definitely. Yeah. And I think we see that sometimes with CGMs as well. You know, having so much data at your fingertips can be really helpful, but for some people, this can be really scary. And that’s where I think having the dietician there to kind of guide you and say, OK, this is the factors that can influence this. Maybe these are the things we need to work on. Let’s experiment with this. That can really help. But yeah, if you go to your doctor, you could have had a lot of stress. You could be coming down with an illness. You could have had a really late night dinner. All of those things can influence your fasting glucose specifically, and then you might feel like things are awry when really, it’s just one small factor that maybe you weren’t taking into account. And again, that’s cool with the CGM, where you can log all those factors, you can see trends over time, which we know are the most important things, right? So one thing with the CGM that you can monitor and this is special and kind of unique for CGMs in particular, is your glycemic variability. And this is just a big fancy word for how much is your glucose fluctuating throughout the day? Again, we want those small like rolling hills of glucose. We don’t want these jagged peaks. And so if you have these jagged peaks and you’re spiking and you’re going really, really high and then your body is responding again by releasing that insulin, sometimes it can release a little bit too much. Just kind of as an overcompensation for that high glucose value and glucose can plummet down, right? So you’re having extreme highs, extreme lows, and that can cause high glycemic variability. And we know that that is one of the biggest risk factors for cardiovascular disease, microvascular damage. You know, all this inflammation can come from those high variability in glucose. So again, you could not you probably could if you monitored if you checked your your fast or your finger prick device every 15 minutes for twenty four hours, you could probably see a little bit of that. But again, that’s not sustainable for anyone. So by seeing, you know, glycemic variability in those big overarching trends, we’re able to to kind of put those pieces together with the CGM.
Peter Bowes: [00:25:00] Are we moving towards a time when devices like this will be virtually invisible, that they will be little nanoparticles subcutaneously hidden under our skin that we don’t need to remove and replace every couple of weeks? And that it’s something that we could potentially just live with and benefit from.
Carlee Hayes: [00:25:18] I think so. You know, if you look at earlier CGM models, they lasted for much shorter than 14 days, right? So we’re continuously increasing the duration, we’re able to use these devices. We know they’re a one time use, so you can’t reuse them. So you know, you do have to replace them every two weeks. But I imagine that time frame getting longer. The device is getting smaller, more compact, more comfortable as time goes on. So I definitely think that’s somewhere where we’re moving and it’s really exciting to be a part of that.
Peter Bowes: [00:25:49] I’m curious in terms of your research, having presumably analyzed data from from many, many users and the potential lessons that you could have learned from that information about how we live our lives, if you could, I suppose bullet point the main issues that arise over and over again from looking at information gathered from a large number of people.
What does big data tell us?
Carlee Hayes: [00:26:11] Yeah, I could probably talk your ear off all day about this because I never stop learning and I see this all the time. But the big takeaways that I think people should know about and that I’ve learned, first of all, is that it’s not uncommon to have high glucose. So, you know, there’s been studies that show up to ninety six percent of healthy, normal metabolism individuals have spikes above that normal range. And so we’re not concerned with the occasional spike outside of threshold. That’s not a make or break thing, but it’s when it’s happening over and over again that we can have a lot of those issues that we talked about, right? So it doesn’t go from you have one high glucose spike and now you have diabetes. It’s when this exposure is repeated over and over again that can cause oxidative damage,inflammation. Ultimately, your body’s going to be producing and releasing more insulin to deal with that. And that can ultimately result in insulin resistance and that can later go into all the disease states that we’ve talked about. So it’s this really complex and kind of slow process that cascades down. And so I think the big thing that I want people to know is that again, you have power in your hands and you can do a couple short little small hacks even without using the CGM to improve your glycemic response. And the first thing I think probably the biggest takeaway that I had is that the timing of your meals matters and this is something, you know, we talked about how everyone has unique responses to foods. That’s one hundred percent true. But this is something I see universal kind of across the board is that our glucose responses are typically higher in the evening hours. So we have insulin sensitivity that’s closely aligned with our circadian rhythm. Circadian rhythm is better in the middle of the day with a sun lowest in the middle of the night as we should be sleeping, right? So insulin sensitivity is no different. We are going to have better insulin sensitivity when we eat during the day hours versus the nighttime hours. And we see this a lot with shift workers or with people that, you know, maybe have really, really late dinners. You know, you’re going to have higher responses to foods that you might respond really well to if you actually just time them earlier in the day. So good rule of thumb is to try and end your eating window about three hours or more before you actually lay down and go to bed for the evening. That’s just going to improve your response. The other thing you can do just kind of a quick hack if you can, if you don’t have any control over when you’re eating is to make that last meal or any late meal of the day just lowering carbohydrates, right? So when we think about glucose increasing the food that is going to cause that to increase the most is carbohydrates. So if you can make that last meal lower in carbohydrate or at least just very, very low glycemic carbohydrates, you can sometimes mitigate that response as well. So I think that’s a huge, huge takeaway and something that’s really stuck with me and with a lot of my clients as we’ve kind of navigated their glucose.
Sleep, circadian rhythms and glucose
Peter Bowes: [00:29:17] So by mentioning the circadian rhythm, which is something that really does fascinate me, I think it’s generally little understood the importance of circadian rhythm and how we live our lives, according to daytime sunshine, bedtime eating patterns, all of those crucial issues, and especially as it applies to how we sleep, which is something I know that upsets and disturbs many, many people when they can’t get seven or eight good hours. And it really comes to the heart of what you’re talking about. And I think, again, little understood, but the impact of eating late and especially, as you say, a high carbohydrate meal just before you go to bed can have a hugely significant impact on the kind of restful or unrestful nights that we have.
Carlee Hayes: [00:30:01] One hundred percent. This is something we see all the time. So, you know, when we think of glucose, the first thing we’re going to, you know, try and address is nutrition, and that’s definitely the biggest piece of the puzzle. But sleep is also one of the main pillars of glucose control, so it kind of goes both ways. Bad sleep can cause high glucose, but high glucose can cause poor sleep as well. So it’s this bidirectional relationship that we just can’t ignore and we can’t ignore when you see it in that data. So even by, you know, being cognizant of your sleep and aiming for at least seven hours good quality sleep that can cause you to have lower values in the morning, better responses to your meals. So there’s been a lot of studies that show that even one night of poor sleep or fragmented sleep so, you’re up in the middle of the night, you go back to sleep that can cause up to 40 percent higher glucose responses to the same meals the next day. And that’s because, you know, sleep and poor sleep is perceived as a chronic stressor. And so when we have that stress, our body puts out more glucose and it takes less glucose in. So simply put, you know, sleep is one of the biggest factors in improving your metabolic health. I know there’s a lot of attention on this, and I think Matthew Walker has really done a great job of bringing this to the forefront and bringing this to everyone’s attention because it’s something that we often just toss aside, you know, everyone says I’ll sleep when I’m dead. But when you actually see how no sleep or poor sleep affects your glucose, you’re more likely to make time for that. You’re more likely to really put that first and to realize that it has a big impact on your metabolic health.
Peter Bowes: [00:31:50] And Matthew Walker, Professor Matthew Walker, being the British sleep expert who’s written a wonderful book about this and the importance of sleep, and he really does an extremely deep dove and fascinating research. I’m interested from your perspective, you wear one of these devices you have worn, and I assume that’s because you’re the founder of the company, not because the doctor has prescribed one for you to use. But I’m interested in what is taught you about your daily lifestyle. Maybe some changes that you might have made and perhaps discovered things that you didn’t realize about yourself.
Carlee’s personal experience with CGM
Carlee Hayes: [00:32:25] Yeah, there’s again, could I talk to you forever about this? I never stop learning. You know, I think when you start wearing a CGM, it’s largely insight based. You’re learning really, really rapidly. You’re learning new things every single day. And that usually happens. I mean, for me, that was a couple of months of that. And then it swaps, right? It turned into, OK, I know the things that I need to do. This is just keeping me accountable. So really, the CGM is great for, OK, I’m going to learn what my body does best with, but also I’m going to continue those habits. So I’m going to make those sustainable. I’m going to make those a part of my normal routine. And when I was learning and I was mostly in that insight phase, I think aside from the circadian rhythm eating late, I was terrible at this. I ate, you know, I was busy all day long and then I would eat right before I went to bed. And what I saw was I had higher glucose values overnight, I had poor sleep because my nervous system was kind of on alert. And that really impacted my sleep quality. But also, I had, you know, higher values even into the morning. So that was one thing that I really made a huge change on is, OK, eat earlier. And then the second thing that I applied to this was walks after meals, and it can sound so silly. And it sounds just like not what you would think would be one of the biggest strategies to improve your glucose. But it really, really is. So, you know, that muscle is our longevity organ, right? Muscle is also a big sink for our glucose, right? So every time we eat, you know, we talked about how insulin is going to cause that glucose to leave the blood and go into the cells and primarily muscle is going to suck up that glucose. So the more muscle mass we have, the more insulin sensitive we can be in those muscles and really soak up that glucose and promote that glucose turnover. So a really, really easy way to do this. Even a five to 10 minute walk after you eat can help your body utilize that glucose from the food that you’re eating and then burn through that glucose storage in the muscle, making room for it to go. So again, that glucose turnover, that’s been the hugest thing for me because as you probably know with working, especially working at home, we can get stuck into sitting at our computers. And we think that as long as we’re getting our one hour workout of the day, we’re good to go. But really, when you monitor your glucose, you see the impact of continuous movement periodically throughout the day. So I make it a point to, OK, every hour I’m going to get up, I’m going to move around. I’m going to help my body utilize that glucose so that I have room for the meals that I’m going to eat. And I think that’s been huge. We also know that strength training is really beneficial, especially when it comes to glucose. So again, muscle is that sink for glucose. So the more muscle mass we have, the more glucose storage space we’re going to have. So again, we’re. We’re walking throughout the day, but we’re also incorporating some strength training and what what I see in my data is that can help my insulin sensitivity that can help my glucose responses for up to twenty four to forty eight hours after. So it’s just really crucial to make sure that’s a part of your lifestyle and to not neglect consistent movement, but also that really, really great resistance, strength training.
Peter Bowes: [00:35:44] Yeah, I think that’s really interesting. And what about I know a lot of people do this. In fact, I do it myself. My first piece of exercise in the day is usually a long walk in the morning before breakfast, and I feel better just physically not having breakfast before that long walk. But a lot of people do it to, I suppose, putting it in simplistic terms to finally purge their bodies after that overnight fast to finally purge their bodies of glucose before embarking on the day as part of a healthy eating and healthy exercise regime. Are there benefits in doing that of exercising before breakfast?
Understanding the impact of exercise
Carlee Hayes: [00:36:21] Oh, definitely, yes. So, you know, a lot of times I’ll be working with a member at NutriSense and maybe they’re going out for a special meal, right? And they they know they’re going to have this meal. It’s something that they really want, and they want to optimize their response to that meal. That’s often one of the strategies that will include is, OK, can you get some sort of movement to clear out that stored glucose make room for glucose coming in to increase your insulin sensitivity before you go into that meal? And I think that’s really, really beneficial. You know, there’s been a lot of studies and you know, they’ve studied is exercise more important before or after the meal? And I think there’s some evidence that after there’s some evidence that before is is more beneficial. But my thought process is, however it works for you. However, you can burn through that glucose and make it sustainable and something that you actually enjoy. That’s what you’re more likely to stick with. So that’s what I’m going to recommend for me. Every single time that I have lunch, I’ve made it part of my routine to go for a two mile walk. And then I come back, I get back to work and I’m avoiding that big glucose spike by helping my body utilize that glucose more efficiently. And when that happens, I’m going to feel more energized. I’m going to feel stable values throughout the day, and that’s going to help me feel better, work better, live a healthier life.
Peter Bowes: [00:37:38] Carlee, you’ve said it a couple of times during this interview that we could talk about these issues for, for a very long time. And I feel exactly the same way because I think it is so incredibly fascinating. Let me just ask you in closing, this is a podcast about human longevity, not necessarily living forever. That would be interesting, but I don’t believe we’re there yet, but living long and healthy and expanding our healthspan. So I’m curious from your perspective, as you look ahead to the decades that you still have to live, do you have longevity aspirations yourself and and how do you live your life with that in mind?
Carlee Hayes: [00:38:12] Yeah, it’s an excellent question, and I do think that I’m always thinking through the lens of glucose. I think we’ve talked about how muscle is our longevity organ and that’s closely tied to glucose. So I’m always thinking of, OK, how can I support my muscle mass? We know that muscle starts to deteriorate and you lose one percent of your muscle mass after a certain age, and that continues to decline. And we also know that, you know, frailty is one of the things that causes your health to decline and really puts you at risk as you get older, especially for women. I think making sure your muscle mass is taken care of and you’re not neglecting that can help your glucose can help your bones can help your quality of life. You know, I love, you know, Peter Attia always talks about the Centenarian Olympics and training your body to support the activities that you’re going to have to do for the rest of your life. So are you going to have to be doing burpees forever? Probably not, but I will probably have to pick up heavy things. And so I’m going to continue to support my muscles by building the muscles that support deadlifts and support kettlebell swings and all of those things. So I’m thinking functional. I’m thinking, how can I use the muscles that are going to help me live a functional life? And same thing with glucose. I’m thinking in terms of reducing the frequency and the excursions of those spikes. So whatever foods are going to cause me those high spikes at whatever times of the day that are going to cause those spikes to be higher. That’s what I’m really going to put my energy into controlling. So for people out there that really want to focus on longevity, I’d say, first of all, test your glucose, see what foods you respond strongly to. If you don’t have access to a CGM and you maybe aren’t interested in trying one. Think about the processing of your food. So we know that glucose metabolism, glucose breakdown, glucose digestion can start as early as in the mouth, right? As soon as you eat a carbohydrate, you have enzymes in your mouth that are breaking down that carb. So the more processed the food is, the quicker that process is going to happen, the more rapid, the glucose spike, so if you think about sweet potatoes, beans, legumes, things that aren’t processed, those are going to take longer to break down and again, cause that more gradual glucose curve because your body has to work for it. We want to make our bodies work. So avoiding things that I always think of processed foods, as you know, if you put something in your mouth and it disintegrates without you even chewing it, that’s a processed food. And that’s typically going to lead to a higher, more rapid glucose spike and a higher propensity to fall down really, really rapidly and cause your energy levels to just be zapped. So again, the closer you can eat to the source of that food, the less processing that food has, usually the slower that glucose curve is going to be, and that’s going to decrease our risk for glycation oxidation in the body. Microvascular damage and all of those things that lead to inflammation and ultimately lead to chronic diseases. So that’s the thing that I’m always focused on.
Peter Bowes: [00:41:21] Carlee, you’ve got a real passion for this subject, which I really respect and appreciate. And I guess this is what gets you out of bed and working every morning. The idea that there’s a lot of good that can be done and achieved out of the science that you’re very familiar with.
Carlee Hayes: [00:41:36] Oh, definitely. I’ve never been more passionate about anything in my life, and I think it’s really helpful and really, really encouraging when I see the people that I work with get that same passion. When you start to monitor these things and then you do experiments and you make small tweaks and you can see the improvement that really ignites a fire, and that’s what’s going to be something people can stick to for the rest of their life. So yeah, it’s definitely a very rewarding field, and I really hope that everyone takes from this podcast to test, don’t guess, and to try out different things and see what’s working for you because you know your body the best.
Peter Bowes: [00:42:14] Carlee, great to talk to you. Thank you very much indeed.
Carlee Hayes: [00:42:16] Thank you so much. This was fun.
Peter Bowes: [00:42:18] Yeah, great pleasure. And if you would like to delve deeper into continuous glucose monitoring, I put some details about NutriSense into the show notes for this episode, you’ll find them at the Live Long and Master Aging website that’s LLAMApodcast.com – LLAMApodcast.com. You’ll also find us and those details at all of the major podcasting platforms, including Apple Podcasts, Stitcher, Pandora and Audible. And while I’m on the subjects of where to find us a quick shout out to our friends at AMightyGoodTime.com, it’s a really valuable, free resource. A one stop shop for events and activities for people who are 50 and over. Thank you guys for also sharing LLAMA. Listening to a podcast is indeed a great activity, no matter what age you are, so check them out Peter Bowes: AMightyGoodTime.com – LLAMA is a Healthspan Media production we’ll be back with another episode soon. In the meantime, do take care and thank you very much for listening.
The Live Long and Master Aging podcast shares ideas but does not offer medical advice. If you have health concerns of any kind you should consult your own doctor or professional health adviser.