Your blood contains all kinds of important nutrients and other substances that you need to be healthy – including sugar. Blood is the liquid transporter that distributes these compounds to all parts of our bodies. Since sugar is one of the compounds our blood transports, it’s important to balance blood sugar naturally to avoid long-term health issues, managing our weight and feel good over-all.
Sugar is a type of simple carbohydrate and is one of our body’s main fuels. The other two fuels are fat and protein. I call it “fuel” because our cells literally burn it to do work. It’s this biochemical burning of fuel in all our cells that creates our metabolism.
So, how does our blood sugar get too high? What diet and lifestyle upgrades can we do to manage it? How does blood sugar affect our mood and energy?
In this post, I’ll talk about the danger of blood sugar imbalance: insulin resistance, and diabetes. I’ll also explain how an imbalance affects our over-all mood. Then I’ll give you 11 proven strategies that can help manage blood sugar level naturally to help you keep your mood and energy more consistent. The good news is that blood sugar levels are responsive to simple diet and lifestyle upgrades.
NOTE: There are several medical, diet, and lifestyle approaches to managing medical conditions. None of these are a substitute for professional medical advice. If you have any of these conditions, or are taking medications for it, please make sure you’re being monitored regularly.
Why it’s important to balance blood sugar.
Our body strives to be in balance. It exerts a lot of energy to make sure that our systems are all running smoothly including our digestive system, nervous system and cardiovascular system. And this includes our blood, as well. Our bodies try to balance our blood pressure, blood volume and blood sugar in order to stay healthy and alive.
There is a normal and healthy range of sugar levels in our blood. The problem doesn’t start until these levels are out of range, i.e. too high for too long.
Here’s how our bodies strive to maintain optimal levels of blood sugar:
1. We eat a food containing carbohydrates (i.e. sugar and/or starch).
2. Our digestive system breaks down the sugar and/or starch into smaller sugars like glucose. These smaller sugars are then absorbed into our bloodstream, raising our blood sugar level.
3.When our blood sugar gets to a certain level, the pancreas (a gland in our digestive system) sends out insulin. Insulin is a hormone that tells our muscles, liver and, ultimately, fat cells to grab that sugar from the blood. These cells use the sugar they need for immediate energy and store the rest for later.
4. The muscles and liver store sugar temporarily. When we need it, our muscles and liver give up their sugar into the blood. This happens, for example, when we haven’t eaten for a few hours, we’re exercising, or we’re under stress. Fat cells, however, turn excess sugar into fat for long-term storage.
As you can see, the amount of sugar in your blood is constantly flowing up and down. Up when we eat; down when the insulin tells the cells to pull it out of the blood. Then up again when we eat again and/or start using some of the stored glucose. And down again as it’s used (burned) or stored.
This is all good and healthy! This is what we aim for.
The dangers of blood sugar imbalance.
The problem with imbalanced blood sugar occurs when the “ups” get too high, and they stay there for too long.
Too much blood sugar can cause heart rate issues (arrhythmias), and in extreme cases, even seizures. When blood sugar stays too high for too long, it can eventually cause long-term damage to organs and limbs.
A common way our blood sugar gets too high is when we eat a lot of sugar in a short time. Especially processed sugar, like in soda pop, energy drinks, desserts, etc. Our digestive system absorbs as much sugar from our food as possible.
This is an evolutionary thing. We inherited this from thousands of years ago when food was scarce, and the next meal was unknown. Our bodies adapted to crave, absorb, and store as much sugar as possible in one sitting, because it didn’t know how long it would be until the next meal. It’s a survival mechanism.
Over a period of years, if we frequently eat a lot of sugar and have increased body fat, our bodies change. The muscle and liver cells start ignoring insulin’s call to absorb sugar from the blood. They become insulin resistant.
When this happens, the sugar stays in the blood for a lot longer than it should. Blood sugar levels become too high for too long. But this doesn’t stop the pancreas from releasing even more insulin. When this happens, you have the paradox of high blood sugar and high insulin.
Some symptoms of insulin resistance are:
- Fatigue after meals
- Sugar cravings that don’t go away, even if sweets are eaten
- Increased thirst
- Frequent urination
Type 2 diabetes
Type 2 diabetes is a long-term condition of high blood sugar, insulin resistance, and inflammation. It increases the risk of many serious conditions like heart disease, kidney disease, blindness, and amputation. Not to mention the number of medications often prescribed to try to keep blood sugar balanced.
Unlike type 1 diabetes, which is a condition where your immune system actually destroys the insulin-producing cells in your pancreas, type 2 diabetes is totally preventable – and even reversable. Type 1 diabetes is an autoimmune condition where your pancreas literally cannot make insulin.
This is often diagnosed early in life (childhood/adolescence) and requires lifelong insulin injections. Less than 10% of people with diabetes have type 1 diabetes; everyone else has type 2.
These are the connections between blood sugar balance, insulin resistance, diabetes, and their symptoms and risks. Blood sugar also influences mood and energy levels.
How blood sugar greatly affects your mood.
Have you ever felt “hangry”? You know that feeling when you are hungry and angry at the same time? Where you will eat anything you can reach to help you feel better? Where you are snapping at your kids, who are probably also getting hungry?
This hangry feeling can be a result of low blood sugar where your body is craving a quick source of energy to help it maintain balance. Your body knows it needs energy, and it doesn’t realize that you have plans for dinner in an hour.
When you respond by eating something high in sugar to provide quick energy, your brain releases feel good chemicals like dopamine to reward you. Your body wants to ensure you avoid starvation, so it rewards you for eating something. Your mood improves quickly with a boost of sugar.
But this energy boost won’t last long! And it can lead to a cycle of dramatic mood and energy changes. Feeling hangry, then feeling good. This repeated dopamine release is what makes sweet foods hard to resist; it is the same feel good chemical that is released by drug use. The feelings that come with eating a cookie or chocolate bar are designed to help you keep your blood sugar balanced, but with so much access to quick, sweet treats it is easy to over-do it.
Blood sugar imbalances have been associated with symptoms of depression, possibly because sugar contributes to inflammation. Read more about inflammation and mental health here. Blood sugar imbalances have also been related to anxiety and panic attacks since increases in blood sugar can signal the body to move into flight or fight mode, even when it isn’t necessary.
11 tips to balance blood sugar naturally.
The good news is that improved blood sugar balance can be achieved with proper nutrition and lifestyle! What you eat, how you eat it, how much exercise and sleep you get, and how you handle stress are all factors that you can improve.
CAUTION: If you’re already diagnosed, and/or taking medications or insulin injections, make sure you speak with your doctor and/or pharmacist before making any changes. They may also want to monitor your blood sugar levels a bit closer when you start making diet and lifestyle upgrades.
Here are my 11 best tips to help you better balance your blood sugar with diet and lifestyle upgrades.
1. Avoid food and drinks that are mostly sugar
First things first. If a food or drink is mostly sugar, please try to reduce, or even cut it out of your diet. I’m talking sweetened beverages (e.g. soda pop, juice, energy drinks, candy, etc.). Many desserts, breakfasts, and even seemingly-healthy choices like some granola bars often have a lot of sugar.
Significantly reducing these will give you the quickest results when it comes to better blood sugar levels. That’s why it’s my number one recommendation – I’ve even written a whole blog post about the benefits of cutting back on sugar.
2. Eat fewer carbohydrates
Your body digests starches by breaking them down into sugar. By reducing the amount of sugars and starches (carbohydrates) you eat, you can reduce that blood sugar spike that happens right after you eat. This has been shown in many studies.
It’s been said that one of the strongest predictors of blood sugar response is the total amount of carbohydrates in a meal.
Reducing your overall carbohydrate intake can help to reduce your blood sugar levels.
3. Choose “low glycemic” starches
If you’ve already cut out a lot of sugary foods and want to reduce your starch intake, then start by ditching the “high glycemic” (i.e. ones that raise your blood sugar too high) starches.
As you can imagine, researchers have measured how fast and how high blood sugar increases with different foods. Foods that are “high glycemic” quickly raise blood sugar quite high. “Low glycemic” foods raise blood slower and to a smaller extent.
This “glycemic effect” is the result of the components in the food itself. Things like the amount of carbohydrate, the type of carbohydrate (i.e. sugar vs starch), and what other nutrients are in the food (i.e. protein, fibre, etc.) as well. The fibre, fat and protein in a food slows down the digestion and absorption of the carbohydrates, so the blood sugar rise slows down too. This results in a lower “glycemic effect.”
High glycemic foods (i.e. ones to avoid) include sugary foods, as well as starchy foods like white bread, many pastas, and rice. Low glycemic foods include ones that are higher in fibre, fat and protein. Examples are meat, seafood, eggs, legumes, sweet potatoes, and most fruit and non-starchy vegetables.
NOTE: Eating a low glycemic food along with a high glycemic food will help to slow down the blood sugar rise from the higher glycemic food. It’s not just the single food that matters, but the rest of the meal also affects your blood sugar. Which leads us to…
4. Eat more fibre
You’ve heard that “fibre makes you regular,” right? It’s so healthy. Most people don’t eat nearly enough. The recommended daily intake of fibre for adults is 21 g – 38 g per day.
This nutrient is not just for “regularity” and gut health, but also for blood sugar balance too.
It works by mixing with the carbohydrates in your meal, and slowing down the absorption of the sugars from those carbohydrates.
Some of the highest fibre foods include cocoa powder, flaxseeds, & legumes.
Feel free to add a spoon of cocoa powder to your smoothie, sprinkle flaxseeds on your cereal, and/or add some legumes to your soup or salad.
5. Eat protein and fibrous vegetables first
Since blood sugar is affected by the amount of carbohydrates you eat, studies have also looked at the order in which you eat different foods.
A few small studies looked at adults with type 2 diabetes. They all had the same meal, but some were asked to eat their protein and fibrous (i.e. non-starchy) vegetables first, while others ate their carbohydrates first.
They found that people who ate the protein and vegetables first had better blood sugar control. One of the studies also showed lower levels of post-meal insulin when the carbohydrates were eaten last.
Another study found these blood sugar benefits to be true even in people without type 2 diabetes.
It’s thought that when we eat carbohydrates first, we start digesting them right away. But, if we eat them after our protein and fibrous vegetables, they have a chance to mix in with the rest of the food in your stomach. This can slow down their absorption, which slows down how fast and high our blood sugar gets after we eat.
The effects of changing food order haven’t been tested in many big studies, but it seems to be a simple and safe habit to get into to help our bodies better regulate blood sugar levels. Try to eat your protein and fibrous vegetables first, and starches last.
6. Enjoy fruit, especially dark berries
Unless your doctor or health practitioner has said otherwise, or you have an intolerance to them, fruit and the fruit sugar “fructose” are generally ok. Fructose has a low glycemic index. Having fructose instead of glucose (regular sugar) can reduce a measure of the average levels of blood sugar over the past two to three months (e.g. HbA1c – a blood test for blood sugar control).
A diet high in fruits and vegetables is great for your health. They contain phytochemicals (phyto=plant), vitamins, minerals, and fibre. Eating whole (not processed or juiced) fruits can help with blood sugar balance. Berries are particularly good, as they contain a lot of fibre and not a lot of sugar. Not to mention that they’re delicious!
Berries, especially dark berries, contain pigments known as “anthocyanins.” These dark-coloured pigments have lots of health benefits including helping sugar metabolism in people with insulin resistance. They can also improve ability to think, and their antioxidant effects are linked to reduced DNA damage. You can get enough anthocyanins from a regular serving of dark berries, so give them a try.
7. Add vinegar & cinnamon to your diet
Try having two tablespoons of vinegar shortly before or with a meal that contains sugars or starches. Why? Because a recent analysis of several studies (a meta-analysis) showed that the vinegar can lower the blood sugar by up to 60% and the insulin by up to 130% compared to the same meal without vinegar. This worked for insulin-resistant people. Even healthy people had a significant benefit.
Cinnamon can help to lower blood sugar levels and improve insulin sensitivity. This effect can happen with even less than one teaspoon per day.
It’s thought that cinnamon works by slowing the emptying of the stomach. Slower emptying means slower absorption and slower blood sugar rise after a meal. Cinnamon also contains antioxidant polyphenols (plant chemicals) that may improve insulin sensitivity.
8. Get enough good quality sleep
Our bodies are wired to work along the sun’s schedule. The objective is to wake up when the sun comes up and get tired when it goes down. Not enough sleep can affect many of our body’s systems, including negatively affecting our blood sugar levels and insulin sensitivity. It can also increase appetite and promote weight gain. Sleep can also affect our mood and mental health.
Even one or two nights of poor sleep can affect our blood sugar levels so regularly getting enough good quality sleep is a great step toward helping our bodies manage blood sugar.
Remember how insulin tells your muscle cells to pull some sugar out of your blood to store for later? Guess what it’s storing it for?
By exercising and burning that stored sugar, you not only improve your blood sugar levels, and your physical and mental health in many ways, but also can reduce insulin resistance. Win-win-win.
This means your muscle cells, especially when they’re moving, absorb and burn more sugar from the blood. This goes for both medium- and high-intensity exercise
10. Reduce your stress
Remember we talked about a couple of those things that releases sugar stored in the liver and muscles, and delivers them back to the blood? Things like not eating for a few hours, and when we’re under stress. Let’s talk about the blood sugar effect of stress hormones like cortisol.
The reason stress hormones release stored sugar is to prepare for the “fight or flight” reaction. Your body becomes physically ready to fight or run. And to do this, you need fuel in your blood, i.e. sugar.
How can you reduce stress? Relaxation techniques like deep breathing, meditation, and yoga can help to reduce stress and lower blood sugar levels. Download more strategies to help decrease stress.
11. Lose excess weight
This is kind of a big and super-complex one, so I left it until the end.
There is a ton of evidence that belly fat, overweight, and obesity are linked with blood sugar balance issues and type 2 diabetes.
Weight loss and reduced waist circumference can work as well as, if not better, than medications.
Quick-glance guide to balancing your blood sugar naturally.
If your blood sugar is creeping up, these are the nutrition and lifestyle upgrades I suggest you make for better health.
- Avoid foods and drinks that are mostly sugar
- Eat fewer carbohydrates
- Choose “low glycemic” starches
- Eat more fibre
- Eat your protein and fibrous vegetables first
- Enjoy fruit, especially dark berries
- Add blood-sugar balancing flavourings of vinegar & cinnamon
- Get enough good quality sleep
- Reduce your stress
- Lose excess weight
Every health change will work better if implemented in small, incremental ways. Which of these strategies can you start with to help you to better control your blood sugar levels? By implementing these choices incrementally, you will start to greatly improve your blood sugar balance, and you will notice improvements to your daily base-line mood, and your over-all health!
NOTE: There are several medical, diet, and lifestyle approaches to managing medical conditions. None of these are a substitute for professional medical advice. If you have any of these conditions, or are taking medications for it, please make sure you’re being monitored regularly.
Akilen, R., Tsiami, A., Devendra, D. & Robinson, N. (2010). Glycated haemoglobin and blood pressure-lowering effect of cinnamon in multi-ethnic Type 2 diabetic patients in the UK: a randomized, placebo-controlled, double-blind clinical trial. Diabet Med, 27(10):1159-67. doi: 10.1111/j.1464-5491.2010.03079.x. LINK: https://www.ncbi.nlm.nih.gov/pubmed/20854384
American Diabetes Association. (2017). Blood Glucose and Exercise. Accessed 2017 Sep 28. LINK: http://www.diabetes.org/food-and-fitness/fitness/get-started-safely/blood-glucose-control-and-exercise.html American Diabetes Association. (2013). Stress. Accessed 2017 Sep 28. LINK: http://www.diabetes.org/living-with-diabetes/complications/mental-health/stress.html
Bernardo, M.A., Silva, M.L., Santos, E., Moncada, M.M., Brito, J., Proença, L., … de Mesquita, M.F. (2015). Effect of Cinnamon Tea on Postprandial Glucose Concentration. Journal of Diabetes Research, 2015, 913651. http://doi.org/10.1155/2015/913651 LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516848/
Brand-Miller, J., Hayne, S., Petocz, P. & Colagiuri, S. (2003). Low-glycemic index diets in the management of diabetes: a meta-analysis of randomized controlled trials. Diabetes Care, 26(8):2261-7. LINK: http://care.diabetesjournals.org/content/26/8/2261.long
Chicco, A.G., D’Alessandro, M.E., Hein, G.J., Oliva, M.E. & Lombardo, Y.B. (2009). Dietary chia seed (Salvia hispanica L.) rich in alpha-linolenic acid improves adiposity and normalises hypertriacylglycerolaemia and insulin resistance in dyslipaemic rats. Br J Nutr, 101(1):41-50. doi: 10.1017/S000711450899053X. Epub 2008 May 20. LINK: https://www.ncbi.nlm.nih.gov/pubmed/18492301
Cozma, A.I., Sievenpiper, J.L., de Souza, R.J., Chiavaroli, L., Ha, V., Wang, D.D., Mirrahimi, A., Yu, M.E., Carleton, A.J., Di Buono, M., Jenkins, A.L., Leiter, L.A., Wolever, T.M., Beyene, J., Kendall, C.W. & Jenkins, D.J. (2012). Effect of fructose on glycemic control in diabetes: a systematic review and meta-analysis of controlled feeding trials. Diabetes Care, 35(7):1611-20. doi: 10.2337/dc12-0073. LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3379616/
Dijk, D.-J. (2008). Slow-wave sleep, diabetes, and the sympathetic nervous system. Proceedings of the National Academy of Sciences of the United States of America, 105(4), 1107–1108. http://doi.org/10.1073/pnas.0711635105 LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2234097/
Dhurandhar, E.J., Dawson, J., Alcorn, A., Larsen, L.H., Thomas, E.A., Cardel, M., Bourland, A.C., Astrup, A., St-Onge, M.-P., Hill, J.O., Apovian, C.M., Shikany, J.M., & Allison, D.B. (2014). The effectiveness of breakfast recommendations on weight loss: a randomized controlled trial. American Journal of Clinical Nutrition. doi: 10.3945/ajcn.114.089573 LINK: http://ajcn.nutrition.org/content/early/2014/06/04/ajcn.114.089573.full.pdf+html
Examine.com Research Digest. (2015). Carbs-protein or protein-carbs … does food order matter? Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels. 10(1). LINK: https://examine.com/store/erd/
Examine.com Research Digest. (2016). Starches last for better blood glucose Manipulating the sequence of food ingestion improves glycemic control in type 2 diabetic patients under free-living conditions. 25(2). LINK: https://examine.com/store/erd/
Franz, M.J., Bantle, J.P., Beebe, C.A., Brunzell, J.D., Chiasson, J.-L., Garg, A., Holzmeister, L.A., Hoogwerf, B., Mayer-Davis, E., Mooradian, A.D., Purnell, J.Q. & Wheeler, M. (2002). Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications. Diabetes Care, 25 (1) 148-198; DOI: 10.2337/diacare.25.1.148 LINK: http://care.diabetesjournals.org/content/25/1/148.long
Gannon, M.C. & Nuttall, F.Q. (2004). Effect of a high-protein, low-carbohydrate diet on blood glucose control in people with type 2 diabetes. Diabetes, 53(9):2375-82. LINK: http://diabetes.diabetesjournals.org/content/53/9/2375.long
Gibbons, C., Dempster, M. & Moutray, M. (2011), Stress, coping and satisfaction in nursing students. Journal of Advanced Nursing, 67: 621–632. doi:10.1111/j.1365-2648.2010.05495.x LINK: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2010.05495.x/abstract;jsessionid=5888D262E55E90844C0DA491A003E01D.f03t03
Hartmann, M., Kopf, S., Kircher, C., Faude-Lang, V., Djuric, Z., Augstein, F., … Nawroth, P. P. (2012). Sustained Effects of a Mindfulness-Based Stress-Reduction Intervention in Type 2 Diabetic Patients: Design and first results of a randomized controlled trial (the Heidelberger Diabetes and Stress-Study). Diabetes Care, 35(5), 945–947. http://doi.org/10.2337/dc11-1343 LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329807/
Health Canada. (2006). Dietary Reference Intakes. Reference Values for Macronutrients. Accessed 2017 Sep 28. LINK: https://www.canada.ca/en/health-canada/services/food-nutrition/healthy-eating/dietary-reference-intakes/tables/reference-values-macronutrients-dietary-reference-intakes-tables-2005.html
Imamura, F., O’Connor, L., Ye, Z., Mursu, J., Hayashino, Y., Bhupathiraju, S. N., & Forouhi, N. G. (2016). Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. British Journal of Sports Medicine, 50(8), 496–504. http://doi.org/10.1136/bjsports-2016-h3576rep LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4853528/
Jenkins, D.J., Wolever, T.M., Taylor, R.H., Barker, H., Fielden, H., Baldwin, J.M., Bowling, A.C., Newman, H.C., Jenkins, A.L. & Goff, D.V. (1981). Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr, 34(3):362-6. LINK: https://www.ncbi.nlm.nih.gov/pubmed/6259925
Khan, A., Safdar, M., Khan, M.M.A., Khattak, K.N. & Anderson, R.A. (2003). Cinnamon Improves Glucose and Lipids of People With Type 2 Diabetes. Diabetes Care, 26(12): 3215-3218. https://doi.org/10.2337/diacare.26.12.3215 LINK: http://care.diabetesjournals.org/content/26/12/3215.full
Kim, S.D. (2014). Effects of Yogic Exercises on Life Stress and Blood Glucose Levels in Nursing Students. Journal of Physical Therapy Science, 26(12), 2003–2006. http://doi.org/10.1589/jpts.26.2003 LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273078/
Kirkham, S., Akilen, R., Sharma, S. & Tsiami, A. (2009). The potential of cinnamon to reduce blood glucose levels in patients with type 2 diabetes and insulin resistance. Diabetes Obes Metab, 11(12):1100-13. doi: 10.1111/j.1463-1326.2009.01094.x. LINK: http://onlinelibrary.wiley.com/doi/10.1111/j.1463-1326.2009.01094.x/abstract;jsessionid=514E8E89A56C254E12EAECA1EC68AFDA.f02t03
Klein, S., Allison, D.B., Heymsfield, S.B., Kelley, D.E., Leibel, R.L., Nonas, C. & Kahn, R. (2007). Waist Circumference and Cardiometabolic Risk: A Consensus Statement from Shaping America’s Health: Association for Weight Management and Obesity Prevention; NAASO, The Obesity Society; the American Society for Nutrition; and the American Diabetes Association. Diabetes Care 30(6): 1647-1652. https://doi.org/10.2337/dc07-9921 LINK: http://care.diabetesjournals.org/content/30/6/1647.full
Krebs, J.D., Parry Strong, A., Cresswell, P., Reynolds, A.N., Hanna, A. & Haeusler, S. (2016). A randomised trial of the feasibility of a low carbohydrate diet vs standard carbohydrate counting in adults with type 1 diabetes taking body weight into account. Asia Pac J Clin Nutr. 25(1):78-84. doi: 10.6133/apjcn.2016.25.1.11. LINK: http://apjcn.nhri.org.tw/server/APJCN/25/1/78.pdf
Li, D., Zhang, Y., Liu, Y., Sun, R. & Xia, M. (2015). Purified Anthocyanin Supplementation Reduces Dyslipidemia, Enhances Antioxidant Capacity, and Prevents Insulin Resistance in Diabetic Patients. doi: 10.3945/jn.114.205674 LINK: http://jn.nutrition.org/content/early/2015/02/04/jn.114.205674.abstract
Lu, T., Sheng, H., Wu, J., Cheng, Y., Zhu, J. & Chen, Y. (2012). Cinnamon extract improves fasting blood glucose and glycosylated hemoglobin level in Chinese patients with type 2 diabetes. Nutr Res, 32(6):408-12. doi: 10.1016/j.nutres.2012.05.003. Epub 2012 Jun 14. LINK: https://www.ncbi.nlm.nih.gov/pubmed/22749176
Magistrelli, A. & Chezem, J.C. (2012). Effect of ground cinnamon on postprandial blood glucose concentration in normal-weight and obese adults. J Acad Nutr Diet, 112(11):1806-9. doi: 10.1016/j.jand.2012.07.037. LINK: https://www.ncbi.nlm.nih.gov/pubmed/23102179
Mang, B., Wolters, M., Schmitt, B., Kelb, K., Lichtinghagen, R., Stichtenoth, D.O. & Hahn, A. (2006). Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus type 2. Eur J Clin Invest. 36(5):340-4. LINK: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2362.2006.01629.x/abstract
Meyer, K.A., Kushi, L.H., Jacobs, D.R., Slavin, J., Sellers, T.A. & Folsom, A.R. (2000). Carbohydrates, dietary fiber, and incident type 2 diabetes in older women. Am J Clin Nutr. 71(4):921-30. LINK: http://ajcn.nutrition.org/content/71/4/921.long
Mohamed Sham Shihabudeen, H., Hansi Priscilla, D., & Thirumurugan, K. (2011). Cinnamon extract inhibits α-glucosidase activity and dampens postprandial glucose excursion in diabetic rats. Nutrition & Metabolism, (8)46. http://doi.org/10.1186/1743-7075-8-46 LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3155477/
National Institutes of Health, National Center for Complementary and Integrative Health. (2017). Stress. Accessed 2017 Sep 28. LINK: https://nccih.nih.gov/health/stress
Nielsen, J.V., & Joensson, E.A. (2008). Low-carbohydrate diet in type 2 diabetes: stable improvement of bodyweight and glycemic control during 44 months follow-up. Nutrition & Metabolism, 5, 14. http://doi.org/10.1186/1743-7075-5-14 LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2424054/
Parker, L., Shaw, C. S., Banting, L., Levinger, I., Hill, K. M., McAinch, A. J., & Stepto, N. K. (2016). Acute Low-Volume High-Intensity Interval Exercise and Continuous Moderate-Intensity Exercise Elicit a Similar Improvement in 24-h Glycemic Control in Overweight and Obese Adults. Frontiers in Physiology, (7)661. http://doi.org/10.3389/fphys.2016.00661 LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5220056/
Peet, M. (2004). International variations in the outcome of schizophrenia and the prevalence of depression in relation to national dietary practices: an ecological analysis. Br J Psychiatry,184:404-8. Link: https://www.ncbi.nlm.nih.gov/pubmed/15123503
Pham, A.Q., Kourlas, H. & Pham, D.Q. (2007). Cinnamon supplementation in patients with type 2 diabetes mellitus. Pharmacotherapy, 27(4):595-9. LINK: http://onlinelibrary.wiley.com/doi/10.1592/phco.27.4.595/abstract
Qureshi, A.A., Sami, S.A. & Khan, F.A. (2002). Effects of stabilized rice bran, its soluble and fiber fractions on blood glucose levels and serum lipid parameters in humans with diabetes mellitus Types I and II. J Nutr Biochem, 13(3):175-187. LINK: https://www.ncbi.nlm.nih.gov/pubmed/11893482
Radahmadi, M. et al. (2006). Effects of stress on exacerbation of diabetes mellitus, serum glucose and cortisol levels and body weight in rats. Pathophysiology, 13(1):51-55. LINK: http://www.pathophysiologyjournal.com/article/S0928-4680(05)00071-4/fulltext
Rosenzweig, S., Reibel, D.K., Greeson, J.M., Edman, J.S., Jasser, S.A., McMearty, K.D. & Goldstein, B.J. (2007). Mindfulness-based stress reduction is associated with improved glycemic control in type 2 diabetes mellitus: a pilot study. Altern Ther Health Med, 13(5):36-8. LINK: https://www.ncbi.nlm.nih.gov/pubmed/17900040
Sacks, F.M., Carey, V.J., Anderson, C.A.M., Miller, E.R., Copeland, T., Charleston, J., … Appel, L.J. (2014). Effects of High vs Low Glycemic Index of Dietary Carbohydrate on Cardiovascular Disease Risk Factors and Insulin Sensitivity: The OmniCarb Randomized Clinical Trial. JAMA, 312(23), 2531–2541. http://doi.org/10.1001/jama.2014.16658 LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370345/
Sahay BK. (2007). Role of yoga in diabetes. J Assoc Physicians India. 55:121-6. LINK: https://www.ncbi.nlm.nih.gov/pubmed/17571741/
Sancini, A., Ricci, S., Tomei, F., Sacco, C., Pacchiarotti, A., Nardone, N., Ricci, P., Suppi, A., De Cesare, D.P., Anzelmo, V., Giubilati, R., Pimpinella, B., Rosati, M.V. & Tomei, G. (2017). Work related stress and blood glucose levels. Ann Ig. 29(2):123-133. doi: 10.7416/ai.2017.2139. LINK: https://www.ncbi.nlm.nih.gov/pubmed/28244581
Schade, D.S. & Eaton, R.P. (1980). The temporal relationship between endogenously secreted stress hormones and metabolic decompensation in diabetic man. J Clin Endocrinol Metab. 50(1):131-6. LINK: https://www.ncbi.nlm.nih.gov/pubmed/7350176
Sheard, N.F., Clark, N.G., Brand-Miller, J.C., Franz, M.J., F. Pi-Sunyer, X., Mayer-Davis, E., Kulkarni, K. & Geil, P. (2004). Dietary Carbohydrate (Amount and Type) in the Prevention and Management of Diabetes: A statement by the American Diabetes Association. Diabetes Care, 27(9): 2266-2271. https://doi.org/10.2337/diacare.27.9.2266 LINK: http://care.diabetesjournals.org/content/27/9/2266.full
Shishehbor, F., Mansoori, A. & Shirani, F. (2017). Vinegar consumption can attenuate postprandial glucose and insulin responses; a systematic review and meta-analysis of clinical trials. Diabetes Research and Clinical Practice. 127, 1-9. https://doi.org/10.1016/j.diabres.2017.01.021 LINK: http://www.sciencedirect.com/science/article/pii/S0168822716308518#!
Shukla, A.P., Iliescu, R.G., Thomas, C.E. & Aronne, L.J. (2015). Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels. Diabetes Care, 38(7): e98-e99. https://doi.org/10.2337/dc15-0429 LINK: http://care.diabetesjournals.org/content/38/7/e98.full
Simard, A-A. & Henry, M. (2009). Impact of a short yoga intervention on medical students’ health: A pilot study. Medical Teacher, 31(10): 950-2. http://dx.doi.org/10.3109/01421590902874063 LINK: http://www.tandfonline.com/doi/full/10.3109/01421590902874063
Stull, A.J., Cash, K.C., Johnson, W.D., Champagne, C.M. & Cefalu, W.T. (2010). Bioactives in blueberries improve insulin sensitivity in obese, insulin-resistant men and women. J Nutr, 140(10):1764-8. doi: 10.3945/jn.110.125336. Epub 2010 Aug 19. LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139238/
Tasali, E., Leproult, R., Ehrmann, D. A., & Van Cauter, E. (2008). Slow-wave sleep and the risk of type 2 diabetes in humans. Proceedings of the National Academy of Sciences of the United States of America, 105(3), 1044–1049. http://doi.org/10.1073/pnas.0706446105 LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2242689/
The Diabetes Prevention Program (DPP) Research Group. (2002). The Diabetes Prevention Program (DPP): Description of lifestyle intervention. Diabetes Care, 25(12), 2165–2171. LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1282458/
Tricò, D., Filice, E., Trifirò, S., & Natali, A. (2016). Manipulating the sequence of food ingestion improves glycemic control in type 2 diabetic patients under free-living conditions. Nutrition & Diabetes, 6(8), e226–. http://doi.org/10.1038/nutd.2016.33 LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5022147/
Tuomilehto, J., Lindström, J., Eriksson, J.G., Valle, T.T., Hämäläinen, H., Ilanne-Parikka, P., Keinänen-Kiukaanniemi, S., Laakso, M., Louheranta, A., Rastas, M., Salminen, V., Uusitupa, M.; Finnish Diabetes Prevention Study Group. (2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 344(18):1343-50. LINK: http://www.nejm.org/doi/full/10.1056/NEJM200105033441801#t=articleTop
USDA (United States Department of Agriculture) Nutrient Database. Search = Fiber. Accessed 2017 Sep 28. LINK: https://ndb.nal.usda.gov/ndb/nutrients/report/nutrientsfrm?max=25&offset=0&totCount=0&nutrient1=291&nutrient2=&nutrient3=&subset=0&sort=c&measureby=g
Vuksan, V., Choleva, L., Jovanovski, E., Jenkins, A.L., Au-Yeung, F., Dias, A.G., Ho, H.V., Zurbau, A. & Duvnjak, L. (2017). Comparison of flax (Linum usitatissimum) and Salba-chia (Salvia hispanica L.) seeds on postprandial glycemia and satiety in healthy individuals: a randomized, controlled, crossover study. Eur J Clin Nutr. 71(2):234-238. doi: 10.1038/ejcn.2016.148. LINK: https://www.ncbi.nlm.nih.gov/pubmed/28000689
Westman, E.C., Yancy, W.S., Mavropoulos, J.C., Marquart, M. & McDuffie, J. R. (2008). The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutrition & Metabolism, 5, 36. http://doi.org/10.1186/1743-7075-5-36 LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633336/
Yancy, W. S., Foy, M., Chalecki, A. M., Vernon, M. C., & Westman, E. C. (2005). A low-carbohydrate, ketogenic diet to treat type 2 diabetes. Nutrition & Metabolism, 2, 34. http://doi.org/10.1186/1743-7075-2-34 LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1325029