How glycemia shapes our health and body weight, according to experts

If there is one thing I learned this year about physical health, it is the scale of problems caused by chronically elevated blood sugar, from disruption of the gut microbiome, reduced concentration and loss of energy, to the formation of wrinkles and premature aging of the body. Elevated or poorly regulated glycemia (blood sugar levels) is one of the key metabolic disorders of the modern lifestyle. The reason certainly lies in the fact that sugar is difficult to avoid. We find it in various foods, even where we would not expect it.

In addition to being directly linked to diabetes, glycemia has a strong impact on body weight, hormonal balance, the health of blood vessels, the liver and the nervous system, and even on the appearance of the skin. How proper nutrition and lifestyle habits can influence blood sugar is explained by clinical nutritionist Nevena Pandža and diabetologist Dr Alda Ranogajec from Poliklinika Mazalin.

Glycemia and nutrition: what to avoid and what to choose?

When glycemia is elevated, diet cannot be viewed universally. As nutritionist Nevena Pandža points out, diet therapy is always tailored to the diagnosis, laboratory results and the therapy prescribed by an endocrinologist. Still, there are foods that are generally recommended to be avoided because they cause sudden spikes in blood sugar. These are primarily “carbonated and non-carbonated soft drinks, industrial sweets, bakery products and wheat bread or rolls, snacks, fast and fatty food, sweetened caffeinated beverages, alcohol and added sugar, as well as other sweeteners such as honey, maple and agave syrup,” the nutritionist states. All of the above can significantly worsen glycemia and increase the body’s insulin load.

Glycemia and carbohydrates

On the other hand, stable glycemia is achieved by properly combining foods. “I recommend that complex carbohydrates from rye bread, whole-grain pasta, buckwheat, rice, quinoa and sweet potatoes be figuratively ‘embraced’ with sources of protein, vegetables and unsaturated fats. I recommend plenty of fiber from vegetables, especially broccoli, cauliflower, cruciferous vegetables, green leafy and bitter vegetables, to support liver and digestive function, as well as fermented vegetables.”

Glycemia and proteins

For stable blood sugar levels, or glycemia, proteins are extremely important. “Sources of protein can include legumes, fish, poultry, eggs, fresh cheese, yogurt, tofu, as well as red meat in smaller amounts,” the nutritionist notes, and when choosing fats she particularly recommends “olive oil and pumpkin seed oil, avocado, nuts and seeds in various forms.”

Glycemia and drinks

We are often unaware of how much sugar we consume through sweetened drinks, which is why choosing fluids properly is extremely important. Nutritionist Pandža particularly recommends “water, unsweetened lemonade, herbal teas and mineral water.”

Glycemia and snacks

Snacks are a frequent enemy of stable blood sugar levels. In this context, certain foods can help, and Pandža especially highlights the benefits of “fruit such as apples, pears, mandarins, oranges and berries” as ideal substitutes for “something sweet after a meal.”

She also notes that “if fruit is eaten on its own as a snack, I recommend pairing it with a handful of nuts, peanut butter without sugar and salt, or with skyr or Greek yogurt, in order to reduce the rise in postprandial glucose (blood sugar levels after a meal),” concluding with the addition that “a walk after a meal can help regulate blood sugar levels better” as a simple and effective trick.

How does glycemia affect body weight?

Courtesy of Alo

According to diabetologist Dr Alda Ranogajec, the relationship between glycemia and body weight depends on insulin. “Elevated glycemia leads to insulin secretion, which allows glucose to enter cells from the bloodstream, especially in the liver, muscles and adipose tissue, and acts as an anabolic hormone: it blocks lipolysis, stimulates lipogenesis and increases appetite, thereby promoting fat storage in the body and weight gain.”

However, there is also an opposite scenario in people who have high glycemia but a lack of insulin. In that case, glucose cannot enter the cells. “The cells are then ‘hungry’ despite high blood sugar levels, which leads to weight loss. In such cases, insulin needs to be replaced, that is, insulin therapy needs to be initiated,” Dr Ranogajec emphasizes.

A third common issue the diabetologist warns about is insulin resistance, a condition in which there is enough insulin, but the cells do not respond to it. “The result is that glucose cannot enter the cells, and the pancreas tries to compensate by secreting increasingly larger amounts of insulin, creating a vicious circle that leads to weight gain and, ultimately, the development of diabetes.”

What are normal blood sugar levels?

As Dr Ranogajec explains, normal blood sugar values, or a state of normoglycemia, imply fasting blood glucose up to 5.5 mmol/L, while values in the oral glucose tolerance test should not exceed 7.7 mmol/L. Glycated hemoglobin values up to 5.6% are also considered normal.

A condition described as prediabetes is characterized by elevated, but not yet diabetic values: fasting blood glucose of 5.6 to 6.9 mmol/L, 7.8 to 11 mmol/L in the oral glucose tolerance test, and glycated hemoglobin of 5.7 to 6.4%.

A diagnosis of diabetes is made when fasting glucose is 7 mmol/L or higher, when randomly measured glucose or values after an oral glucose tolerance test are 11 mmol/L or higher, and when glycated hemoglobin is greater than 6.5%

Long-term effects of elevated glycemia on health

Chronically elevated glycemia does not only affect body weight, but overall health as well. “Elevated glycemia leads to an increase in the proportion of adipose tissue in the body, especially visceral fat tissue, which accumulates around the organs and acts as an endocrine organ. In addition to storing energy, it secretes numerous hormones such as leptin, adiponectin and resistin, which are important for regulating metabolism and appetite, as well as cytokines that promote chronic low-grade inflammation, responsible for most complications of obesity, including insulin resistance, endothelial dysfunction, accelerated atherosclerosis, diabetes, cardiovascular disease and non-alcoholic fatty liver disease,” Dr Ranogajec concludes.

Given that sugar is increasingly highlighted as a factor in premature aging, the diabetologist adds that “elevated blood glycemia also leads to protein glycation and the formation of advanced glycation end products (AGE – Advanced Glycation End Products), which damage collagen and elastin in blood vessels, which can lead to kidney damage, retinopathy and atherosclerosis, in nerves (neuropathy) and in the skin (loss of elasticity, wrinkles, slower wound healing).”

The basis of glycemia regulation is not complicated

Changes in daily routines that can improve blood sugar levels are not overly complex. Nutritionist Nevena Pandža and diabetologist Dr Alda Ranogajec agree on several key factors that contribute most to stable glycemia.

They particularly highlight the Mediterranean diet as the highest-quality dietary pattern for long-term health. It emphasizes the quality of carbohydrates, sufficient protein intake from natural sources, an abundance of vegetables, healthy fats such as olive oil, reduced intake of added sugar and salt, and the use of herbs such as garlic and rosemary.

Avoiding refined foods and simple carbohydrates is important for overall health, even when there is no issue with glycemia, while dark chocolate with a high cocoa content can have its place in the diet if consumed in moderation.

Daily physical activity is also key, and as little as five to ten minutes of movement after a meal can make a difference in regulating blood sugar. The diabetologist particularly points out that “exercise lowers glycemia in the short term by enabling glucose to enter the muscles independently of insulin, and in the long term reduces insulin resistance.”

Regulating glycemia is not a short-term goal, but a long-term strategy for preserving health. This approach requires a lifestyle change, and proper nutrition, regular physical activity, quality sleep and an individualized medical approach are key tools in the prevention of metabolic diseases, maintaining a healthy body weight and extending healthspan.