#118 – Ask Me Anything with Dr. Casey Means (Chicken Soup | Sushi | Matcha? Why are all these causing a glucose spike?)

Why is matcha causing a glucose spike? What about chicken soup or sushi? How do we take cinnamon and vinegar? My exercise is causing a spike, is this good? We often get questions from our community around the impact of specific foods and activities. In this episode, Levels Chief Medical Officer, Dr. Casey Means, answers some of these questions and gives better alternatives.

01:50 – Watch out for the sugar in your tea

If you’re experiencing spikes from your matcha tea, it’s probably because of the caffeine or the sugar in the milk you’re using.

So we’ve got the question, “My matcha spikes me 20 to 30 points. Any ideas why?” So I think this could probably be two different things. It’s probably not the tea itself, which is basically just a ground up green leaf, but it’s probably either the caffeine or the milk that’s being used. So caffeine can sometimes cause a small glucose spike because it almost acts like it promotes the stress hormone release in the body, which can sometimes cause us to mobilize some glucose. So some people will notice a spike after coffee or caffeinated beverages. The second thing is that if you’re using milk with the matcha, just make sure that it’s an unsweetened milk. Some people are sensitive to dairy milk, because it does have some sugar in it. It might raise glucose. And then of course for non-dairy milks, you want to choose one that has no sugar in it. And some people are actually sensitive to nut milks, even that are unsweetened, just because the nut itself has a little bit more sugar. Sometimes cashew milk or macadamia nut milk might make people spike a little bit more even if they’re unsweetened milk. I tend to do really well with almond milk in terms of not getting a glucose spike if it’s unsweetened.

03:02 – Swap out the rice in your sushi

To get the lowest glycemic impact from sushi, either skip the rice altogether or make it at home with cauliflower rice.

So this member asks, “Is sushi without soy sauce still pretty bad? And does that mean rice as a side to meat and veggies is bad?” So first of all, I wouldn’t use the words bad or good when we’re talking about these things. We’re really just talking about the raw data here. Does it have a large glycemic impact or not? And over time we want to reduce our glycemic spikes, our glucose spikes, our glycemic variability, because we know over the long term, fewer glucose spikes, less glycemic variability is better for overall health. So with sushi, what we’ve found is that sushi rolls with rice tend to spike higher than other foods in the same category like sashimi. So sashimi is just going to be the fish alone. So that’s one way to enjoy sushi potentially without the spike is to just have maybe fewer of the actual rice rolls and then more of the sashimi, which is just straight fish. One thing that I love to make is cauliflower rice sushi. It’s actually super simple. It takes like 10 minutes at home and basically you just take a bag of riced cauliflower from the grocery store. It’s like $3 organic bags, put it in a microwave safe container in the microwave until it’s heated mix in some chia seeds, some tahini, some unsweetened rice wine vinegar. Let it sit for a little bit. And then basically just use that as you would use rice on your sushi making. Put in some avocado, some fish, some tofu, whatever you want in there. And then I generally use tamari, which is a gluten free soy sauce. And that gives me zero spike as much cauliflower sushi as I could possibly want to eat.

05:30 – Mix in some cinnamon

Cinnamon can help lower your glucose response so add it to your smoothies, coffee, or even take a pill.

Okay, this member asks, “How do we take cinnamon and vinegar?” AKA, how do we consume this stuff? Because the research is fairly strong that both cinnamon and vinegar actually can lower our glucose responses, which is pretty cool, but we don’t always think about reaching for these things. So with cinnamon, there’s lots of different options. You can add a couple tablespoons to your smoothie in the morning. It’ll just like fold right in and hide. You can add a teaspoon to your coffee, mix it in. Sometimes what I’ll do is I’ve got the milk frother and while my milk is frothing, I’ll actually put the cinnamon right in. And what that does is it incorporates it into the milk and makes it kind of like a cinnamony milk versus if I just put it straight into my coffee, sometimes it gets a little clumpy. You can also put cinnamon into like rubs that you’re making for like a meat or a chicken or a tofu, like add it to a spice mix and then rub it on the food. And then there’s also now supplements that are basically just straight cinnamon that you can just take straight. That’s another way to get it.

06:30 – Use vinegar in your salad dressings

Vinegar also lowers glucose response. Add it to your diet by making your own salad dressings.

Now for vinegar. So most of the vinegar that I end up eating is in the form of salad dressing. So I have a big stock of vinegars. I always make sure to look at vinegar labels to make sure it doesn’t have sugar in it. Some vinegars like sneakily do have higher sugar concentration. So just make sure you’re looking, but I just have this small mini food processor on my counter at all times. And I will just throw together dressings like very, very frequently. And the base is usually always like vinegar. So rice wine vinegar to make more of like an Asian style dressing, balsamic vinegar, I’ll use champagne vinegar, white wine vinegar. So all of these will work and mix it with a little tahini, a little olive oil, Dijon mustard, tamari, spices, garlic, shallots, very simple to make a delicious, healthy dressing filled with vinegar and get like a couple tablespoons in. Another way you can do it is actually just to add it to some water and then just take it like a drink.

08:12 – Expect a glucose spike during exercise

High intensity exercise causes glucose stores in the liver to break down and be released into the bloodstream.

Okay, this member’s asking, “Why does blood sugar go up when we exercise? And is this good?” Great question. A lot of people will see a fairly significant glucose spike when they do high intensity exercise. So exercise that’s really pushing your body to its limits. So thinking like 70, 80% or more of your max heart rate or VO2 max, what this is going to do is it actually sends a signal to your body that you’re under stress. The body is working hard and that is going to release stress hormones in the body. And those stress hormones travel to the liver and actually cause you to very quickly break down stored glucose so that we store glucose in the liver in the form of something called glycogen and the stress hormones cause you to release that into the bloodstream because the body thinks it needs to respond to some sort of stress. And so it needs sugar for the brain and the muscles. And so that’s what the body’s doing.

09:08 – Understand the exercise glucose spike

The glucose spikes are actually a good thing physiologically because you’re using up your stores of glucose and burning fat.

One is because you’re exercising. So you’re actually using the muscles and you’re going to use that glucose that’s released. So the glucose is released from the liver and it’s being used by the muscles. So there’s a sink for it, which is important. The second thing is that muscles are kind of cool in the sense that they actually can take up glucose without insulin. So this is one of the only tissues that can do this. Normally cells need insulin to bind the cell membrane to allow glucose to go in, but in muscles, actually the muscle contraction itself can cause glucose uptake, which is kind of cool. So you’re not necessarily getting as much of the insulin hit with that blood sugar rise. And the third reason that it’s potentially advantageous is that it’s clearing your liver of its stored glucose. And when we have about a few hours of glucose stored in the liver, as sort of like our short term account of glucose, and that’s going to be the first stuff that we use before we actually burn fat. So if you’re clearing out the liver of some of its stored glucose, you’re putting your body into a state where it’s going to be more likely to actually start burning fat.

10:43 – Pick a different noodle for your soup

You might be spiking from chicken noodle soup becuase of the noodles. Make it at home and use low carb noodles instead.

All right, so this member’s asking, “Do you know why chicken soup would spike my glucose levels? Not enough fat?” So I like the way you’re thinking with not enough fat because of course balancing fat, protein, fiber and carbs is going to be a good way to keep glucose more stable. And that’s probably part of it. Chicken soup doesn’t have a lot of fat, right? It’s chicken is pretty lean and usually not a lot of oil used in these things. I’m assuming that if this is like a traditional chicken soup, that there’s noodles in it. And so I’m guessing that it’s the pasta or the noodles in there that’s causing the glucose spike. These are generally made of refined white flour, which is going to turn into glucose in the bloodstream. Another thing it could be is potentially some of the other vegetables that are used in it are high glycemic. So if there’s carrots in there, those sometimes spike people, not everyone, but it’s one of the more higher glycemic vegetables. There might be potatoes in here which could also do it. The way I would potentially make a chicken soup is using a nice broth base, some low glycemic vegetables like onions, garlic, celery, chicken, and a bunch of different spices, and then use alternative noodles. Like I love konjac root noodles, which are essentially root vegetable that have almost virtually no carbohydrates, because it’s so much fiber. You can get these in the form of a brand called NuPasta and N-U Pasta.

Dr. Casey Means (00:06):

Is sushi without soy sauce still pretty bad? And does that mean rice as a side to meat and veggies is bad? So first of all, I wouldn’t use the words bad or good when we’re talking about these things. We’re really just talking about the raw data here. Does it have a large glycemic impact or not? And over time we want to reduce our glycemic spikes, our glucose spikes, our glycemic variability, because we know over the long term, fewer glucose spikes, less glycemic variability is better for overall health.

Ben Grynol (00:32):

I’m Ben Grynol, part of the early startup team here at Levels. We’re building tech that helps people to understand their metabolic health. And this is your front row seat to everything we do. This is a whole new level. AMA, ask me anything. Often we get these questions from the community through different social platforms, but these questions come in and people have very specific curiosities around often food. Why do certain foods result in glucose spikes? Well, Dr. Casey Means, chief medical officer and co-founder of Levels sat down and answered some of these questions. In this episode, she talked about chicken soup, sushi and matcha. Why are all these different things causing glucose spikes? It was really cool to hear Casey’s perspective on everything and give more insight into why these items might be causing glucose spikes for some members. Here’s Casey.

Dr. Casey Means (01:50):

Okay. So we’ve got the question, “My matcha spikes me 20 to 30 points. Any ideas why?” So I think this could probably be two different things. It’s probably not the tea itself, which is basically just a ground up green leaf, but it’s probably either the caffeine or the milk that’s being used. So caffeine can sometimes cause a small glucose spike because it almost acts like it promotes the stress hormone release in the body, which can sometimes cause us to mobilize some glucose. So some people will notice a spike after coffee or caffeinated beverages.

Dr. Casey Means (02:22):

The second thing is that if you’re using milk with the matcha, just make sure that it’s an unsweetened milk. Some people are sensitive to dairy milk, because it does have some sugar in it. It might raise glucose. And then I’m first of course, for non-dairy milks. You want to choose one that has no sugar in it. And some people are actually sensitive to nut milks, even that are unsweetened, just because the nut itself has a little bit more sugar. Sometimes cashew milk or macadamia nut milk might make people spike a little bit more even if they’re unsweetened milk. I tend to do really well with almond milk in terms of not getting a glucose spike if it’s unsweetened.

Dr. Casey Means (03:02):

All right. So this member asks, “Is sushi without soy sauce still pretty bad? And does that mean rice as a side to meat and veggies is bad?” So first of all, I wouldn’t use the words bad or good when we’re talking about these things. We’re really just talking about the raw data here. Does it have a large glycemic impact or not? And over time we want to reduce our glycemic spikes, our glucose spikes, our glycemic variability, because we know over the long term, fewer glucose spikes, less glycemic variability is better for overall health. So with sushi, what we’ve found is that sushi rolls with rice tend to spike higher than other foods in the same category like sashimi. So sashimi is just going to be the fish alone. So that’s one way to enjoy sushi potentially without the spike is to just have maybe fewer of the actual rice rolls and then more of the sashimi, which is just straight fish.

Dr. Casey Means (03:53):

One thing that I love to make is cauliflower rice sushi. It’s actually super simple. It takes like 10 minutes at home and basically you just take a bag of riced cauliflower from the grocery store. It’s like $3 organic bags, put it in a microwave safe container in the microwave until it’s heated mix in some chia seeds, some tahini, some unsweetened rice wine vinegar. Let it sit for a little bit. And then basically just use that as you would use rice on your sushi making. Put in some avocado, some fish, some tofu, whatever you want in there. And then I generally use tamari, which is a gluten free soy sauce. And that gives me zero spike as much cauliflower sushi as I could possibly want to eat. And another thing to think about within terms of rice, if you really love rice and don’t want to give that up is to how to parrot appropriately to have minimal glucose spike.

Dr. Casey Means (04:43):

So you want to be thinking about food sequencing as well if you’re eating rice and make sure your front loading your fat, protein and fiber earlier into the meal so that you can offset that carbohydrates that you’re eating later in the meal. And then there’s other tips and tricks you can do. Like maybe if you’re having sushi, that’s the day that you have an apple cider vinegar shot before your meal, which we know will lower glucose spikes or make sure you’re just taking a walk right after you eat that high carb sushi meal to kind of offset some of the [inaudible 00:05:14] impact. So there’s ways to work with it, but definitely plug for cauliflower rice sushi. It’s really fun to make and we’ll definitely impress your friends.

Dr. Casey Means (05:30):

Okay, this member asks, “How do we take cinnamon and vinegar?” AKA, how do we consume this stuff? Because the research is fairly strong that both cinnamon and vinegar actually can lower our glucose responses, which is pretty cool, but we don’t always think about reaching for these things. So with cinnamon, there’s lots of different options. You can add a couple tablespoons to your smoothie in the morning. It’ll just like fold right in and hide. You can add a teaspoon to your coffee, mix it in. Sometimes what I’ll do is I’ve got the milk frother and while my milk is frothing, I’ll actually put the cinnamon right in. And what that does is it incorporates it into the milk and makes it kind of like a cinnamony milk versus if I just put it straight into my coffee, sometimes it gets a little clumpy. You can also put cinnamon into like grubs that you’re making for like a meat or a chicken or a tofu, like add it to a spice mix and then rub it on the food. And then there’s also now supplements that are basically just straight cinnamon that you can just take straight. That’s another way to get it.

Dr. Casey Means (06:30):

Now for vinegar. So most of the vinegar that I end up eating is in the form of salad dressing. So I have a big stock of vinegars. I always make sure to look at vinegar labels to make sure it doesn’t have sugar in it. Some vinegars like sneakily do have higher sugar concentration. So just make sure you’re looking, but I just have this small mini food processor on my counter at all times. And I will just throw together dressings like very, very frequently. And the base is usually always like vinegar. So rice wine vinegar to make more of like an Asian style dressing, balsamic vinegar, I’ll use champagne vinegar, white wine vinegar. So all of these will work and mix it with a little tahini, a little olive oil, Dijon mustard, tamari, spices, garlic, shallots, very simple to make a delicious, healthy dressing filled with vinegar and get like a couple tablespoons in. Another way you can do it is actually just to add it to some water and then just take it like a drink.

Dr. Casey Means (07:29):

One that tastes pretty good is apple cider vinegar. So you put a couple tablespoons in a glass of water and just drink that before dinner or first thing in the morning is one way to do it. You can add vinegar and drizzle it over steamed or roasted vegetables for a little bit of [inaudible 00:07:46]. And then of course another option is to eat fermented foods which actually make in the fermentation process, there will be the creation of acetic acid, which is essentially vinegar. And so fermented foods can help get you some vinegar as well. So things like kimchi and sauerkraut are good options.

Dr. Casey Means (08:12):

Okay, this member’s asking, “Why does blood sugar go up when we exercise? And is this good?” Great question. A lot of people will see a fairly significant glucose spike when they do high intensity exercise. So exercise that’s really pushing your body to its limits. So thinking like 70, 80% or more of your max heart rate or VO2 max, what this is going to do is it actually sends a signal to your body that you’re under stress. The body is working hard and that is going to release stress hormones in the body. And those stress hormones travels the liver and actually cause you to very quickly break down stored glucose so that we store glucose in the liver in the form of something called glycogen and the stress hormones cause you to release that into the bloodstream because the body thinks it needs to respond to some sort of stress.

Dr. Casey Means (09:00):

And so it needs sugar for the brain and the muscles. And so that’s what the body’s doing. And the reason this is so different than a food spike is for a couple reasons. One is because you’re exercising. So you’re actually using the muscles and you’re going to use that glucose that’s released. So the glucose is released from the liver and it’s being used by the muscles. So there’s a sink for it, which is important. The second thing is that muscles are kind of cool in the sense that they actually can take up glucose without insulin. So this is one of the only tissues that can do this. Normally cells need insulin to bind the cell membrane to allow glucose to go in, but in muscles, actually the muscle contraction itself can cause glucose uptake, which is kind of cool. So you’re not necessarily getting as much of the insulin hit with that blood sugar rise.

Dr. Casey Means (09:43):

And the third reason that it’s potentially advantageous is that it’s clearing your liver of its stored glucose. And when we have about a few hours of glucose stored in the liver, as sort of like our short term account of glucose, and that’s going to be the first stuff that we use before we actually burn fat. So if you’re clearing out the liver of some of its stored glucose, you’re putting your body into a state where it’s going to be more likely to actually start burning fat. So those are all the reasons why glucose spike from exercise is not necessarily something we need to worry about. And we definitely have seen that people who engage in exercise like high intensity interval training, or pretty, fairly intense aerobic exercise, where they do see a glucose spike, these are exercises that we know actually increase insulin sensitivity over time and even very quickly. And so are associated with good metabolic outcomes, even though you may be seen the spike on the glucose monitor.

Dr. Casey Means (10:43):

All right, so this member’s asking, “Do you know why chicken soup would spike my glucose levels? Not enough fat?” So I like the way you’re thinking with not enough fat because of course balancing fat, protein, fiber and carbs is going to be a good way to keep glucose more stable. And that’s probably part of it. Chicken soup doesn’t have a lot of fat, right? It’s chicken is pretty lean and usually not a lot of oil used in these things. I’m assuming that if this is like a traditional chicken soup, that there’s noodles in it. And so I’m guessing that it’s the pasta or the noodles in there that’s causing the glucose spike. These are generally made of refined white flour, which is going to turn into glucose in the bloodstream. Another thing it could be is potentially some of the other vegetables that are used in it are high glycemic.

Dr. Casey Means (11:24):

So if there’s carrots in there, those sometimes spike people, not everyone, but it’s one of the more higher glycemic vegetables. There might be potatoes in here which could also do it. The way I would potentially make a chicken soup is using a nice broth base, some low glycemic vegetables like onions, garlic, cellery, chicken, and a bunch of different spices, and then use alternative noodles. Like I love konjac root noodles, which are essentially root vegetable that have almost virtually no carbohydrates, because it’s so much fiber. You can get these in the form of a brand called NuPasta and N-U Pasta. There’s also tofu noodles out there, like shirataki noodles that you can buy at the grocery store. And these basically taste like delicious ramen noodles, but they will spike your glucose. So that is what I’m guessing is happening with the chicken soup. Also, if there were maybe like crackers on the side or anything like that, that can also contribute.