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episode #298

Interview with Carlee Hayes: Reach Your Health Potential by Utilizing a Continuous Glucose Monitor (CGM)

October 23, 2023 in Podcast

Intro

This week I interviewed Carlee Hayes!

Carlee is a Registered Dietitian Nutritionist (RDN) and the Senior Nutrition Manager for Nutrisense, a company utilizing continuous glucose monitors (CGMs) to build personalized diet and lifestyle plans.

In this episode, we discuss how to utilize a CGM to optimize your health along with:

  • Tracking Postprandial Glucose
  • How Certain Foods affect Your Glycemic Variability
  • Importance of Muscle for Managing Blood Glucose
  • Meal Timing when Metabolizing Foods
and much, much more!



Brian (0s):

Coming up on the GET, LEAN, Eat, Clean, Podcast.

Carlee (4s):

I think from a consumer or even just a general lay person standpoint, it's really difficult to know what you specifically should be doing. Your grandma might be telling you one thing your healthcare provider might be telling you another. So to cut through all of that noise is really challenging. I think that's exactly what the CGM does. So if you're looking at that data and you kind of know how to interpret it, and remember you're getting it in real time. So once you put this on your arm, you get that data on your phone in real time. As soon as all of these factors, you know, your sleep, your stress, what you're eating, how you're moving, as soon as you do that activity or experience that influencer, you'll see how it's impacting your Glucose in the moment.

Carlee (44s):

And I think that's really cool because again, you're not having, you're not reading an article that's telling you to do something. You are seeing what your body is telling you.

Brian (53s):

Hello. and welcome to the Get Lean Eat Clean podcast. I'm Brian Gryn and I here to give you actionable tips to get your body back to what it once was, five, 10, even 15 years ago. Each week I'll give you an in depth interview with a health expert from around the world to cut through the fluff and get you long term sustainable results. This week I interviewed Carlee Hayes. Carlee is a Registered dietician and senior Nutrition manager for Nutrisense, a company utilizing continuous glucose monitors to build personalized diet and lifestyle plans. We discussed how to utilize a CGM to optimize your health, along with Tracking Postprandial Glucose How Certain Foods affect Your Glycemic Variability, the Importance of Muscle for Managing, Blood Glucose, Meal Timing when Metabolizing Foods.

Brian (1m 41s):

and much, much more. Really enjoyed my interview with Carlee. I know you will too. Thanks so much for listening and enjoy the show. All, right Welcome to the Get Lean Eat Clean podcast. My name is Brian Gryn and I have Carlee Hayes on welcome to the show.

Carlee (1m 57s):

Thanks, Brian. I'm so happy to be here.

Brian (1m 60s):

Yeah, thanks for coming on. I know you've been on a bit of a podcast tour yourself, right?

Carlee (2m 5s):

Oh yeah. Making my way around.

Brian (2m 8s):

And Senior Nutrition manager at Nutrisense, correct? Correct.

Carlee (2m 12s):

You got it.

Brian (2m 13s):

And maybe explain to individuals what Nutrisense is and sort of how you got involved with them.

Carlee (2m 19s):

Definitely. So Nutrisense, I think we're kind of referred to as the CGM company, which is true. But essentially we are a health tech company and we are using Continuous, Glucose monitoring technology to bridge the da, the gap between data, so real human data and all the nuances and personalized insights that go with that and sustainable behavior change. So kind of using that, your body's own data to build personalized health and lifestyle plans. And as far as me, how I got into this, so I did not start out in a tech startup. This was not, you know, something that I planned. I started out in a very, very traditional setting.

Carlee (2m 60s):

So I am a dietician by trade. I was trained, went to the a VA internship and, and kind of got my schooling there and afterwards went directly into a very, very traditional outpatient counseling position. So I was usually working with individuals that had just come to me with a diagnosis of diabetes or pre-diabetes or something from their doctor. So it was that diagnosis that kind of prompted that referral to me and we would work together on, you know, managing that chronic condition. And while I loved that, I really loved what I did and, and kind of helping individuals in all different disease states or just ways of life, I just got me thinking that, you know, why, why am I the last referral here?

Carlee (3m 43s):

Why is Nutrition and lifestyle changes? What we're, you know, prioritizing after that disease diagnosis? And when you look at some of the research behind these chronic lifestyle related conditions like diabetes or heart disease or anything along those lines, most of those, so about 80% of those, you know, take decades to develop and can be prevented or at least delayed if you acted early enough. And that seemed to be the biggest problem in my mind, is that we weren't acting early enough. We were waiting and waiting and waiting until that full-blown disease state that diagnosis came about. And then we were treating it with health and lifestyle changes.

Carlee (4m 23s):

So while I, I loved that I started to look for other solutions. And back then, this was 2019, I started to see these companies popping up all over using Continuous Glucose monitoring or CGMs in kind of a non-traditional way. So if you've ever seen a CGM, if you have a family member with diabetes or you know someone with type one diabetes, you might have seen a CGM. So this is the little device that you wear kind. Yeah, a patch on the back of your arm. And, what it's doing is measuring your blood sugar or your, if we're gonna be correct, your interstitial fluid sugar or Glucose all the time. So continuously. And that's traditionally only used with individuals in those disease states to manage their insulin or manage poorly controlled blood sugars.

Carlee (5m 11s):

But I started to see that this was being used in a preventative way. And I know you've kind of have talked about this as well, but you know, preventative health I think is the key, but it's not something we always prioritize in our current healthcare system. So to see this, this device used in that way and this meaningful data used by individuals in a multitude of ways was really exciting to me. And that's when Nutrisense was just starting to take members. So I was the first dietician that they brought on and I haven't looked back since. And I think, you know, just seeing that moment click in someone's mind when they see their behaviors and how they impact their Glucose or their metabolism, which we can get into, and seeing how that can trigger that behavior change has been really meaningful and impactful to me.

Carlee (5m 59s):

And so just hoping to bring that message to as many people as possible.

Brian (6m 3s):

That's great. Carlee. And so you've been with the company for what, like four years?

Carlee (6m 8s):

Yes. We just had our fourth, fourth an anniversary birthday. So we've been working with members for a little over four years now. And it's been a wild ride. It's been really, really fun. And, and we've grown a lot as a company. So

Brian (6m 23s):

Yeah. And I actually have one right here. I've, I've used it on and off. There we go. Nutrisense. Nice. Yeah, and I, I will say the, the best marketing for a Continuous, Glucose Monitor is just a wear one. 'cause when I do wear 'em around, like people ask me like, what is that like? It's, it's definitely a talking point. People are wondering if maybe I, I am diabetic, I tell them I'm not. This is just like more of a preventative or just to a tool, right? Like to get more information. I always tell people with a lot of these wearables, there's, I mean, nothing replaces actually doing the like foundational principles of health, right? Like exactly focusing on sleep, stress management, obviously eating correctly and things like that.

Brian (7m 3s):

But this is just another tool. Maybe explain to people how they can use this as a preventative tool to like improve their health.

Carlee (7m 12s):

Yes, great question. And I also get those questions all the time when I wear a CGM. So my hope is that this kind of becomes the new, you know, fall accessory where, where it's something you wanna see and people want to see that. So yes, you are right. And I can kind of slow down. I, I know your audience might be a little bit more familiar with CGMs, but for those that are not, this is what it looks like. So if you've known someone one with diabetes, you might have seen them use like a finger prick device, right? So that's where, you know, before you're eating or maybe two hours after you eat a meal, you prick your finger and you measure your, your Glucose or your blood sugar. And that gives you a point of time measurement or kind of like a snapshot into what your Glucose and therefore your metabolism is doing at that point in time.

Carlee (7m 53s):

And, what the CGM does is you have this applicator, you have the device, you insert it into the back of your arm. And I know that's always kind of scary because there is a needle that you use to apply that, but you can probably speak from experience, it hurts a lot less than a finger prick, would you agree?

Brian (8m 10s):

Yeah, it's, it's easy. Yeah. You feel it for like a second and that's it. Yeah, yeah,

Carlee (8m 15s):

Exactly. So go ahead, sorry.

Brian (8m 17s):

Yeah, no, exactly. You get used to it and you put it on pretty much almost where your tricep is located, right? Yeah. Yep.

Carlee (8m 29s):

So usually kinda where you're, you have the most Fat on the back of your arm, So, we currently use the freestyle libre, which is only approved for use right here. I know some people, you know, if you have diabetes or you're using other brands, you can apply them like in your stomach or your, your thigh. We are only using the one that is applied right here. But yeah, exactly what you said, it's a one-time stick. And the, the benefit of that is that you have that data in real time from what your body's doing for 14 days. So each sensor lasts 14 days, right? And then after that time you pull it off and you replace it with a new one. So it kind of gives you, I always think of this as like pulling the curtain back and seeing what's going on underneath the hood or what's going on behind the seam in your body.

Carlee (9m 10s):

I think when you look at health, there's a lot of noise, right? There's a lot of people telling you this is the thing to do, or No, no, no, this is the thing to do. And if you, I always find it funny, if you Google any specific food, you can find an article telling you why you shouldn't eat that food, right? Right, right. So I think from a consumer, or even just a general layperson standpoint, it's really difficult to know what you specifically should be doing. Your grandma might be telling you one thing your healthcare provider might be telling you another. So to cut through all of that noise is really challenging. I think that's exactly what the CGM does. So if you're looking at that data and you kind of know how to interpret it, and remember you're getting it in real time. So once you put this on your arm, you get that data on your phone in real time.

Carlee (9m 54s):

As soon as all of these factors, you know, your sleep, your stress, what you're eating, how you're moving, as soon as you do that activity or experience that influencer, you'll see how it's impacting your Glucose in the moment. And I think that's really cool because again, you're not having, you're not reading an article that's telling you to do something. You are seeing what your body is telling you. And you, you speak to this as well, but there is so much bioindividuality when it comes to healthcare, and I always say there's no one size fits all diets, but to find out what your specific size of healthcare or diet or anything is, is, is a challenge. So that's just a tool to kind of cut through that noise, cut through the BS, and tell you exactly how your body's responding to what you're doing on a, on a daily basis.

Carlee (10m 40s):

And from there you can make small tweaks, you can experiment, you can do specific things to see how it impacts either improves or does not improve your Glucose. And we can talk about, I think it might be helpful to talk about like what Glucose is and why that's important, but I think that's the key thing there is that in real time you're able to see how your behaviors are impacting you. And in a society that's very driven by, you know, instant gratification or just that gamification of, of everything that we're doing, that is one of the most meaningful and motivating things that we can do.

Brian (11m 16s):

Yeah, and you, you talk about like Variability maybe touch on like what Glycemic Variability is within like foods and based on how like the Nutrisense can, you know, measure, measure that throughout the day.

Carlee (11m 30s):

Yes, definitely. So I'll take it a step back and just talk a little bit about what Glucose is because I think, you know, you hear blood sugar, you hear Glucose and we mostly know what that is, but just to make sure we're all on the same page, when you think about your metabolism, right, this is in the most layman's terms, the sum of reactions that are incurring in your body when you're process processing energy. So this is how your body's responding to the foods or whatever factors that you're putting in, it's how it's responding to that. So one of the key things that is involved there is a metric called Glucose. So this is your body's preferred source of fuel and we need a certain amount of that in our bloodstream at all times.

Carlee (12m 14s):

And this is a really, really small amount. So if you think about your body and kind of how it works, it's trying all the time to maintain homeostasis and that applies to Glucose or blood sugar too. So what that means is all the time it's trying to keep it in a very, very stable range, right? It wants to keep it stable in that homeostatic kind of range. And from the research that we've seen, for a normal person with a normal functioning metabolism, that range is about 70 to one 40 milligrams per deciliter. So that's a pretty, you know, tightly controlled range. And so within that range, there are three main metrics that we're looking for. And the first one is one that if you've ever had a traditional lab draw from your doctor, you're probably pretty familiar with, and that's your fasting Glucose.

Carlee (12m 59s):

So that's just what your blood sugar is doing. Well have you, after you've been fasting, you're kind of in that fasted state usually for about eight hours. So when you wake up, that's what your fasting Glucose is. So when you go to your doctor, and I recommend that everyone continues to do their annual at least lab draws because those are really important, just like that finger prick device, it's only giving you a snapshot of the time, right? It's telling you what your body's doing at that given moment. And while that can be really helpful for monitoring how things are doing over time, that doesn't give you the full picture, right? It's just the snapshot And. what we wanna see is that movie is how I like to think of it or like a time lapse. And so the other two metrics that we Monitor or that we look at for metabolic health are very uniquely a benefit of wearing a CGM.

Carlee (13m 47s):

So the first one is your Postprandial Glucose or your after meal response. So this is one, if you are not wearing a CGM, this is incredibly challenging to track. So if you've ever, I don't know, have you ever tested your Postprandial with a, with a finger prick?

Brian (14m 5s):

No, no,

Carlee (14m 7s):

No, no. It's not fun. I'll tell you that right now because you, what you want to see is a gradual increase in, in blood sugar. So whenever we eat food, we do expect to see blood sugar to increase or your Glucose to increase. That's normal. That's your body responding to that food, that's your metabolism at work. But the, the devil is in the details as they say, right? So you wanna see a very small kind of gradual increase in blood sugar from where you're starting at. So your baseline, and then with that, you want to see it return back down to your baseline within about two to three hours. So those things. And then keeping it below that one 40 threshold that we're looking for. So if you think about it, and this is challenging if you're not like looking at a graph, but think of it as just kind of like a, a gradual hill is what you wanna look at.

Carlee (14m 53s):

So if you are spiking really high, so above that one 40 range, or you're having a giant shift, so maybe you started really low and then you went, you know, kind of moderate, those are really, really large fluctuations in your blood sugar. And if we go back to that homeostatic state, that means that your body's working really, really hard to bring your blood sugar back down to baseline. And that's not what we want, right? We want our body to be able to tolerate what we're eating really well and promote those good Glucose curves as we look at those. So if you are not using a CGM, this would mean you'd have to prick your finger before you eat about 20 minutes, one hour, hour and 32 hours.

Carlee (15m 33s):

And then hope that it's back down to that baseline. And from those points you can kind of see that curve. But the, the unique thing about the CGM is that you see it all in one like very, very beautiful picture without having to prick multiple times. And all of that's in real time. All of that is something you see on your phone as soon as you're eating takes about, you know, 15 minutes for it to show up. But you're able to see how every specific food impacts you. And then the third thing we're looking at, and this is what you had mentioned, is Glycemic. Variability. And this is something that without a CGM would be extremely challenging, if not impossible to track. So this is just this like very huge kind of sciencey word for how many like shifts, how big of a swings are you having in your Glucose?

Carlee (16m 21s):

So remember we're, we're trying to keep that homeostatic state and if we are having giant swings over and over every time we're eating or multiple times throughout the day, that means that we're what I call riding the blood sugar rollercoaster. So essentially your blood sugar is spiking really high, your body's working really hard to bring that down. And then sometimes what will happen is you'll crave certain foods because you're back down and you've had those larger shifts. So that is very high Variability and that's what I, I like to think of this in terms of mountains, right? You're thinking jagged peaks, that's not what we want. We want those kind of rolling hills of Glucose that are more gradual and that are easier for your body to tolerate and kind of control in that range.

Carlee (17m 5s):

So a low Glycemic Variability is what we're looking for. And this is a complicated formula that we won't get into, but thinking of it in terms of those shifts, those swings, how hard is your body having to work to keep it in that level time and a time again over and over? And one thing that I always stress with every single person that looks at their blood sugar is that one single spike in your Glucose is, okay, this happens to every single person, myself included, I've spiked above one 40, I've had giant shifts. But I think those one-offs are not gonna make or break you. It's when over and over and over again for years, for decades, you're having these larger shifts.

Carlee (17m 47s):

That is what ultimately can cause inflammation, microvascular damage, oxidative damage, and then ultimately lead to those disease states. So again, if we are not measuring that until we're already at that problem, or if we're not seeing that these huge shifts are happening, we are missing this giant opportunity to make small little tweaks that can have a huge impact on our health outcomes. So when we think about preventing those chronic diseases, I always say this isn't sexy, right? We all know what we should be doing, we all know we shouldn't be eating sugar or all of those things, right? I think that's pretty well known, but the long-term effects of that are, they're not right in our face all the time until you see the data and when you see those data And, you know, kind of what it can cause over time, that's that motivation to kind of control those blood sugar spikes or at least kind of build that curiosity mindset to figure out what you can tweak to get it in that right range.

Brian (18m 46s):

Yeah. And you talk about like what we can eat and I think the nice thing about something like a CGM is that individuality that you can find because there's a lot of just general like ideas out there as far as like the perfect foods to eat and not to say that everything is tied to necessarily the glu Glucose, right? Like there's obviously bad foods that might not be sensed on the, as a, you know, a big Variability as far as Glucose is concerned. Yeah. But do you find that there's certain foods, you know, just 'cause you work with, you're working also with clients who buy the Nutrisense, right? I know that's an option to work with like a Nutritionist to help sort of identify foods or, or even just like different activities or different things that could be affect, that could affect your Glucose in a negative manner.

Brian (19m 37s):

So are there certain sort of either body or either lifestyle changes or certain food choices that you find keep coming up again?

Carlee (19m 48s):

Yes, definitely. So to answer your question, yes, working with members see that data all the time. And so there's definitely things that I always look for because they're very common influencers, but there's so much, again, bio individuality that it's hard to say for certain this food will spike you or this food will will not, right? Right. So a good example of that is, you know, I have a coworker that we've worked at Nutrisense both for four years. We're both very, very healthy. We both lift weights similar ages. So you know, we're both dieticians, you would think that we'd have very similar responses to the same foods. But when we both wear CGMs together, we'll notice certain foods like sweet potatoes for example, I respond really, really well to starchy vegetables, like sweet potatoes, winter squash.

Carlee (20m 32s):

I keep my Glucose in a very controlled range even with, you know, a good amount of those. But if she has even a small amount, she will spike beyond that one 40 threshold and it will take her longer to return back down to baseline. So that is a food, even a whole food, right, that you would think, oh, sweet potatoes are better than white potatoes. I should be able to tolerate those. Well that's one that I wouldn't have suspected until I saw that data myself. So I think that was a really cool thing for me just to see that that is a huge, huge factor to, to, to consider. And I don't know if you, did you spike to any foods like that?

Brian (21m 5s):

Well, what I was gonna ask on that point is do you think there's something else, an another underlying issue that could be the reason why you respond better than she didn't perhaps be gut related or who knows? Yeah, you know,

Carlee (21m 23s):

Yeah, that's a good question and I've thought about this a lot. Yeah. But when we think about the other influencers that kind of create that bioindividuality or influence our unique individual response, you call that a big one, which is microbiome differences, right? We all have a very different host of microbiota in our guts and that can influence how we tolerate foods, which foods we crave, how much of specific foods that we can do well with. So that's a big one. Genetics is also a big one. So those are a little bit harder to explore or to define, but I think those are two that I always consider. The one that I think probably influences my response versus my coworker's response is our muscle mass. So she is a very, very muscular person, just naturally, lots of mu muscle mass, which props to her, that's awesome.

Carlee (22m 10s):

I'm not, I'm a string bean, I'm, I don't have a whole lot of muscle mass even though I lift and even though I do all the things, and when we look at Glucose, so whenever we eat a meal specifically with carbohydrates, right, that's going to increase our Glucose a little bit more. And like I mentioned, that's what we want to see. That's a normal response. But the degree of which that spike occurs is largely related to how much muscle we have. So our first way of mitigating any Postprandial or after meal response is by soaking that Glucose up into our muscles. So that is a huge sink for Glucose. And that is a big reason why men typically have better Glucose responses to those larger carbohydrate meals than women, right?

Carlee (22m 51s):

You have a larger muscle mass reserve, so you have a larger sink for that incoming fuel or that incoming Glucose. So if you, you know, have more muscle mass, I think of this as more storage, right? You can store Glucose there for use, and the more muscle you have, the more you can store. The other place that we store Glucose is in the liver. So that's kind of our reserve and we can, we can tap into that if we need to. We don't have as much control over that in the moment, right? So, we can't just say, yeah, I'm gonna shuttle this Glucose into the liver, it's gonna go into our muscles if we have that storage space available. So another way that we can really kind of biohack that is by adding movement around our meals, right?

Carlee (23m 32s):

So if you think about your, your muscles as a sink And, you know, that they can kind of soak up that Glucose, think of them as a sponge. If you are eating a meal that has a larger amount of carbohydrates in it, a really great thing to get into the habit of is even going for a 10, 15 minute walk after your meal to soak up that Glucose. And if you're putting it to use, then less of it's going to stay in the blood, more of it's gonna be utilized. You're gonna control that spike. That's exactly what we want. Another thing that you can do is to time your higher carbohydrate meals around your lifting sessions. So I know you talk about this, I, I'm very passionate about this, but lifting weights, Resistance training is critical for not only bone health, but also metabolic health and how you're kind of processing your Glucose.

Carlee (24m 19s):

So if you have a big, like I'm doing squat tober, I don't know if anyone else is doing that, but if you're doing a, a squat session, that is a perfect time to add in more carbohydrates to your day. So if you're sitting at lunch and you're, you know, at a desk job, you're not moving, maybe don't have the foods that are going to cause that higher Glucose spike. So those are typically your higher carbohydrate foods. Instead you can time those for when you're gonna be using those muscles and building that sink. And then long term, if you're building your muscle, if that's something you're working towards, I think it's really motivating to know that you're gonna have more Glucose storage space. You can tolerate more carbohydrates. And that's a really cool thing to do with your CGM as well, is just see how much carbs, which types of carbs that you specifically do best with.

Carlee (25m 5s):

And then you can kind of figure out where, where to put those, what time you can put those in your day.

Brian (25m 12s):

Yeah. All great points. And, what about the Timing of your meals? you know, one of the things I've just noticed, even without the CGM on, 'cause I haven't had one on in a little a while now, but I noticed that mornings I can handle foods actually better than I can in the middle of the day. That and, and even at night, what, what, what, what have you learned about the Timing of meals?

Carlee (25m 36s):

Yes, I'm really glad you brought this up because this is, you know, you asked what are some things that you found almost universally or that everyone should kind of keep in mind. And I think Timing is one that is universal, doesn't matter. Your unique individual bio-individuality, the Timing of which you eat foods, especially you know, your larger meals or your higher carbohydrate meals is going to have a huge impact on how well you metabolize and process that food. And then ultimately what your Glucose curve looks like. So what we find, and this is really interesting to explore if you ever wear a CGM, is that your insulin sensitivity, and remember insulin is that hormone that kind of takes that Glucose outta your blood and moves it into your cells so that you can use it.

Carlee (26m 21s):

We want to be sensitive to insulin. So I think that's always something that's confusing is insulin Resistance versus insulin sensitivity. Insulin Resistance is what we don't want. We want to be responsive to that insulin and that means we want to promote insulin sensitivity, we wanna be sensitive to the impacts of that hormone. So insulin sensitivity is closely aligned with our circadian rhythm. So that's our body's kind of natural clock, if you will. And that just means that we're kind of on this, this timeframe every single day and this repeats every day. And usually this is for most people, insulin sensitivity is best in the middle of the day and then lowest in the middle of the night. So it's kind of aligned with, with our, our other hormones.

Carlee (27m 3s):

So as your sleep hormones are revving up your digestion hormones, so insulin are revving down. So it's kind of that inverse relationship and we can use that to biohack our responses and kind of improve how we respond to foods. So you had mentioned, you know, in the morning you respond better to most foods, which is super interesting and we can get into that in a minute, but I think that's really helpful. Most people find that if they have foods later in the evening, they are almost always going to have larger responses than if you had that same exact food earlier in the day. Yeah. So say you take that sweet potato example, you had that at 9:00 PM you're probably gonna have a much larger spike than if you had it at breakfast with your eggs or at lunch with whatever you're having.

Carlee (27m 50s):

So Timing your larger meals, or specifically your higher carb meals earlier in the day can really align with that clock. And that's one of the biggest hacks that I think anybody can do even if they're not wearing a CGM. So that's a good one.

Brian (28m 4s):

And, what about eating as far as helping to promote sleep? Have you noticed, because I know, you know, there's some, I don't know, there's some talk out there that sort of back loading carbs actually might even help with sleep. What, what have you learned about that?

Carlee (28m 20s):

I think this really depends on the person. I would say as a blanket statement, I'm gonna recommend limiting foods right before bed. Sure. Just because again, your, your hormones aren't working. That's not what they're, they're built for. But I have seen this be very individual. So for some people having a little bit of food right before bed can actually help with sleep, specifically protein. So what I would always recommend is start with protein. See if you can have a little bit of that. So if you do dairy, like cottage cheese is a really great one because it has a little bit of carbs, but a little bit of protein to kind of balance it out. So if you do well with dairy or if you, you know, are including that in your diet anyway, that's a really good thing to have right before bed to see how it improves your sleep. But sometimes we'll see kind of this also inverse relationship with foods and sleep.

Carlee (29m 3s):

So if you have high Glucose that's causing, or that's caused by the foods that you're eating, that can negatively impact your sleep. And then also if you have one night of poor sleep, this can negatively impact your insulin sensitivity the entire next day. So sleep is critical. You, you talk about this as well, which I think is helpful, but I think this is just as important as what you eat is how you eat it and then how you manage that in accordance with your sleep. So limiting carbs right before bed, unless you're super active or unless you're Utilizing those muscles a little bit to help kind of moderate that. Sometimes we'll see that have like a delayed response if you eat right before bed. So you might, you might have like highly elevated Glucose overnight or you might have a higher fasting Glucose if you did eat late.

Carlee (29m 48s):

So those are just things to look for if you do that. But with everything I'm always gonna tell everyone, experiment, see what works, jot it down, see what you feel, and then you can kind of treat yourself as an an equals one experiment with that.

Brian (30m 0s):

Yeah. And And, what I found interesting when I was using one was not just how foods affected me, but how, like you mentioned like sleep and like I would do like even working out how this can affect sort of your Glycemic Variability and, and like, you know, how, how how your, your body responds to different activities.

Carlee (30m 21s):

Yes. I always think of this in terms of pillars. So, we think of metabolic health and therefore Glucose health as kind of on this, this pedestal, we've got four pillars that are holding it up. The first one is food. And as a culture, I think we put the most emphasis on food, right? Because it's in our control, you know, we can, well, you know what we can eat that seems a little bit more tangible than any of the other ones. But food. And that includes what you eat, when you eat, how you eat, how much you eat. There's so many factors there. But also the other three pillars exercise. So how much you're using those muscles when you're using those muscles? Are you exercising once a day for an hour or multiple times for short bits throughout your day?

Carlee (31m 2s):

Those are all things that can influence Glucose and hold up that that pedestal. And then stress I think is another huge one that gets often overlooked. Or maybe there's a little bit less insight into that. I think with these wearables we're able to see that a little bit closer and we're not able to kind of turn a blind eye anymore, which is helpful. But we started Nutrisense a couple of months before the pandemic, before Covid And. what was interesting is that we were seeing these increases in Glucose and we didn't know why, right? We knew that stress was impacting it, but what we saw was if someone had covid and they didn't know it yet, they'd see their Glucose increase, right? So that inflammation, that stress, that illness on the body caused that physical response in that Glucose.

Carlee (31m 47s):

So think of that in terms of your everyday stress. So it might not be as big, it might not be a huge spike that you'll see, but you might see gradual increases in Glucose so that like your baseline, your fasting Glucose might be a little bit higher if you're stressed. And also you might have a reduction in insulin sensitivity to meals that you normally respond well to. So if you are stressed chronically, you'll see this. But also if you have acute stressors, I will, I've monitored people's data and they've had a stressful phone call and they see a spike in their Glucose. Hmm. I've been bucked off of a horse. When I wore a CGM, I saw a huge spike in Glucose. So I think like if you were only looking at food, you would not know what that was.

Carlee (32m 29s):

You would be very confused by that, that response. But stress has just as big of an impact as all those other factors as well. So, we can't discount that too.

Brian (32m 38s):

Yeah. I mean it's something people don't think about. Yeah. They always say, well

Carlee (32m 42s):

It's to Monitor, you know? Yeah,

Brian (32m 44s):

Yeah. 'cause they just think, oh, CGMs for food. But really no, it's, it's these other things like stress that could, that could affect the, the, the CGM in the, in your Glucose throughout the day.

Carlee (32m 54s):

Yeah. And one of the things that I think is special about our program, and of course I'm biased because I, I love Nutrisense and I love what we do, is that we combine that data with a real human to help you kind of break down those pieces. So when you start looking at Glucose data, I think of it as in terms of you're looking at music on a sheet for the first time and you don't know what it trying to figure it out. You don't know, right? There's so many different things that you haven't been trained on. Glucose data is very similar. You might see those spikes, but you're kind of thinking to yourself like, is this a food spike? Is this a bad spike? Should I do this? What should I do? Right? So I think having that human there to kind of break down those factors and show you what you should be focusing on is really critical.

Carlee (33m 36s):

And in a time of AI where you don't know who's human and who's not, it's nice to have that real human person on your side that can help decode that and then apply it to your specific goals.

Brian (33m 46s):

Yeah, no, I love that. What else have you learned? Let's, obviously you've been the company for four years. Have you changed your thoughts on any things regarding lifestyle or, or health or like foods or things like that, that, that, since you've been with Nutrisense then, you know, when you started

Carlee (34m 7s):

100% on almost everything.

Brian (34m 9s):

Really. Okay. I think

Carlee (34m 10s):

I'm always changing my mind about multiple things all the time, which if you're paying attention, you probably are too, right? Everything's changing all the time. I think one of the things that I hear so often when people start to look at Glucose, and this definitely happened to me, is I had a very rigid way of thinking, right? you know, I'm not gonna ever have white rice because I'm gonna have brown rice, or I'm going to have sweet potatoes over white potatoes, right? We had those like food rules that were taught based on Glycemic index or whatever it is. But when I started to actually look at the data, I found that I have very similar responses to both. So what can be really freeing when you start to look at your own data is recognizing that if it's in moderation, if it's supporting your Glucose goals and your metabolic health, and then if you like a food better, you can probably find a way to incorporate it into your diet, right?

Carlee (35m 4s):

That's not something we wanna do all the time. you know, I'm not eating four cups of white rice every single day, but I like it better than brown rice and my body does okay with it. And I think, again, that can be freeing. We live in a world that has so many really harsh food rules that can be limiting. It can make you feel like you're on a diet or it make you feel like you are out of control with foods because you can't find a way to balance it in a normal diet. And I think that's not a healthy mindset to have around food, right? We all obviously want 80% of our diet to be supporting metabolic health and fighting inflammation and not processed. All those things are still true, but having that, that knowledge to incorporate those foods in a quote unquote healthy way, really helps kind of neutralize food and make you feel like you're in control of, of your health, which I think is really helpful.

Carlee (35m 53s):

So that's been the biggest one. I don't know if you've noticed any of that, but that's the one that jumps out at me first.

Brian (35m 58s):

Also too, what about, you know, mixing foods to your advantage, right? Like, like you mentioned white rice and people might be thinking, oh, that's just gonna be a huge spike, but which is not necessarily a bad thing, right? As long as it comes back to baseline. But what if you had, you know, like sushi, right? So you got a protein in there and you got maybe some seaweed and those can sort of level each other out, right?

Carlee (36m 24s):

Yes. And I'm really glad you brought this up. So there are two, I think, hacks or universal rules that everyone should follow, even if you're not wearing a CGM, even if even with all this stuff that I said about food freedom, all that, the first is to never have carbs on in isolation. So no naked carbs. I think that's critical. And the cool thing about seeing how they, those naked carbs impact your Glucose is that you never wanna do those again. You kind of have that mental image in your head every time you plan a meal. But when we eat carbohydrates, those are our quickest digesting macronutrients, our quickest digesting foods. And if you think about it, when you have a low blood sugar or you know, in, in the case of someone with hypoglycemia, what do they tell them to, to do to increase that blood sugar really quickly?

Carlee (37m 12s):

Drink carbohydrates, eat carbohydrates, don't have any protein, right? Because that's very, very quickly absorbed and converted into Glucose to keep our blood sugar up. So that same rule applies for eating carbohydrates in isolation. If you're going to eat a piece of bread and you eat it without any other protein, Fat, anything else on it, you're probably gonna have a pretty large spike. But if you had protein first, if you had vegetables first and kind of paired it with some things that take longer to digest, you were going to promote a more gradual, better response in your Glucose. And that's something that I think everybody should do every single time that they eat protein first or or vegetables first, both of those things can kind of slow down that response.

Carlee (37m 53s):

And in that similar fashion, never break a fast with carbohydrates. So this is kind of along the same lines, but I see this, you know, we have a lot of people that do extended fast that we work with And, you know, we work with anyone that's doing any type of diet. So if you want to do that, we're here to support you and kind of help you do it the best way possible according to your preferences. But if you're doing a fast, the worst thing that you can do is break it with carbohydrates again, because your body is going to turn those into blood sugar quicker. But also after a long fast or even a shorter fast, you're gonna have a slight reduction in your insulin sensitivity. So it's gonna cause that larger peak, that larger spike, and then ultimately it might contribute to that blood sugar roller throughout the day.

Carlee (38m 37s):

So the best way to do that is to always break your fast. And this includes breakfast, right? When first thing you eat in the day, break it with protein that's gonna keep your blood sugar a little bit more stable and support a kinda more gradual shift if you do have carbohydrates.

Brian (38m 52s):

Interesting. Now when you mentioned carbohydrates, you know, let's just take fruit for example. you know, things that, for example, like an apple, I would assume that having an apple would be, I mean obviously everyone's a little bit different how they respond to it, but you know, you have fiber and you have maybe other nutrients that might help slow down digestion. So maybe when you say carbs, are you referring to fruit as well? Or it does it depend?

Carlee (39m 18s):

Yeah, it kind of depends. I think with fruits we see very, very different responses to each individual fruit. Now berries almost universally have a pretty good response because they're super low Glycemic, really, really high fiber. So blueberries, raspberries, strawberries, those are typically pretty safe to include whenever you want apples. I think maybe at one point I could tell you that they were gonna promote a good response, but now they've gone from this size to this size, so the portion size is just maybe a little bit more than one should have without any protein included. However, remember it could depend on your muscle mass, how you're moving, kind of all those other factors, your stress, your sleep, those could also influence how you're going to respond to that one food, right?

Carlee (40m 1s):

So what I always tell people to do is a 30 gram carbohydrate experiment, and this again is just to promote that curiosity mindset and do things in a very systemized approach to experiment and see what works best for you. So essentially what you do is you have 30 grams of different types of carbs. If you wanted to try all fruits, that's awesome, do all fruits. I think that's probably one of the most interesting ones because the responses are so different. But you have those around the same time of day with the same context of your meal. So either on their own or with the same amount of protein. And then you just see how those different carbohydrate types impact your Glucose. And I've seen some really cool responses to that.

Carlee (40m 42s):

The most common spikes for from fruits, mango, pineapple, kind of those tropical fruits and then also dates. Those are the ones any dried fruit really will cause typically a larger response, but always gotta test for yourself.

Brian (40m 58s):

Interesting. And, what ab, what about Proteins? Is there a limit on that? I mean, you know, per meal is, is that something that you guys see or you know, protein can also, I know you said not as much perhaps, but protein can also spike blood Glucose as well, right?

Carlee (41m 15s):

Yeah, yeah, definitely can. It's less common, right? Because protein typically does have like an insulinogenic effect. So it might even cause like if you're eating just protein on its own, nothing else, it sometimes can cause blood sugar to drop a little bit But, it just depends on what you're eating when you're eating and all those other factors kind of combined there. But with protein, I always tell people to kind of titrate it on how active you are, how much you need. So that's something that I would usually calculate for someone from the research that I've seen, and this is gonna sound really nerdy, but people can typically tolerate 0.4 to 0.55 grams per kilogram per meal. So that should be maybe like a starting point and then you can titrate it based on your response or based on your satiety, we know that protein can help you maybe feel a little bit more full, a little bit more satisfied from that meal.

Carlee (42m 1s):

So I always filter it through that lens of, okay, how's it res making my Glucose respond? Am I full? Am I feeling good? Is this satiating? And then you can kind of add your carbohydrate after that to build that full meal.

Brian (42m 15s):

Excellent. And this was great. Is there anything else you want to touch on regarding CGMs? And I know there's a few companies out there. You guys aren't the only ones obviously, but it lasts for two weeks, right? And individuals just put it on their arms and I like, I, I liken it like you said, like it's a tool that people can use just to get some data points. They don't, I don't personally think need, they need to have it like an all year around thing. Maybe some people do if they're in a certain state and they really are and, and this is helping them sort of become accountable. But you know, like for myself, I saw it for a month, you sort of get a feel, especially if you're eating the same foods and you're doing the same thing over and over.

Brian (42m 57s):

Yeah, I didn't, I didn't feel like I needed it for months and months and months. But some people, you know, might, especially starting out, yeah,

Carlee (43m 4s):

It really depends on the person and how big your goal is. So I always say that the first couple of weeks to a month is just learning. You're just learning your baseline, you're seeing what your normal blood sugar looks like. And then maybe once you've got that established, you can identify the biggest things you want to change and come up with some small tweaks, experiments to test those specific things. So if you're seeing those larger responses in the evening, maybe you trial eating earlier or adjusting the composition of that meal and see how that goes for a couple of days. And then once you see that that's working All, right, cool, you're gonna, you've got that plan for the evening. And so it depends on how many of those little experiments or tweaks that you need to make and how, how far your baseline is from where you want to be.

Carlee (43m 49s):

So sometimes those take a little bit of work to, to find out what works for you. But the benefit of the CGM. And I think the thing that makes it so helpful for things like weight loss, right, is that it then becomes a motivation or like an accountability tool. So the first part probably 90% learning and then it flips to about 90% accountability. So for me specifically, I know that I wanna avoid that large shift. I know how I feel when I have that large shift. So I've kind of started to associate those larger spikes with poor energy levels, just not feeling motivated throughout the day. I feel hangry later on. So those are the small things that I think I've been able to identify in my own trends and Now I know what causes those.

Carlee (44m 32s):

So it's that motivation to avoid that. And so if you have a larger goal, I think sometimes just having that accountability buddy to show you in real time either, oh that was a good decision or man I gotta, I gotta not do that tomorrow. I think that's the benefit and that's where we can see it be really helpful for weight loss. Or also if you are like an athlete and you want to optimize your performance, you can see if you're bonking in your workouts and then you can make tweaks and adjust and then see it pay off. So I think those are the things that might take a little bit more time, but for a lot of people, yeah, you get a good baseline, you get a good rhythm and then maybe it's something you do every now and again. So maybe once a year you, you check back in, make sure things are going good, fine tune, address, anything that maybe has slipped off or new problems as they arise.

Carlee (45m 19s):

I think one thing that we know is that with every season of life comes new challenges. So what worked well for you before might not work well for you in a couple of years. So I think it's something where you might do it periodically just to maintain those pro proactive health benefits, but probably not forever for every single person.

Brian (45m 38s):

Great. Yeah. Well Carlee, thank you so much. Best place for people to find you.

Carlee (45m 46s):

Yeah, so if you want to learn more about me or connect with me about, you know, Glucose nerd out, I'm on LinkedIn, Carlee Hayes, you can also learn more about Nutrisense. We're on Instagram, Facebook, Twitter, also LinkedIn, Nutrisense io. And so if you are ready to, to kind of try this out, definitely do that. But even if not, we're posting a lot of research kind of tips, hacks, all those things on Instagram. So just join the fun and in the conversation.

Brian (46m 14s):

Awesome. Well this was great. I mean we could have talked probably for another hour, but I think people have a good idea if they've never heard of it. And this is just sort of the, they're just, you know, touching their toes in the, the, the water and wanna maybe learn a little bit more. So I appreciate you coming on the podcast, Carlee. Thank you.

Carlee (46m 32s):

Thank you so much. This is fun.

Brian (46m 35s):

Thanks for listening to the Get Lean Eat Clean podcast. I understand there are millions of other Podcasts I out there and you've chosen to listen to mine and I appreciate that. Check out the show notes at Brian grin.com for everything that was mentioned In, this episode. Feel free to subscribe to the podcast and share it with a friend or family member that's looking to get their body back to what it once was. Thanks again and have a great day.

Carlee Hayes

Carlee Hayes is a Registered Dietitian Nutritionist and the Lead Dietitian at NutriSense, a company that leverages continuous glucose monitoring technology and data to prevent disease and improve healthspan. With an extensive background in nutrition counseling, weight management, and metabolic health, Carlee is on a mission to stop preventable diseases and help people live their healthiest lives.

https://www.nutrisense.io/

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