Matthea Rentea MD leads discussions on obesity and chronic weight management. Her guests range from experts in the fields that intersect with obesity and wellness, to individuals successful in their weight journey. She is a Board certified Internal Medicine and Diplomate of the American Board of Obesity Medicine and founder of the Rentea Metabolic Clinic, a Telehealth clinic for residents of the state of Indiana and Illinois that helps comprehensively with weight management. This podcast is for information and education purposes only. No medical advice is being given. Please talk to your physician for what is right for you.
Is your breakfast making mornings harder than they need to be?
You eat well, you move your body, you’re doing all the “right” things… so why is your blood sugar still higher in the morning? There’s a natural hormonal shift happening when you wake up that can make blood sugar harder to manage, especially if you’re insulin resistant or post-menopausal.
In this episode, I break down the physiology behind it and share two simple, practical changes that can make a real difference.
References
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All of the information on this podcast is for general informational purposes only. Please talk to your physician and medical team about what is right for you. No medical advice is being on this podcast.
If you live in Indiana or Illinois and want to work with doctor Matthea Rentea, you can find out more on www.RenteaClinic.com
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Today I'm gonna really quickly talk about a question that I got asked, which is so good: Are we more insulin resistant in the morning? And then if we are, what we can do about it. And I'm gonna answer this because it's super counterintuitive. You would assume if you are not looking at the physiology that maybe you do better with carbohydrates in the morning, that the sugars, and then it gets worse and worse throughout the day. But for a lot of people, it's opposite. I'm gonna explain the physiology super quickly, one minute or less I always joke. It's not true. I can't do it in one minute. And then I'm gonna give you two tips. They are super easy, super practical. You could do them today, that you can start to get yourself on a better track if this is happening for you. So first of all, what naturally occurs in our body as humans, we operate on a circadian rhythm. In the morning, naturally about 3:00 to 8:00 AM, somewhere in there, we have a rise in hormones like growth hormone, cortisol, things like that. When that goes up, that says, "Hey liver, release sugar." The sugar is released and, ah, you wake up, right? So it's like it's your wake-up alarm within your body. That is normal. That is natural. Now, the morning blood sugar should not be going over 100. Once it's over 100, that's impaired fasting glucose. So let's say that your doctor has said you're insulin resistant, you're pre-diabetes, you have diabetes, things like that. If that's the case for you, then there's something abnormal happening in the morning for you, and let's explain what it is. So that circadian rhythm is happening. Cortisol goes up, growth hormone goes up, things like that. Liver releases blood sugar. If you have insulin resistance, you can't handle that blood sugar as easily. You can't get it into the cell, so it stays in the bloodstream longer. And that's an easy way to think about it, is natural things are occurring, but you can't respond to them appropriately. When that happens, in long term you end up having health problems. The good news is we can actually do a lot about this. And so now that you know, all right, in the morning, I already have it stacked against me based on how the hormones are working out. And especially, by the way, if you are post-menopausal. So if you're not on hormone replacement therapy, your estrogen levels are down. That makes insulin resistance worse. Your cortisol regulation can be different. And so now it's even worse. So you already had insulin resistance. Now we throw the lower hormone levels from being in menopause. Now it's like multiple insults that are leading it to be harder and harder for your health to work out in a positive direction. If you have either a finger stick glucose, or you used a CGM, or you have fasting blood sugar and you see that it's 100 or more, or frankly really even 90 or more, these two tips can help, and even if you don't have insulin resistance. All right. Two things we're gonna do. Number one In the morning, we're gonna focus on a little bit of a lower carbohydrate meal and more protein and fiber forward. Reason being we're not already in an environment where your blood sugar's up potentially, giving yourself even more that you have to deal with. The protein and fiber that you're having, it's going to not spike your blood sugar even more in the morning, so that's helpful. Now, notice I said in the morning. I didn't say all day long low carb, never having carbs. That did not exit my mouth. It's just in the morning we wanna be mindful of that. I'm gonna tell a quick patient story here I'll never forget. I had a patient in the past. This person was incredibly healthy with what they were eating, how they were exercising. They actually did not have overweight or obesity. They had an elevated blood sugar at one point. Their hemoglobin A1C was pre-diabetic, and they were like, "Oh, my gosh. How can this be? I'm so healthy. I'm doing all the things that are recommended." And I said to them, "What are you eating for breakfast?" And it turned out that they were having only carbohydrate. There was no fiber, no protein. And so I said, "Listen, the only change I want you to make for the next three months," because hemoglobin A1C is a three-month marker, I said, "Just make your breakfast more primarily protein." I think we talked about eggs. I forget what else, but just going more to not being just like a baked good or oatmeal, although it does have some fiber in it. Again, some people just can't handle it as much. So I said, "Hey, let's go over more to protein forward." They came back three months later, blood sugar normal. That's a very small change, right? Okay, so focusing on your mornings, and go slowly in that direction. You don't have to suddenly overhaul everything. Remember when you hear information like what I'm saying, you get yourself there progressively. Maybe you start to add in a tablespoon or two of Greek yogurt before you have that other carbohydrate-heavy breakfast, and you start to take yourself in a direction where it makes sense for you, and over time you end up having a higher protein breakfast. All right. By the way, as far as protein goes with a meal, if we can get 15 grams, amazing. I would love ideally for you to get 30 grams of protein per meal, but if we can get to 15, it's a start. The second thing you're gonna do is in the morning if you can do just a little bit of movement. Anything, like 10, 15 minutes, even if it's a light walk. What you're gonna be doing there is you're gonna be bringing down the blood sugar irrespective of what's happening with insulin. Now, not everybody has the time in the morning, but I want you to start to ask yourself, "If this really mattered to me, could I get up a few minutes earlier?" Maybe you don't go to a gym, and you're not making this all hard and complicated. Maybe you just walk back and forth in the kitchen, but can you start to look at in the morning might this really help me? Years ago when I started to work on all this, I did a CGM, a continuous glucose monitor. For two weeks I saw based on what I was eating and how I was moving what was my blood sugar doing, in the morning, before meals, after meals, all of it, and it was shocking to me. I have a history with pre-diabetes that I had even before losing a lot of weight. I had reversed with nutrition and movement alone. What is shocking to me, though, to this day, because I have that history, the morning sugars are a problem for me. But because in the morning I am eating in a way that supports my body and I'm walking an hour in the morning, I'm doing a lot of things, not only in the morning, throughout the day to support myself, I don't have evidence on the labs of there now being a problem. But again, if you really look at the trends, you can see, oh, like that's there, but I'm doing things to help myself. I say these two tips because it's really empowering to know it doesn't matter if you've been dealt the hand of insulin resistance, that you got that genetic gift from your family, fine. But let's do things that can help you. Remember, your roadmap, what works for you, is always gonna be different than other people. The best thing I heard the other day, your goal, your target. So don't worry about what other people are doing. They might be able to eat and move entirely differently than you, and it works out for them. But for you, the timing of when you do these things really matter. I hope that this was helpful to you today. If you liked this, I have the podcast, The Obesity Guy with Mathea Rentia, MD. I talk about a lot of amazing stuff on there. If you go to rentiaclinic.com/podcastroadmap, there's a free podcast roadmap that I have where it breaks down all the different categories of topics that I've mentioned on the podcast. For example, let's say you wanna know about one of the newer medications that are out. It'll say medication. It'll have hyperlinks to each of the episodes where I talk about it. I've got hundreds of episodes at this point. I know that you're not gonna wanna go dig back through all the old stuff. But if you wanna know exactly what you wanna find, you can get that free podcast roadmap. All right, we'll talk soon.
