Authors: Dr. Colin Michie, Paediatrician and Dr. Steve Hyer, Physician and endocrinologist.
How is your 2020 going? Have your January resolutions to become a different, better human begun to have an effect?!
The advertising industries encourage us to buy into something – a cream, a dietary supplement, some magic that is new and wonderful for our resolutions. But what does the science show? Of all human habits and behaviours, what resolutions have the most effect?
No surprises here! Although the psychological persuasion of short-term, easy resolutions is strong, they rarely last. So, a crash diet, a gym subscription or revised daily schedule alone will be useful only for those with iron-hard willpower.
What is interesting from these investigations is that they show some resolutions are more effective than others and that most of us can do a little better. A crucial difference to attain success is to focus on two ways to get to your goal rather than one: a long-term method as well as a short-term one, at the same time.
Make two agendas, two plans: One for the next few months and the other reaching into the end of 2020. Two track resolutions with a fast lane and a slow lane are much more effective for almost everyone!
You probably take this two-track approach already in planning your year’s relaxation. For instance, there will be a big party in three weeks for a family birthday, for which you have to do some important chores.
But then you aim to take off in late August to visit friends in Aruba for a break. This is the short-term, fast lane and a longer term, slow lane method. At a biological level, your body’s muscles are designed on similar principles.
Larger muscles of the legs, for instance, are packed with fast twitch fibres that enable you to sprint, without oxygen, to catch that child who is in difficulty on a beach. But then to walk to the baker on a Sunday morning, slow twitch fibres in the legs come into action. These need oxygen and take longer to fatigue.
Living longer – two tracks for glucose
Another biological example of twin tracks influences our ageing and is relevant to many of our resolutions for the future: the control of our sugar or glucose levels. Glucose is important for us – our brains run on nothing else!
After a meal, glucose levels rise quickly, within minutes. Starches in foods such as yam, potatoes, plantain, rice and corn are digested efficiently; sugars in fruits or your sweet cup of tea are broken down, contributing to this spike. The body has a rapid system to move this out of the blood and into cells – insulin.
Insulin does not always work as efficiently or as rapidly as we would like, however. For various reasons, it is not always effective at packing glucose away into the muscles and liver as fast as one might like.
A slow route of removing glucose then takes over. Glucose becomes attached to many proteins and fats in and around the blood vessels. This sounds reasonable, but it is not harmless and comes with problems.
Some of this “sticking down” contributes to our ageing. For instance, glucose stuck to the proteins lining the blood vessels makes these vessels become stiff and less elastic. Stiff blood vessels cause havoc.
They can lead to high blood pressure, strokes, heart attacks, dementia, leg ulcers and aneurysms. Glucose stuck to proteins in the filter system of the kidneys causes them to fail. None of this is good news.
The business of sticking glucose to these molecules takes place over hours. In your body’s normal repair processes, it will eventually be removed. So is it important for you? Surely it does not matter?
One way to look at this is to review those who are long-lived. Those living in “Blue zones” of the planet, such as in the Nicoya peninsula of Costa Rica, are exceptionally healthy and long lived.
They show few impacts of chronic diseases. They have less cardiovascular disease, less dementia, less malignancy and longer lives. This population is not genetically very different from others elsewhere in the Caribbean, but their diet and lifestyles are distinctive.
One feature of their lifestyle is few glucose spikes. Small groups living in other blue zones show similar features; because of their diets, they all have low glucose spikes in common. (These groups all undertake regular physical activity – without a gym – which is probably important too).
What about your glucose spikes?
Another effective way of looking at glucose in your system is to examine your red cells. These live in the bloodstream for about four months. They are full of haemoglobin proteins which carry oxygen. Red cells do not carry any repair mechanisms of their own, so that when they are old, they are recycled in the spleen and liver.
Extra glucose will become stuck to their haemoglobins, one of which is called Hiba. Any added glucose can be measured as “HbA1c”. Levels of HbA1c will show what your glucose levels have been doing for the last few months, so is commonly used by doctors to let you know if glucose spikes are a problem for you. If you have several long, high glucose spikes every day, your HbA1c levels will rise.
This glucose damage problem is probably important for all of us, not just those with insulin problems (for instance, those with diabetes). We should all devise lifestyles to reduce glucose damage to our systems.
A low sugar diet will reduce the spikes. Avoiding regular fruit juices, carbonated drinks, pastries, cakes and candies is important. There are some other valuable strategies that might work for you too. These start in the supermarket.
First, eat more plants! This not only helps save the planet by reducing greenhouse gases, and giving a gift to everyone’s future, it also increases your fibre intake – a big plus in curbing your glucose spikes or the load of glucose. We should all be eating five fruits and vegetables a day. Do you?!
Second, look out for the sugar content of any foods you purchase that are processed – check those labels! It is always better to cook your own food, as processed products are likely to contain extra sugar, salt and preservatives in levels you would not use if you did the cooking. And, Caribbean cooking is full of brilliant recipes.
The wisdom of Caribbean recipes
As an example, take rice. Boiled white rice has a high glycaemic index, meaning that it causes a high glucose spike after a meal. Brown rice tends to have a moderate index, some 10% less than the white.
But rice and peas, as made with most recipes, including Dominican moro de habichuelas, has a glycaemic index 20-25% lower than white rice. Cooks on Spanish islands use refried beans in many recipes – these too have a low glycaemic index.
Adding these pulses and tamarind to stews and soups is a great habit that will reduce their glycaemic index, as will using vinegars in your cooking or salads. All this will help your fast track insulin systems function better.
Finally, consider those old pieces of probably old-fashioned advice from your grandparents (along with their recipes!). Eat small helpings. Do not snack during the morning or afternoon. Have a larger meal in the middle of the day and a smaller one early in the evening.
If you are not hungry, miss a meal! All these pieces of guidance reduce glucose spikes and the negative effect of this one nutrient on our lives.
So whether diet was part of your 2020 resolutions or not, get out a calendar and make a plan! One with a short-term part (get more physical activity) and a long-term part (join in some physical activity or charity exercise later this year). Remember those Nicoyans with their enviably small glucose spikes!
“Slowly my body grows a single sound, slowly I become a bell, an oval, disembodied vowel, I grow, an owl, an aureole, white fire poesia.” Metamorfosi, I. Luna Derek Walcott.