Continuous Glucose Monitoring (CGM) is key to individualize nutrition and accelerate fatloss
Carbohydrates and sugars significantly effect fatloss, fat gain and body composition due to changes in blood sugar levels.
In simple terms, the higher the average blood sugar level and the greater the blood sugar fluctuations, the harder is it to get lean, stay lean and build muscle.
This has been very well documented in research and real life over the years. One thing that is still overlooked is the individual blood sugar response to a certain food by a certain person.
So how much do carbohydrates and sugars effect blood sugar?
Not all carbohydrates and sugars effect blood in sugar the same.
The concept of the glycemic index and glycemic load shows that different carbohydrates and sugars have vastly altered effects on the blood sugar level.
One of the most commonly used examples is that white bread leads to a greater blood sugar spike than a chocolate bar. On the other hand some sugars like from berries barely effect blood sugar.
The glycemic index and glycemic load is a statistical analysis of the average effect of carbohydrates and sugars of a certain food and their effect on blood sugar level.
Why are statistics are great, yet often useless?
One of the biggest downfalls of statistics is that they primarily look at the total average and not at the individual extremes.
For example, statistics show that the average height of a male in the world is 1.75m with a standard deviation of 10cm. That means males are between 1.65m and 1.85m tall. Thats correct. For about 80% of the population. And then there are males with a height below 1.65m and above 1.85m. Statistics miss out on them.
The same is true for the glycemic index/load. It is a statistical assumption which is true in most cases including a standard deviation. In the extremes, the glycemic index/load is highly incorrect.
Yes, we all react different to certain carbs (sometimes).
This is actually one of the main reasons why diabetics have to constantly measure their blood sugar to prevent fluctuations.
If the carbohydrate influence on blood sugar could just be calculated by glycemic index/load it would be a 1+1=2 calculation and measuring wouldn’t be needed. Physiology is not that simple though.
Nutrition — including carbohydrate intake — has to be individualised from client to client. Not all carbs effect everyone the same.
What is an individualised blood glucose assessment?
About 6 years ago I experimented with continuous glucose monitoring for the first time. A YPSI A-Licence Trainer received a device from one of his clients who worked in the medical supply industry for free.
The measurements and individual response to foods where in many cases as one would expect. Then in some cases, quite off.
The biggest drawback at the time was the investment for the device of 800 Euro for a four-day measurement. This investment made the technology useless for the average client.
In 2017, Rob Wolf published his book Wired to Eat. The book revolves around the idea of assessing carb choice and intake for each person individually via a glucose meter two hours after each meal.
This was the first time I read from someone making this point in mainstream media. The main message of his book is ‘how one reacts to a certain carbohydrate, sugar and food is highly individual’. Things to consider included:
- Determine it for each person using a glucose meter two hours post meal
- Avoid carb-foods that cause spikes
- Eat carb-foods that don’t lead to spikes more often
Why not just use a regular glucose meter?
The drawback of using a regular glucose meter two hours after a meal is that one is only assessing a certain point, not a full curve.
It can be the case that one hour after the meal the blood sugar level shot from 100 mg/dl to 200mg/dl, then two hours after the meal the blood sugar is back to 110 mg/dl. If one just has the number 110 mg/dl looks like the food barely had any impact on blood sugar. An hour before though the blood sugar was through the roof.
In a perfect world, one should at least use a glucose meter every 15 minutes to get multiple points that lead to a curve of response. This is needed to make an accurate assessment of the blood glucose response, but obviously pricking your finger to draw some blood 60 times per day is just not practical.
What exactly is is Continuous Glucose Monitoring (CGM)?
This is where a Continuous Glucose Monitoring (CGM) device comes into play.
A CGM device measure sugar levels every couple minutes for a full 24hr per day via a small sensor with a small needle under skin, which then gives one a full curve of blood sugar response to meals and daily life situations. This makes a CGM device the best option to measure blood sugar responses to each individual client.
Previously, CGM devices have been on the high investment side and not practical with clients. This changed about a year ago.
My colleague and friend Roan Heming from the UK dug out a new CGM device that only costs about 59 Euro (or 39 to 99 USD depending on the country you live in) for a full 14 days. This is a much lower investment than before.
Suddenly, the technology can be used systematically throughout the year with clients to create what I consider the highest level of individualised nutrition available today.
Why is fine-tuning carbohydrate choice so important?
Since this new CGM device has become available I use it with every intermediate to advanced client whose goal is body comp changes.
The individual reactions are severe. Two examples of severe reactions include a rise of blood sugar to 194 mg/dl with quinoa and to 165 mg/dl with tomatoes.
Quinoa is statistical a great source of carbs. And tomato is a vegetable with a low starch-content that should not lead to any increase in blood sugar. For those two specific clients it did though.
Tomato is a vegetable. An all-you-can-eat food. What happens if that clients eats tomatoes on a salad every day? Consistent blood sugar fluctuations is the answer. The proven answer in his case.
On the other hand I have seen many clients have an increase of less than 10 mg/dl with foods like dark chocolate, oats and even gluten-free pancakes and more. Statistics still count.
For example I have never seen someone do well on wheat bread in all the measurements I have done with clients so far. Yet, using CGM has been the single biggest addition to my toolbox since starting to use skinfold measurements to bookkeep and accelerate fatloss and body comp changes in 2009.
And the results I have seen with it, especially with being able to give clients much more carbs, will still get lean have been tremendous.
Individualised nutrition is the future.
Nutrition is highly individual. Nothing works for everybody. Some things work statistically well in most cases. Then there are exceptions. Some get lean on high carb diets. Most get much leaner faster on low carb diets. Few get blood sugar spikes from tomatoes. Most get no blood sugar spikes from tomatoes.
Determining how a client reacts to what is key in finding what will work for that client. Especially when we talk about the best body comp results possible.
Using Continuous Glucose Monitoring (CGM) specifically to individualize nutrition and accelerate fatloss is one of the primary topics of the YPSI Online Module B on „Individualized Nutrition“. In these Online Lectures, that are available from anywhere in the world at any time, I look into the science of blood sugar management and explain the protocols I use with clients to effectively implement Continuous Glucose Monitoring (CGM) specifically to individualize nutrition and accelerate fatloss. How to use the device. Which device to choose. How to use CGM for other goals such as sleep quality. And much more. Its a step-by-step guide with many examples and case studies to elevate your knowledge and skills. To get faster results.
Picture: Fitness entrepreneur Roan Heming wearing a CGM device during training.