Enter Farah Hillou, an Abu Dhabi-based integrative and functional nutrition certified practitioner, who focuses on addressing nutritional and physiological imbalances, as well as environmental triggers, to help get to the root cause of an individual’s health challenges including gut health and hormone imbalances.
Her approach uses mind-body medicine and “food as medicine” to help achieve optimal health and longevity. She also provides concrete and easy-to-follow tips for managing your blood sugar in health and if you are dealing with pre-diabetes, insulin resistance and Type 2 diabetes.
Why we are hearing so much about blood sugar
In the UAE, especially in the region, there is a very high prevalence of diabetes, and a lot of people have insulin resistance and they don’t know about it. A lot of people started really focusing on their health, physical health, mental health, emotional health during COVID and started running checkups and blood sugar readings. I think that’s when a lot of people found out that they may be insulin resistant, or they started digging into their health a little bit more. I think it’s also coincidentally, or the timing is very close, to a lot of tech that’s been coming out in terms of CGMs or continuous glucose monitors and they’ve been trending now, but for a good reason, because it really helps you better understand what is happening in your body. It’s a sensor that you wear on your arm. It’s been there for a really long time, but it was mostly for diabetics. Now, anybody and everybody can really have it on and download the app and understand and monitor what’s happening to their sugar levels in real time. Based on sleep patterns, food, whatever you have to eat, drink, it really obviously is going to impact your sugar levels, and it helps you better understand what’s going on internally and helps empower you to make better decisions.
What insulin resistance is and why it’s happening
It’s normal that once you have your meal, even if you have a small snack, even if you have a piece of date, your blood sugar levels are going to naturally increase. However, when they are constantly spiking and dropping and spiking and dropping, over time, your body could develop what we call insulin resistance. Once blood sugar levels rise, this signals the pancreas, an important organ in the body, to release insulin. The insulin really helps the cells take up this glucose to store it for later fuel, basically. Insulin is really important because it does allow the body to use glucose for every single function that happens day in and day out. It also helps, let’s say, hormone production, growth, so insulin is important. However, with these spikes and drops, spikes and drops in blood sugar levels, and as a result, over time, the cells stop responding to insulin as well as they should, so insulin resistance develops. Many people, as I mentioned initially, are walking around with insulin resistance and they don’t know about it.
You’re exhausting your cells. You’re exhausting your cells and they stop responding to this insulin. That’s when insulin resistance develops, and over time, if it’s not caught early on or if it’s not addressed, it can develop to diabetes, especially, again, depending on lifestyle factors, family history, genetics as well. That’s how insulin resistance can form, and eventually, diabetes. Again, insulin resistance is reversible, so that’s the good news.
How to do that reversing
There’s really a lot that we can do. We have a lot of control over our lifestyle and the choices that we make day in and day out. We may not always make the best choices, and that’s okay, but I always say, what’s the okay option? What’s the better option? What’s the best option? We aim to make the best options always, but sometimes even the better option is also good enough. Simple lifestyle hacks. Food, to start off with. We always say ensure that your meals are balanced. Balanced in terms of there are, I’ll say, four components that you need to have as part of your meals in order to ensure that your blood sugar levels are rising at a steady and gradual level as opposed to spiking. We want to think healthy fats, fiber, protein, prioritizing protein, and even fermented foods. Those can all help, in one way or another, control the blood sugar increases that happen after a meal.
Healthy fats, fiber and protein
Healthy fats, think your avocados, olive oil, nuts and seeds, your fiber. Fiber is really, really important. For diabetics and non-diabetics, it can really help blunt this sugar level rise, especially soluble fiber. There are different types of fiber, but think your soluble fibers like beans, oats, your cut oats, apples, pears, even some seeds. Your dietary fiber, we need about maybe 50 grams a day, so we really need quite a large amount, and we are really falling short. 45, 50 grams. Your healthy fats, your dietary fiber, and your protein. Protein, again, think legumes, fish, seafood, poultry.
Fermented vegetables like your sauerkraut, for example, kimchi, even apple cider vinegar. There is some research to show that if you have maybe a teaspoon or even a tablespoon of apple cider vinegar mixed with a glass of water before your meal, not only does that help with digestion, but it can reduce blood sugar spikes after a meal. Apple cider vinegar with mother is a fermented source. Even making substitutes like instead of white bread going for sourdough bread, because that’s fermented. Yogurt made with culture. Fermented foods really help feed the gut microbiome. Gut microbiome has also been linked with insulin sensitivity. Those are really what should comprise our meals.
What you eat first has been shown to impact how fast your blood sugar levels are going to rise. If you were to have, let’s say, your fiber first, so maybe veggies, if you start off with, maybe a vegetable soup or a salad, at least, you’re guaranteeing extra fiber. Then, you can start ideally with the protein, the healthy fats, and towards the end of the meal, maybe the bread or the rice, if you’re having that on the side. If it’s all mixed together, again, starting off with your salad.
Cool off your starches
Also, there is some research, interestingly, to show that for those high resistance starch like rice, potatoes, pasta, if you cook these, and then cool them down and then reheat them, that can also reduce blood sugar spike.
Food pairing, in general, is exactly what we were talking about, in terms of, having your fat, healthy fats, fiber and protein. That’s when you’re having your main meals. I would say, if you are having a smaller meal or a light snack, choosing at least two of these components. Let’s say, fiber, you could have your fruit for fiber, and then maybe pair it with a couple of walnuts or almonds, for example. If someone can tolerate lactose or dairy, then they can have maybe some yogurt, again, getting in more of the good probiotics or bacteria. Pairing food is really avoiding, in this case, a source of carbohydrates by itself. Especially, in Ramadan, there’s always an abundance of food. We don’t eat for about 14, 15 hours, sometimes longer.
Then, once we do break our fast, first of all, we tend to have dates. This is usually a cultural/religious practice. What we could do is, to have maybe a few walnuts, or a few almonds with it, or to control how much dates we have.
Fasting is helping
In the context of blood sugar balance and metabolic health, it can really help control blood sugar levels, cholesterol levels, blood pressure. It helps support gut health and digestion. It helps with autophagy, and the renewal and recycling of cells. Longevity is such a hot topic right now, and it can really help promote longevity, as long as it’s done the right way. There’s a lot of debate and a lot of science really on intermediate fasting, and Ramadan fasting, and low-calorie diets. It’s important to keep in mind that it lasts for a month, and this is really our opportunity to make the most out of this month, in terms of, let’s say, diet and lifestyle. Because it’s our way to help cleanse our body, detoxify our body, practice mindful eating, focus on foods that really nourish us. Practicing mindful eating is really important. Going back to these simple hacks that we mentioned, even when there is an abundance of food, what do you have first? Dehydration can be common. It’s really important to keep hydrated. Going back to the benefits, they far outweigh any risks. Keeping in mind that pregnant women, lactating women, diabetic people, who are taking certain medications, need to consult their physician. The average healthy individual, fasting can be really, really beneficial. Especially, during the holy month when we bring in the spirituality, and the mindfulness aspect.
We tend to underestimate the importance of the Suhoor meal. We focus so much on the Iftar meal, and then different cultures can sometimes also do things differently. Usually, at Iftar, sometimes certain cultures have maybe soup and salad, and then wait an hour or two, have their prayers, and then have their main meal.
Whereas sometimes you just eat everything at the same time. Then, the Suhoor meal is usually at around 2, 3, 4am. It’s really important to have that. It’s a breakfast meal. You’d want to think of foods healthy, nutrient-dense foods that you would have for breakfast. That can also help stabilize blood sugar levels, at least, during the early hours, and you exercise, movement.
Exercise when is best for you
We always get asked what time, when should I exercise when I’m fasting? It really has to be very individualized. It really depends on the individual, what they were used to doing beforehand. I find a lot of people feel good working out right before they break their fast. Within maybe an hour or two before they break their fast. Usually, during the course of the day, you’ve depleted a lot of your glycogen or glucose stores. In a way, it’s also good because you might start to tap in some fat stores as well. If you are thinking of working out a bit more in with high intensity, perhaps, having it right before Iftar.
I’d always advocate for incorporating some movement, even if it’s a walk after you eat, like in 30, 60 minutes, maybe even 90 minutes after you eat, because that really helps control blood sugar levels as well.