Continuous Glucose Monitoring to Prevent Disease and Increase Healthspan

July 31, 2020

Kara Collier, RDN, CNSC is a Registered Dietitian, Nutritionist and Certified Nutrition Support Clinician who specializes in glucose control and metabolism. She’s also the Director of Nutrition for Nutrisense, a company that uses continuous glucose monitoring (CGM) to help their clients become aware of the factors impacting their blood sugar. Kara oversees a team of dietitians leveraging CGM data to build tailored nutrition and lifestyle plans.

On this podcast, Kara talks about the value of using CGM to optimize metabolic health, prevent disease, and improve healthspan. She discusses how CGM captures critical information missed by traditional glucose screening tests and how the data can then guide lifestyle changes. We discuss optimal fasting and peak glucose ranges, the accuracy of CGM, and the 5 lifestyle pillars that tend to have a significant impact on blood glucose.

Here’s the outline of this interview with Kara Collier:

[00:02:54] Nutrisense; Continuous glucose monitors (CGM).

[00:05:38] Article: The Rise of Nutritionism, by Kara Collier; Michael Pollan.

[00:06:54] Book: Thinking, Fast and Slow, by Daniel Kahneman.

[00:08:12] Chris Masterjohn.

[00:10:07] Why measure blood glucose.

[00:12:07] Freestyle Libre.

[00:13:51] Podcast: Postprandial Fatigue: Is It Normal To Need A Nap After Lunch? with Megan Hall.

[00:14:05] Glycocalyx: Podcasts with Malcolm Kendrick: Why Cholesterol Levels Have No Effect on Cardiovascular Disease (And Things to Think about Instead) and A Statin Nation: Damaging Millions in a Brave New Post-health World; Podcast with Ivor Cummins: Coronary Artery Calcium (CAC): A Direct Measure of Cardiovascular Disease Risk.

[00:14:18] Micrograph images of glycocalyx after a high-carb meal.

[00:15:39] Importance of peak glucose values (<140); Studies: 1. Wang, Xinlei, et al. "Delay in glucose peak time during the oral glucose tolerance test as an indicator of insulin resistance and insulin secretion in type 2 diabetes patients." Journal of diabetes investigation 9.6 (2018): 1288-1295; 2. Gastaldelli, A. M. A. L. I. A., et al. "Beta-cell dysfunction and glucose intolerance: results from the San Antonio metabolism (SAM) study." Diabetologia 47.1 (2004): 31-39; 3. Takahashi, Kei, et al. "Four plasma glucose and insulin responses to a 75 g OGTT in healthy young Japanese women." Journal of diabetes research 2018 (2018); 4. American Diabetes Association. "Postprandial blood glucose." Diabetes care 24.4 (2001): 775-778.

[00:18:11] Book: The Lean Startup: How Today's Entrepreneurs Use Continuous Innovation to Create Radically Successful Businesses, by Eric Ries.

[00:22:46] Optimal fasting glucose range; 82-88 mg/dL; Studies: 1. Bjørnholt, JØRGEN V., et al. "Fasting blood glucose: an underestimated risk factor for cardiovascular death. Results from a 22-year follow-up of healthy nondiabetic men." Diabetes care 22.1 (1999): 45-49; 2. Nichols, Gregory A., Teresa A. Hillier, and Jonathan B. Brown. "Normal fasting plasma glucose and risk of type 2 diabetes diagnosis." The American journal of medicine 121.6 (2008): 519-524; 3. Shin, Jin Young, Hye Ree Lee, and Duk Chul Lee. "Increased arterial stiffness in healthy subjects with high-normal glucose levels and in subjects with pre-diabetes." Cardiovascular diabetology 10.1 (2011): 30.

[00:24:44] Measuring glucose in blood vs. interstitial fluid; Article: Cengiz, Eda, and William V. Tamborlane. "A tale of two compartments: interstitial versus blood glucose monitoring." Diabetes technology & therapeutics 11.S1 (2009): S-11.

[00:25:47] Doug Hilbert from Virta Health; Podcasts with Doug: How Busy Realtors Can Avoid Anxiety and Depression Without Prescriptions or the Help of a Doctor, and Ancestral Health Symposium ‘18 Recap.

[00:26:16] Accuracy of CGMs.

[00:32:31] Nutrisense program details.

[00:35:06] The Miracle Moment Podcast, with Josh Turknett, MD.

[00:36:42] Factors affecting blood glucose: Food, meal timing, exercise, sleep, stress.

[00:38:10] Podcast: Nudge Tactics for Performance and Health, with Simon Marshall, PhD.

[00:38:47] Podcast: Chrononutrition and Early Time-Restricted Eating for Metabolic Health, with Greg Potter, PhD.

[00:41:28] Effects of alcohol and stress on blood glucose.

[00:46:49] Oura ring.

[00:47:04] Podcast: How to Manage Stress, with Simon Marshall, PhD.

[00:47:46] Stress management strategies.

[00:51:43] Predictive potential and technology integrations.

[00:55:53] Nutrisense.io.