Something few know is that stable blood sugar can be an important key to getting rid of or reducing symptoms such as PMS, PCOS, fatigue, sweet tooth, irregular or weak ovulation and difficulty getting pregnant. A blood sugar that rides a roller coaster is often not favorable when it comes to hormones or fertility.
Why is a balanced blood sugar important?
Do you recognize symptoms such as severe PMS, irregular or weak ovulation , difficulty conceiving, energy dips, mood swings or strong sweet tooth? Then it could be that your blood sugar is unbalanced. Given that blood sugar is not something we measure daily, the symptoms of unstable blood sugar are similar to many other "common" symptoms we can experience in our everyday life, such as fatigue and brain fog. This means that it can be difficult to see the connection to blood sugar in particular.
If we have too low blood sugar or no blood sugar, we die. If we have high blood sugar instead, it can damage tissues in the body at the same time as it affects several of the hormones that regulate our female reproductive system. Having a balanced and even blood sugar is therefore important both for our general health and from a fertility point of view.
Now is the time to dive deep into the basics when it comes to blood sugar and gain an understanding of what glucose means, how carbohydrates affect blood sugar, the difference between different types of carbohydrates, whether "natural" sugar is better than white sugar and much more. Parts of the information in the post are taken from the books, Glucos Revolution , It Starts With The Egg and The fifth Vital Sign as well as other research.
What is glucose?
Glucose is the body's main source of energy. We get it mostly through the food we eat where glucose travels through the bloodstream to our cells. How high a concentration of glucose we have during a day can vary, large increases in glucose concentration are called glucose peaks, which affects everything from our fertility to our mood, our sleep, our skin, our weight, our immune system, and the risk of heart disease. How high a concentration of glucose we have in our blood and what our blood sugar curve looks like throughout the day is mainly influenced by what and how we eat, how we move and how much stress we are exposed to.
To make this super clear:
Glucose peaks = means a high concentration of glucose in the blood.
Blood sugar curve = how glucose levels change during a day .
What is insulin?
Glucose and insulin go hand in hand. Insulin is a hormone produced in the pancreas and secreted into the blood after a meal. When we eat things that contain glucose (carbohydrates and white sugar), the pancreas releases large amounts of the hormone insulin in response to elevated levels of glucose in the blood. Insulin's task is to signal to the muscles and fat cells to absorb glucose so that it does not continue to circulate in the blood. We do not want to have too much glucose in the blood as this means that the blood sugar continues to be high, which can have several damaging effects on the body.
The more glucose, the more insulin is needed to get the job done. If this goes on for a long period of time, that is, if we have high levels of glucose in the blood and insulin trying to process it, eventually the cells will become resistant to insulin's message to take up glucose. This is called insulin resistance . The cells no longer respond to the insulin's message, which means that the blood sugar continues to be high as the sugar is not "allowed to enter" the muscles or the fat cells. The body then responds by producing even more insulin, which creates an imbalance. All the sugar and insulin that circulates can become a problem for our fertility as it affects the hormone system, which in turn largely regulates our fertility.
If we have high blood sugar or a blood sugar that rides a rollercoaster (over time), the body perceives it as stress , which in turn affects our sex hormones and our ovulation . This, in turn, causes symptoms that can manifest as, for example, PCOS, weak or irregular ovulation, increased PMS or worsening symptoms of endometriosis.
How do carbohydrates affect blood sugar?
When we eat carbohydrates, it is broken down to its smallest component, which for most carbohydrate-rich foods is glucose, which is a type of sugar . This happens so that glucose can then pass the intestinal wall and enter the blood. So whether you've been eating white bread, cookies, quinoa or beans , it will eventually break down into glucose . What differentiates different carbohydrate-rich foods is how their distribution of fiber and glucose content looks like and how they in turn affect blood sugar. The more carbohydrates we eat (unless it mostly contains fibres), the higher the concentration of glucose we will have in the bloodstream.
Carbohydrates is a collective name for starch, fructose, sucrose and fibres, which you could say are four siblings with different personalities that come from the same parent (glucose). Every "plant" (which all of these actually are) is converted to glucose (and fructose) when we eat it except for the fiber which passes straight through to the gut without affecting blood sugar.
To clarify, when we eat starch, it is broken down in the body into glucose . When we eat sucrose, it breaks down into glucose and fructose. When we eat fiber, it remains fiber . Then there is a difference between different types of starch, as some contain more or less fiber than others, which will have an effect on your blood sugar. To make it clear, we take an example; for example, if you eat broccoli, which largely contains fibers and a small amount of starch, it will not affect your blood sugar to such a large extent as it goes unbroken to the intestine (thanks to the fibers) where it becomes food for the good bacteria.
So carbohydrates are a collective name for the following: starch, sugar and fiber (glucose, fructose and sucrose). To make it extra clear, when we talk carbohydrates we are talking about:
- Starchy foods such as mixed potatoes, rice, bread, carrots, sweet potatoes, parsnips, oatmeal, wheat, beans, lentils, soybeans and seeds. Some of these contain more or less fiber and starch.
- Sugary foods that contain a high proportion of glucose, fructose and/or sucrose such as soft drinks, cakes, sweets, ice cream, bars, dried fruit, juice, various sweeteners such as honey and agave syrup and fruit smoothies.
- Fruit that often contains a high proportion of both fructose and glucose. Tropical fruits such as banana, mango and pineapple are higher in sugar than, for example, citrus fruits such as lime, grapefruit and various berries such as blueberries, raspberries and red currants (many berries are lower in glucose and fructose).
- When we write sugar , we refer to white sugar.
As we mentioned earlier, fiber technically falls under the category of carbohydrates, but it works in a completely different way than its siblings. Some carbohydrates contain a greater proportion of fiber, which are carbohydrates that we humans cannot break down (which is a positive). They pass through the body without any energy being taken up and without affecting the blood sugar to any great extent. The higher the proportion of fibres, the less blood sugar is affected. Examples of fibers are in nulin, which is mainly found in the chicory root , various cruciferous vegetables such as broccoli, cauliflower and white cabbage, as well as cold potatoes and unripe bananas, which mostly contain resistant starch.
What is the difference between refined carbohydrates and complex carbohydrates?
For example, when we eat fast and refined (processed) carbohydrates such as wheat flour, pasta or flakes where the grain has been processed, broken down and pulverized into a flour, the starch becomes more readily available, which means that it is broken down much faster in the body. The glucose thus reaches the blood faster, which in turn causes the blood sugar to spike quickly.
When we eat carbohydrates in their whole form , such as root vegetables, quinoa and berries - foods that have not undergone any process in which they are broken down - it takes longer for the body to break down the starch and glucose does not reach the blood as quickly. This means that the blood sugar does not rise as quickly, but increases gradually, unlike when we eat processed carbohydrates, which cause a rapid increase in blood sugar. Whole foods that are not processed simply take longer for the body to break down and thus raise blood sugar more slowly but will eventually become glucose and thus have an effect on blood sugar.
The link between fast carbohydrates and ovulation problems
An interesting study that addresses the subject is The Nurses Health Study in which over 100,000 women participated. Every two years, the women who participated answered questions about diet, exercise, pregnancy, miscarriage and other lifestyle factors. From the group of 100,000 women, a subgroup of more than 18,000 women who were trying to conceive and had previously reported no problems with infertility were selected. The researchers examined eight years of data from this subgroup to understand how nutrition might have an impact on fertility. Based on this, they divided the group into two further subgroups, where one group had reported having problems with irregular or absent ovulation and those who did not have problems with ovulation, and then compared the diet between the groups. One aspect that stood out in the results was the link between carbohydrates and ovulation problems.
What they found was that the total amount of carbohydrates the women ate was not linked to ovulation problems, but rather the type of carbohydrates they ate. The women who ate fast and processed carbohydrates that caused rapid increases in blood sugar were 78% more likely to have problems with ovulation than the women who ate complex and slow carbohydrates. The conclusion they were able to draw from this was that it is not about the total amount of carbohydrates in the diet, but about the type of carbohydrates we eat, when we eat them and how we eat them. The carbohydrates most strongly linked to ovulation problems were processed carbohydrates such as cereal, white rice and bread, while brown rice and dark bread were linked to a lower risk of infertility.
Which sugar is best?
On a molecular level, there is no difference between white sugar, honey, agave syrup, coconut sugar, brown sugar, maple syrup or palm sugar as they are all made of glucose and fructose molecules. They are just packaged differently and have different names. Then there is a difference in that honey, unlike white sugar, contains a variety of other vitamins and minerals.
The bottom line is that in the end it will still break down into sugar in the body, when it reaches your small intestine it will still be fructose and glucose (which affects your blood sugar the same way). So simply explained, your body does not process sugar differently whether it comes from a sugar plant, agave plant, honey or from mango. For that matter, you don't have to avoid them, but if you eat them in large quantities, it may be good to change the way you eat them.
Is dried fruit good for blood sugar?
When a plant or a fruit is processed and the fibers are removed (which happens when you dry the fruit), it becomes any kind of sugar. There is still a certain amount of fiber left, but when you dry fruit, you take all the water out of the fruit, which makes it easier to eat many more pieces of dried fruit than we would if we ate fresh fruit whole. This can result in a major impact on blood sugar.
Any sugar regardless of its color (brown sugar, white sugar, whatever plant it comes from) is still glucose and/or fructose which will cause a spike in blood sugar. A tip is therefore that when baking with dates, use fresh dates over dried dates (and only use as many as you need) and when eating fruit, eat whole fresh fruit rather than dried fruit.
So, how should one really think when it comes to carbohydrates?
The most important thing when it comes to carbohydrates is when we eat them, how we eat them and how we combine them. It's also about the types of carbohydrates you eat and how your meal composition looks over a week. Many of our experts have seen in their practice that many women eat far too little protein and fat in relation to carbohydrates. In some cases, of course, it is the other way around where, for example, there is some form of carbohydrate fear, which is not beneficial as women of childbearing age may need a certain amount of quality carbohydrates in order for the body to feel safe enough to ovulate. We have some women of childbearing age who have eaten a diet based on keto (mostly protein and fat and minimal carbohydrates) for a long period, for example, have experienced various menstrual-related problems.
It is important to keep in mind that we can react differently to the same type of food. It can also differ in different periods of life depending on what your lifestyle looks like right now, how much you move, how much stress you are exposed to and where you are in your menstrual cycle.
How do I balance my blood sugar through diet?
The amazing thing when it comes to blood sugar is that we ourselves have the power to stabilize it through small (or big) changes in our lifestyle and diet. As with everything else in our body, nothing is separate from the other so all parts of our lifestyle such as stress, sleep, exercise (exercise increases our insulin resistance), recovery, our relationships and thoughts about ourselves affect blood sugar.
If you liked this post, we recommend you also read Tips on how you can stabilize your blood sugar, where we share simple (but revolutionary) tips on how you can stabilize your blood sugar through diet and lifestyle. A must read is also How you can use vinegar to balance your blood sugar, there we go into how vinegar has a positive effect on blood sugar, what type of vinegar you can use, in which cases you should avoid it and much more.
Note: This blog post is for educational purposes. It is not intended to diagnose, treat or cure. If you have health problems, it is important to discuss them with an expert. We work closely with the Livakliniken , which is run by one of Womensync's external experts, Maria Särén, where you can turn if you are looking for advice. Please state "Womensync" when booking.
Chakraborty P, Goswami SK, Rajani S, Sharma S, Kabir SN, Chakravarty B, Jana K. Recurrent pregnancy loss in polycystic ovary syndrome: role of hyperhomocysteinemia and insulin resistance . PLoS One. 2013 May 21;8(5):e64446. Available at: < https://doi.org/10.1371/journal.pone.0064446 >
Tian L, Shen H, Lu Q, Norman RJ, Wang J. Insulin resistance increases the risk of spontaneous abortion after assisted reproduction technology treatment . J Elin Endocrinol Metab. 2007 Apr;92(4):1430-3. Available at: < https://doi.org/10.1210/jc.2006-1123 >
Chavarro JE, Rich-Edvards JW, Rosner BA, Wilnett WC. A prospective study of dietary carbohydrate quantity and quality in relation to risk of ovulatory infertility. Eur J Clin Nutr. 2009. Jan;63(1):78-86. Available at: < 10.1038/sj.ejcn.1602904 >
Craig, L., Ke, R. and Kutteh, W., 2002. Increased prevalence of insulin resistance in women with a history of recurrent pregnancy loss. Fertility and Sterility , 78(3), pp.487-490. Available at: < https://doi.org/10.1016/S0015-0282(02)03247-8 >
McGrice, M., & Porter, J. (2017). The effect of low carbohydrate diets on fertility hormones and outcomes in overweight and obese women: a systematic review. Nutrients , 9(3), 204. Available at: < https://doi.org/10.3390/nu9030204 >
Melanson KJ, Zukley L, Lowndes J, Nguyen V, Angelopoulos TJ, Rippe JM. Effects on high-fructose corn syrup and sucrose consumption on circulating glucose, insulin, leptin and gherlin and on appetite in normal-weight women. Nutrition . 2007;23:103-112. Available at: < https://doi.org/10.1016/j.nut.2006.11.001 >
Stanhope KL, Griffen SC, Bair BR, Swarbrick MM, Keim NL, Havel PJ. Twenty-four hour endocrine and metabolic profiles following consumption of high-fructose corn syrup-, sucrose-, fructose-, and glucose-sweetened beverages with meals. Am J Clin Nutr. 2008;87:1194-1203. Available at: < https://doi.org/10.1093/ajcn/87.5.1194 >
Russel JB, Abboud, C., Williams, A., Gibbs, M., Pritchard, S., & Chalfant, D. (2012). Does changing a patient's dietary consumption of proteins and carbohydrates impact blastocyst development and clinical pregnancy rates from one cycle to the next? . Fertility and Sterility , 98(3), S47. Available at: < https://doi.org/10.1016/j.fertnstert.2012.07.849 >
Inchauspé, J., 2022. Glucose revolution . Melbourne, VIC: Penguin Life.
Fett, R., 2014. It starts with the egg. Franklin Fox Publishing.