Choline is your nutrient for brain power, liver health, fat digestion, muscle strength and strong cell membranes.

Choline is getting more attention in nutritional circles but still many people do not realize how important it is for their health. So, let’s get choline basics clear. 

What’s choline?

Choline resembles B-vitamin, serves as a unique and essential nutrient required for many processes in the body, including structural, metabolic, and regulatory functions. It is especially important for proper function of your liver, your muscles, and your brain; is involved in lipid metabolism and cellular membrane composition and repair. 

Humans can make only small amounts of choline therefore we need to consume this nutrient through the diet to prevent deficiency. 

Choline tasks in your body 

Choline has a wide range of functions including:

  1. Acts as a methyl donor which is needed for methylation to promote DNA repair, detox and to regulate many processes 
  2. Is used for the synthesis of sphingomyelin and phosphatidylcholine; both compounds are elements of our cell membranes and support their function 
  3. Phosphatidylcholine also helps digest fats
  4. Is used as a precursor for acetylcholine synthesis, a neurotransmitter which helps us contract muscles, helps us to “rest and digest”, and in the brain it helps us to concentrate, to learn, to form memories, and even to get REM sleep   
  5. Choline works in a close collaboration with vitamin B12 and folate and suboptimal levels any of the trio can affect the levels and function of the other two
  6. Participates in the formation of platelet aggregating factor
  7. Supports secretion of very low-density-lipoprotein from the liver
  8. Is essential for proper brain development and function

Low choline levels and choline deficiency

Choline deficiency is real and causes clinically evident disease in humans. 

If you don't have sufficient choline levels, you are at higher risk of fatty liver disease, hepatic necrosis and inflammation. 

 choline deficiency - liver

You will probably be surprised to find out that if the brain needs neurotransmitter acetylcholine and is not getting choline from dietary sources, then it can breakdown the brain tissue for phosphatidylcholine and phosphatidylserine, two fat-based components of neuron tissue from which acetylcholine can be synthesized. 

Because choline is found predominantly in animal-derived foods, vegetarians, vegans, and people with certain food allergies (eggs) and people on the autoimmune diet may have a greater risk for inadequacy

Symptoms of choline deficiency may include

  • Feeling anxious or restless
  • Feeling tired and fatigued 
  • Fatty liver (non-alcoholic fatty liver disease NAFLD)
  • Muscle damage and aches
  • Poor memory and poor cognitive function
  • Hyperhomocysteinemia
  • Hemorrhagic kidney necrosis
  • Nerve tingling and pain

Since choline is essential for brain development and its function, poor choline levels might be a contributing factor in neurodegenerative diseases. Studies in mice show that adequate choline levels may reduce Alzheimer’s disease pathology.  

Choline deficiency - alarming signals

Watch out for red flags: if you experience brain fog, poor attention and memory, muscle twitching, unpredictable moods, or nerve tingling, your body might be telling you to get more choline.

The importance of choline in pregnancy, lactation and early childhood

Recent evidence suggests that maternal choline intake during pregnancy and lactation has long-term beneficial neurocognitive effects on children and is often insufficient. 

Adequate maternal choline intakes during pregnancy and breastfeeding are associated with better child attention, memory, and problem solving whereas low maternal choline intakes have been shown to increase the risk of both neural tube defects and cleft palates, as well as memory issues and other cognitive impairments in the child later in life. 

choline in pregnancy

Food sources of choline

Our body can make choline after methylation of the amino acid serine using S-adenosyl methionine (SAM). Choline is also present in foods; in small amounts in a free form and more commonly as part of the phospholipid lecithin (phosphatidylcholine) therefore foods rich in lecithin such as egg yolks, organ meats, muscle meats, shrimps, cod, salmon, wheat germ, soybeans, and peanuts are a good choline source. Lecithin is also added to many foods as an emulsifier. The best choline sources are egg yolks, liver and wheat germ. For example, 100 gram of liver contains approximately 350-400 mg of choline. Best plant foods as a source of choline include Brussel sprouts, wheat germ, soybeans, peanuts, almonds, peas, broccoli and cabbage.  

Food sources of choline - eggs

If you eat a diverse diet with whole-foods including animal products and foods containing fats, you are likely to get enough choline from your diet. The best is to consume the choline rich foods out evenly across your meals.

If you do not eat animal products, the simplest way to add more choline is to consume wheat germ (150 grams daily), to have nuts, seeds, and beans. 

Eating betaine rich foods such as red beets, spinach and wheat germ can support your choline levels because betaine supports methylation and reliefs choline’s methylation responsibility, making choline more available to turn it into phosphatidylcholine or acetylcholine.

Choline supplementation 

If you suspect that you are not getting enough choline from the diet, a supplement such as Alpha-GCP, phosphatidylcholine, lecithin, or TMG might be the right choice to prevent choline deficiency. Always best to consult it with a professional. 

How much choline is too much?  

Choline toxicity from foods is less likely to happen but high choline intakes from supplements are associated with a fishy body odor due to the accumulation of trimethylamine (TMA), vomiting, excessive sweating and salivation, hypotension, and liver toxicity. Approximately 3500 mg choline per day is considered an upper tolerable (maximum) daily dosage for adults, and typically the daily recommended intake ranges between 400-500 mg choline. 

Too much choline can lead to the following symptoms:

  • Fishy body odor (trimethylaminuria)
  • Lower blood pressure (hypotension)
  • Sweating
  • Salivation
  • Gastrointestinal distress
  • Diarrhea
  • Nausea and vomiting

Information provided here is meant for educational purposes only, and does not constitute medical or nutritional advice or act as a substitute for seeking such advice from a qualified health professional.

Reference list: 

  1. Wallace, Taylor C. PhD, CFS, FACN; Blusztajn, Jan Krzysztof PhD; Caudill, Marie A. PhD, RD; Klatt, Kevin C. MS; Natker, Elana MS, RD; Zeisel, Steven H. MD, PhD; Zelman, Kathleen M. MPH, RD, LD Choline, Nutrition Today: 11/12 2018 - Volume 53 - Issue 6 - p 240-253
  2. Korsmo HW, Jiang X, Caudill MA. Choline: Exploring the Growing Science on Its Benefits for Moms and Babies. Nutrients. 2019 Aug 7;11(8):1823. 
  3. Bekdash RA. Neuroprotective Effects of Choline and Other Methyl Donors. Nutrients. 2019 Dec 6;11(12):2995. 
  4. Velazquez R, Ferreira E, Winslow W, Dave N, Piras IS, Naymik M, Huentelman MJ, Tran A, Caccamo A, Oddo S. Maternal choline supplementation ameliorates Alzheimer's disease pathology by reducing brain homocysteine levels across multiple generations. Mol Psychiatry. 2020 Oct;25(10):2620-2629. 
  5. Wiedeman AM, Barr SI, Green TJ, Xu Z, Innis SM, Kitts DD. Dietary Choline Intake: Current State of Knowledge Across the Life Cycle. Nutrients. 2018 Oct 16;10(10):1513.
Diseases, Microbiome and gut health, Nutrition
Stop acid reflux

My clients are often surprised that changing their eating habits alone can relieve the acid reflux symptoms. The key strategy is to do it right and to be consistent. 

Many people around the globe and some of my clients struggle with the symptoms of acid reflux but not many know that acid reflux is not necessarily caused by having too much gastric acid but rather the acid is in the wrong place. It’s a common misconception about acid reflux to think that we have too much of gastric acid. On the contrary, the plentiful of people suffering from acid reflux have rather hypochlorhydria (too little stomach acid) than hyperchlorhydria (too much stomach acid). 

Fast reading:

  1. What is acid reflux?
  2. Acid reflux symptoms
  3. How to stop acid reflux?
  4. What causes acid reflux?

What is acid reflux?

Acid reflux is a common gastrointestinal complain with symptomology of heartburn, a burning pain in the lower chest. It’s driven by stomach acid flowing back up to the esophagus (the food pipe). It can happen for example when increased intra-abdominal pressure overpowers the lower esophageal sphincter (LES, a ring muscle), as seen in people with hiatal hernia or obesity. The esophageal sphincter acts as a valve preventing stomach acid, stomach content from backing up into esophagus. When this system fails, we may experience the symptoms of acid reflux. Noteworthy, reflux of gastric contents into the esophagus is normal physiology. However, when reflux (occurring frequently) leads to symptoms, esophageal mucosal injury or both, we talk about gastroesophageal reflux disease (GERD).

Acid reflux symptoms

Heartburn is a common symptom of acid reflux and some patients perceive it as an angina-like chest pain. Functional heartburn has the same symptoms without signs of reflux. Some people experience regurgitation which is a rise of gastric content into the mouth with sour/bitter tasting, without associated nausea or retching. Other symptoms of reflux may include hoarseness, cough, and asthma as well as pharyngitis, sinusitis, pulmonary fibrosis, recurrent otitis media, and sleep apnea. Some individuals will also experience bloating, burping, difficulty swallowing, hiccups, or nausea. Interpret these symptoms as your body sending you signals that there is something going on. “Treating” them with anti-acids and over-the-counter drugs (H2 blockers, aginate drugs, or proton pomp inhibitors), may help relieving the symptoms however will not address the underlying cause.

Acid reflux symptoms

How to stop acid reflux?

The best to stop acid reflux is to find the underlying cause. Sometimes your own detective work will be enough and sometimes you may need some testing to find out what’s behind it. 

Regardless of the cause, one of the most effective ways to reduce acid reflux is to invest in healthy eating habits. 

  • Eat healthy foods. I am sure you have heard many times to eat healthy and you might  be tired of it but if you want your digestive system to function at its best, a healthy diet is a must. Make your own meals by using fresh, real foods and by skipping processed foods. Go mentally back in time, before the convenient foods existed, what would you eat then? A home-made soup or an instant powder soup? A lollipop or a handful of berries? There is a difference not only in their taste, but also in their nutrient content. Keep it simple and avoid CRAP: processed foods, alcohol, sodas, artificial sweeteners, fried foods; and TRIGGER foods such as spicy foods, garlic, onion, tomatoes, chocolate and coffee. 
  • Go for cooked over raw. When having digestive complaints, it’s often better to eat cooked (and warm if you like) foods over raw and cold foods, they are more soothing and easier to digest. 
  • Chew well. Eat mindfully without rushing, CHEW your food properly (20 times before swallowing). Make eating moments mindful, look at your food, smell it, taste and savor it. It’s not only important what we eat but also how we eat. Proper chewing promotes better digestion. Be consistent with it.  
  • Drink chamomile, peppermint, or ginger tea, or cabbage juice. Some people find a relief after having yoghurt or milk. 
  • Avoid large meals. Don’t overeat, eat 4 to 6 small meals at fixed times. Don’t eat 2-4 hours before going to bed, especially heavy to digest meals.
  • Stay well hydrated BUT do not drink a lot with your meals as this increases the volume of the stomach and its contents. Drink mostly between meals. 
  • Try slippery elm bark tea or chew on the bark, it has been used for generations to relief acid reflux.
  • Be physically active but keep it moderate, do something you enjoy.
  • Sleep with your head and upper body slightly elevated.
  • Consider stress management activities such as yoga, psychological therapy, relaxation, exercise, mindfulness – if you feel like stress is overtaking your life.
  • Consider chiropractic adjustment, osteopathic care or acupuncture.
How to stop acid reflux - healthy food

What causes acid reflux?

  • Eating unhealthy and eating too much. A typical western diet rich in simple carbohydrates (sugars and starches), processed foods, and little vegetables promotes dysfunction of the digestive system and as a consequence acid reflux may occur. Often, when we eat convenient foods, we also have a tendency to overeat.  
  • Obesity. Obesity is commonly associated with acid reflux and GERD. The access weight can put extra pressure on the valves and sphincter causing stomach acid release.
  • Hiatal hernia. Hiatal hernia is an abdominal abnormality observed when the upper part of the stomach and lower esophageal sphincter (LES) move above the diaphragm. In this scenario, acid can move up into the esophagus causing acid reflux symptoms. The diaphragm is a muscle helping to keep gastric acid in our stomach. Consider osteopathic or chiropractic care.
  • Overtraining. High impact exercises and overtraining can put extra pressure on your abdomen triggering acid reflux.
  • Wearing tight-fitting clothes, lying down, bending over.
  • Smoking cigarettes. Smoking increases acid production and can contribute to GERD or acid reflux.
  • Certain medications and supplements such as antibiotics, muscle relaxers, blood pressure drugs, ibuprofen, potassium and iron supplements can affect the functioning of the digestive system and cause acid reflux.
  • Helicobacter pylori infection. Infection with H. pylori can manifest itself with heartburn. If you suspect it may play a role in your complaints, get yourself tested.
  • Low magnesium. Low magnesium can influence muscle tension and impair the function of the esophageal sphincter by not retaining the acid in the gastric cavity.
  • Chronic cough, stress, food sensitivities foods can also contribute to acid reflux.
  • Digestive issues. Think of reduced saliva causing decreased digestive buffering, poor digestive esophageal motor function causing reduced food clearance, or poor gastric emptying causing increased refluxate.
  • Underdeveloped GI tract as by babies, may also promote acid reflux because the digestive tract does not work optimally yet.
  • Pregnancy. During the pregnancy growing fetus can put extra pressure on the esophageal valve and this may promote the release of gastric acid and symptoms of heartburn.

If your symptoms do not subside after improving your eating habits and lifestyle, please seek medical help to properly evaluate the underlying cause. Long-term acid reflux (GERD) can lead to Barrett’s esophagus, manifested as esophageal scarring and constriction which leads to swallowing disorders.

Information provided here is meant for educational purposes only, and does not constitute medical or nutritional advice or act as a substitute for seeking such advice from a qualified health professional.

A reference list:

Diseases, Nutrition
Skin problems – what you need to know

Skin is the largest body organ and it acts as a barrier interacting with the outside environment. This barrier protects us, helps us to regulate body temperature, prevents the invasion of foreign particles and pathogens, prevents excess water loss, protects us from oxidative stressors, and allows the sensations of touch, heat, and cold. 

Fast reading:

  1. Skin problems - causes
  2. Skin micronutrients
  3. Top nutrients required for healthy skin
  4. Skin problems - skin microbiota
  5. Skin problems - lifestyle
  6. Skin problems - supplements

Skin problems - causes

Skin problems such as acne, eczema or psoriasis are often a manifestation of underlying health issues. The problem lies not in a lack of a particular soap, an anti-bacterial remedy or a corticosteroid immunosuppressant cream. You need to look deeper, “underneath” the skin. When I have clients with skin problems, we look at their wellbeing holistically, we don’t focus exclusively on skin itself, we look beyond that. To heal your skin, you may need to address possible underlying causes. Skin problems are often partly be determined by our genetics, our biochemistry and partly by our environment including the quality of food we consume, the air we breathe-in, the pollutants and toxins we are exposed to. So, if common skin disorders can be influenced by environment, factors such as nutrition and lifestyle might be sufficient in order to prevent and even reverse or reduce the flare-ups. Therefore, we want to focus on what we can influence, and we want to find our triggers and our soothers. Below you can find info on nutrients with a special role in skin health and on what to pay attention to when skin problems affect your life. Managing your skin health with nutrition, improving digestive function, reducing stress and optimizing lifestyle habits can provide benefits not only for your skin, but for your overall well-being. 

Skin problems

First, take into account that your skin problems could be related to: 

  1. Allergies (IgE driven reactions to foods and airborne allergens), food intolerances (poor functions of certain digestive enzymes), food sensitivities (IgG driven reactions)
  2. Hormonal imbalances (acne is often a result of hormonal imbalances)
  3. Autoimmune disease 
  4. Gut health issues (dysbiosis, infection)
  5. Poor nutritional status (low levels of vitamin A, vitamin D or zinc)
  6. Exposure to toxins and environmental pollutants
  7. Use of skin irritants (cosmetics, perfumes, chemicals)
  8. Compromised skin barrier
  9. Genetics
  10. Chronic stress 

Skin micronutrients

Certain nutrients are particularly important for healthy skin. Macronutrients such as amino-acids, lipids and carbohydrates are building blocks of the skin and are essential for its structure and function. 

In addition to macronutrients, skin needs micronutrients such as vitamins and minerals to properly regulate its function. In this section, we will focus mostly on micronutrients. 

These include vitamins A, C, E, and K2, zinc, biotin, sulfur, pantothenic acid (B5), niacin (B3), silica, selenium, and the omega-3 fatty acids. When we lack these nutrients, our skin can manifest it by dermatitis, rashes, acne, poor wound healing, raised bumps on the backs of the arms, and loss of skin firmness. Many nutrients act in concert with other nutrients so a deficit of one can make the other less effective. Thus, focusing on one nutrient only, might not entirely address the problem. 

The best way to get these nutrients is by eating real, whole-food sources, eating colorful foods, and diversity of foods; and by avoiding processed foods, added sugars, food additives, foods from the packages. 

Healthy skin

Top nutrients required for healthy skin

Vitamin A for skin problems

Vitamin A: lack of it causes the skin to be rough and dry which often first appears as rough, raised bumps on the back of the arms. Vitamin A-rich foods include liver and cod liver oil, kidney, cream and butter (pastured cows), and egg yolks (pastured chickens). If you take cod liver oil, it will provide you with vitamin A and vitamin D.

Vitamin C for skin problems

Vitamin C plays an important role in the regulation of the structural protein collagen, which is necessary for the extracellular stability of the skin. Inadequate vitamin C levels can contribute to the development of hyperkeratosis pilaris, the common problem with the follicles being damaged when collagen formation is impaired. True deficiency of vitamin C is uncommon but we often consume low quantities of it, particularly in a diet with a low fruit and vegetable intake. The highest sources of vitamin C include bell peppers, guava, dark leafy greens, broccoli, Brussels sprouts, kiwi, citrus fruits, strawberries, cilantro, chives, thyme, basil, and parsley.

Vitamin E for skin problems

Vitamin E is a potent fat-soluble and anti-inflammatory agent, found in our skin. Our bodies store vitamin E in our fat cells, and we depend on adequate dietary intake to maintain optimal levels. Adequate levels of this vitamin in the skin may prevent inflammatory damage from sun exposure. Food sources of vitamin E include spinach, turnip greens, chard, sunflower seeds, almonds, bell peppers, asparagus, collards, kale, broccoli, Brussels sprouts, and olive oil.

Vitamin K2 for skin problems

Vitamin K2 is an important player in protecting us from heart disease, forming strong bones, promoting brain function, supporting growth and development, helping to prevent cancer, ensuring healthy skin, and this vitamin is likely beneficial for preventing wrinkles and premature aging. Vitamin K2 is also necessary for the proper functioning of vitamin A- and vitamin D-dependent proteins. Vitamin A is essential for proper skin cell proliferation and cannot work properly if vitamin K2 is not available. Vitamin K2 is important in the treatment of acne, keratosis pilaris, and other skin symptoms of vitamin A deficiency. Good sources of vitamin K2 include butter and other high-fat dairy products from grass-fed cows, egg yolks, liver, natto, sauerkraut and cheese.

Zinc for skin problems

Zinc supports immune function, protein synthesis, wound healing, DNA synthesis, cell division, regulation of gene expression. It also has anti-inflammatory properties and protects against UV radiation. People with serious acne are found to have lower levels of serum zinc than healthy individuals. You can find zinc in animal sources including seafood (oysters, scallops, and other shellfish), kidney, liver, and red meat. Plant foods such as pumpkin seeds and other nuts can also be high in zinc, but zinc from these sources might be less bioavailable.

Copper for skin problems

Copper serves as an antioxidant, stimulates the maturation of collagen, and modulates melanin synthesis. Food rich is copper include beef liver, sunflower seeds, nuts, dark chocolate, chickpea, asparagus, kale, and goat cheese.

Biotin (vitamin B7) for skin problems

Biotin (vitamin B7) acts as a cofactor for enzymes that regulate fatty acid metabolism with fatty acids being critical for the health of the skin. When biotin intake is insufficient, fat production is altered, and the skin cells are the first to develop symptoms. Low biotin intake/levels can contribute to hair loss, dandruff, erythematous (red and inflamed) dermatitis around the mouth and other areas of the face and scalp. In infants, inadequately low biotin amounts might contribute to “cradle cap” and seborrheic dermatitis in adults. Biotin rich foods include egg yolks, liver, Swiss chard, romaine lettuce, almonds, and walnuts.

Sulfur for skin problems

Sulfur is a critical mineral for skin health and overall wellness. Sulfur is necessary for collagen synthesis, which gives the skin its structure and strength. Having enough sulfur in your diet can help maintain collagen production and keep your skin looking firm. Foods containing sulfur include egg yolks, meat, poultry, and fish, garlic, onions, Brussels sprouts, asparagus, and kale. Fermented foods, like sauerkraut, with well bioavailable sulfur serve as an excellent source of sulfur and a healthy component of a diet for radiant skin.

Pantothenic acid (vitamin B5) for skin problems

Pantothenic acid (vitamin B5) is required for proper growth, metabolic function, energy production, for protein and fat synthesis, and is needed by many different types of skin cells for regeneration and growth. Vitamin B5 is also involved in the growth and differentiation of keratinocytes, which are essential for maintaining a healthy skin barrier. Keratosis pilaris (chicken skin) is a common skin condition caused by impaired keratinocyte growth, which may improve from increased pantothenic acid consumption. Pantothenic acid also significantly increases levels of glutathione in the cells, which acts as a potent antioxidant in the skin. Pantothenic acid can be found in various foods and some of the richest sources include liver and kidney, egg yolk, broccoli, fish, shellfish, chicken, dairy products, mushrooms, avocado, and sweet potatoes.

Niacin (vitamin B3) for skin problems

Niacin (vitamin B3) is a vital payer in cell metabolism acting as a coenzyme in energy producing reactions including the breakdown of carbohydrates, fats, and proteins, as well as anabolic reactions such as fatty acid and cholesterol synthesis. Niacin deficiency is uncommon, however in certain health conditions such as in celiac disease, IBS, Crohn’s disease impaired niacin absorption from the diet happens. Low niacin levels can lead to the skin-related symptoms such as dermatitis and scaling. Niacin rich foods include meat, poultry, red fishes such as tuna and salmon, and seeds. Milk, green leafy vegetables, coffee, and tea also provide some niacin. For most healthy people, a diverse diet with adequate meat consumption should be enough to meet niacin’s nutritional needs.

Silica for skin problems

Silica is required for normal collagen formation. It maintains the health of connective tissues by interacting with the formation of glycosaminoglycans (GAGs), such as hyaluronic acid, which are structural building blocks of collagen tissues. Inadequate silica content can result in reduced skin elasticity and impaired wound healing. To ensure adequate silica intake include in your diet leeks, green beans, garbanzo beans, strawberries, cucumber, mango, celery, asparagus, and rhubarb. 

Selenium for skin problems

Selenium is a crucial trace mineral with numerous health benefits, for general health as well as the skin health. One of the most important jobs of selenium is being a component of glutathione peroxidase, an enzyme necessary for the antioxidant function of glutathione (master antioxidant in our body that protects against cellular damage from the free radicals that cause inflammation and aging and promote skin cancer). Individuals with acne have been shown to have low levels of blood serum selenium, as well as low levels of selenium-dependent glutathione activity. The richest food sources of selenium are Brazil nuts, organ meats and seafood, followed by muscle meats. Fish such as cod, tuna, halibut, sardines, and salmon are excellent sources, along with liver and meats like beef, turkey, lamb.

Omega-3 fatty acids (EPA and DHA) for skin problems

Omega-3 fatty acids (EPA and DHA) have anti-inflammatory properties and are essential in healthy skin. Adequate levels of omega-3 fatty acids have been shown to decrease inflammation and to reduce the risk of acne and other skin problems by decreasing insulin-like growth factor (IGF-1) and preventing hyperkeratinization of sebaceous follicles. These fatty acids are abundant in cold-water fatty fish such as sardines, salmon, mackerel, tuna, anchovies, and black cod. The added value of eating fish rather than taking fish oil is that apart from getting these omega-3s, you also get other nutrients such as vitamin D, zinc and selenium.

Skin problems -  nutrients

Skin problems - skin microbiota

You probably have heard about the importance of the gut microbiome to your health but did you also know that our skin is home to millions of bacteria, fungi and viruses that compose the skin microbiota. Skin microorganisms have essential roles in the protection against invading pathogens, the education of our immune system and the breakdown of natural products. When the skin barrier is broken, the skin is malnourished or when the balance between good and bad microbes is disturbed, skin conditions or even systemic disease can result. 

Certain common skin diseases associated with changes in the microbiota (termed dysbiosis, meaning an altered microbial state) include acne, eczema and chronic wounds. 

In order to preserve healthy skin microbiome, do not over-use skin products, unnecessary topical medications, detergents, skin irritants, or chemicals. 

Skin problems - lifestyle

Manage your stress. Stress can be associated with numerous skin conditions as the skin is influenced by many of the hormones and neuropeptides involved in the stress response, such as corticotropin-releasing hormone, adrenocorticotropin hormone (ACTH), cortisol, epinephrine and norepinephrine. (Chronic) Stress compromises the effectiveness of the gut barrier as well as the skin barrier, impairing the integrity and protective function of these barriers. Stressful situations often trigger skin related flare-ups. If you are prone to feel stressed and you suffer from skin issues – managing stress will be essential for healthy skin. Find ways that work for you to deal with stress such as meditation, mindfulness, sports, a therapy and be consistent with practicing it. For example, have three “go-to” stress relievers that work for you such as taking a few deep breaths, stepping outside for few minutes, reminding yourself to just “let it go,” perking up your posture and carrying yourself confidently (stress can make you hunched over) or planning something you look forward to at the end of your stress-filled day. In addition, contact with nature, cultivating pleasure, connections, and making time for play and laugh are wonderful stress remedies. 

Increase ultraviolet exposure especially if you spend most of the time indoors. Ultraviolet light (from sunlight or alternatively UVA/UVB tanning beds) can be helpful in the management of psoriasis, vitiligo, acne, eczema, dermatitis, and lichen planus. In addition, sunlight promotes vitamin D3 synthesis and offers additional cognitive benefits of spending time outdoors. Be mindful that (too much) sun exposure (particularly if it leads to sunburn) can make skin conditions worse, and not all skin conditions (such as rosacea) benefit from ultraviolet light. If your skin condition worsens after sun exposure, then reduce sun exposure until your skin condition is under control.

Get enough rest and quality sleep. Quality sleep helps you regenerate, calm the nervous system and get the inflammation under better control. Prioritize a healthy sleeping routine, minimize electronic media and distractions around bed time. Go to bed around 10pm-11pm.

Incorporate regular physical activity to your routine but avoid overtraining, choose an activity you enjoy doing

Apply the 8x8x8 rule: 8 hours of sleep, 8 hour of work, 8 hours of rest 

Skin problems - supplements

Next to a healthy diet, which should serve as foundation of any therapy, there are certain supplements that may be helpful for people with skin complaints.

These include Vitamin C, quercetin, vitamin D, vitamin A, zinc, high quality multivitamin or group B vitamins, Cod liver oil or omega-3 fatty acids. 

Nothing works?

If you do all the right things: eat healthy, exercise, sleep well, do not use skin damaging products, have stress under control and yet your skin does not improve – dig deeper to find the reason why. Asses your nutritional status, check your hormones, your gut health, digestion, rule out allergies, food intolerances or autoimmunity. 

Information provided here is meant for educational purposes only, and does not constitute medical or nutritional advice or act as a substitute for seeking such advice from a qualified health professional.

Reference list

are supplements useful or useless?

I have learned a lot about dietary supplements in the last couple of years and I do keep learning. Before I became a parent, I was never rigorously taking any supplement. Only occasionally, I purchased a low-quality multivitamin from a drug store and I have never noticed any effect. After my second daughter was born, I was sleep deprived, constantly exhausted, not functioning as normal. It seemed like my body was not only missing sleep but some nutrients as well. But little I knew at that time about the power of proper nutrition. At some point, in the act of desperation, I decided to try a high-quality mineral supplement.

And I was blown away. On the days I took it, I felt and functioned much better and I even looked much better. It was not only my perception, even people around me could tell a difference. My poor nutrient status became obvious then. It was also the time when I realized that proper nutrition and supplementation can be very powerful.

Fast reading:

  1. Do I need to take supplements at all?
  2. Maintenance supplementation vs therapeutic supplementation
  3. What supplements should i take?
  4. How to select a high-quality supplement?
  5. My favourite supplement brands

With the knowledge and experience I have now, I am quite critical as to what I supplement myself and what I recommend to my clients. I always look for high quality, high purity, and high bioavailability products. No trash supplements are on my list. Poor quality supplements are a waste of money.


Do I need to take supplements at all?

If we lived in a perfect world, ate nutrient dense foods, had no chronic stress, no sleep issues, no environmental toxins and chemicals, if we had plenty time to relax, if we were born naturally to a healthy mother, if we were breastfed for few years, if we used no drugs and antibiotics - then none of us would ever need to take supplements. 

Does it describe your life?

It does not describe my life and I am afraid there are only few lucky ones who fit this description. Unfortunately, for most of us - being chronically stressed, malnourished, sleep deprived, and over-medicated is normal, rather than exceptional. It is always essential for your wellbeing to build a healthy foundation by eating a clean diet, reducing exposure to toxins, managing stress, cultivating a positive attitude, having a quality sleep and getting most nutrients from foods. If you are able to get and absorb sufficient amounts of all essential nutrients naturally from foods, and your body is able to utilize them, that's the best way to go. Sometimes however - getting all we need from foods is not optimal, especially with chronic health problems. Then, the right supplementation can be very valuable in achieving good health. On the contrary, if you focus only on taking supplements without addressing your stress, sleep, attitude and a diet – the supplements will not be a magic pill to sustain good health. Some people do well without supplements but they would do better with them. For some people, supplements are completely out of discussion as it does not feel right to take them. That’s ok. If you are open to taking supplements, at first try to find out what you need and what you want to achieve. The best way is to use supplements as a supportive tool to enhance health, prevent disease, and/or reach certain health goals.

Maintenance supplementation vs therapeutic supplementation

Nutritional supplementation incorporates the use of vitamins, minerals, other various molecules and botanicals to promote good health and to prevent or treat disease. You can take supplements as a form of a maintenance regimen or to meet some specific therapeutic goals.

Maintenance supplementation

Maintenance supplementation involves supplementing with basic micronutrients that may be difficult to obtain from a healthy diet. Examples might include a multivitamin, vitamin D, vitamin A, omega-3 fatty acids such as EPA and DHA. Even if you eat a healthy diet, it can be very difficult to get all the required nutrients from foods alone. Firstly, the vitamin and mineral content of conventionally grown foods has decreased over past decades. Secondly, not everyone can digest, absorb and assimilate nutrients very well.

Therapeutic supplementation

Therapeutic supplementation is focused on addressing a particular health condition or a symptom, like iron deficiency, vitamin B12 deficiency, anxiety or insomnia. Therapeutic supplementation is beyond the scope of this blog as it largely depends upon the individual health status and the problems to be addressed. Even though maintenance supplementation may also vary based on your circumstances, there are some common guidelines I want to share with you.

What supplements should i take?

If you do take supplements, do it wisely. Take the supplements that have the potential to support you. 

A high-quality multivitamin and mineral supplement

It will provide you with the essential nutrients, can be highly effective in preventing common deficiencies and more convenient to take than few separate mineral and vitamin supplements. Multis are best taken with meals, for example breakfast or lunch. My favourite brands for synthetic multivitamins include Pure Encapsulations, Thorne Research, Seeking Health, Vitals and from food based multi products consider Terranova, Garden of Life or New Chapter.

Fish oil - Cod liver oil

It can be a quite potent food-based supplement if you want to boost your immunity for example. It is an excellent source of omega-3 fatty acids, such as EPA and DHA, vitamin D3, and vitamin A. My favourite brand at the moment is Rosita cod liver oil (CLO).

What supplements should i take?

If you do not take (regularly) a multivitamin and/or fish oil, consider individuals nutrients such as:

Vitamin D

Vitamin D deficiency is quite common, however it’s best to get your vitamin D level tested before supplementation. We can get vitamin D from two sources: food and sunshine. Seafood is the only significant source of vitamin D, but you’d still have to eat a lot of it to get enough. The D3 produced after sun exposure, along with the D3 we get from food, gets converted by the liver into 25-hyrdroxy-vitamin D (25D), which is what typically gets measured when you have a vitamin D test. The optimal blood serum level of 25D level is around 50 ng/mL. One of the best sources of vitamin D is high-vitamin cod liver oil. It contains not only vitamins A & D, but also omega-3 and natural vitamin E and other quinones.


Magnesium is needed for hundreds of enzymatic reactions within our body and most of us, to lesser or greater extent, is on a magnesium deficient spectrum. High stress, poor diet and lack of sleep increase your need for this nutrient. Most multivitamin supplements do not contain enough magnesium to meet your daily needs. Magnesium is also obtained from foods, such as leavy greens, nuts and seeds but most people does not get the required amounts. Therefore, many of you will benefit by taking extra magnesium, for example between 150 – 350 mg daily. Select chelated forms of magnesium such as magnesium glycinate, or magnesium malate because they’re better absorbed and tend to have fewer side effects. If you are constipated, try magnesium citrate.

Omega fatty acids

Depending on your diet, health status and goals, you may consider to supplement with omega-fatty acids. There are omega-3, omega-6 and omega-9 fatty acids. Among various omega fatty acids only two fatty acids are considered to be essential for humans, meaning they cannot be synthesized by humans. It is alpha-linolenic acid (an omega-3 fatty acid) and linoleic acid (an omega-6 fatty acid). Some other fatty acids are sometimes classified as "conditionally essential", meaning that they can become essential under certain conditions such as disease, malnutrition; examples include docosahexaenoic acid (an omega-3 fatty acid) and gamma-linolenic acid (an omega-6 fatty acid). EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are omega-3 fats found primarily in cold-water fish like salmon, mackerel, herring, sardines, anchovies, and halibut. EPA and DHA play an important role in fetal development, cardiovascular and immune health, weight management, cognitive function, and much more. Low intake of these important nutrients, or their precursors, has been associated with a wide range of health problems. It’s a good idea to supplement with a high quality DHA/EPA if you do not eat fatty fish, approximately 500–1,000 mg on regular basis of EPA and DHA combined, or have a cod liver oil as it contains EPA and DHA and fat-soluble vitamins like vitamin A and D. ALA (α-Linolenic acid) is an omega-3 fatty acid found primarily seeds and oils, including flaxseed, walnuts, chia, hemp, and many common vegetable oils. GLA (gamma-linolenic acid) and LA (linoleic acid) are omega-6 fatty acids found in plant foods (seeds and nuts) and plant oils (flaxseed oil, evening primrose oil, borage oil, canola oil). Omega-9 fatty acids are not essential in humans because they can be synthesized from carbohydrates or other fatty acids but we still need the and the most common source if olive oil. Using a cold press, organic quality blend oil combing flax seed oil, borage oil, hemp oil and olive oil is also a good way to get the various fatty acids from foods. 

Plant-Based Antioxidants such as Flavonoid Extracts or “Green Foods”, or plant extracts with an anti-inflammatory effect

Consider it in particular if your diet is deprived of vegetables, fruits, and herbs. Consider grape seed extract, pine bark extract, green tea extract, ginkgo biloba extract, ashwagandha, curcumin, milk thistle extract, bilberry extract, Hawthorn extract, red beets, berries, or leafy greens. The plant kingdom is very diverse and there is plenty of potent nutrients within. Think of well-known herbs such as thyme, rosemary, basil which are wonderful nutrient boosters for your health.   

Vitamin B-complex

B vitamins are essential to coordinate various processes within our body such as neurological function and energy production. Most B vitamins do not remain stored in the body, so they must be acquired daily from the diet to help maintain optimal health. Especially when you have chronic health issues, the chance is high you don’t get enough of them from foods to meet our daily needs.


If you do not consume many fiber rich foods such as veggies and you have poor gut health or blood sugar swings, supplementing with various fiber powders may be very beneficial. 

How to select a high-quality supplement?

Not all supplements are created equal. Therefore, choose high-quality supplements containing bioavailable forms of vitamins and minerals, high quality plant extracts, or standardized plant ingredient formulations. You also want to use supplements that do not contain unnecessary additives, fillers, coatings, colourings, sweeteners, hydrogenated fats, allergens, heavy metals and other unwanted contaminants. Be aware that supplements might also be a source of impurities acquired during the manufacturing process. Supplement manufacturing and marketing is not strictly regulated, therefore there is a lot junk supplements on the market that do not contain what they claim and even may have harmful ingredients. Thus, quality first! 

Forms of supplements: select a powder or a capsule form over tablets, if possible. In general, tablets contain more additives than powder/capsule forms, or liquid forms. Liposomal forms are good especially for plant extracts such as curcumin, resveratrol or active form of glutathione. Watch out for additives such as sugars, colorings. 

In addition to a quality product, choose the formula that’s right for you, a child formula for children, an adult formula for adults, or a prenatal formula during pregnancy.

Food based (natural) vitamins and minerals versus synthetic ones?

Sometimes natural is better (vitamin E, K), sometimes synthetic and sometimes it does not matter with respect to their activity. They all can be helpful at the right dosages and harmful when over-dosed. Most of us think that food-based vitamins are a better idea than synthetic ones. They do work for some people but not everyone will tolerate food-based supplements. For me, not all food-based supplements work well as I can develop an allergic reaction. On the other hand, I see great results with high quality synthetics. If you tolerate food-based multivitamins, then take them. If you don’t, then try synthetic ones. Sometimes, you just need to try to find the best match.

Consider following when taking food-based vitamin and mineral supplements:

  • food-based products can cause mild to severe reactions (reactivity to foods) as they contain food-based compounds
  • many food-based supplements contain - apart from food-based nutrients - also synthetic ones, these products often contain misleading labels such as “natural”, “whole food based”
  • food-based supplements will not necessarily provide you more vitamins and minerals, dosages of vitamins and minerals are often inexact and low in food based supplements but you may get other plant compounds of potential health benefits
  • food-based supplements may be contaminated with heavy metals such as lead or fungus 
  • food-based supplements can consist of a dry extract from plants or a combination of purified compounds from plant food
  • food-based supplements are often more expensive

My favourite supplement brands

Some of my favourite supplement brands include Seeking Health, Pure Encapsulations, Thorne Research, NOW Foods, Designs for Health, Life Extension, AOV, Vitals, Bonusan and Jarrow Formulas. From food-based supplements, I recommend brands such as Terranova, Garden of Life, Viridian, New Chapter. 

There is no single brand that has it all. For certain nutrients, I like one brand over the other brand and a certain brand might have a better combination of nutrients for one client and another brand will work better for the other client.  

Diseases, Microbiome and gut health, Nutrition
Gut glossary

ANTIBIOTIC – antibiotics, or antibacterials, are a type of antimicrobial used to target bacteria, and are often used in medical treatment of bacterial infections. They can either kill or inhibit the growth of bacteria.

DYSBIOSIS – also called dysbacteriosis, this refers to microbial imbalance on or inside the body. Dysbiosis is most commonly reported as a condition in the digestive tract.

FERMENTATION – a chemical process that converts sugar and carbohydrates into acids, gases, and/or alcohol. It occurs in yeast and bacteria, but also in oxygen-starved muscle cells, as in the case of lactic acid fermentation. Humans use fermentation to produce food and beverages.

GUT MICROBIOTA – microorganisms residing in the gastrointestinal tract (GI tract).

GASTROINTESTINAL TRACT/DIGESTIVE SYSTEM – an organ system responsible for consuming and digesting foodstuffs, absorbing nutrients, and expelling waste.

INTESTINAL BARRIER (gut barrier) – is essential in human health and constitutes a tight barrier that controls what gets absorbed into the bloodstream. It is a semi-permeable barrier that allows the uptake of essential nutrients and immune sensing, while being restrictive against pathogenic molecules and bacteria, this filtering structure is essential function of the gastrointestinal tract. The central component of the barrier is formed by intestinal epithelial cells, which physically separate the intestinal lumen and the body. In addition, various molecules are secreted into the intestinal lumen to reinforce the barrier function and a variety of immune cells below the epithelial layer provides additional protection. 

INTESTINAL PERMEABILITY - is defined as the system describing the control of material passing from inside the gastrointestinal tract through the epithelial cells lining the gut wall, into the rest of the body. The intestine normally exhibits some permeability, which allows nutrients to pass through the gut, while also maintaining a barrier function to keep potentially harmful substances (such as antigens) from leaving the intestine and migrating to the body more widely. A crucial function of the intestinal epithelium is the maintenance of a proper barrier function, allowing the permeability of nutrients, water and ions, but limits entry of pathogens and bacterial toxins. 

INCREASED INTESTINAL PERMEABILITY aka LEAKY GUT – refers to a compromised intestinal barrier, meaning that the gut lining might have a sort of “cracks or holes”. Physiologically, our intestinal barrier is permeable but it’s problematic when the permeability is increased allowing translocation of partially digested food, toxins, and bugs to the tissues beneath the gut barrier. The expression “leaky gut” is getting a lot of attention in medical blogs and social media; however, many doctors will be unfamiliar with this term. This undesired translocation may trigger immune system, promote inflammation and lead to changes in the gut microbes that could lead to problems within the digestive tract and beyond. The current research shows that abnormalities in the intestinal barrier, intestinal bacteria and inflammation may play a role in the development of several common chronic diseases.

POSTBIOTIC - also known as metabiotics, biogenics, or metabolites - are products or byproducts made by live bacteria, or released after bacterial lysis. Studies demonstrate that postbiotics may play a role in general health and well-being, providing physiological benefits to the host. An example of a postbiotic is butyric acid. It’s a Short Chain Fatty Acid made by intestinal bacteria and by probiotic bacteria. 

PROBIOTIC – live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. The term derives from the Latin preposition pro (“for”) and the Greek adjective βιωτικός (biotic), the latter deriving from the noun βίος (bios, “life”).

PREBIOTIC – generally refers to compounds (food ingredients) that induce the growth and/or activity of commensal microorganisms (eg bacteria and fungi) that contribute to the wellbeing of their host. A prebiotic is a selectively fermented ingredient that results in specific changes in the composition and/or activity of the gastrointestinal microbiota, thus conferring benefit(s) upon the host’s health.

SYMBIOSIS – interaction between two or more different biological species.

SYNBIOTYK - A mixture comprising live microorganisms and substrate(s) selectively utilized by host microorganisms that confers a health benefit on the host. Simply, Probiotic(s) + prebiotic(s) working to achieve one or more health benefits. 

MICROBE – an organism that is microscopic.

MICROORGANISM – a microscopic living organism, single- or multiple-celled. Microorganisms include bacteria, archaea, protozoa and some fungi and algae. Viruses are also sometimes classified as microorganisms.

MICROBIOTA – sometimes called microflora; a community of symbiotic, commensal and pathogenic microorganisms inhabiting either the surface of the body or its different cavities: the skin, mouth, ears, vagina and gastrointestinal tract, among others.

MICROBIOME – the collective genomes of the microorganisms that reside in an environmental niche, such as a gut microbiome referring to microbial genomes found in the gut.

Microbiome and gut health, Nutrition

Tip #1 What to look for when choosing a probiotic supplement

  • Choose a reputable brand
  • Select products specifying probiotics by genus, species and strain, such as Lactobacillus acidophilus DDS- Look for strains that occur naturally in human gut microbiota, and that have been clinically tested
  • CFU (Colony Forming Units). The number of live microorganisms in each serving or dose through the expiration date should be mentioned
  • Recommended dosage should be indicated
  • Choose age/condition-appropriate products
  • Ignore meaningless claims about health benefits. If they sound too good to be true, choose another brand
  • Proper storage conditions. Some probiotic products should be refrigerated and others stored at room temperature
  • Corporate contact information should be provided
  • the expiration date and the batch number should be mentioned on product packaging
  • select products with fewer or no additives

Tip #2 Probiotics during and after antibiotics

  • Follow the recommendations of your health care professional
  • Follow manufacturers’ recommendations for dosage and frequency if taking probiotic supplements
  • Generally, take probiotic food/supplements 1-3 hours after taking antibiotics, and continue for at least 2-4 weeks after the antibiotic course
  • It is important to consume prebiotic food as it stimulates the growth of beneficial bacteria
  • Consume nourishing foods that will boost your immune system and help to balance your gut microbes
Patients taking antibiotics may suffer from digestive upset and are at risk of antibiotic-associated diarrhea, thrush, and Clostridium difficile infection.

Tip #3 Feed your probiotics and your gut microbes

If you take a probiotic supplement and you want the bacterial species to thrive, you need to feed them. It's the same when it comes to feeding and nourishing your endogenous microbiome. Your own bacteria and probiotic bacteria need food in order to survive and proliferate. Feeding them is as important as having them. By feeding them well, more species will thrive which will promote even higher microbial diversity.

And why should you even care about the microbial gut diversity? Microorganisms residing in our gut contribute to our wellbeing and to the way our body functions. Researchers study extensively their role in health and in disease. The westernized lifestyle and diet reduce our microbial diversity, consequently contributing to many inflammatory non-communicable diseases. There is still a lot to be learnt but we currently know that the microbial gut diversity increases resilience, stimulates our immune system and strengthens the ability to fight off specific diseases. One could say, the more - the merrier.

The higher microbial diversity and well nourished gut microbes - the better your health foundation! Tips:
  • Go for a healthy, balanced and diverse diet, add to your cuisine plenty of vegetables and legumes so your microbes have a feast, have fruits for their beautiful colors and polyphenols, have fermented foods to get natural probiotics, and foods rich in soluble fiber. Raw foods and fermented foods harbor environmental microbes, whereas fiber rich foods promote growth of beneficial bacteria
  • Reduce consumption of sugars if you have a sweet tooth (overconsumption of sugars can stimulate the growth of yeast such as Candida albicans)
  • Breastfeed your infant if possible, components of breast milk nourish not only the infant but also friendly bacteria present in mother milk and in the infant’s gut. Microbes present in breast milk and in the gut contribute to the development of the infant’s immune system
  • Avoid unnecessary antibiotics and other medications (hormones) as their use have a negative effect on your microbial diversity
  • Avoid unnecessary medical interventions, such as plastic surgeries or C-sections out of convenience. If a C-section is medically necessary, consider swabbing the newborn with mother’s vaginal microorganisms
  • Reduce the use of hand sanitizers and wash your hands with water and soap
  • Get dirty, have contact with nature, farm animals and pets (contact with animals is microbiologically beneficial especially at the young age)
  • Go back to the basics and think of foods, environments and activities our grandparents were brought up with! They had simple, unprocessed foods and plenty contact with nature!

It’s a common dilemma. Excess sugar consumption over last decades has made this substance our number one health enemy. Even if you don’t eat sweets, you are probably exposed to more sugar than you realize. There is also some confusion around sugars. Some say sugars are healthy, others that they are not. Some say we need them whereas others say we don’t. Sugar substances have many faces as they come in natural and artificial forms. Apart from shared sweetness they may have various properties such as calorie high and calorie free. Sugar substances can also exert various effects on our body including blood glucose swings, inflammation, dysregulation of hormonal system and gut microbiome. Their effect is also dose-dependent and sugar type-dependent.


Sugars belong to carbohydrates, compounds constructed from carbon, oxygen and hydrogen atoms. Carbohydrates comprise of simple carbohydrates and complex carbohydrates. Simple carbs often refer mostly to sugars and act as quick-burning fuels because they elevate blood sugar quickly and therefore you want to eat less of this type. Complex quality carbs are broken down in a steadier manner with a less dramatic effect on blood sugar, and therefore considered a better choice.

I am not extreme to the point where we all need to be a on a sugar-free regimen. My goal is rather to educate so you avoid Excess Sugars, unhealthy sugars, have overall healthy carbs and feel guilt-free if you have a cake once in a while. It’s all about balance and moderation. To my opinion, more than exclusion of certain macronutrients like carbs – is a skill of balancing macronutrients and having the right proportions on your plate.

Sugar reality check

To give an example, 1 teaspoon of table sugar equals about 4 grams of sugar.

Some popular “health” foods such as:

  • fruit yoghurts typically contain 3 - 8 teaspoons of sugar,
  • granola between 3 – 6 teaspoons,
  • protein bars between 3 to 6 teaspoons,
  • orange juice between 4 to 6 teaspoons

and the list goes on.

Now, if you have what’s commonly considered a “healthy” breakfast consisting of fruit yoghurt with granola, a french toast and a glass of orange juice, guess what? You are set for a morning sugar bomb, 15 – 30 teaspoons of sugar (60 – 120 grams) to start a day!

Sugar reality check

Now, let’s look at how much glucose circulates in your bloodstream, do you know? There is about 8 grams of glucose (2 teaspoons) circulating in your bloodstream. So, what happens with all the sugar if you consume 60 – 120 grams of it for breakfast only? You wish it disappears, right? But it does not.  It needs to be burned off or stored. There is however only a certain amount you can burn, the rest will be stored: first as glycogen in your liver and muscles and then, all over the body as fat. Moreover, excess sugar wreaks havoc your health, your hormones get out of balance, your cardiovascular system and various tissues get inflamed, your gut health gets under fire, your sleep is disrupted, your brain outperforms.

RED FLAGS: worth to realize is that when you frequently FEEL MORE TIRED, or MORE ENERGETIC (or both at times) after your meals, it suggests that your blood sugar is imbalanced. In the past, oftentimes after my meals (with plenty of pasta, rice or potatoes and little veggies) I had a dip and felt like going to bed or I was having sugar cravings. I did not know why, now I know it was due to a blood sugar imbalance. Right now, I do not experience that because I pay attention to what I eat and to the proportions of different food groups. My blood sugar is stable and energy steady throughout the day, simply by balancing the proportions. If I could change it, so you do!

Sugar: dose matters

As with many substances, small quantities can be quite safe whereas large quantities lethal, think of alcohol, drugs, medicines, certain foods and herbs. It’s quite similar with sugar too. Sugar is toxic at the certain dose. It’s not a secret that long-term excess sugar consumption is killing us slowly. Be sugar smart and mind your sugar dose!

Tip: If you want to stay on a save side, reduce your sugar intake to minimum. Stay away from any foods and drinks with over 4-6 grams of sugar per serving and any foods & drinks listing sugar (including all fancy sugar names) as one of the first 3 ingredients on food and drink labels.

Also, don’t get tricked by thinking that:

  • Coconut sugar or date sugar is a healthy alternative to high-fructose corn syrup and table sugar. It may sound healthy but your body will recognize it and process it as sugar.
  • Sugar is just empty calories so it’s ok – no, it’s more than that. Excess sugar causes inflammation, insulin resistance, diabetes, heart problems, hormonal issues, GI issues, cancer.
  • Replacing sugary drinks with “diet” or “sugar free” drinks is a better alternative. Both are harmful for you.

The bitter-sweetness of artificial sweeteners

The food industry, in order to find a “solution” to side effects such as risk of insulin resistance and diabetes of sugar consumption due to its high glycemic index, high glycemic load and high calorie load, came up with what might seem like a “magic” answer – artificial sweeteners. You may have heard of artificial sweeteners such as aspartame, saccharin, sucralose and acesulfame. Artificial sweeteners brought to the table the sweetness, stable blood glucose levels and few or no calories. What else can you ask for, one might think? Seems like a perfect solution. Yet, not quite.

They are often hidden in “sugar free” - “diet” drinks. There are studies showing that the frequent consumption of artificial sweeteners can increase the risk of heart disease, diabetes, weight gain, can disrupt the gut microbiome and promote glucose intolerance. On the top of it, intake of artificial sweeteners tricks our brain to consume even more by dysregulating hunger and satiety feeling. When you drink a calorie free “diet coke” which is sweet, your brain will be confused as to why this “sweet drink” is calorie free. In nature, our physiology is trained to associate sweet foods and drinks with calories. So what may happen when it’s sweet but contains no or little calories – our body may ask for more sweets and drinks to correct this imbalance! It’s a dangerous zone. Cutting calories in this way might create a vicious cycle, is harmful and still keeps you hooked by sweetness. Artificial sweeteners and sugar make you crave sweetness, they alter your brain chemistry and metabolism.

Remember: if you are craving sweet foods and drinks – it indicates your blood sugar is off balance.  

“Free Sugars” trap

You probably came across a term “FREE SUGARS” and you might be confused as to what exactly it refers to. Free sugars refer to any sugars added to a food. It includes natural and industrial sugars and the “free sugars” list is quite long. The common ones include table sugar, glucose-fructose corn syrup, agave, honey, maple syrup, brown rice syrup, date sugar, glucose, grape sugar, fruit juice, caramel, carob syrup, coconut sugar, maltodextrin, dextrose, dextran, maltose. Your body does not need these free sugars to be added to your foods and the industry adds it to most foods and drinks they manufacture. We are being chronically overdosed with free sugars. In the pre-agriculture times sugar wasn’t common, people ate it seasonally and occasionally from fruits and honey.

Watch out for sugar alcohols

Sugar alcohols are sweet and are naturally present in fruits and vegetables. It inspired the food industry to use them as sweeteners. They are added to sweets, confectionary products, chewing gums, medicines, dietary supplements, and tooth pastes. They have different chemical structure than sugars and they are usually less sweet than artificial sweeteners. Similarly to artificial sweeteners they don’t influence blood glucose levels but they have calories, only less than sugar. They became quite popular and are commonly recommended instead of sugar or artificial sweeteners.

The most common sugar alcohols include mannitol, xylitol, sorbitol, maltitol. You can easily spot them by reading food labels because their names end with suffix “-ol”. Commonly one of the problems with sugar alcohols is that we don’t absorb them very well (except erythritol). As a result, they can cause gastrointestinal discomfort including diarrhea, flatulence, and bloating. Sugar alcohols can be partly metabolized by your gut microbes, so if eaten in excess they can alter your gut microbiome. Again and again, because they are sweet – they keep you craving sweetness and sugar. If you consume them in quantities as present in real foods such as in fruits and vegetables you probably will not have any problems. If you consume unnatural quantities however, by adding few spoons of xylitol to your every drink or food, your body will protest and manifest it one way or the other. The best is to keep sugar alcohols consumption to minimum.


Let’s give a little bit attention to stevia, it became quite popular as a sugar substitute over past years. Stevia corresponds to Stevia rebaudiana plant which contains steviol glycosides (Rebaudioside A) responsible for the sweet taste. Steviol glycosides derived from stevia are naturally low in calories and do not raise blood sugar levels when consumed. There is however some controversy and probable safety issues around the use of stevia plant extracts, high-quality purified steviol glycosides (Rebaudioside A) are considered generally safe for use in food. If you use stevia, make sure you know what you buy and use as “stevia”: plant extract or purified steviol glycosides and always use it sparingly.


How our body reacts to carbohydrates?

One of the main reasons, sugars gained so much negative attention is because they can mass up with our blood glucose levels, oftentimes consequently leading to insulin resistance and diabetes type 2. It happens when we over consume sugars. Our body constantly thrives to maintain normal blood glucose concentration by removing glucose from the blood (for example after sugar ingestion) or by returning glucose to the blood (when blood glucose level is too low) from cells and tissues.

What we eat, at what quantity and how often can impact blood glucose levels. Simple sugars like glucose and complex sugars like starches which are easily digestible to glucose, can impact blood glucose levels the most. Insulin is responsible than for lowering the blood glucose levels, it drives the cellular uptake of glucose so if you eat a lot glucose and/or starch your body will produce more insulin accordingly, at least at the beginning. Long term overconsumption of foods rich in glucose and starch can alter your hormones and disrupt many physiological processes resulting in health problems including insulin resistance, inflammation, weight gain, depression, dementia, cancer, skin issues to name a few. This vicious sugar cycle makes you crave even more sugar.

Did you know that (white) bread, rice, pastas, corn flakes and flour-based products are rich in starch? To know what effect certain foods, have on our blood glucose levels, scientists came up with the terms of glycemic index (GI) and glycemic load (GL). Glycemic index tells you how ingested carbohydrates (from various foods) impact your blood glucose levels, which may be influenced by your capability to digest and absorb (glycemic response to the food). For example, high-GI foods (white bread, mashed potatoes) that are rapidly digested and absorbed cause a quick raise in blood glucose levels whereas low-GI foods (leafy greens) which are not rapidly digested and absorbed will cause a much lower peak in blood glucose levels, keeping it stable. Glycemic load considers the quantity and the quality of the carbohydrate in a food, it is the glycemic index times the grams of carbohydrates on a given amount of the food. Therefore, one food’s GI and GL can differ as in case of carrots. The carbohydrates in carrots have a high GI score however carrots have a low GL factor because they don’t contain many carbs per serving.

TIP: I recommend eating healthy starches such as starches from legumes, root vegetables, quinoa, buckwheat, potatoes, oats or brown rice. You just don’t want to overeat them, typically try to keep them around ¼ - 1/3 portion of your main meals, and have plenty of veggies, adequate protein and healthy fats next to it. The effect of these carbs (eaten in moderation) on your blood sugar will be minimal as long as there is fiber, protein and fat as well.

How to go around sugars and carbs?

  • Avoid excess sugars (simple carbs)
  • Have complex carbs (veggies, legumes, whole grains) over simple carbs (natural and artificial sugars, fruit, honey, syrups, table sugar, juices)
  • In particular avoid added sugar (free sugar) – it is a real health trouble maker and if you pay attention to what you buy you can quite easily do it
  • Read labels if you purchase pre-packed products
  • If you want some sweetness, get sugar from natural food sources like fruits and honey (alternatively stevia, or erythritol, or xylitol), in moderation of course
  • Carbs are best when they come from vegetables, fruits, intact whole grains and beans.
  • Break the vicious cycle of sweetness, the more sweetness you eat the more you crave = the more your blood sugar is imbalanced. Break the cycle by introducing more healthy foods.
  • Keep our blood sugar stable by having the right proportions on our plate. For example, you can simply combine following to prepare a balanced lunch and dinner: non starchy veggies (about 40-60% by volume) + Protein source (about 15-25% by volume) + Healthy Fat (about 10- 25% by volume) + Healthy starches (about 10-20% by volume) + herbs and spices.
  • Red flags: if you frequently feel more tired, or more energetic after your meals, it suggests that your blood sugar is imbalanced. Are you Feeling more tired/sleepy/brain fog after eating? If yes, you probably had too many carbs such as starches, sugar in your meal. Reduce carbs, have more veggies and see how you feel after your next meal. Are you Feeling more energetic/concentrated after eating? If yes, then your blood sugar was probably too low, indicating low blood sugar – hypoglycemia. To avoid blood sugar swings (high and low), it’s important to have balanced meals/snack by having protein, healthy fats and not too much healthy carbs. Ideally, when you eat healthy foods at the right proportions you will feel no difference after and between your meals. Your energy will be stable through the day.

For those who are carving more info, let’s briefly present CARBOHYDRATES

Carbohydrates comprise of simple carbohydrates and complex carbohydrates. Sugars belong to carbohydrates, compounds constructed from carbon, oxygen and hydrogen atoms.

Simple carbohydrates are structurally the simplest carbohydrates and two groups can be distinguished: monosaccharides and disaccharides.

  • Monosaccharides (1 sugar unit), often called simple sugars, can’t be broken down to smaller carbohydrate units, the most common include glucose, fructose and galactose.
  • Disaccharides (2 sugar units) consist of two simple sugar units (two monosaccharides), examples include lactose, sucrose, maltose and trehalose. Sucrose is a table sugar.

Complex carbohydrates are structurally longer carbohydrates including oligosaccharides containing 3 to 10 saccharide units and polysaccharides containing more than 10 units.

  • Oligosaccharides (3-10 sugar units) consist of 3 to 10 simple sugar units and the most common include raffinose, stachyose, and verbacose.
  • Polysaccharides (more than 10 sugar units) are long chains of simple sugar units ranging from several units up to the hundreds. You can find among this group plant starch and cellulose, and animal derived glycogen. Starch, cellulose and glycogen consist of only glucose units. Dietary fiber belongs to this group.

Reference list:

  1. Gropper SS and Smith JL. Advanced Nutrition and Human Metabolism. Sixth Edition. Wadsworth Cengage Learning. 2012.
  2. World Health Organization. Sugars Intake for adults and children. March 2015
  3. American Heart Association. Kids and added sugars: how much is too much?
  4. Yang Q, Zhang Z, Gregg EW, Flanders WD, Merritt R, Hu FB. Added sugar intake and cardiovascular diseases mortality among US adults. JAMA Intern Med. 2014 Apr;174(4):516-24.
  5. Zupanič N, Miklavec K, Kušar A, Žmitek K, Fidler Mis N, Pravst I. Total and Free Sugar Content of Pre-Packaged Foods and Non-Alcoholic Beverages in Slovenia. Nutrients. 2018 Jan 30;10(2).
  6. Singh GM, Micha R, Khatibzadeh S, Lim S, Ezzati M, Mozaffarian D; Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE). Estimated Global, Regional, and National Disease Burdens Related to Sugar-Sweetened Beverage Consumption in 2010. Circulation. 2015 Aug 25;132(8):639-66.
  7. Suez J, Korem T, Zilberman-Schapira G, Segal E, Elinav E. Non-caloric artificial sweeteners and the microbiome: findings and challenges. Gut Microbes. 2015;6(2):149-55.
  8. Suez J, Korem T, Zeevi D, Zilberman-Schapira G, Thaiss CA, Maza O, Israeli D, Zmora N, Gilad S, Weinberger A, Kuperman Y, Harmelin A, Kolodkin-Gal I, Shapiro H, Halpern Z, Segal E, Elinav E. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature. 2014 Oct 9;514(7521):181-6.
  9. Stephan BC, Wells JC, Brayne C, Albanese E, Siervo M. Increased fructose intake as a risk factor for dementia. J Gerontol A Biol Sci Med Sci. 2010 Aug;65(8):809-14.
  10. Ruanpeng D, Thongprayoon C, Cheungpasitporn W, Harindhanavudhi T. Sugar and artificially sweetened beverages linked to obesity: a systematic review and meta-analysis. QJM. 2017 Aug 1;110(8):513-520.
  11. Yang Q. Gain weight by "going diet?" Artificial sweeteners and the neurobiology of sugar cravings: Neuroscience 2010. Yale J Biol Med. 2010 Jun;83(2):101-8. Review.
  12. Tryon MS, Stanhope KL, Epel ES, Mason AE, Brown R, Medici V, Havel PJ, Laugero KD. Excessive Sugar Consumption May Be a Difficult Habit to Break: A View From the Brain and Body. J Clin Endocrinol Metab. 2015 Jun;100(6):2239-47.
  13. Malik VS. Sugar sweetened beverages and cardiometabolic health. Curr Opin Cardiol. 2017 Sep;32(5):572-579.
  14. Avena NM, Rada P, Hoebel BG. Evidence for sugar addiction: behavioral and neurochemical effects of intermittent, excessive sugar intake. Neurosci Biobehav Rev. 2008;32(1):20-39. Epub 2007 May 18. Review.
  15. Kuhnle GG, Tasevska N, Lentjes MA, Griffin JL, Sims MA, Richardson L, Aspinall SM, Mulligan AA, Luben RN, Khaw KT. Association between sucrose intake and risk of overweight and obesity in a prospective sub-cohort of the European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk). Public Health Nutr. 2015 Oct;18(15):2815-24.
  16. Jennifer A. Nettleton, Pamela L. Lutsey, Youfa Wang, João A. Lima, Erin D. Michos, David R. Jacobs, Jr. Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care. 2009 Apr; 32(4): 688–694.
  17. Glenda N. Lindseth, Sonya E. Coolahan, Thomas V. Petros, Paul D. Lindseth. Neurobehavioral Effects of Aspartame Consumption. Res Nurs Health. Author manuscript; available in PMC 2017 Sep 27.Published in final edited form as: Res Nurs Health. 2014 Jun; 37(3): 185–193.
  18. Durán Agüero S, Angarita Dávila L, Escobar Contreras MC, Rojas Gómez D, deAssis Costa J. Noncaloric Sweeteners in Children: A Controversial Theme. Biomed Res Int. 2018 Jan 8;2018:4806534.
  19. Belloir C, Neiers F, Briand L. Sweeteners and sweetness enhancers. Curr Opin Clin Nutr Metab Care. 2017 Jul;20(4):279-285. Review.
  20. Stanhope KL, Havel PJ. Endocrine and metabolic effects of consuming beverages sweetened with fructose, glucose, sucrose, or high-fructose corn syrup. Am J Clin Nutr. 2008 Dec;88(6):1733S-1737S.

Information provided above is meant for educational purposes only, and does not constitute medical or nutritional advice or act as a substitute for seeking such advice from a qualified health professional. 

Diseases, Nutrition
Insulin resistance

Blood sugar imbalance is a commonly undiagnosed problem. Stable blood sugar is essential to overall health. Blood sugar imbalance can relate to (chronically) low or high blood sugar. Some people experience both, fluctuating blood sugar levels between low and high. Drops in blood sugar are known as hypoglycemia and high blood sugar spikes can refer to insulin resistance.

The early recognition of these symptoms will help you prevent excessive and unnecessary inflammation, and will give you the opportunity to take effective measures to reclaim your health. Glucose serves as your brain’s fuel and fuel for the cells throughout the body. When you do not have stable blood sugar (glucose), you comprise your overall health and your brain health.

Fast reading:

  1. Why insulin resistance is problematic?
  2. What is insulin resistance?
  3. Insulin resistance symptoms
  4. How can insulin resistance be diagnosed?
  5. Insulin resistance - eating to balance your blood sugar might fix the problem
  6. Find your carbohydrate tolerance

Why insulin resistance is problematic?

Many people are unaware that they have blood sugar imbalance and insulin resistance is a silent blood sugar problem. It is widely undiagnosed and if not managed it increases the risk for prediabetes, type 2 diabetes and a host of other serious health problems, including heart attacks, strokes, polycystic ovary syndrome (PCOS), hypertension, and hyperlipidemia known as metabolic syndrome, and cancer.

Why insulin resistance is problematic?

What is insulin resistance?

Insulin is a hormone made by the pancreas and its job is to help glucose in your blood (blood sugar) to enter the cells in your body, where it’s used for energy. Glucose comes from the food and drinks you consume. When blood glucose levels rise after you eat, your pancreas releases insulin into the blood. Insulin then helps to lower blood sugar (glucose enters the cells) to keep it in the normal range.

Insulin resistance is a condition when cells of the body don’t respond properly to insulin and they can’t easily take up glucose from the blood. As a result, it is more likely that glucose will build up in the blood leading to elevated blood sugar levels.

A growing body of evidence has consistently shown that insulin resistance is linked to low-grade systemic inflammation.

When the body becomes resistant to insulin, it tries to cope by producing more insulin (hyperinsulinemia), therefore people with insulin resistance are often producing more insulin than healthy people.

What is insulin resistance?

Insulin surges promote inflammation in the brain and in the body. Interestingly, blood sugar/insulin levels impact the brain’s ability to make neurotransmitters and are elucidated to play a role in neurodegenerative diseases such as Alzheimer's disease. Thus, unstable blood sugar affects brain’s biochemistry, causes inflammation and compromises your brain health.

Becoming insulin resistant does not happen over-night, it typically takes years to get there. Most common reason includes a diet high in sugars, sugary foods, sweets, cookies, sodas, bread, pasta, pastries, excess rice & potatoes, and grains. In addition, high stress, poor sleep and lack of physical activity. Being obese on itself increases insulin resistance as well. However, it is possible to be insulin resistant without being overweight or obese.

Insulin resistance symptoms

Insulin resistance develops in stages. During the initial - compensated phase of insulin resistance, insulin levels are higher, and normal blood glucose levels are still maintained. If compensatory insulin secretion fails, then either fasting or postprandial glucose concentrations increase. Eventually, type 2 diabetes develops when glucose levels become higher and the resistance increases and compensatory insulin secretion fails. The inability of the pancreatic β-cells to produce sufficient insulin in a condition of hyperglycemia is what characterizes the transition from insulin resistance to type 2 diabetes.

The symptoms become more pronounced once secondary effects such as higher blood sugar levels occur.

Insulin resistance symptoms may include:

  • thirst or hunger
  • feeling hungry even after a meal
  • increased or frequent urination
  • tingling sensations in hands or feet especially when insulin resistance progresses to type 2 diabetes
  • feeling more tired than usual
  • feeling sleepy after meals
  • frequent infections
  • difficulty concentrating (brain fog)
  • weight gain around the middle (belly fat)
  • high blood pressure
  • high cholesterol levels
  • Some people may have darkened skin in the armpit or on the back and sides of the neck, a condition called acanthosis nigricans
  • Polycystic Ovary Syndrome (PCOS) might be a red flag to consider insulin resistance
Insulin resistance  symptoms - hunger

How can insulin resistance be diagnosed?

There is no single perfect test used in clinic for diagnosis. But the easiest screening way, next to the clinical presentation, is to do a blood test for (fasting) blood serum glucose and insulin (and often other markers like Ab1c, cholesterol, triglycerides).

There are also helpful tools for insulin resistance assessment such as the Quantitative Insulin Sensitivity Check Index or a Homeostatic Model Assessment of Insulin Resistance (HOMA-IR).

Insulin resistance - eating to balance your blood sugar might fix the problem

If you suspect you may have insulin resistance or prediabetes, there are things you can do to reduce inflammation and to be healthier.

Golden tips include avoiding sugary foods and drinks, avoiding processed foods and drinks, and having balanced meals consisting of real foods. Plant foods (veggies, fruits) rich in phytonutrients such as polyphenols-flavonoids with their anti-inflammatory and anti-oxidative powers should be plenty full on your plate. Keeping a moderate carbohydrate intake is also recommended. Think of a Mediterranean like diet. Some people also benefit from a ketogenic diet.

Most people will do well keeping following proportions on their plate:

  • About 50-65% of non-starchy vegetables
  • About 15-25% of quality protein
  • About 15-30% of healthy fats
  • About 5-15% of healthy starches
  • Herbs, spices and salt

Healthy eating also includes eating fruits but preferably have them as a snack or a dessert.

Food groups: vegetables, fruit, protein rich foods, fat rich foods, herbs and spices, and heathy starches

Find your carbohydrate tolerance

First of all, having nutritious breakfasts with high quality protein and fat, (low-carbs) can be very powerful to stabilize your blood sugar.

For many people having little bit carbs for breakfast, a little more for lunch and even more for dinner will do the trick in keeping your blood sugar stable.

To find your carbohydrate tolerance monitor following: if you feel sleepy or crave sugar after you eat, you probably have eaten too many carbohydrates. But in case of severe insulin resistance you may feel sleepy even if you haven’t eaten any starchy or sweet foods. Let’s say you had beef and a salad for lunch and you still feel sleepy after eating. It might suggest that you are at the advanced stage of insulin resistance. In this case, it’s worth working with a professional who can help you correct the problem with nutrition and nutraceuticals.

Information provided below is meant for educational purposes only, and does not constitute medical or nutritional advice or act as a substitute for seeking such advice from a qualified health professional. 

Reference list

  1. Rhea EM, Banks WA. Role of the Blood-Brain Barrier in Central Nervous System Insulin Resistance. Front Neurosci. 2019;13:521. Published 2019 Jun 4.
  2. Spinelli M, Fusco S, Grassi C. Brain Insulin Resistance and Hippocampal Plasticity: Mechanisms and Biomarkers of Cognitive Decline. Front Neurosci. 2019;13:788. Published 2019 Jul 31.
  3. Tao L, Liu H, Gong Y. Role and mechanism of the Th17/Treg cell balance in the development and progression of insulin resistance. Mol Cell Biochem. 2019;459(1-2):183–188.
  4. Ren N, Kim E, Li B, et al. Flavonoids Alleviating Insulin Resistance through Inhibition of Inflammatory Signaling. J Agric Food Chem. 2019;67(19):5361–5373.
  5. Gołąbek KD, Regulska-Ilow B. Dietary support in insulin resistance: An overview of current scientific reports. Adv Clin Exp Med. 2019;28(11):1577–1585.
  6. Yaribeygi H, Farrokhi FR, Butler AE, Sahebkar A. Insulin resistance: Review of the underlying molecular mechanisms. J Cell Physiol. 2019;234(6):8152–8161.
  7. Ballak DB, Stienstra R, Tack CJ, Dinarello CA, van Diepen JA. IL-1 family members in the pathogenesis and treatment of metabolic disease: Focus on adipose tissue inflammation and insulin resistance. Cytokine. 2015;75(2):280–290.
  8. Barazzoni R, Gortan Cappellari G, Ragni M, Nisoli E. Insulin resistance in obesity: an overview of fundamental alterations. Eat Weight Disord. 2018;23(2):149–157.
  9. Zand H, Morshedzadeh N, Naghashian F. Signaling pathways linking inflammation to insulin resistance. Diabetes Metab Syndr. 2017;11 Suppl 1:S307–S309.
  10. Maciejczyk M, Żebrowska E, Chabowski A. Insulin Resistance and Oxidative Stress in the Brain: What's New?. Int J Mol Sci. 2019;20(4):874. Published 2019 Feb 18.
  11. Petersen MC, Shulman GI. Mechanisms of Insulin Action and Insulin Resistance. Physiol Rev. 2018;98(4):2133–2223.
Diseases, Nutrition

During the day, depending on various factors, blood sugar (glucose) levels fluctuate slightly at physiological levels. This is normal.

Glucose is the main source of energy for our body and brain. Glucose comes from foods and drinks. One of the hormones involved in glucose utilization, is insulin. Insulin’s job is to help glucose enter our cells where it’s used for energy. The levels of circulating blood sugar should not be too low and not too high. The standard normal lab range is around 3.5 and 6.0 mmol/L (63 to 108 mg/dL).

A stable blood sugar level is essential to our overall health.

What is hypoglycemia?

If blood sugar falls below the healthy range, it’s called HYPOGLYCEMIA. Then, you might not feel well. There are several reasons why this can happen; the most common is a side effect of drugs used to treat diabetes. Diabetics are under a medical care and are educated about the risk of hypoglycemic symptoms so I am not going to talk about hypoglycemia in relation to diabetes management. Hypoglycemia can happen in people who do not have diabetes.

Here, I cover some aspects of non-diabetic hypoglycemia. It’s relatively common but many people are not aware of it.


Symptoms of hypoglycemia

Symptoms of hypoglycemia can differ from person to person. You may have one or more mild-to-moderate symptoms.

Typical symptoms of hypoglycemia include:
  • feeling hungry
  • feeling dizziness and light-headed if meals are missed
  • feeling shaky, jittery
  • feeling tired and eating to relieve fatigue
  • becoming easily irritated, upset, tearfull and nervous
  • craving for sweets between meals
  • increased energy after meals
  • weakness
  • tingling lips
  • a fast or pounding heartbeat (palpitations)
  • poor memory, forgetfulness
  • anxiety
  • blurred vision
  • paleness

Some people experience hypoglycemia also during sleep. If that happens, they may cry out or have nightmares, sweat excessively, feel tired, irritable, or confused after waking up.

Why some people feel anxious, they sweat, or have thumbing heart when their blood sugar levels drop?

Because low blood sugar triggers the release of stress hormones (to promote glucose release from its storage form like glycogen) and puts the body in the “fight-or-flight” mode. Moreover, at the point of glucose shortage (combined with a lack of ketones) the brain will not get enough glucose which can be manifested as drowsiness, difficulty concentrating, confusion, blurred vision, slurred speech, or numbness.

To know whether you are experiencing low blood sugar, you need to check your blood sugar. If you are experiencing symptoms and you are unable to check your blood sugar for any reason, you can try to treat hypoglycemia and best discuss it with your general practitioner.

hypoglycemia - checking blood sugar

What causes non-diabetic hypoglycemia?

There are two types of non-diabetic hypoglycemia:

  • Fasting hypoglycemia: may be related to a disease (liver disease, hypothyroidism, eating disorders), certain medications, herbal supplements such as fenugreek, ginseng, cinnamon, or to alcohol, malnutrition, or exercise.
  • Reactive hypoglycemia: which happens within a few hours of eating a meal, the causes may be unknown but possibly include: hyperinsulinemia (elevated insulin levels), meals high in refined carbohydrates such as white bread or foods high in sugar, prediabetes. And it’s more prevalent in women with polycystic ovary syndrome (PCOS).

In addition, low blood sugar can be caused by a low carbohydrate intake as well as by a high carbohydrate intake. Chronic high carbohydrate consumption (especially simple sugars) can cause over production of insulin and insulin helps our body to “insert” glucose into the cells where it can be utilized as energy. Some people make too much insulin (inappropriate levels for the level of blood glucose) and if insulin is able to effectively “insert” glucose into the cells, blood sugar can drop too much causing hypoglycemia.  The possible risk of high insulin levels includes a high risk of brain issues because insulin inhibits lipolysis and ketogenesis, thus preventing the generation of alternative brain substrates (such as ketone bodies), the brain might be deprived of the fuel then.

NOTE. If you started a low-carb diet and you experience some of the symptoms mentioned above, you might be getting too little fuel (energy from carbs and/or fats). Meaning that your carbohydrate intake went down but your fat intake did not increase to balance the fuel intake which can lead to hypoglycemic episodes. It’s quite common to follow a low-carb diet without a proper consideration of providing the fuel for the body and the brain.

How to prevent low blood sugar?

  • Have small amount of protein every 2 - 3 hours. This does not mean eat a full meal every two to three hours – a few bites will do. The idea is to keep your blood sugar stable without activating your adrenals to release stress hormones and raise blood glucose. Suggested proteins include nuts, seeds, a boiled egg, or meat, or a low-carbohydrate protein drink. For some people, eating 5 to 6 small meals each day instead of 3 large meals and snacks works best.
  • Avoid refined carbohydrates such as white bread, cakes, cookies, regular sodas, syrups, and candy.
  • Avoid drinks or foods that contain caffeine and alcohol. Caffeine and alcohol may cause you to have the same symptoms as hypoglycemia, and may cause you to feel worse.
  • Avoid sweets before bed. If you have a tendency to hypoglycemia, your blood sugar will crash during the night, long before your next meal is due. Chances are your adrenals will kick into action, creating restless sleep or that 3am wake up with anxiety.
  • Eat diversity of healthy foods. In a nutshell, foods that should be on your menu include vegetables (various vegetables which will provide complex carbohydrates, polyphenols, anti-oxidants and other nutrients), protein source (mushrooms, poultry, fish, nuts, meat, seeds, legumes, eggs, alternatively a protein powder), healthy fats (extra virgin olive oil, flax seed oil, avocado, coconut fat, goose fat, duck fat, borage oil, evening primrose, and ghee/grass-fed butter), healthy (resistant) starches (sweet potato, rice, buckwheat, quinoa, tubers) in moderation, and various herbs and spices.
  • Check your carbohydrate intake. If you are on a very low-carb diet (and not on a ketogenic diet), you might be getting too little carbs to sustain a stable blood glucose.
  • Track your symptoms and situations in which they happen. Pay attention when your symptoms occur, is it before meals or when you skip a meal? Write down your symptoms, time the episodes and relation to food ingestion, comorbid conditions, medications and social.
  • In case of severe hypoglycemia, have a sugary drink or snack – try something like a small glass of fruit juice or a small handful of sweets.

Treatment of hypoglycemia

Treatment depends on the cause of the hypoglycemia. For example, if a medicine you take is causing hypoglycemia, you need to discuss it with your health care professional. If hypoglycemia is caused by low hormone levels, you may need to take hormones.

Information provided below is meant for educational purposes only, and does not constitute medical or nutritional advice or act as a substitute for seeking such advice from a qualified health professional. 

Reference list

  1. Desimone ME, Weinstock RS. Non-Diabetic Hypoglycemia. In: Feingold KR, Anawalt B, Boyce A, et al., eds. Endotext. South Dartmouth (MA):, Inc.; 2000.
  2. Kittah NE, Vella A. MANAGEMENT OF ENDOCRINE DISEASE: Pathogenesis and management of hypoglycemia. Eur J Endocrinol. 2017;177(1):R37–R47.
  3. Kandaswamy L, Raghavan R, Pappachan JM. Spontaneous hypoglycemia: diagnostic evaluation and management. Endocrine. 2016;53(1):47–57.
  4. Scheen AJ. Central nervous system: a conductor orchestrating metabolic regulations harmed by both hyperglycaemia and hypoglycaemia. Diabetes Metab. 2010;36 Suppl 3:S31–S38.
  5. Diabetes Canada Clinical Practice Guidelines Expert Committee, Yale JF, Paty B, Senior PA. Hypoglycemia. Can J Diabetes. 2018;42 Suppl 1:S104–S108.
  6. Mumm H, Altinok ML, Henriksen JE, Ravn P, Glintborg D, Andersen M. Prevalence and possible mechanisms of reactive hypoglycemia in polycystic ovary syndrome. Hum Reprod. 2016;31(5):1105–1112.


There is no one-size-fits-all healthy plate but most people will benefit from the tips provided here. Others may need more strict and individualized approach to address their health issues such as with allergy, intestinal dysbiosis, diabetes, autoimmune disease, nutritional deficiencies, or food intolerance. Generally speaking, if you are eating health promoting foods, you follow a healthy life style - then don’t overanalyze or get obsessed in what you’re eating and just enjoy your real food. After all, there’s more to life than food! But now let’s focus on food.

I want to help you to compose health promoting meals. No dieting and calories counting as long as you chose the best quality of health-promoting real foods. The quality is more important than the quantity. You want to have foods on your plate that were alive because they promote life and health, on the contrary factory and processed foods promote disease. Follow the mother nature principles and you are on the safe side.

What should be on your plate?

Real Food. Mostly plants. Not too much.

I based it on the Michael Pollan’s quote stating “Eat food. Mostly plants. Not too much.” It’s the essence and your primary goal. I have made 6 rules to make it more precise and helpful for you so you can start creating your healthy plates. This is how proportions of different food groups should look like on a healthy plate, according to me.

6 keys rules to compose healthy plates (for breakfast, lunch and dinner)

#1 Have only real foods on your plate and resist processed foods – real foods contain information (proteins, fats, carbohydrates, vitamins, minerals and phytonutrients, water) that our bodies utilize to run and optimize countless number of processes. A handful of candies can’t be compared with a handful of wild blackberries, the first one has no nutritional value and undermines our health whereas the second one is laden with nutrients and promotes our health. Highly processed foods disrupt our biology, the flow of information and are devastating to our health. They are not made to promote our health but to promote addiction. In nowadays world reading labels is essential. Remember that foods that are the best for us come as mother nature designed them: naked and not packed, labeled and processed.

To give you a feeling of do’s and don’ts, read some of Michael Pollan’s quotes:

  • “Don't eat anything incapable of rotting”, “Eat only foods that will eventually rot”.
  • “Don't eat anything your great-grandmother wouldn't recognize as food.”
  • “If it came from a plant, eat it; if it was made in a plant, don't.”
  • “Avoid food products containing ingredients that no ordinary human would keep in the pantry”
  • “Don’t eat anything with more than five ingredients, or ingredients you can't pronounce”

I could not agree more.

#2 Have lots of non-starchy vegetables on your plate – vegetables should be the largest portion on your plate, it truly can be a game changer for you and your gut microbes! Have a variety of colors from various vegetables (leafy greens, cruciferous vegetables, stalks and stems). Vegetables are your main source of dietary fiber (complex carbohydrates), various phytonutrients, minerals and vitamins. You don’t need to have a plenty of various vegetables with every single meal but strive to have at least 1-4 different vegetables.

#3 Have adequate quality protein on your plate – think of pastured meat, eggs, poultry, wild fish or nuts and seeds, legumes, nuts, seeds, and  mushrooms.  For some plant protein sources you may need to have a relatively more protein volume to get the same amount of protein as from animal source, for example 100 grams of beef or chicken contains about 25 grams protein whereas 100 grams of cooked chickpeas about 7 grams protein,  lentils about 9 grams protein, and quinoa about 12 grams protein. Peanuts, nuts and seeds are more protein dense plant foods. Noteworthy, animal proteins all contain every single of the essential amino acids, so they're called complete proteins. On the contrary, each plant food you eat has a different amino acid composition. For example, grains and cereals are extremely low in lysine. If you only eat grains and cereals, you won't get enough lysine. Whereas, legumes such as peanuts, peas, dry beans and lentils contain a lot of lysine. On the other hand, legumes aren't good sources of tryptophan, methionine and cystine, but those amino acids are found in grains and cereals. Grains and legumes are called complementary proteins because when you combine them (for example quinoa + lentils), you get all of the essential amino acids. Nuts and seeds are also complementary to legumes because they contain tryptophan, methionine, and cystine.

#4 Have healthy and real fats on your plate and avoid fake fats - include unsaturated fats (most of plant origin) and saturated fats (most of animal origin, except coconut oil), the best is to eat them in most natural forms, non-processed. We need both types of fats, in the right balance and of high quality. Many people often have: too high intake of commercial saturated fats by consuming too much dairy (cheese), meat (pork, lamb), ready-to-eat products, cookies, chips, chocolate, margarines; and too high intake of unsaturated omega-6 rich foods  such as grains, nuts, seeds, and plant oils. Omega-3 fatty acids are anti-inflammatory and omega-6 fatty acids pro-inflammatory. We need both of them but in the right balance. Sources of omega-3 fatty acids include fat fish, spinach, purslane, or flax seeds, pastured eggs, poultry and grass-fed beef. Include in your menu foods rich in unsaturated fats (which are essential for proper cell function) such as fat fish (wild), avocado, olives, hazelnuts, wild meat, pastured poultry and have naturally occurring saturated fats in your diet including coconut oil, ghee/butter, lard, duck fat, eggs or meat/poultry. Tip: Unsaturated fats are prone to oxidation which is promoted by heat, improper storage, light, processing therefore use unsaturated fats such as cold pressed extra virgin plant oils such as olive oil, flax seed oil, avocado oil, or borage oil for cold meals. If you buy an olive oil that’s suitable for cooking, baking – it means it’s refined oil. For warm/hot meals use (unrefined) saturated oils which are more stable during heating (lower oxidation risk) including extra virgin coconut oil, grass-fed butter, ghee, lard, goose fat, duck fat. Fake fats include processed vegetable oils, margarines and oil spreads – stay away from them.

#5 Have herbs, spices and unrefined salt – herbs help to stimulate digestion, detoxification and offer an antimicrobial effect. Spices offer immune boosting, anti-inflammatory and anti-disease properties. Salt is an important micronutrient that helps to regulate fluid balance, blood flow, the function of muscles, heart, nervous system and our brain. Unrefined sea salts and mine salts contain trace minerals that support our physiology, refined table salt however is stripped of these micronutrients. Moreover, herbs, spices and salt stimulate our senses, enrich our meals and simply make our food tasteful. Tip: combine your spices and herbs with high quality oil to promote absorption of certain phytochemicals.

#6 Watch your starch intake – starch overconsumption is a common problem in our western diet, where grain based products (breads, pastas, rice) over flow our plates. It’s like asking for trouble. Why? Because of too much starch and too little nutrients and as a result you are on a right track to get blood glucose swings, GI complaints and gut dysbiosis, to name a few issues. Let me cite here another brilliant quote of Michael Pollan: “The whiter the bread, the sooner you’ll be dead”. I suggest eating starches in moderation, in a size of a side dish. Also, instead of wheat use quinoa, buckwheat, or high quality oats and millet. Your carbohydrate intake may depend on your activities and daily needs but try to keep a moderate-carbohydrate intake. Think of vegetables as a source of complex carbohydrates and tubers, (sweet) potatoes as a source of healthy starch (simple carbs). Listen to your body, observe how you feel after starchy rich meals and find the balance of your starch intake. If you have carbohydrate intolerance, meaning your blood sugars stay elevated after eating, you may need to go down with starch and sugar consumption to stabilize it. Tip: refrigerate starchy cooked foods such as grains (pasta, rice), stem and root tubers (potatoes, beets), legumes (beans) for at least about 12 hours before consumption. Refrigeration will promote starch retrogradation, meaning that amylose and amylopectin chains reform and firm-up, become more resistant to our digestive enzymes. It has a positive effect on your blood glucose as it slows the rise of blood sugar following a meal and prolongs satiety. In addition beneficial microbes may also utilize it as food.

Let’s talk about proportions

Keeping below ratio of different food groups works well for most people.

Strive to have on your plate:

  • About 50-70% of non-starchy vegetables
  • About 10-15% of quality protein
  • About 15-30% of healthy fats
  • About 5-15% of healthy starches (optional)
  • Herbs, spices and salt

Some foods combine both high fat and high protein content: sardines, herring, pork, chicken with skin, red meat with fatty tissue, nuts and seeds.

Strive that most of your meals will have this composition of nutrients. If it feels overwhelming now, don’t get discouraged but take small steps: first start optimizing one meal, for example your breakfast or your dinner. Once you mastered it, you can upgrade another meal.

Healthy eating also includes eating fruits but preferably have them as a snack or a dessert.

Meal composition

I combine my meals by putting together lots of cooked, steamed or raw veggies (Brussel sprouts, cauliflower, broccoli, cabbage, asparagus, carrots, celery, chard, spinach, kale, leek, garlic, tomatoes, peppers, cucumber, lettuce, onion, sugar snaps, green beans etc.) with quality protein (eggs, poultry, wild caught fish, grass-fed beef, mushrooms, wild game, seeds, nuts, legumes, sheep cheese, goat cheese etc.) accompanied by healthy fats (naturally present in foods like avocado, olives, seeds and nuts and extracted oils in a form of olive oil, coconut oil, ghee, flax seed oil etc.), herbs, spices and salt. For some meals, I add healthy starches (buckwheat, quinoa, oats, potatoes, sweet potatoes, red beets, legumes etc.). If you have digestive issues, it may help if you avoid meals comprised of simple carb and starch rich foods with protein rich foods, meaning don’t combine meat with grains, potatoes or rice but go for meat, egg, seeds, nuts with vegetables or for grains, legumes, potatoes with vegetables.

Last but not least: snacks and desserts

Below are foods I eat if I snack or have a dessert.

Real food Snack ideas: olives, seeds, nuts, fresh and dry fruit, raw vegetables without or with a dip (pesto, avocado, tomato tapenade, tahini etc.), vegetable chips, chickpea chips, sweet potato toast with a grass-fed butter or a nut butter, vegetable smoothie, grass-fed cow yoghurt, coconut yoghurt, a piece of quality sheep cheese (manchego) or goat cheese, homemade chocolate milk, avocado, pickled sardines, radish, hard-boiled egg, light salad, coconut flesh, healthy sushi, quinoa cookie, banana bread, soup, bone broth, unsweetened coconut water.

Real food dessert ideas: A piece of dark chocolate (preferably min 80% cacao), avocado-cacao pudding, fruit ice cream (blended frozen fruits alone or with yogurt/kefir), dates, oatmeal cookies, coconut cookies, fresh or dry fruit, nuts, banana bread, fried banana slices with cinnamon, home-made apple or berries crumble, home-made brownie.