The other day, in a true sign of my overwhelming nerdiness, I had a Facebook debate about blood chemistry markers.

A friend asserted that, if they could only ever have one blood chemistry marker run for the rest of their life, it would be hemoglobin A1C. Considered the gold standard for monitoring for elevated blood sugar, A1C is essentially a 3-month average of how well you have controlled your glucose levels. The friend’s view was that, since this is so critical to controlling inflammation, it’s the key piece of information to have to avoid insulin resistance and thereby, chronic disease.

I politely disagreed. It’s entirely possible to have a totally normal A1C, and still have deeply dysregulated blood sugar and insulin resistance. I see it all the time on labs. Glucose regulation is a complex system (understatement!), which is why I evaluate blood sugar control by looking at as many as 7 specific blood sugar markers. A1C is just one piece of the puzzle.

But, here’s the fun part. As I told my friend, give me a food journal and let me evaluate your symptoms, and I can predict with pretty darn good accuracy how your blood sugar will look. Hyperglycemia, or high blood sugar, is entirely a lifestyle-related condition. Your diet, your stress levels, and your movement routine are what dictate how your blood sugar is controlled. Taking a look at all those things and understanding whether you experience symptoms like fatigue after meals or abdominal weight gain (as just two examples), clues me in to dysregulated blood sugar pretty confidently.

One of my absolute favorite interventions for elevated blood sugar is time-restricted feeding. Put simply, it means restricting your eating to certain hours of the day, with an elongated fast overnight. A good target is a minimum of a 12 hour fast overnight, with 14 hours being even better. Some people do so well, they quickly move into 16 hours fasted, eating their meals only in an 8-hour window during the day. (ie, eating only between 9 am and 5 pm). Extending your hours without food allows your glucose regulation systems to take a break overnight and can be a very effective way to re-sensitize cellular insulin receptors—meaning, helping your cells to allow insulin to bring glucose into the cells for energy again.  Most people feel great on time-restricted feeding, and find it very helpful for regulating blood sugar, weight, and energy. There’s also good research that it can help with overall longevity. One caveat: if you’re known to have low blood sugar/hypoglycemia, this isn’t something you want to try. (PS that’s also a lifestyle condition, so reach out, and let’s get that under control!)

So, what marker did I say would be my one “desert island” blood chemistry marker, instead? You’ll have to stay tuned for my next newsletter to find out!