August 14, 2025 • 23 mins
Metabolic health is the foundation for how well we age—and for women, it influences everything from energy and mood to hormone balance. In this episode, longevity expert Dr. Karen Koffler explores the fundamentals of metabolic health, the role of blood sugar stability, the impact of inflammation, and the connection between metabolism and hormones. She shares how small, intentional changes can help women improve resilience, maintain energy, and protect their health across life stages.
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Speaker 1 (00:01):
Welcome to hear something good on women's health and longevity.
We are so grateful to our partners P ANDNG, maker
of trusted brands like Tampex Always and Always Discreet, and Walgreens,
the women's well being destination, supporting every stage. Together, we'll
bring you something good each week on women's health and longevity,
and it wouldn't be possible without their support. Each week,
(00:23):
we aspire to bringing the good news on women's health
by talking to renowned scientists and medical experts, and by
sharing health advice that can help you live healthier and happier. Today,
we're talking to longevity expert doctor Karen Koffler, and we'll
learn why focusing on your metabolic health can be one
of the most important things you can do for your
overall well being. Doctor Koffler is a Professor of Medicine
(00:46):
at the University of Miami School of Medicine and a
physician at Lifespan Medical focus on longevity Medicine. She also
has her own private practice focus on women's health and longevity.
Speaker 2 (00:57):
Welcome, doctor Kaefler, Thank you for having me back.
Speaker 1 (01:01):
So we've been hearing a lot about metabolic health lately.
Could you break down what metabolic health actually means, especially
in the context of women's health and longevity.
Speaker 3 (01:14):
Sure, So, really, our metabolism is how we take food
and air and water and we convert it into energy,
which we then use to build tissue, repair damage, build hormones,
digestive enzymes, neurochemicals, et cetera.
Speaker 2 (01:36):
Everything that we need to run every day.
Speaker 3 (01:40):
Whether or not we're efficient at converting calories and information
from food into energy that then gans gets transmuted into
these other processes.
Speaker 2 (01:53):
So that's the simple fact of metabolism.
Speaker 3 (01:56):
And actually, if you think about it, we're thirty seven
trillion cells that perform millions of chemical reactions per second,
which is what our metabolism ends up being. So it's
like something like ten to the fourteen chemical reactions per second.
Speaker 2 (02:15):
That's fourteen zeros after the number ten.
Speaker 3 (02:18):
That's what our body is performing moment by moment every
day in order to manifest our metabolism.
Speaker 1 (02:25):
I think, in kind of common parlance, people often talk
about having like you have a great metabolism or you
have a high metabolism. But metabolic health is something that
we should all really be aspiring to. Why is that
and how do we make our metabolic health better.
Speaker 2 (02:41):
Yeah, because it really does determine.
Speaker 3 (02:43):
Like I said, when you use that word, when you
understand that there are these systems that allow us to
either operate efficiently or inefficiently, that really determines our aging process. Right.
The more efficient we are in our metabolism, the better
we are at aging. And the less efficient we are,
(03:05):
the less energy is generated, the less ability to repair
damage tissue, the lisibility to respond to stress, the less
resilient we are, the more inflamed we are, the more
we're apt to get angry when we don't eat because
we're not able to convert fat to fuel and we're
so reliant on carbohydrates. Those are signs of an inefficient metabolism.
(03:29):
And the fact is we're aging faster if our metabolism
is inefficient or slowed.
Speaker 1 (03:34):
So there's been a huge, huge emphasis, I would say,
on the roll of sugar and what sugar does to
your metabolic health in simple terms, Can you tell us
why sugar intake is so important to monitor and what
that does to metabolic health?
Speaker 2 (03:51):
Sure?
Speaker 3 (03:52):
Probably sugar and the ability to regulate our blood sugar
levels is one of the most important determined of metabolic
health and The reason is is because the human design
is to maintain the blood sugar level within a pretty
narrow range. And that evolved because, you know, carbohydrates were
(04:14):
not our primary source or main source of fuel the
way they have evolved to be today, and therefore the
rise of diabetes that we witness today. So maintaining a
good blood sugar means you're eating foods that do not
create these spikes and therefore valleys. When we eat and
(04:36):
we have carbohydrates in a meal, insulin is released in
order to allow for blood sugar to rise and then fall.
Insulin drives blood sugar into cells so that cells can
utilize that energy for its various processes. If there's too
much sugar coming in the pancers will respond with an
(04:56):
overabundant amount of insulin, which then wrap it drops our
blood sugar level, and those massive swings really are harmful
for our metabolism.
Speaker 1 (05:07):
So people talk about trying to stabilize their blood sugar
and as you just describe, it's important to maintain a
stable blood sugar level. What's the best way to do
that and how does that kind of impact different aspects
of your health, whether it's your energy level, your brain health,
your sleep, your mood. How does this whole ensemble of
(05:29):
metabolic health impact your life?
Speaker 3 (05:31):
So your point is a really good one because the
blood sugar, your wide fluctuations and blood sugar do affect
all those things, your sleep, your metabolism, your hormonal health,
your immune system. Every system is adversely impacted by rapid
rises and rapid falls of blood sugar levels. So that
(05:52):
is one key way that Also, the other ways that
we can impact our metabolism is by maintaining low levels
of inflammation, by maintaining low blood pressures. You know, one
of the ways we measure it is by measuring waste circumference.
So we want to see a woman's waist circumference less
(06:13):
than thirty five inches in a man's less than forty,
And that tells us whether or not somebody is storing
excess fat in their abdomen, which is around their organs,
which is far more inflammatory. And lipid levels. Lipid levels
are another key indicator as to whether or not wearing
good metabolic health. Know that lipids, in other words, cholesterol
(06:34):
and triglycerides are negatively impacted also by high levels of sugar,
So you could see in so many ways high sugar
impacts so many aspects of our metabolism and therefore our
aging process.
Speaker 1 (06:49):
As I think, you know, I became more familiar with
trying to track my blood sugar levels through a continuous
glucose monitor or CGM, which a lot of obviously diabetics
use in very important to their maintaining their health. I
am not diabetic or even pre diabetic, but a lot
of people have started using cgms or testing them to
(07:09):
help monitor their blood sugar levels. What do you think
about that trend?
Speaker 2 (07:13):
Well, I'd be curious to know what did you notice?
How you did it? Yeah?
Speaker 1 (07:17):
Well, I mean for me, it was interesting because it
was a bit of an experiment to see just to
understand what is impacting my blood sugar levels and to
understand what that spike means, both in terms of my
energy level and also what foods were spiking my blood
sugar levels, which is interesting because everybody has a different,
you know, a different reactions to different foods. Of course,
(07:39):
there are some foods that are more prone to spike
your blood sugar levels, as you mentioned, like you know,
carbohydrates in its most purest form. But what I did
find was that it did have an impact on my
behavior because when I saw certain foods spiking my blood sugar,
I was like, oh, I don't want that, So I'll
trade that for this to keep in the kind of
(08:00):
control zone of you know what, you know, that stabilized zone,
which I think is somewhere typically between seventy and one
hundred and ten if I got that right. So I
was trying to stay in that zone by adjusting my habits,
and so I think the CGM helped me do that.
And that's kind of what I found. But I'm curious
what you think about it.
Speaker 3 (08:17):
Exactly what you described is exactly what we notice in
our patients that you know, everyone, like you said, everyone
is unique. Some people really spike to things like grapes,
other people don't. You know, it's across the board. People
really benefit by finding out, like you did, exactly what
foods are going to negatively impact their blood sugar level.
(08:39):
So I think personalizing your own nutrition is one of
the big gifts that a CGM gives us.
Speaker 2 (08:48):
And then just the ability to become.
Speaker 3 (08:50):
More aware of how your blood sugar does get affected
by foods throughout the day, and that you can make
other choices and have a direct impact on that.
Speaker 2 (09:00):
It's very empowering you get to decide your own diet.
Speaker 1 (09:03):
I mean, I think that was also very interesting about
that is well, you start thinking a lot more about
blood sugar. I mean a lot of people think about
blood sugar all the time because they are diabetic, and
it's super important to be monitoring all monitoring that. But
for those of us who are just interested in trying
to maintain blood sugar levels, I think the CGM helped
also in understanding other ways to do it. So I
(09:25):
know there are different techniques you can use in terms
of food and exercise to stabilize your blood sugar so
that you don't have to give up every single food
item that you might like, but there are ways to
eat in certain orders or taking ten minute walks. What
do you recommend around stabilizing your blood sugar.
Speaker 2 (09:42):
Well, you said it exactly.
Speaker 3 (09:44):
I mean, first of all, probably the smartest thing you
can do postprandially or after a meal is to go
for a walk. That is a really terrific way to
help stabilize blood sugars, and we see that in diabetics.
Diabetics who regularly walk even just ten minutes after a
meal have more stable blood sugars than diabetics who choose
(10:05):
not to do that, and overall that will impact their
requirement for medications and so forth and their weight going forward.
Speaker 2 (10:12):
So it benefits them out at multiple levels.
Speaker 1 (10:15):
The order in which we eat, what do you think
about that?
Speaker 2 (10:18):
Yes, so that's a really good question.
Speaker 3 (10:21):
You really for those of us who love desserts, you
really should eat it first and then.
Speaker 2 (10:26):
Eat your meal. I can do that.
Speaker 3 (10:28):
That's not a problem, yeah.
Speaker 2 (10:31):
Because the fact is, you know, it's funny.
Speaker 3 (10:33):
We eat desserts in the evening after our meal, which
will drive up our insulin level, which will plummet our
blood sugar level, which will cause a rise in cortisol,
which will disrupt our sleep and plant fat right on
our bellies. Oh my gosh, not the least of which
is contribute to insulin resistance. So for those of us
(10:55):
who grew up always having you know, ice cream after
dinner or something like that, first of all portion sizes,
of course, but also making it more complex. So one
of the things I'll tell my patients who really have
a story about having need to have a sweet after dinner,
dark chocolate covered almonds, something that slows down the absorption
(11:17):
of the sugar will blunt that insulin response, and therefore
you won't have these wild swings and blood sugar and
therefore you'll have a more stabilized cortisol response. Alcohol after
dinner is a problem because it's pure sugar and it
will do the same thing.
Speaker 2 (11:35):
And most people who.
Speaker 3 (11:37):
Drink and then stop and then reintroduce alcohol very definitely
notice that their sleep is worse, typically with two or
three am awakenings. So that's a very good point about
the order. The complexity of the food matters. If there's
more fat and protein associated with carbohydrates, the rise in
blood sugar and therefore insulin will be less.
Speaker 1 (12:00):
Just what you want, okay, but definitely ice cream first.
Speaker 2 (12:05):
Yeah, especially if it's meant a good tip.
Speaker 1 (12:07):
Yeah, So as women sort of are going through, actually
for all ages of women, there is a pretty clear
correlation between metabolic health and as you mentioned hormones for instance,
I know there's a relationship between female hormones and the
hormone cortisol, which is called the stress hormone. Obviously, cortisol
regulates various bodily functions, including how your body uses sugar
(12:30):
for energy. So how do they all work together?
Speaker 3 (12:34):
You know, when we're younger and our hormones are beginning
to when we're kids and we're going through adolescents. You know,
estrogen is actually a great modifier of particularly cortisol. Estradial
blunts cortisol, and we have an abundance of it as
we're going through puberty and beyond.
Speaker 2 (12:56):
And that's why.
Speaker 3 (12:57):
Many women will say, oh, if I've overeaten and I
just watch my diet for a couple of days and
I get backed down in my usual weight, and then
they go through menopause and they find that's not the
case at all.
Speaker 2 (13:09):
And a lot of.
Speaker 3 (13:10):
That has to do with the fact that dropping estradoal
levels loses some of the control or balancing effect that
estradial has on cortisol.
Speaker 2 (13:21):
And once that happens, in particular, if.
Speaker 3 (13:23):
A woman is already running with higher levels of cortisol,
now they're getting sort of a double whammy. They lose
that ability to sort of blunt the effect of cortisol.
And interestingly, during our cycles, when we are cycling, especially
during the follicular phase, estra dial, which is the first
half of the cycle, the first two weeks of the cycle,
(13:45):
our extra dial levels are higher which quiets down cortisol,
and we're more stress resilient during that time. And many
women will notice that they're more irritable as they get
closer to their period because they're extra dial levels are
at their nator, they're at their lowest, so they're less resilient.
Cortisol makes them a little bit more irritable. A little
(14:07):
bit more on edge.
Speaker 1 (14:09):
Tell us a little bit about the relationship between estradle
cortisol and how it makes us feel well.
Speaker 3 (14:16):
I think it's really well exemplified in the last half
of a woman's cycle, when they're her estra dial levels
are dropping. Estradle actually has a role in producing serotonin,
and so when those levels are dropping, serotonin levels and
endorphin levels can be dropping, progesterone levels can be varying,
(14:39):
and all of that can be driving a carbohydrate craving.
Not only are those changing levels doing that, but as
are neurotransmitters like serotonin drops, We're going to be in
a lower mood. So what do we do. We grab
the chocolate. And it makes great sense because it actually
(15:00):
does blunt cortisol, which puts us in a better mood
and makes us less stress, and it satisfies that craving.
It's sort of an appropriate response. It's not the healthiest response,
but it is an appropriate response. And I share that
because I want women to understand that what they're feeling
is biochemically driven.
Speaker 2 (15:19):
There's nothing wrong with them.
Speaker 3 (15:21):
They're actually having an appropriate response to the changing hormone levels. Now,
what you choose to do with that at those moments
is really up to you. But having that understanding, I
think is really important.
Speaker 1 (15:33):
So what could you do then instead of grabbing the chocolate,
which you know is the easy and very pleasurable solution.
Speaker 3 (15:40):
Right Well, one thing is to be very attentive to
the stress in the second half of your cycle. Because
you're not as equipped with a dropping estra dial level,
you're not as equipped to handle stressors.
Speaker 2 (15:53):
That's a good part of.
Speaker 3 (15:55):
The month to say no to a lot of things,
because you know, dropping estra dial means less blunted cortisol,
and dropping progesterone, which is a calming hormone, contributes to
the same thing. So I think if you pay attention
to how you feel in that second half and nurture
yourself a little bit more in effective ways, schedule massages,
(16:18):
schedule times, out with friends, schedule anything that will uplift you,
and that action itself is going to help balance out
those changes in the second half of the month. And
then if you do desire, you know, if you end
up having something, make it a healthy choice. It's not
hard to choose very dark chocolate or very dark chocolate
(16:40):
with nuts or something like that.
Speaker 2 (16:42):
And of course you know, portion control.
Speaker 1 (16:45):
And for those of us who are in perimenopause or
menopause and so are extra dial levels may be different
than you know, cycling, what do you recommend for those
of us.
Speaker 3 (16:56):
Even more important, even more important, And I I really
do see that's when a lot of women, you know,
without the support of estrogen, which is a very resilient hormone,
a lot of women do say it starts saying no
at that time because they really don't have as much
of the reserves as.
Speaker 2 (17:16):
They've had before.
Speaker 3 (17:17):
So making it perfectly fine to say no to a
lot and unpack your day, leaving more time for your
own self care, I think is actually essential.
Speaker 2 (17:29):
It's really what your body is demanding.
Speaker 1 (17:31):
Well, that's great advice, and I think it's very consistent
with what you've told us in the past two which
is as you're going through different stages of life, you
have got to prioritize self care and it's not sort
of an optional thing. And I know for many of us,
and for women in particular, it's a question of in
some instances, putting your health first and then being able
to sort of go about everything else that you do.
(17:52):
So super interesting. So are there key signs that women
should be looking at other than the CGM monitor that
I was talking about, You monitor their metabolic health. Is
there something that we should be concerned about? Or if
we see certain signs, should we be thinking about our
metabolic health more seriously?
Speaker 3 (18:09):
Well, I think certainly waking in our mid section is
a very clear sign that we have been seeing too
much carbohydrates. We've probably or possibly been too sedentary, we
may be developing insulin resistance, and so that really requires
that we get bloods drawn for fasting blood sugar, fasting
(18:32):
insulin levels and humoglobin ae C.
Speaker 2 (18:35):
The humoglobin A one C gives us a look at
how well have you been handling sugar over the prior
three months, So that really takes three months to affect
a change, and what it's basically measuring, To be honest,
with you is how much sugar is stuck to the
red blood cell.
Speaker 3 (18:53):
The higher that number, the more your red blood cells
are coated with excess essentially, and that is very pro inflammatory.
And that's not just happening in your red cells. That's
happening all over your body. It's just that's an easy
access for us to take a look at. That's what
hemoglobin A once C tells us. So the higher that
(19:15):
number is, the more you're basically caramelizing your tissues and
too high sugar, and that we want to see come down.
So those three blood values can really help us triglycerides.
When we get our cholesterol checked, our triglycerides reveal how
well we're handling sugar because they will most definitely be
driven up along with LDL if we have too much
(19:37):
sugar coming into the system.
Speaker 1 (19:39):
So oftentimes when we're talking, I always think, Oh, I
wish I knew this earlier in life. What can young
women do to build metabolic resilience and get started early?
Speaker 3 (19:50):
Yeah, you know, it really comes down to the basics,
and I do think a lot of young women today
are increasingly aware. Don't be tempted by the brightly colored,
artificially flavored, super high sugar on steroids, treats that are
now made available to us. And honestly, if you ever
(20:13):
saw the work that goes into the scientists that are
trying to tempt us with those things, you'd be amazed.
That alone would turn you off from eating those kinds
of foods. But go back to what nature intended us
to eat. Don't eat foods that were made in a lab.
So if you can't pronounce the ingredients, you know that
doesn't belong in your body. That's a basic one movement,
(20:37):
which is a big ask these days. As we get
you know, our lives have been made more and more convenience,
so we move less. Finding reasons to move park further away,
take the stairs when you're on an escalator, take the
stairs when you're down an airport, walk down the moving walkways.
Speaker 2 (20:55):
Like find reasons to move more.
Speaker 3 (20:58):
Your sleep is so incredibly important because poor sleep will
al to cortisol. Cortisol has a negative effect on hormones,
very negative effect on hormones. It lowers the brain's ability
to communicate with the ovaries to produce the right amount
of estrogen and so forth. And that's why women who
(21:19):
are stressed very often have menstrual irregularities, so identifying where
the stress is coming from and doing something about that
because biochemically it's having a very significant effect on you
at multiple levels, but your hormones for sure. So it
really comes to the basics eating well, sleeping well, moving
(21:41):
as major ways to keep your metabolic self and the
best possible shape as you age.
Speaker 2 (21:48):
Well.
Speaker 1 (21:48):
I love talking to you, and I think in a
future episode it would be wonderful to talk more about
inflammation in particular, but just having the basics of metabolic
health and understanding what it means. You gave us a
lot of good practical things that we can do and
to take it seriously because as you said, it's sort
of the sort of foundation to our overall health. And
really appreciate the conversation with you.
Speaker 2 (22:10):
Sure, thank you for having me.
Speaker 1 (22:14):
What a great conversation. Here are the top takeaways from today. First,
treat metabolism as your longevity engine. A strong metabolism doesn't
just burn calories, it powers repair and resilience. Second, keep
blood sugar steady. Frequent rises and drops in blood sugar
can strain your metabolism. Support steady energy by making balanced
(22:39):
food choices For example, pair carbohydrates with protein and healthy
fats at each meal, and take a ten minute walk
after eating. As a simple guide. When possible, choose foods
made from whole, recognizable ingredients. Lastly, align self care with
your hormones. In the second half of your menstrual cycle
or during menopause, your stress for drops. Doctor Koffler recommends
(23:02):
distressing by saying no more often, by spending time with friends,
and by satisfying cravings with healthy snacks. Have a great Day.
For more podcasts from iHeartRadio, check out the iHeartRadio app,
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Today's episode of Here's Something Good on women's health and
longevity was brought to you by p ANDNG, maker of
(23:25):
trusted brands like Tampas Always and Always Discreet, and by Walgreens,
the women's well being destination supporting every stage
Welcome to hear something good on women's health and longevity.
We are so grateful to our partners P ANDNG, maker
of trusted brands like Tampex Always and Always Discreet, and Walgreens,
the women's well being destination, supporting every stage. Together, we'll
bring you something good each week on women's health and longevity,
and it wouldn't be possible without their support. Each week,
(00:23):
we aspire to bringing the good news on women's health
by talking to renowned scientists and medical experts, and by
sharing health advice that can help you live healthier and happier. Today,
we're talking to longevity expert doctor Karen Koffler, and we'll
learn why focusing on your metabolic health can be one
of the most important things you can do for your
overall well being. Doctor Koffler is a Professor of Medicine
(00:46):
at the University of Miami School of Medicine and a
physician at Lifespan Medical focus on longevity Medicine. She also
has her own private practice focus on women's health and longevity.
Speaker 2 (00:57):
Welcome, doctor Kaefler, Thank you for having me back.
Speaker 1 (01:01):
So we've been hearing a lot about metabolic health lately.
Could you break down what metabolic health actually means, especially
in the context of women's health and longevity.
Speaker 3 (01:14):
Sure, So, really, our metabolism is how we take food
and air and water and we convert it into energy,
which we then use to build tissue, repair damage, build hormones,
digestive enzymes, neurochemicals, et cetera.
Speaker 2 (01:36):
Everything that we need to run every day.
Speaker 3 (01:40):
Whether or not we're efficient at converting calories and information
from food into energy that then gans gets transmuted into
these other processes.
Speaker 2 (01:53):
So that's the simple fact of metabolism.
Speaker 3 (01:56):
And actually, if you think about it, we're thirty seven
trillion cells that perform millions of chemical reactions per second,
which is what our metabolism ends up being. So it's
like something like ten to the fourteen chemical reactions per second.
Speaker 2 (02:15):
That's fourteen zeros after the number ten.
Speaker 3 (02:18):
That's what our body is performing moment by moment every
day in order to manifest our metabolism.
Speaker 1 (02:25):
I think, in kind of common parlance, people often talk
about having like you have a great metabolism or you
have a high metabolism. But metabolic health is something that
we should all really be aspiring to. Why is that
and how do we make our metabolic health better.
Speaker 2 (02:41):
Yeah, because it really does determine.
Speaker 3 (02:43):
Like I said, when you use that word, when you
understand that there are these systems that allow us to
either operate efficiently or inefficiently, that really determines our aging process. Right.
The more efficient we are in our metabolism, the better
we are at aging. And the less efficient we are,
(03:05):
the less energy is generated, the less ability to repair
damage tissue, the lisibility to respond to stress, the less
resilient we are, the more inflamed we are, the more
we're apt to get angry when we don't eat because
we're not able to convert fat to fuel and we're
so reliant on carbohydrates. Those are signs of an inefficient metabolism.
(03:29):
And the fact is we're aging faster if our metabolism
is inefficient or slowed.
Speaker 1 (03:34):
So there's been a huge, huge emphasis, I would say,
on the roll of sugar and what sugar does to
your metabolic health in simple terms, Can you tell us
why sugar intake is so important to monitor and what
that does to metabolic health?
Speaker 2 (03:51):
Sure?
Speaker 3 (03:52):
Probably sugar and the ability to regulate our blood sugar
levels is one of the most important determined of metabolic
health and The reason is is because the human design
is to maintain the blood sugar level within a pretty
narrow range. And that evolved because, you know, carbohydrates were
(04:14):
not our primary source or main source of fuel the
way they have evolved to be today, and therefore the
rise of diabetes that we witness today. So maintaining a
good blood sugar means you're eating foods that do not
create these spikes and therefore valleys. When we eat and
(04:36):
we have carbohydrates in a meal, insulin is released in
order to allow for blood sugar to rise and then fall.
Insulin drives blood sugar into cells so that cells can
utilize that energy for its various processes. If there's too
much sugar coming in the pancers will respond with an
(04:56):
overabundant amount of insulin, which then wrap it drops our
blood sugar level, and those massive swings really are harmful
for our metabolism.
Speaker 1 (05:07):
So people talk about trying to stabilize their blood sugar
and as you just describe, it's important to maintain a
stable blood sugar level. What's the best way to do
that and how does that kind of impact different aspects
of your health, whether it's your energy level, your brain health,
your sleep, your mood. How does this whole ensemble of
(05:29):
metabolic health impact your life?
Speaker 3 (05:31):
So your point is a really good one because the
blood sugar, your wide fluctuations and blood sugar do affect
all those things, your sleep, your metabolism, your hormonal health,
your immune system. Every system is adversely impacted by rapid
rises and rapid falls of blood sugar levels. So that
(05:52):
is one key way that Also, the other ways that
we can impact our metabolism is by maintaining low levels
of inflammation, by maintaining low blood pressures. You know, one
of the ways we measure it is by measuring waste circumference.
So we want to see a woman's waist circumference less
(06:13):
than thirty five inches in a man's less than forty,
And that tells us whether or not somebody is storing
excess fat in their abdomen, which is around their organs,
which is far more inflammatory. And lipid levels. Lipid levels
are another key indicator as to whether or not wearing
good metabolic health. Know that lipids, in other words, cholesterol
(06:34):
and triglycerides are negatively impacted also by high levels of sugar,
So you could see in so many ways high sugar
impacts so many aspects of our metabolism and therefore our
aging process.
Speaker 1 (06:49):
As I think, you know, I became more familiar with
trying to track my blood sugar levels through a continuous
glucose monitor or CGM, which a lot of obviously diabetics
use in very important to their maintaining their health. I
am not diabetic or even pre diabetic, but a lot
of people have started using cgms or testing them to
(07:09):
help monitor their blood sugar levels. What do you think
about that trend?
Speaker 2 (07:13):
Well, I'd be curious to know what did you notice?
How you did it? Yeah?
Speaker 1 (07:17):
Well, I mean for me, it was interesting because it
was a bit of an experiment to see just to
understand what is impacting my blood sugar levels and to
understand what that spike means, both in terms of my
energy level and also what foods were spiking my blood
sugar levels, which is interesting because everybody has a different,
you know, a different reactions to different foods. Of course,
(07:39):
there are some foods that are more prone to spike
your blood sugar levels, as you mentioned, like you know,
carbohydrates in its most purest form. But what I did
find was that it did have an impact on my
behavior because when I saw certain foods spiking my blood sugar,
I was like, oh, I don't want that, So I'll
trade that for this to keep in the kind of
(08:00):
control zone of you know what, you know, that stabilized zone,
which I think is somewhere typically between seventy and one
hundred and ten if I got that right. So I
was trying to stay in that zone by adjusting my habits,
and so I think the CGM helped me do that.
And that's kind of what I found. But I'm curious
what you think about it.
Speaker 3 (08:17):
Exactly what you described is exactly what we notice in
our patients that you know, everyone, like you said, everyone
is unique. Some people really spike to things like grapes,
other people don't. You know, it's across the board. People
really benefit by finding out, like you did, exactly what
foods are going to negatively impact their blood sugar level.
(08:39):
So I think personalizing your own nutrition is one of
the big gifts that a CGM gives us.
Speaker 2 (08:48):
And then just the ability to become.
Speaker 3 (08:50):
More aware of how your blood sugar does get affected
by foods throughout the day, and that you can make
other choices and have a direct impact on that.
Speaker 2 (09:00):
It's very empowering you get to decide your own diet.
Speaker 1 (09:03):
I mean, I think that was also very interesting about
that is well, you start thinking a lot more about
blood sugar. I mean a lot of people think about
blood sugar all the time because they are diabetic, and
it's super important to be monitoring all monitoring that. But
for those of us who are just interested in trying
to maintain blood sugar levels, I think the CGM helped
also in understanding other ways to do it. So I
(09:25):
know there are different techniques you can use in terms
of food and exercise to stabilize your blood sugar so
that you don't have to give up every single food
item that you might like, but there are ways to
eat in certain orders or taking ten minute walks. What
do you recommend around stabilizing your blood sugar.
Speaker 2 (09:42):
Well, you said it exactly.
Speaker 3 (09:44):
I mean, first of all, probably the smartest thing you
can do postprandially or after a meal is to go
for a walk. That is a really terrific way to
help stabilize blood sugars, and we see that in diabetics.
Diabetics who regularly walk even just ten minutes after a
meal have more stable blood sugars than diabetics who choose
(10:05):
not to do that, and overall that will impact their
requirement for medications and so forth and their weight going forward.
Speaker 2 (10:12):
So it benefits them out at multiple levels.
Speaker 1 (10:15):
The order in which we eat, what do you think
about that?
Speaker 2 (10:18):
Yes, so that's a really good question.
Speaker 3 (10:21):
You really for those of us who love desserts, you
really should eat it first and then.
Speaker 2 (10:26):
Eat your meal. I can do that.
Speaker 3 (10:28):
That's not a problem, yeah.
Speaker 2 (10:31):
Because the fact is, you know, it's funny.
Speaker 3 (10:33):
We eat desserts in the evening after our meal, which
will drive up our insulin level, which will plummet our
blood sugar level, which will cause a rise in cortisol,
which will disrupt our sleep and plant fat right on
our bellies. Oh my gosh, not the least of which
is contribute to insulin resistance. So for those of us
(10:55):
who grew up always having you know, ice cream after
dinner or something like that, first of all portion sizes,
of course, but also making it more complex. So one
of the things I'll tell my patients who really have
a story about having need to have a sweet after dinner,
dark chocolate covered almonds, something that slows down the absorption
(11:17):
of the sugar will blunt that insulin response, and therefore
you won't have these wild swings and blood sugar and
therefore you'll have a more stabilized cortisol response. Alcohol after
dinner is a problem because it's pure sugar and it
will do the same thing.
Speaker 2 (11:35):
And most people who.
Speaker 3 (11:37):
Drink and then stop and then reintroduce alcohol very definitely
notice that their sleep is worse, typically with two or
three am awakenings. So that's a very good point about
the order. The complexity of the food matters. If there's
more fat and protein associated with carbohydrates, the rise in
blood sugar and therefore insulin will be less.
Speaker 1 (12:00):
Just what you want, okay, but definitely ice cream first.
Speaker 2 (12:05):
Yeah, especially if it's meant a good tip.
Speaker 1 (12:07):
Yeah, So as women sort of are going through, actually
for all ages of women, there is a pretty clear
correlation between metabolic health and as you mentioned hormones for instance,
I know there's a relationship between female hormones and the
hormone cortisol, which is called the stress hormone. Obviously, cortisol
regulates various bodily functions, including how your body uses sugar
(12:30):
for energy. So how do they all work together?
Speaker 3 (12:34):
You know, when we're younger and our hormones are beginning
to when we're kids and we're going through adolescents. You know,
estrogen is actually a great modifier of particularly cortisol. Estradial
blunts cortisol, and we have an abundance of it as
we're going through puberty and beyond.
Speaker 2 (12:56):
And that's why.
Speaker 3 (12:57):
Many women will say, oh, if I've overeaten and I
just watch my diet for a couple of days and
I get backed down in my usual weight, and then
they go through menopause and they find that's not the
case at all.
Speaker 2 (13:09):
And a lot of.
Speaker 3 (13:10):
That has to do with the fact that dropping estradoal
levels loses some of the control or balancing effect that
estradial has on cortisol.
Speaker 2 (13:21):
And once that happens, in particular, if.
Speaker 3 (13:23):
A woman is already running with higher levels of cortisol,
now they're getting sort of a double whammy. They lose
that ability to sort of blunt the effect of cortisol.
And interestingly, during our cycles, when we are cycling, especially
during the follicular phase, estra dial, which is the first
half of the cycle, the first two weeks of the cycle,
(13:45):
our extra dial levels are higher which quiets down cortisol,
and we're more stress resilient during that time. And many
women will notice that they're more irritable as they get
closer to their period because they're extra dial levels are
at their nator, they're at their lowest, so they're less resilient.
Cortisol makes them a little bit more irritable. A little
(14:07):
bit more on edge.
Speaker 1 (14:09):
Tell us a little bit about the relationship between estradle
cortisol and how it makes us feel well.
Speaker 3 (14:16):
I think it's really well exemplified in the last half
of a woman's cycle, when they're her estra dial levels
are dropping. Estradle actually has a role in producing serotonin,
and so when those levels are dropping, serotonin levels and
endorphin levels can be dropping, progesterone levels can be varying,
(14:39):
and all of that can be driving a carbohydrate craving.
Not only are those changing levels doing that, but as
are neurotransmitters like serotonin drops, We're going to be in
a lower mood. So what do we do. We grab
the chocolate. And it makes great sense because it actually
(15:00):
does blunt cortisol, which puts us in a better mood
and makes us less stress, and it satisfies that craving.
It's sort of an appropriate response. It's not the healthiest response,
but it is an appropriate response. And I share that
because I want women to understand that what they're feeling
is biochemically driven.
Speaker 2 (15:19):
There's nothing wrong with them.
Speaker 3 (15:21):
They're actually having an appropriate response to the changing hormone levels. Now,
what you choose to do with that at those moments
is really up to you. But having that understanding, I
think is really important.
Speaker 1 (15:33):
So what could you do then instead of grabbing the chocolate,
which you know is the easy and very pleasurable solution.
Speaker 3 (15:40):
Right Well, one thing is to be very attentive to
the stress in the second half of your cycle. Because
you're not as equipped with a dropping estra dial level,
you're not as equipped to handle stressors.
Speaker 2 (15:53):
That's a good part of.
Speaker 3 (15:55):
The month to say no to a lot of things,
because you know, dropping estra dial means less blunted cortisol,
and dropping progesterone, which is a calming hormone, contributes to
the same thing. So I think if you pay attention
to how you feel in that second half and nurture
yourself a little bit more in effective ways, schedule massages,
(16:18):
schedule times, out with friends, schedule anything that will uplift you,
and that action itself is going to help balance out
those changes in the second half of the month. And
then if you do desire, you know, if you end
up having something, make it a healthy choice. It's not
hard to choose very dark chocolate or very dark chocolate
(16:40):
with nuts or something like that.
Speaker 2 (16:42):
And of course you know, portion control.
Speaker 1 (16:45):
And for those of us who are in perimenopause or
menopause and so are extra dial levels may be different
than you know, cycling, what do you recommend for those
of us.
Speaker 3 (16:56):
Even more important, even more important, And I I really
do see that's when a lot of women, you know,
without the support of estrogen, which is a very resilient hormone,
a lot of women do say it starts saying no
at that time because they really don't have as much
of the reserves as.
Speaker 2 (17:16):
They've had before.
Speaker 3 (17:17):
So making it perfectly fine to say no to a
lot and unpack your day, leaving more time for your
own self care, I think is actually essential.
Speaker 2 (17:29):
It's really what your body is demanding.
Speaker 1 (17:31):
Well, that's great advice, and I think it's very consistent
with what you've told us in the past two which
is as you're going through different stages of life, you
have got to prioritize self care and it's not sort
of an optional thing. And I know for many of us,
and for women in particular, it's a question of in
some instances, putting your health first and then being able
to sort of go about everything else that you do.
(17:52):
So super interesting. So are there key signs that women
should be looking at other than the CGM monitor that
I was talking about, You monitor their metabolic health. Is
there something that we should be concerned about? Or if
we see certain signs, should we be thinking about our
metabolic health more seriously?
Speaker 3 (18:09):
Well, I think certainly waking in our mid section is
a very clear sign that we have been seeing too
much carbohydrates. We've probably or possibly been too sedentary, we
may be developing insulin resistance, and so that really requires
that we get bloods drawn for fasting blood sugar, fasting
(18:32):
insulin levels and humoglobin ae C.
Speaker 2 (18:35):
The humoglobin A one C gives us a look at
how well have you been handling sugar over the prior
three months, So that really takes three months to affect
a change, and what it's basically measuring, To be honest,
with you is how much sugar is stuck to the
red blood cell.
Speaker 3 (18:53):
The higher that number, the more your red blood cells
are coated with excess essentially, and that is very pro inflammatory.
And that's not just happening in your red cells. That's
happening all over your body. It's just that's an easy
access for us to take a look at. That's what
hemoglobin A once C tells us. So the higher that
(19:15):
number is, the more you're basically caramelizing your tissues and
too high sugar, and that we want to see come down.
So those three blood values can really help us triglycerides.
When we get our cholesterol checked, our triglycerides reveal how
well we're handling sugar because they will most definitely be
driven up along with LDL if we have too much
(19:37):
sugar coming into the system.
Speaker 1 (19:39):
So oftentimes when we're talking, I always think, Oh, I
wish I knew this earlier in life. What can young
women do to build metabolic resilience and get started early?
Speaker 3 (19:50):
Yeah, you know, it really comes down to the basics,
and I do think a lot of young women today
are increasingly aware. Don't be tempted by the brightly colored,
artificially flavored, super high sugar on steroids, treats that are
now made available to us. And honestly, if you ever
(20:13):
saw the work that goes into the scientists that are
trying to tempt us with those things, you'd be amazed.
That alone would turn you off from eating those kinds
of foods. But go back to what nature intended us
to eat. Don't eat foods that were made in a lab.
So if you can't pronounce the ingredients, you know that
doesn't belong in your body. That's a basic one movement,
(20:37):
which is a big ask these days. As we get
you know, our lives have been made more and more convenience,
so we move less. Finding reasons to move park further away,
take the stairs when you're on an escalator, take the
stairs when you're down an airport, walk down the moving walkways.
Speaker 2 (20:55):
Like find reasons to move more.
Speaker 3 (20:58):
Your sleep is so incredibly important because poor sleep will
al to cortisol. Cortisol has a negative effect on hormones,
very negative effect on hormones. It lowers the brain's ability
to communicate with the ovaries to produce the right amount
of estrogen and so forth. And that's why women who
(21:19):
are stressed very often have menstrual irregularities, so identifying where
the stress is coming from and doing something about that
because biochemically it's having a very significant effect on you
at multiple levels, but your hormones for sure. So it
really comes to the basics eating well, sleeping well, moving
(21:41):
as major ways to keep your metabolic self and the
best possible shape as you age.
Speaker 2 (21:48):
Well.
Speaker 1 (21:48):
I love talking to you, and I think in a
future episode it would be wonderful to talk more about
inflammation in particular, but just having the basics of metabolic
health and understanding what it means. You gave us a
lot of good practical things that we can do and
to take it seriously because as you said, it's sort
of the sort of foundation to our overall health. And
really appreciate the conversation with you.
Speaker 2 (22:10):
Sure, thank you for having me.
Speaker 1 (22:14):
What a great conversation. Here are the top takeaways from today. First,
treat metabolism as your longevity engine. A strong metabolism doesn't
just burn calories, it powers repair and resilience. Second, keep
blood sugar steady. Frequent rises and drops in blood sugar
can strain your metabolism. Support steady energy by making balanced
(22:39):
food choices For example, pair carbohydrates with protein and healthy
fats at each meal, and take a ten minute walk
after eating. As a simple guide. When possible, choose foods
made from whole, recognizable ingredients. Lastly, align self care with
your hormones. In the second half of your menstrual cycle
or during menopause, your stress for drops. Doctor Koffler recommends
(23:02):
distressing by saying no more often, by spending time with friends,
and by satisfying cravings with healthy snacks. Have a great Day.
For more podcasts from iHeartRadio, check out the iHeartRadio app,
Apple Podcasts, or wherever you listen to your favorite shows.
Today's episode of Here's Something Good on women's health and
longevity was brought to you by p ANDNG, maker of
(23:25):
trusted brands like Tampas Always and Always Discreet, and by Walgreens,
the women's well being destination supporting every stage
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