Blood Sugar: A Holistic Conversation About Diabetes, Insulin Resistance & Heart Health

10/10/2023 | Season 3, Episode 87

Dr. Drew Sinatra

Dr. Drew Sinatra

Dr. Ken Redcross

Dr. Ken Redcross


In this special presentation of Be HEALTHistic, naturopathic physician Dr. Drew Sinatra welcomes his Healthy Directions colleague, internist Dr. Ken Redcross, to discuss the impact that blood sugar can have on our heart health, and how this relationship is truly integral to our overall health and well-being. When we think about blood sugar, we tend to connect it to diabetes. But blood sugar, insulin levels and insulin resistance, diet, cholesterol levels, obesity, metabolic syndrome — these are all factors that determine our cardio health, and we need to realize that all these systems are connected.

First, the doctors discuss the fact that almost 12% of the population, or 37 million Americans, have Type 2 diabetes, and they share the red flags they see in their patients that usually signal blood sugar issues. The doctors talk about the role of insulin in the body, the difference between Type 1 and Type 2 diabetes, how the American diet is fueling obesity, hypertension, and blood sugar issues, and how metabolic syndrome is often the result of this cluster of conditions.

Next, Dr. Drew talks about a recent trip to Greece and the doctors dive into the differences in the diet and lifestyle in America vs. Europe, and why the Mediterranean diet is so healthy, particularly for cardiovascular health and blood sugar control. They also talk about the importance of movement, and what you can do besides hitting the gym to get some exercise in. Then, the doctors discuss how continuous glucose monitors can help patients diligently track blood sugar, but at a cost. From there, they touch upon the importance of AMPK, and they share some key details to know about fasting.

Finally, the doctors discuss berberine, a natural solution for the management of blood sugar and lipids that is comparable with Metformin, a pharmaceutical anti-diabetic drug. They also share some other wonderful supplements that support healthy blood sugar and discuss why vitamin D is such an important nutrient to be getting enough of. Don’t miss this super-informative and engaging episode of Be HEALTHistic!



Dr. Drew Sinatra: Hi, and welcome to a special presentation of the Be HEALTHistic podcast, presented by Healthy Directions. Today we're going to be focusing on the impact that blood sugar can have on our heart health, and how this relationship is truly integral to our overall health and well-being.

Now, obviously this is a topic very close to my heart, no pun intended, because cardiology was my dad, Dr. Stephen Sinatra’s specialty, and we've talked about this topic quite a bit on this podcast in previous seasons.

Now, when we think about blood sugar, we tend to automatically connect it to diabetes, which we all know has become a silent epidemic here in the U.S. But blood sugar, insulin levels and insulin resistance, cholesterol levels, weight — these are all factors that determine our cardio health, too, and we need to realize that all of these systems are connected.

Today I'm going to be discussing this topic with internal medicine specialist and my Healthy Directions colleague, Dr. Ken Redcross, whose experience being an internist will add a lot of value and expertise to the conversation.

Welcome Dr. Ken!

Dr. Ken Redcross: Oh, thank you for having me on, Drew. I've been waiting. Thank you. Finally, finally!

Dr. Drew Sinatra:Finally, made it happen.

Dr. Ken Redcross:It's good to be connected. Exactly, exactly. No, thank you for having me on…I've seen it from afar and had so much admiration and love for your father. So thank you for bringing me on.

Dr. Drew Sinatra: Thank you. Well, I wanted to first give our listeners some stats here on diabetes because it's mind-blowing, actually, when you think about what's happening in this country. So according to the CDC, there are 96 million Americans over the age of 18 that have pre-diabetes. Okay? That's 38% of the population. And that's not taking into consideration those that are under 18 years old.

Dr. Ken Redcross: Right.

Dr. Drew Sinatra: And then, we know that 11.3% of the population, or 37 million Americans, have Type 2 diabetes.

Dr. Ken Redcross: That's right.

Dr. Drew Sinatra: Okay. So this is just mind-blowing when you think about how much we are struggling with blood sugar issues in this country. And so today we're going to talk about why this is happening and also some solutions to help improve blood sugar for people.

Dr. Ken Redcross: Yeah, no, thank you. And this is just so important. I see it so differently in my office lots of times, and like you say, we're talking about 90 million people who are suffering in silence and don't know.

Dr. Drew Sinatra: Yes.

Dr. Ken Redcross: And so this is so big that we're on here. So once again, thanks for having me.

Dr. Drew Sinatra: Yeah. So I guess when you have someone come in to you, what for you sets off some alarm bells that we may be dealing with a blood sugar issue?

Dr. Ken Redcross: One of the bigger things that I noticed that we'll see a lot in America, and a lot of it is our diet, is those who are either what we call obese or those that we call overweight. It's a big, big risk factor and it's most of America at this point. So anytime I see that, Drew, it always starts me kind of peeling back the layers of the onion to look for other things that could also be predisposing them to that and increased blood sugar.

Dr. Drew Sinatra: Exactly, yeah. And I'm sure our listeners are obviously familiar with high blood sugar and what that means, but let's talk about the connection with insulin here, and the role that insulin plays in the body. So can you tell our listeners about the importance of insulin and why we're talking about it?

Dr. Ken Redcross: Yeah. So look, everyone, insulin is one of the magnificent things that our body makes. It comes out of the pancreas and it's important to help drive that sugar that's in our blood sugar that we eat or what have you, but drive it into the cell where it does so many important things.

But what we've learned is that when we are not at the correct weight, whether we're overweight or obese, it doesn't really matter how much insulin is kind of circulating around. The body's almost agnostic saying, “Well, what is that actually?” It doesn't recognize it. And so therefore you can check the insulin levels and they look fine, but the blood sugar's going up because your body's not reacting.

Dr. Drew Sinatra: Yeah. So you mentioned looking at insulin. Do you measure a fasting insulin on people and just get that understanding of what's happening there?

Dr. Ken Redcross: You know what, I don't really necessarily always do the fasting insulin. I mean, one of the things I do in everyone, I always mention, and you'll hear it no matter what, even if you're not diabetic, it's called a hemoglobin A1C. I actually check that, everyone, and that's a measurement of the amount of sugar on a red blood cell over a three-month interval. So it kind of allows me to window-shop or look in your home and see a little bit of what's happening when you're not in there with me. And if that number is over 5.7 or even equal to 5.7, you Drew, know, you're at risk. You're already kind of at glucose intolerance level right there.

Dr. Drew Sinatra: Yeah. Yeah. Once you've entered over that 5.7 range, that's when you're in the “pre-diabetes” range.

Dr. Ken Redcross: There you go. There you go.

Dr. Drew Sinatra: Which is good, in a way, because now we have evidence that, hey, we need to really work on your blood sugar, talk about exercise, talk about diet, maybe some supplements to help bring that down, which we'll get into later today.

Dr. Ken Redcross: Absolutely.

Dr. Drew Sinatra: Now, what about the difference between Type 1 and Type 2 diabetes? Can you help our listeners understand that?

Dr. Ken Redcross: I can. So everyone, so Type 1, I don't see so much in my office, and the reason why I say that, they're usually already seen by the specialist for hormones called an endocrinologist. Type 1 tends to be caught a little bit younger, call it kind of young adulthood as far as adulthood when you get Type 2 typically, but it's more of an autoimmune disease. That means, everyone, that your body's kind of fighting those cells and the pancreas that I talked about, they're called the islets of Langerhans, they're kind of fighting that cell and we're learning more and more about those autoantibodies that we're called. So that's the one that's always going to require insulin, right? Because they don't have it. Type 2, as we'll talk about a little bit later, can be done with some things that we can control. And not always insulin, but sometimes insulin plays a role. So that 1 and 2, you're going to see mainly Type 2, and that's the one that we really, really can control and why we're really talking about this today.

Dr. Drew Sinatra: Exactly. And also, too, we should note that a Type 1 diabetic, they don't fit the profile, so to speak, as a Type 2 diabetic. So you might see someone that's really thin and say to yourself, “Well, how could they have diabetes? They're really thin.” But no, that's just because they're lacking insulin and they need to be taking insulin. And so, different situation there.

Dr. Ken Redcross: Absolutely, Drew. Thank you for mentioning that, Drew. That was key to bring in there because it doesn't appear that they're the type diabetic that you see in Type 2, but like you said, they're so, so different in the way they're managed,

Dr. Drew Sinatra: Yeah.

Dr. Ken Redcross: And in the etiology or the causes of the diabetes, as well.

Dr. Drew Sinatra: Yeah, exactly. All right, so we're painting this picture of diabetes right now and people are thinking to themselves, okay, one in three Americans essentially have an issue with blood sugar. Let's talk about the reasons for that occurring.

So right off the bat, diet, you mentioned it, let's talk about the standard American diet and why that's causing such blood sugar issues for people.

Dr. Ken Redcross: Oh my gosh, I don't know how much time we have today on the podcast when you talk about our diet! All right, so the diabetic diet, I'm sorry, the American diet isn't a great one, everyone. It's one that predisposes us to a lot of fat, a lot of salt, a lot of sugar, all the above. And we talked a little bit about being overweight or obese and those sort of things, but you're also getting some other disease states that are really making it worse, right? Hypertension, high cholesterol, all of those get intertwined to really cause some mega issues and challenges that we all get, especially when you look at our diet in the United States.

Dr. Drew Sinatra: Yeah. And I mean the symptoms that you just mentioned there, if we add on a couple, we enter into the realm of metabolic syndrome, right?

Dr. Ken Redcross: Yes.

Dr. Drew Sinatra: So we're talking about high blood sugar, high blood pressure, we have the abdominal obesity there, elevated triglycerides, dyslipidemia, low HDL, and that's a constellation, really, of signs and symptoms that people have that kind of puts them into that category of metabolic syndrome.

Dr. Ken Redcross: No, absolutely. And Drew, I'm glad you mentioned that, when you talk about the obesity in the abdomen, everyone. We always talk about this BMI sort of story. It's like, oh, my BMI is here, my BMI high. Look, the research starting to show, it's really more about the waist circumference. We're seeing that it's the waist ratio that may be even more important than BMI, which can actually be different for certain ethnicities and certain groups and that sort of thing. So that waist circumference that you're mentioning, and that's a big thing to kind of keep in mind, as well.

Dr. Drew Sinatra: Exactly. And two, we talked about diet briefly here in terms of just how poor it is in the United States, and I'm going to give you an example really quickly of how I went to Greece recently and really got a different perspective on how they're eating differently than we are.

Dr. Ken Redcross: Absolutely.

Dr. Drew Sinatra: But I want to point this out to people because this is super important, is that the food companies are unfortunately in control of us. Right? It's a reality. When you go to the supermarket, there's all this advertising on the boxes that kind of lure you in. I mean, I know my kids when I'm walking down the aisle, they're saying, “Hey, could we get that?” Because there's a cartoon figure on it. I mean, there's programming that's happening from a young age. And also, too, there's ingredients in this food, particularly like sugar, that we get hooked on, that we get addicted to. And so it's not our fault, per se, that we're having elevated blood sugars issues these days. I tend to blame a lot of it on the food industry because there's no regulation around it. You can go out and buy sugar all you want and start eating it, and no one's going to tell you that it's bad for you really. Right?

Dr. Ken Redcross: Yeah. Yeah. Yeah.

Dr. Drew Sinatra: And unfortunately, we're just fueled by our addictions and it's like I'm just getting more fed up as time goes on with our food industry because nothing's being done about it. And you can just do whatever you want, and buy whatever sugary food, high refined carbohydrate food you want, eat it, and it's not good for you.

Dr. Ken Redcross: No, you're right. And it's interesting because it's really, like you're saying, it's the wild, wild west.

Dr. Drew Sinatra: Yeah.

Dr. Ken Redcross: I mean, imagine everyone, when we've talked about this at the top of our segment about how many people we have running around with blood sugar and don't even know it. Imagine if instead, everyone, we now put labels to kind of earmark some of those foods you're talking about, Drew, to say, “Hey guys, you can enjoy this, but this may cause metabolic syndrome. Enjoy!” No, it wouldn't be taken.

And so if we really decided, and as a society decided we wanted everyone really healthy and we know the things that are good for us, and you're mentioning in Greece and the Mediterranean diet, that's something else we can chat about, as well. But the importance there, imagine if we did that with each one of those food products, how our longevity would increase, how our health would improve. So you're right, it's kind of a big kind of game. And so luckily podcasts like yours, Drew, bring this to light so that everyone can say they have a point there.

Dr. Drew Sinatra: Yeah, exactly. So here's my experience from Greece, and I think you traveled to Europe too this summer, so maybe we'll compare our experiences.

Dr. Ken Redcross: There we go.

Dr. Drew Sinatra: But when I was in Greece…you might have a croissant, okay, just like people might have a croissant here. Now the croissant is not sugary, it's a savory pastry. Okay?

Dr. Ken Redcross: Right.

Dr. Drew Sinatra: And with that croissant, they may give you some sliced cheese or some sliced meat that might balance out a little added fat, protein, right, that help reduce that insulin response that your body's going to have. And they might have some yogurt with some fruit. A traditional Greek breakfast is also with olives and feta cheese.

Dr. Ken Redcross: That right.

Dr. Drew Sinatra: So you're incorporating more than just a muffin that's high in sugar, or a bagel, or another pastry that's just loaded with refined carbohydrates and sugar. And to top it off, too, I always tell people, I mean, think about it, the classic American breakfast might be like coffee, which is fine. But you're layering in tons of sugar into that, and then you're having your muffin with that, and then you're chasing it down with a glass of orange juice.

Dr. Ken Redcross: That's right.

Dr. Drew Sinatra: Just setting you up for poor glucose regulation in the body.

Dr. Ken Redcross: No, absolutely. And one of the things you mentioned with that Mediterranean breakfast, everyone, it's the portion size. The portion size is also very, very different when you're there in Greece and you have that Mediterranean diet, balancing beautiful things like olives and those things that are so important, nuts, seeds, things that we don't necessarily have in our diet, that's really, really important to make sure we're getting all that we need out of our food. And not all those added calories from the sugar that you're mentioning.

Dr. Drew Sinatra: Yeah, exactly. Exactly. So we can't stress enough, people listening, that diet is just so, so key with this and we could just talk for so long about it. Let's briefly segue into exercise and really importance of, and I like to say movement, too, because I think exercise triggers people sometimes. But really, move your body as much as you can. Right? So even if you're listening to this podcast, maybe go for a walk with your phone in your pocket, go for a walk, get some exercise while listening to it. Get up from your desk on a regular basis, try to walk around the neighborhood, whatever it is, just move your body in any way that you can because when you do that, you're going to have much more efficient regulation of your blood sugar, and it'll help lower blood sugar, too. If you've ever known a Type 1 diabetic, before the insulin pumps were really big and they can kind of,

Dr. Ken Redcross: Right. Right.

Dr. Drew Sinatra: Figure out exactly what insulin dose they needed in that moment, they'd have to go for a run around the neighborhood to lower their blood sugar quickly after a meal. So…

Dr. Ken Redcross: Yep.

Dr. Drew Sinatra: It's testament there that we need to be moving our bodies more. So I wanted to hear from you, what do you recommend for exercise for those that are suffering from blood sugar imbalance?

Dr. Ken Redcross: So Drew, it's funny you mentioned that. I'm old enough to remember when the Type 1 diabetics had to run around before the pumps got so big. Okay? And so you're absolutely right. So when I talk about exercise, I tell everyone, the CDC says we're supposed to be getting 150 minutes a week of moderate exercise, or 90 minutes a week of high intensity exercise. So if you think about that 150 minutes a week, guys, it's only 30 minutes a day. And so you can pile in other days and so forth.

But the point is you get almost a 20 to 25% reduction in mortality. You're here on this earth 20% longer, everyone, in essence, when you're getting the right amount of exercise. And so when everyone thinks of exercise, they always think about the heart, which we should. But we're talking about blood sugar. And what happens is guess what, not only does your heart get the benefit, but when those muscles are moving, guess what they need everyone? It needs glucose.

Dr. Drew Sinatra: Yes.

Dr. Ken Redcross: It needs sugar. So therefore it drives in there to make sure that you can walk. And also, I should say, too, the other studies have shown…now I am a big fitness enthusiast, cycler, cross-fitter. But the study showed, maybe I'm the crazy one, because you can get the same benefits from a brisk walk after dinner, almost, depending on your speed and that sort of thing. And that's one of the big things with you being out in Greece and talking about the Mediterranean diet. They looked at the studies, Drew, and they saw that one of the big things they did, not only did they eat better than us, but they usually walk after dinner.

Dr. Drew Sinatra: Yes.

Dr. Ken Redcross: And that may be a reason why blood sugars are not like ours. And their incidence of diabetes isn't like ours. So when you talk about, and I'm glad you used the word movement, because I say that, too, because exercise is different for each one of us, right?

Dr. Drew Sinatra: Yeah. Yeah.

Dr. Ken Redcross: But the point is, is to move that body for that amount of time that I mentioned to really get the benefits.

Dr. Drew Sinatra: And I always mention, too, to people…even mentioning the word “gym,” it can be triggering, right? I don't want to go to the gym, I don't like the gym.

Dr. Ken Redcross: Right. Right.

Dr. Drew Sinatra: So find something that you enjoy doing. Maybe it's swimming, maybe it's hiking, maybe it's cycling, like what you're doing, or CrossFit. But something that you enjoy doing. Because if you're not enjoying what you're doing for movement exercise, the reality is you're not going to do it.

Dr. Ken Redcross: It's not going to last. It's not going to last.

Dr. Drew Sinatra: It's not going to happening.

Dr. Ken Redcross: And the good thing is, like I said, I'm very serious, everyone, they showed that walking the right pace in the right amount of time just as equal to me being crazy, lifting weights left and right racing to get the exact same benefit for your blood sugar and for your cardiovascular health. So that's something for those who like you don't want to see that gym. There's other ways you can do it at home.

Dr. Drew Sinatra: Yeah, exactly. Now for people that want more objective evidence of their blood sugar and where they're going with it, obviously you can get your labs done, we can do the fasting glucose, we can do the hemoglobin A1C, maybe a fasting insulin if we want to check in on that parameter.

Dr. Ken Redcross: Yeah, that's right.

Dr. Drew Sinatra: What's your thought on the continuous glucose monitors and how people that don't have pre-diabetes or diabetes, should they be using one?

Dr. Ken Redcross: Oh gosh, that's a great question. Look, it's a tough one, Drew, because we're talking about 90 million people out there.

Dr. Drew Sinatra: Yeah.

Dr. Ken Redcross: And we're talking about people who really, that we know need it as far as Type 2 diabetics who really could get a benefit. So look, I like to err on the side of caution. So I would love for them to monitor that. Along with that, Drew, a lot of what we're doing on your podcast today, educating around it, too.

Dr. Drew Sinatra: Yeah.

Dr. Ken Redcross: And it allows me to educate when they have that kind of glucose monitor, even if it's a little bit of overkill it seems. Look at the lives we save when we educate like this, and they're able to say you know, doc, we have a conversation now about your blood sugar, and now it becomes top of mind.

Dr. Drew Sinatra: Yes.

Dr. Ken Redcross: So I kind of like it, but once again, I realize it may be a little over the top, but I'd rather be over the top, in this case, when we talk about blood sugar.

Dr. Drew Sinatra: Well, it's funny because I definitely recommend them when people do have pre-diabetes, to kind of gain an understanding of like, “Oh, you know what? I just had this glass of orange juice, or I just had this glass of my latte, my oat milk.” Right? And to see the glucose spike that happens from that, I think it just helps build awareness around the foods that you're eating, the drinks you're consuming, and how that's influencing your blood sugar, including exercise, too. You can see it drop after you've done a run or something, right?

Dr. Ken Redcross: Absolutely. Absolutely.

Dr. Drew Sinatra: But you're right. I mean, it's tough because I think insurance doesn't cover a lot of these continuous glucose monitors. And so you send in the prescription and then you got to do a prior authorization, and that's a lot of work.

So I'm with you that I wish that we could be, I guess, recommending this more to those that don't have diabetes, but the reality is not everyone can get access to one. And secondly, they can be expensive if insurance isn't covering them.

Dr. Ken Redcross: Yeah, they can. And I try to think about diabetic educators and places — a lot of health departments and that sort of thing, they have programs. So yes, everyone, unfortunately it isn't covered by most insurances. With what we're talking about with the diabetes epidemic, there's a good shot with one in three people that you're going to have a family member or someone who may be already dealing with blood sugar issues, too.

Dr. Drew Sinatra: Exactly. Yeah.

Dr. Ken Redcross: So something to think about a little bit. But hopefully the awareness will really be helpful to make that available to a little bit of everyone. But unfortunately you're right Drew, it isn't.

Dr. Drew Sinatra: Yeah. Okay. Okay. So I want to quickly get into supplements, but before we do, I wanted to mention AMPK, and I know that you're very familiar with this, so I wanted you to sort of explain what this is and why are we talking about AMPK and how it relates to blood sugar?

Dr. Ken Redcross: Oh gosh, everyone. So I am a practicing internist as you mentioned, but I love cell biology, Drew. So when you think about AMPK, everyone, AMPK is a kinase, it's an enzyme. You all remember enzymes in science, it makes reactions happen. The reason why AMPK is so pivotal is because it does two important things. When we talk about berberine, everyone, it helps to support the blood sugar, but it helps to do it in different ways. It helps to express the insulin receptor better so that it's more effective. It also helps to express LDL receptors for cholesterol, to make sure that cholesterol is getting out of our blood, making sure that cholesterol is not being absorbed, making sure the cholesterol is being excreted.

So this particular kinase or enzyme does things that not only are important for our blood sugar to also help postprandial blood sugar. That means, everyone, after we eat, we all get this spike. But berberine helps to quell that, as well, which is what we want.

So when you talk about this one enzyme or kinase, what have you, it is so, so important for blood sugar support and cholesterol support, and it's important to understand this science so that when you start to take this, you can see what am I supposed to look for with this, how this is doing for me and for my body.

Dr. Drew Sinatra: Right. Right. And the AMPK, if I'm understanding this correctly, it tends to get activated when ATP levels or energy levels drop in the body. Is that correct?

Dr. Ken Redcross: That is absolutely correct. In fact, the AMPK, everyone, is adenosine monophosphate. That's one. ATP for exercise, everyone, there's three phosphates. So you're absolutely right, Drew. That's how it gets activated.

Dr. Drew Sinatra: Okay. And you mentioned berberine as being one compound, which can help increase levels of AMPK. Also, we should mention two basic things before we go into more supplements, and that is exercise and caloric restriction and fasting. Right?

Dr. Ken Redcross: Yeah.

Dr. Drew Sinatra: Those are all tied in with helping activate AMPK, as well.

Dr. Ken Redcross: Absolutely.

Dr. Drew Sinatra: Which go hand in hand with what we're talking about here, right? It's like…

Dr. Ken Redcross: No, it does.

Dr. Drew Sinatra: …exercise and fasting when needed.

Dr. Ken Redcross: No, it does Drew, and I'm glad you mentioned the fasting piece and some of the other things that didn't necessarily require only supplementation. Because doing some of the things we're talking about in addition to supplementation only heightens the benefit.

Dr. Drew Sinatra: Exactly.

Dr. Ken Redcross: So I'm glad you mentioned that because fasting's become so important and so many of my patients love talking about that, also.

Dr. Drew Sinatra: Yeah, and actually while we're on the fasting topic, I mean, it's so funny because you can get into that rabbit hole of fasting and think to yourself, well, fasting's only good for me. Right? But the more I research it, sometimes I'm coming across literature that's suggesting that fasting may not be good to do on a regular basis. Let's say you're doing intermittent fasting every single day.

Dr. Ken Redcross: Right.

Dr. Drew Sinatra: What is your thought on that, of “skipping” breakfast and then eating your lunch and then having your dinner and then fasting through the night? What's your thought on that?

Dr. Ken Redcross: No, Drew, you hit the nail right on the head. So it's one of these things, everyone, that something is good for you like this. You don't have to take it to this extreme sort of level. So when I talk about fasting, one of the things I always mention, look, breakfast is the biggest important part of our day, everyone. I mean, you've been asleep for eight hours, your body's working, your brain needs glucose. Everything is working. You got to feed your body. You got to give it the energy that it lost overnight.

Now, one of the things I talk about with fasting, kind of like you said, Drew, is that I tell them to give me four or five days a week. I don't even like to block them in because I like to…number one with the fasting, it also depends on a bunch of other things. Are you a big exerciser? Are you under a lot of S-word? That's stress, Drew, I never say the word. Are you under a lot of S-word and that sort of thing? So I usually tell people, give me five days a week of intermittent fasting, and I don't even go crazy. What I typically do, Drew, is I kind of do an abbreviated intermittent fast where I try to stop all of my food by seven o'clock.

Dr. Drew Sinatra: Yes.

Dr. Ken Redcross: So I try to squeeze mine in. It allows me to maybe have that one little cookie around seven o'clock that'll digest in time and it won't deposit in the abdomen by the morning, but I like to do it that way. So it's kind of baby steps, everyone. So fasting does some really important things, but to your point, Drew, when you start to see that it's almost the negative effects when you do it too much. I typically see lots of times.

Dr. Drew Sinatra: Yeah. Yeah. And you said one cookie, not a package of cookies.

Dr. Ken Redcross: There you go…and I mean it, too. I look at the labels, everyone, and so I have this thing, and I shouldn't. I'm going to reveal this only because we're all family. So I like these little Chessman cookies and I like it because I'm a big tea guy, like you said, I just came back from Europe, so I was in the perfect place for a tea cookie. So I look at that, everyone, it's like 120 grams of calories for three cookies. So once again, I'm familiar with this and we're thinking about it. So I realized that I can get away with that one if I want to towards my fasting window. I can have fun with that. And so a lot of you can, too, with your little thing that you love to have as far as on the sweet side.

Dr. Drew Sinatra: Yeah, exactly. And that's where moderation comes in handy, right?

Dr. Ken Redcross: Exactly. Great call.

Dr. Drew Sinatra: Moderation is the key.

Dr. Ken Redcross: Absolutely.

Dr. Drew Sinatra: So you mentioned tea, and I believe that green tea, I think it's EGCG, the compound in green tea, also activates AMPK.

Dr. Ken Redcross: Yep, great call.

Dr. Drew Sinatra: We know that. And then there's also a couple of the compounds. I think there's alpha-lipoic acid, ginseng, and is there any more?

Dr. Ken Redcross: No, and that's a good one. Alpha-lipoic acid, it activates the AMPK, but to your point, also supporter for blood sugar.

Dr. Drew Sinatra: For blood sugar, exactly.

Dr. Ken Redcross: Yeah. Yeah. So it's absolutely a good call.

Dr. Drew Sinatra: Yeah, exactly. And then I want to get into berberine in one moment here, but really quickly, I want to mention the phrase autophagy. We spoke about this many times in the podcast before, but all these things that we're talking about, even the intermittent fasting, that's promoting this concept called autophagy, which is really kind taking out the trash of each of your cells, it's allowing the body to sort of break down things that don't need to be there and then getting rid of it. So AMPK also improves or activates autophagy, which we really want, as well.

Dr. Ken Redcross: Absolutely. And that's a really, really big one to think about. Look, we go through our lives each and every day trying to rid our bodies of junk and trash that we can't control. Things that we can control, that we put hand to mouth, but then some other things that we can't control. So that autophagy is a huge part of making sure that we stay, as I like to say, healthy and whole.

Dr. Drew Sinatra: Exactly. Yep. So we mentioned berberine, so I want to jump in with berberine and why that's so good for blood sugar and lipids and many other things, as well. There was a study, I believe it was in 2008, 2009, that actually did a head-to-head looking at berberine versus Metformin. Metformin's a biguanide, that's a very common anti-diabetic or glucose type drug that people use to help lower their blood sugar. It's also an anti-aging medication that people use, as well, to…I believe inhibit…inhibits mTOR.

But in that study that looked at berberine versus Metformin, interestingly enough, I don't know if you saw this, Ken, but the doses are the same, right? You use Metformin 500 TID. They also use berberine 500 milligrams three times a day, as well.

Dr. Ken Redcross: 1500, yeah.

Dr. Drew Sinatra: I came across it the other day, I said, that's interesting. But yeah, in that study they found that there was a comparison there that happened between Metformin and berberine, meaning they both did well at helping lower blood sugar. So that was really promising to see. And I think that's why berberine came on the scene, especially in the last three to five years, but really 10 years ago plus that's when we really started having some research come in about berberine.

What else do you like about berberine and how it works with diabetes and blood sugar?

Dr. Ken Redcross: So Drew, you're right. So that study was very interesting…and it was interesting in that it was interesting that you pointed out the dosages were almost identical.

Dr. Drew Sinatra: Yeah.

Dr. Ken Redcross: And then the other thing, that's the thing I like about it, everyone, is that when you're sitting there, one of the things you try to do as a doctor, my Hippocratic oath is to “do no harm.”

Dr. Drew Sinatra: Yes.

Dr. Ken Redcross: And obviously I'm not saying Metformin does harm, but to your GI tract, sometimes you're going to say, “Oh my gosh, doc, I want to kill you, you didn't tell me!” So I always tell patients that with Metformin you can get a lot more, some GI things, it gets better in time. So I say all that to say that berberine kind of allowed me kind of another arrow in my quiver to be able to deal with diabetes and with blood sugar and that sort of thing. So it's nice to be able to offer something that I always will say, Drew, that's closer to the earth with it being a plant-based ingredient, as well. So it's nice to kind of be able to have that balance.

Dr. Drew Sinatra: Yeah, exactly. And I think of Metformin as reserving that for treating diabetes if needed. Right?

Dr. Ken Redcross: There you go.

Dr. Drew Sinatra: You can certainly treat diabetes with all the things we've been talking about today, including berberine, if people are really motivated to make some changes. But I tend to really like berberine for that pre-diabetes condition…

Dr. Ken Redcross: Yep.

Dr. Drew Sinatra: Right? Where we're just creeping up on the blood sugar and we know that we can help reverse that and get it back down.

Dr. Ken Redcross: 100%. I do the same, Drew.

Dr. Drew Sinatra: Exactly.

Dr. Ken Redcross: Exact same thing.

Dr. Drew Sinatra: Yeah. And it's overall, the Hippocratic oath is “do no harm.” Right? So overall it is well tolerated. I mean, sometimes you get the occasional GI upset from berberine, but that's pretty rare. You see that once in a blue moon, so it's a very safe compound. You can take it for extended periods of time. And it also has a lipid lowering effect, too, which is also very promising. It can help sensitize insulin, so it can help with insulin resistance.

And yeah, it's a really cool compound because it comes from many different plants out there. I mean people are probably familiar with Goldenseal, Oregon grape root grows all over the place here in the Pacific Northwest.

Dr. Ken Redcross: That's right.

Dr. Drew Sinatra: There's coptis, which is more of the Chinese medicine version of it, and there's also barberry, as well.

Dr. Ken Redcross: And barberry. And the thing I love about it is its one of those things, look, I'm a Western trained doc. We didn't talk about this in my one week of nutrition when we went to med school. So it's nice to be able to offer something that's, like you said, the safety profile is wonderful, the benefits are even more wonderful, and you're talking about something that's helping to support blood sugar. And we've already talked about what usually comes with that disarrangement of your lipids, of your cholesterol, everyone, whether it's lowering your HDL, increasing your triglycerides, increasing the LDL. So the fact that berberine can do both of those things, to support both of those things, is huge, especially in my pre-diabetic. So I'm just like you in that sense, Drew, to where that prebiotic, I'm sorry, that prediabetes group gets that special kind of setup to start to keep them from some of the heavier things that may be required.

Dr. Drew Sinatra: Yeah. And I mean, you and I, we can share our anecdotal experiences through patients all day and all night, but really there are a ton of clinical studies that have been done on berberine to help show these benefits that we're talking about. So well-researched compound and yeah, I can't speak highly of it enough, and obviously you can't either so.

Dr. Ken Redcross: Yeah, yeah, yeah. You're very much preaching to the converted and I love that. And to be able to have more. I mean this Ozempic challenge that's been out, the best thing that's come from TikTok doc is the fact that millions of more people will now hear about berberine. They may not have heard about it before the Ozempic challenge kind of called berberine nature's Ozempic. So it's great because the education is really growing around berberine. I think so many people are going to benefit from this compound.

Dr. Drew Sinatra: Yeah. And I mean, I'm happy you mentioned Ozempic too, because I think there's a time and a place for that medication.

Dr. Ken Redcross: Yeah.

Dr. Drew Sinatra: And I do believe that over time we'll have better substances out there that can be used for weight loss. But berberine, it's been around for a long time. We know it's safe and it's effective and we should certainly be using it in this population.

Dr. Ken Redcross: Absolutely, absolutely.

Dr. Drew Sinatra: Yeah. Anything else that you use in terms of supplements with your patients that might help support blood sugar? Anything else that comes to mind?

Dr. Ken Redcross: It's interesting when you say that because one of the ones I always talk a lot about is vitamin D, as well. Vitamin D is important to support over 36 organs, 2000 genes, and there's receptors for vitamin D just about everywhere, everyone. And so I usually use vitamin D, as well, Drew, to kind of balance things. It's almost like my balance. And the interesting thing is the levels should be between 40 and 60. When we look at the levels, when you go to your doctors or even to a doctor western trained like myself, you look at the parameters and it says 30 is normal and that's only for bone health, everyone. That was for back in the day with rickets and that sort of thing. It's different now.

So the 40 to 60 tends to be that sweet spot where you get the bigger benefits with vitamin D. So I always make sure that my patients, especially with blood sugar issues…and actually, honestly, with hypertension and cholesterol, which can go along with that, with the metabolic syndrome, that the vitamin D levels are where they need to be, along with Omega three, which is also important for lipids.

Dr. Drew Sinatra: And Ken, maybe you can help me answer this question. I've been wondering this for a long time. Sorry to put you on the spot.

Dr. Ken Redcross: I'm going to try. Exactly.

Dr. Drew Sinatra: Here it is. So we have this level of vitamin D, a lot of people are low in it. I'd say, I don't know, maybe three out of five people I test are low.

Dr. Ken Redcross: Yep.

Dr. Drew Sinatra: These are not folks that are lathering sunscreen on all the time that's going to prevent conversion of vitamin D in the skin. These are people that are getting out in the sun on a regular basis. Why are we seeing this epidemic, so to speak, of low vitamin D? Do you have any…

Dr. Ken Redcross: Yeah, I do.

Dr. Drew Sinatra: …reason for that?

Dr. Ken Redcross: I do, actually. That's a great question. So there's a few things going on. So one of the things I love to do, everyone, is also help the elderly. So we're talking about a huge population that doesn't get out in the sun, like that population you're mentioning. And then there's other people, like myself, who have more melanin in their skin, whether they're the African-American or Latino or whichever. The point is the melanin blocks the sun's rays. So you'll find the number one lowest group in vitamin D levels are African-Americans, followed by Latin Americans or Hispanics second. So it's a little bit of that, as well. The other thing we're realizing is that we really don't have that much natural vitamin D in our diets. One of the things we used to do back in the day, everywhere I guess from the south, I mean they'd always give you a teaspoon of cod liver oil.

The reason why we did that, right? You remember those days and so, it's about that fatty and omega three, but it's about vitamin D, natural vitamin D. So when you look around, there's not a lot of foods that are really naturally in vitamin D. People will say, “oh, well I take milk every day.” Guess what? It's fortified. It doesn't come naturally, guys, it's added. So you look at your diet, you look at the elderly, you look at minorities who are big, a big part of that. And then you look at those who do go out, which is that balancing act, right? You go out, you're fair skinned, you want to wear sunblock because you don't want to get any basal cell carcinomas and that sort of thing. But then it blocks the rays. So we're seeing and learning more about, gosh, we don't have a lot in our diet, and we have some people who are kind of set up to have low vitamin D. So that's part of the issue. So hopefully was able to answer a couple of things.

Dr. Drew Sinatra: Ken, you nailed it, man. That was great. That was great. Well look, as we wrap up here, I just wanted to leave our listeners with hope in the sense that if you are suffering with a blood sugar issue, if you've got pre-diabetes, even full-blown Type 2 diabetes, there's so much that you can do to help improve glucose levels. And really, you've seen this, Ken, right? I mean you've seen hemoglobin A1Cs in the sevens, high sixes, they come back down in normal range…

Dr. Ken Redcross: Oh, yeah.

Dr. Drew Sinatra: …over a 12-month period. It's possible, everyone, you can totally do this, right? There's so many different things that you can use to get your blood sugar down. But it is super important and so many ways to kind of approach this, and I just want you to know that it can be done. It's possible.

Dr. Ken Redcross: Absolutely. And one of the things I always love to say, especially when you deal with blood sugar, because everything is a lot of doom and gloom, I always say it's not your fault and it's not your fate. And it's important to really, really feel that mantra because it's true. We have so many things that we can do to really change your life, and hopefully from even listening to us today ,too, Drew, we just changed so many lives today. And so I'm happy you mentioned that.

Dr. Drew Sinatra: Exactly. Yeah. So thank you everyone for joining us. We had an awesome discussion today. I can't wait to have you on again, Ken.

Dr. Ken Redcross: Thank you. Thank you so much for having me on, Drew.

Dr. Drew Sinatra: And everyone, have a great day and we'll see you next time.

Dr. Ken Redcross: Be well.

Announcer: Thanks for listening to this special presentation of Be HEALTHistic, presented by Healthy Directions. If you enjoyed this episode, don't forget to like, comment, and share wherever you listen or watch. To subscribe to our podcast or to listen to past episodes, visit our website at See you next time.


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Dr. Drew Sinatra

Meet Dr. Drew Sinatra

Dr. Drew Sinatra is a board-certified naturopathic doctor and self-described “health detective” with a passion for promoting natural healing, wellness, and improving quality of life by addressing the root cause of illness in patients of all ages. His vibrant practice focuses on treating the whole person (mind, body, and spirit) and finding missed connections between symptoms and health issues that are often overlooked by conventional medicine.

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Dr. Ken Redcross

Meet Dr. Ken Redcross

Board-certified internist and best-selling author, Dr. Ken Redcross helps patients achieve remarkable health outcomes by addressing overlooked metabolic imbalances and nutrient deficiencies.

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