By. Dr. Olisa Mak, ND
When considering cardiovascular risk, the obvious focus is cholesterol. Are our cholesterol levels high, especially our total cholesterol, low-density lipoproteins (LDL) and chol/HDL ratio. The relationship seems simple – lower our cholesterol levels to lower our cardiovascular risk.
For better or worse, the big picture isn’t so simple. In addition to our cholesterol levels, blood sugar regulation acts as one of the earliest and most overlooked drivers of cardiovascular disease. And even in people who do not have diabetes, unstable blood sugar can quietly increase cardiovascular risk for years, before showing up clearly on routine labs.
It’s not just high blood sugar that we’re concerned about but repeated blood sugar fluctuations and chronically elevated insulin levels. The concern is not simply high blood sugar but repeated blood sugar spikes and chronically elevated insulin levels that force the body to constantly adjust.
Understanding this connection changes how we approach prevention and means early intervention.
What Is Blood Sugar Regulation?
Blood sugar regulation refers to how efficiently your body manages glucose after you eat.
When you consume carbohydrates, they are broken down into glucose and released into the bloodstream. Imagine breaking apart a beaded necklace into individual beads. Insulin is then released to move glucose into cells for energy.
When this system works well:
- Blood sugar rises gradually
- Insulin responds appropriately (if blood sugar is low, insulin is also low and vice versa)
- Energy remains stable, flexible and adaptable
When it does not:
- Blood sugar spikes quickly
- Insulin rises sharply
- Energy crashes follow
Over time, repeated spikes and elevated insulin create metabolic strain or stress on the system and how your body handles carbohydrates.
If you’ve had your fasting blood glucose levels tested – your result may have been below the recommended 5.6mmol/L.
While your blood sugar levels may be normal, it’s important to identify the range of fluctuation to fully understand how much or how hard your body is working to maintain balance or homeostasis.
The Vascular Impact of Blood Sugar Spikes
The issue is cumulative vascular stress.
Repeated glucose spikes can:
- Irritate and damage the lining of blood vessels (the endothelium)
- Increase oxidative stress
- Promote systemic inflammation
- Raise triglycerides
- Encourage the production of smaller, denser LDL particles
This environment makes it easier for plaque to form within arteries.
Heart disease rarely develops overnight. It develops gradually, through repeated exposure to metabolic stressors — and unstable blood sugar is one of them.
WHAT IS OXIDATIVE STRESS?
The term oxidative stress describes a state where the body is burdened by having more unstable molecules (free radicals) than the body can “mop up” with antioxidants. Repeated blood sugar spikes increase the production of these free radicals, damaging the lining of blood vessels and oxidizing LDL cholesterol – changes that promote inflammation and make plaque formation more likely.
NOTE: Oxidizing LDL means chemically damaging LDL particles through exposure to free radicals, making them more inflammatory and more likely to contribute to plaque buildup in arteries.
In addition to creating vascular stress, chronically elevated insulin levels directly influence lipid patterns by signalling to the liver to produce more cholesterol and triglycerides.
It’s possible to have “normal” total cholesterol while still having:
- Elevated triglycerides
- Lower HDL
- A more atherogenic lipid profile
AND it’s possible to have elevated total cholesterol but low cardiovascular risk.
What does this mean? It means that our basic cholesterol panels (total, LDL, HDL, chol/HDL and triglycerides) may not be sufficient in showing us the whole picture. As with the rest of the body, it’s important to cast a wider testing net to correctly assess cardiovascular risk.
Early Warning Signs
Blood sugar instability may not be obvious on routine testing. And like always, it’s important to evaluate symptoms ALONG with test results.
BUT there can be subtle clues, including:
- Strong cravings for carbohydrates or sugar
- Afternoon fatigue or post-meal crashes
- Brain fog after eating
- Increased abdominal weight
- Elevated triglycerides
- A family history of diabetes or heart disease
These are signals worth paying attention to.
The Power of Early Intervention
Cardiovascular disease is often the downstream effect of long-standing metabolic dysfunction. And so properly identifying blood sugar dysregulation early on provides us with a powerful opportunity to provide early intervention.
Blood sugar regulation is also highly responsive to lifestyle changes. Small adjustments can significantly reduce long-term risk.
Supporting Blood Sugar for Heart Health
- Build meals around fibre-rich vegetables and whole foods
- Pair carbohydrates with protein and healthy fats (and eat the carbohydrates last)
- Prioritize strength training and regular movement
- Support sleep quality
- Reduce frequent snacking that keeps insulin elevated
Consistency matters more than perfection.
Helpful Tip: Use Your Calves After Meals
When muscles contract, they pull glucose out of the bloodstream — even without insulin. Research shows that activating large leg muscles, including the soleus (calf muscle), can reduce post-meal blood sugar spikes and improve insulin sensitivity. Simple calf raises or seated “soleus push-ups” for a few minutes after eating may help support more stable glucose levels.
THE BOTTOM LINE
While cholesterol plays a crucial part in our cardiovascular health, it is only part of it.
Repeated blood sugar spikes and elevated insulin levels can damage blood vessels, increase inflammation, and promote plaque formation long before diabetes is diagnosed.
By supporting stable blood sugar, you are directly supporting vascular integrity, reducing inflammation, and protecting long-term heart health.
Heart disease prevention begins long before cholesterol becomes abnormal.
To have your cholesterol levels and blood sugar regulation fully assessed, book in with one of our Naturopathic Doctors. Movement is extremely important for strengthening heart health. Book in with one of our RMT, manual osteopath and acupuncturist.
