eliminate-sugar-and-monitor-glucose
Bryan emphasizes that even exercise won't stimulate NO production if blood sugar is elevated because glucose 'glues' the enzyme that makes nitric oxide into a non-functional conformation. He recommends everyone get a CGM, even without a prescription, to see in real-time how foods affect them. He notes that sugar is sticky like its name implies, binding to hemoglobin (raising HbA1c) and the eNOS enzyme, leading to endothelial dysfunction.
Glucose non-enzymatically glycates proteins, including the endothelial nitric oxide synthase enzyme. This glycation locks the enzyme in a conformation unable to produce NO. It also glycates hemoglobin, reducing oxygen-carrying capacity, compounding the hypoxia and vasoconstriction.
If you if you're exercising when you have high blood sugar, you're not going to make any nitric oxide cuz that glucose has glued this enzyme to where it can't undergo confirmational change to produce nitric oxide.

