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Blood Sugar & Sleep: Everything You Need to Know

April 8, 2021
Written by
Team NutriSense
Reviewed by
a person sleeping in bed

Blood sugar (or blood glucose) can have a significant impact on your sleep patterns. In fact, uncontrolled glucose levels might be the reason you are having trouble sleeping. 

Sleep and glucose have a bidirectional relationship. In one direction, how well or poorly you sleep will directly impact your glucose levels. In the other direction, what your glucose levels are like going into the night and during sleep will impact your sleep. 

Why does it matter? Blood sugar affects sleep, and sleep affects physical health. Short sleep duration—defined by the Centers for Disease Control and Prevention (CDC) as less than seven hours in a 24-hour period—can have a significant impact on your health. Adults who are short sleepers are more likely to have chronic health conditions like diabetes, obesity, or heart disease. 

So, getting control of your sleep habits can positively affect your health and longevity. We’ll show you how you can do just that by monitoring your glucose levels. 

Why does sleep affect blood sugar?

The relationship between sleep and blood sugar levels is complex. Sleep is essential to allow your body to restore and repair itself. When you don't get enough sleep, several changes occur in your body. Let's explore them one by one. 

Sleep impacts insulin levels

Sleep affects your hormone levels and your circadian rhythm. Your circadian rhythm naturally controls your sleep-wake cycle by responding to things like light and dark levels. Most people have a reasonably consistent circadian rhythm as adults. 

There is a small group of nerve cells that form what’s called the “master clock” in your brain. This internal clock controls hormone secretion, temperature, eating habits, and digestion. To work optimally, it requires a consistent circadian rhythm. Keeping this rhythm is key to regulating your metabolism, insulin, and blood glucose, as well as your sleep-wake cycle.

When your circadian rhythms are out of sync, your body's metabolic health can decline—and a risk for diabetes can increase. 

Research published in the journal “Endocrinology and Metabolism Clinics of North America” identifies that sleep deprivation reduces insulin sensitivity. This leads your body to produce more insulin to stabilize blood glucose levels. The more insulin resistant your cells become, the greater the risk that your insulin and blood sugar levels will chronically rise. This eventually leads to glucose intolerance and diabetes. 

According to the CDC, even just one night of insufficient sleep can affect your body’s ability to use insulin effectively.

a person eating a slice of pizza near opened fridge at night

Sleep regulates hunger hormones

Two hormones that regulate your appetite are leptin and ghrelin. Leptin plays several roles within your body. Two of its key jobs are long-term energy regulation and metabolism. You may have heard it referred to as the starvation or satiety hormone. 

The fat cells in your body release leptin, telling your brain when you have enough energy. When released, it suppresses your appetite, making you feel satisfied. If leptin levels are low, your appetite increases. 

Several studies have found that short sleep duration reduces leptin levels, leading to overeating and weight gain. In turn, the craving to eat more results in an increased intake of carbohydrates which raises glucose levels. 

Ghrelin has the opposite function of leptin, increasing your appetite by telling your brain that your body needs more food. This is one of the reasons why certain fad diets often fail. When you don’t eat enough, ghrelin levels increase, making it harder to stick to your diet.

Another thing that increases ghrelin levels is lack of sleep. The surge in ghrelin prompts you to feel hungry, leading you to eat more carbohydrates, which will raise your glucose levels. 

There is also an added problem with high ghrelin levels, as it can reduce glucose tolerance

Sleep impacts sympathetic nervous system activity

Sleep deprivation, or broken sleep, can lead to an increase in sympathetic nervous system activity. In stressful or dangerous situations, the sympathetic nervous system is what controls your “fight or flight” response. Lack of sleep can cause your “fight or flight” mode to kick in during the day and night, releasing stress hormones like cortisol. 

When your sympathetic nervous system is overly active, it can reduce insulin secretion and promote insulin resistance. Both of these can lead to chronically raised blood sugar levels. 

When blood sugar levels become raised, it can cause lifelong chronic conditions such as pre-diabetes, diabetes, or metabolic syndrome. 

Sleep modulates inflammation

Research shows that sleep deprivation increases inflammation levels in the body. This effect can happen after even a single poor night’s sleep. Inflammation is one of your body’s defense mechanisms, providing valuable protection against viruses and bacteria. 

But, if inflammation is chronically high, it can lead to lifelong conditions such as metabolic syndrome, type 2 diabetes, heart disease, and obesity. It can also cause further complications and a poorer prognosis.

a person laying in beg and struggling with falling asleep

Sleep impacts brain function

Glucose is fuel for the brain. It provides the energy needed to carry out its functions. When you’re sleep-deprived, the metabolic activity in your brain decreases significantly. 

Overall, studies state that sleep deprivation has damaging effects on brain function—particularly functions such as alertness, attention, decision making, and cognitive processes. 

Sleep helps to regulate body fat

Sleep helps to maintain your body weight in many different ways, including regulating hunger hormones and insulin levels, as discussed earlier. 

Research published in the journal “Diabetologia” shows that lack of sleep increases levels of free fatty acids in your blood. Those high fatty acid levels lead to a reduction in insulin sensitivity and hamper your body’s ability to metabolize fat. 

Controlling glucocorticoid levels is another body fat regulator. Glucocorticoids are hormones that control several processes such as metabolism, inflammatory response, and brain function. One of the principal glucocorticoids is cortisol (also known as the stress hormone). 

Studies show that when we’re sleep-deprived, cortisol levels increase both during that night of disrupted sleep and the following day’s long period of wakefulness. When cortisol levels increase, it can lead to insulin resistance. This can lead to an increase in blood sugar, weight gain, and potentially Type 2 Diabetes.

So, a lack of sleep negatively impacts your glucose levels in many ways. But what typically happens to your blood sugar levels when you get a good night’s sleep? Do you know what your normal blood sugar levels should be overnight?

a person using finger prick method to test their glucose level

What happens to blood sugar while you sleep

Normal glucose levels while sleeping

In a healthy individual, glucose levels will go up and down while you sleep, which is normal. Despite this, they should generally stay within the range of 70-100 mg/dl. 

There is a lot of research available on optimal morning fasting glucose values (after sleeping and fasting for at least eight hours) because these are the values that your physician or a researcher would test at a lab. This research tells us that an optimal waking fasting glucose value is between 70-90 mg/dL. 

But, there is less research available on what optimal glucose levels are while you’re sleeping. So, the advice is currently to aim for overnight glucose values within the 70-100 mg/dL range most of the night and overnight values that keep your 24-hour average glucose below 105 mg/dL. 

To recap, the key glucose levels you are looking to maintain are:

  • Glucose levels when asleep between 70-100 mg/dL
  • Optimal morning fasting glucose values between 70-90 mg/dL
  • Overnight values that keep your 24-hour average glucose below 105 mg/dL

Dawn phenomenon

This is a regular occurrence that happens in every person. In the early morning hours, certain hormones (growth hormone, cortisol, and catecholamines) cause the liver to release sugar into the bloodstream. The process may cause a short-term increase in glucose. This is your body’s “natural alarm clock.”

a person laying in bed and turning off an alarm

For most people, the dawn phenomenon usually occurs between 4 am and 8 am, but it does depend on your sleep-wake cycle. Your glucose levels should come back down within a few hours following the release of insulin. 

For those with insulin resistance and/or diabetes, glucose levels have difficulty coming back down after that morning surge. This can lead to higher-than-normal blood sugar levels at the start of the day.

How do blood sugar levels impact sleep?

Remember, sleep and glucose have a bidirectional relationship. Not only does a lack of sleep affect your blood sugar levels, but poor glucose levels also negatively affect your sleep. 

Both too low and too high blood sugar levels can have an impact on your sleep patterns. 

High blood sugar

There are several reasons why high blood sugar levels affect your sleep:

  • Pre-bed high blood sugar levels can affect the nervous system, making it hard to fall and stay asleep. This can trigger insomnia and increase cortisol and adrenaline levels, preventing your body from fully relaxing. 
  • You may need to go to the bathroom more often, disrupting your sleep. This is due to your kidneys trying to flush the excess glucose out of your body.  
  • High blood sugar can lead you to feel dehydrated, waking you from your sleep to rehydrate with a glass of water.
  • They can also cause you to feel hot, irritated, and unsettled, making it difficult to sleep. 

Low blood sugar

Low blood sugar can occur in both diabetics and non-diabetics. It can also be highly disruptive to sleep. Your blood sugar levels can drop due to stress, alcohol, insulin resistance, and other medical conditions. 

Symptoms of low blood sugar include dizziness, lightheadedness, and blurred vision. Low blood sugar levels can affect your sleep in the following ways:

  • It causes the release of cortisol and adrenaline. These hormones wake you up and stir your appetite. 
  • When trying to raise your blood sugar levels back to normal, your body overreacts by increasing your appetite. If you then eat when you should be sleeping, it can upset both your glucose levels and sleep-wake cycle. 
  • Low blood sugar levels can further disrupt sleep by causing insomnia, nightmares, sudden waking, and sweating.
a person laying in bad and looking at a clock

The sleep disruption caused by high/low blood sugar levels can lead to a troublesome loop of both poor sleep and poor glucose control. 

But, it’s not only sleep duration that impacts glucose levels, making this cycle even more complex. Sleep patterns also play their part in glucose control, so let's explore them a little further, too. 

What sleep patterns impact blood sugar levels?

Sleep deprivation

Sleep deprivation occurs when you don’t get enough sleep. The CDC recommends at least seven hours of sleep a night to maintain optimal health. Sleep deprivation is also a form of chronic stress, stimulating cortisol. 

Inadequate sleep will raise glucose levels. There is no getting around it; if you are not getting adequate and sufficient sleep, then your glucose levels will be higher and increase your risk of insulin resistance. Full stop. 

Sleep fragmentation

A fragmented night of sleep disturbs your periods of deep sleep. Newer research shows deep sleep (or slow-wave sleep) seems particularly important in regulating hormone balance. That includes both insulin sensitivity and glucose tolerance. 

A study funded by the National Heart, Lung, and Blood Institute (NHLBI) highlights that African Americans with broken sleep patterns and severe sleep apnea are much more likely to have raised blood sugar levels. 

Even if you get a total of eight hours of sleep, disruptions and lack of deep sleep can cause glucose levels to be higher. The study produced by the NHLBI advises that better quality sleep leads to better blood sugar control. 

a person laying in bed with their eyes opened

Sleep insufficiency

Sleep deprivation, sleep fragmentation, or a combination of both can cause sleep insufficiency. Once it sets in, it affects our everyday ability to maintain alertness, perform, and remain healthy.  

It can lead to insulin resistance, as well. One research study showed that participants who slept for just four hours had 40% higher glucose levels on average. The participants’ glucose levels were reaching diabetic status, and on top of that they experienced a 24% decreased insulin sensitivity. 

REM sleep 

a person waking up in the morning

REM sleep is a specific stage of sleep which occurs at various intervals throughout the night. During REM sleep, a person often has rapid eye movements, increased body movements, and a faster heart and breathing rate. This is often cited as one of the most important cycles of sleep for recovery and energy. 

REM sleep has a positive effect on glucose levels, as research shows that levels decrease by an average of 5% during REM sleep.

That’s a lot of information to take in about sleep and blood sugar! Stay tuned for more on the topic soon.

Engage with Your Blood Glucose Levels with Nutrisense

Your blood sugar levels can significantly impact how your body feels and functions. That’s why stable blood glucose levels can be an important factor in supporting overall wellbeing.

With Nutrisense, you’ll be able to track your blood glucose levels over time using a CGM, so you can make lifestyle choices that support healthy living.

When you join the program, our team of credentialed dietitians and nutritionists are available for additional support and guidance to help you reach your goals.

Ready to take the first step? Start with our quiz to see how Nutrisense can support your health.

Click here to listen to the podcast.
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Blood Sugar & Sleep: Everything You Need to Know
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Tips and Tricks for Staying Healthy in the Summer
Tips and Tricks for Staying Healthy in the Summer

If you're gearing up to travel or spend more time outdoors this summer, here are a few tips to help you stay safe and hydrated in the sun.

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Tips for a Healthy, Happy Purim
Tips for a Healthy, Happy Purim

Purim, a joyous occasion celebrated around March or April every year, is just around the corner! Read on to learn more about the holiday and the delicious foods that accompany it.

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5
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Thoughtful Valentine's Day Gift Ideas from NutriSense Dietitians
Thoughtful Valentine's Day Gift Ideas from NutriSense Dietitians

Still haven't settled on the perfect gift for your Valentine this year? Take a look at our Nutrition Team's favorites for some thoughtful ideas.

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10
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The Warning Signs of Nerve Damage You Should Watch Out For
The Warning Signs of Nerve Damage You Should Watch Out For

Because nerve damage can have many silent symptoms, it often goes undiagnosed in the early stages. Read on to learn more about what causes nerve damage and some warning signs to watch out for.

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7
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The Ultimate Guide to Fiber and its Effect on Metabolic Health
The Ultimate Guide to Fiber and its Effect on Metabolic Health

Ready to learn all about fiber beyond just the basics? In this post, we dive deep into the different kinds of fiber and health benefits of each. From functional fiber to fermentation, we break down all the jargon into a layman's language.

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The Relationship Between Cardio and Blood Sugar
The Relationship Between Cardio and Blood Sugar

Did you know that cardio can help you lose weight as well as optimize your health and blood glucose? Here's everything you need to know about cardio and its relationship with blood sugar.

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7
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The Side Effects of Unhealthy Weight Loss
The Side Effects of Unhealthy Weight Loss

Find out what unhealthy weight loss is and learn more about its side effects and what you can do to prevent them.

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6
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The Relationship Between Low Blood Sugar and High Blood Pressure
The Relationship Between Low Blood Sugar and High Blood Pressure

Learn about the warning signs of low blood sugar and the relationship it has on blood pressure.

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10
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The Positive Impact Weight Lifting Has on Blood Sugar
The Positive Impact Weight Lifting Has on Blood Sugar

Here is everything you need to know about the relationship between weight lifting and blood sugar.

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7
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The Relationship Between Cholesterol and Blood Sugar
The Relationship Between Cholesterol and Blood Sugar

Cholesterol plays a very important role in the human body, contributing to the structure of the cells, helping with vitamin D synthesis, and also promoting the production of steroid and sex hormones, like cortisol, aldosterone, testosterone, and estrogen. But how exactly is cholesterol connected to blood glucose levels?

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The Link Between Sleep Apnea and Diabetes
The Link Between Sleep Apnea and Diabetes

NutriSense dietitian Katrina Larsen, MS, RD,N, LD, CDCES discusses the risk factors for sleep apnea and how this disorder is linked to other health conditions.

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The Paleo Diet and Blood Glucose Levels
The Paleo Diet and Blood Glucose Levels

The premise of the paleo diet is that the body can handle a mix of meats, fruits and vegetables, eggs, fish, and complex carbohydrates better than processed meats, refined fats, grains and simple carbohydrates because it evolved to eat the first category as hunter-gatherers.

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The Health Benefits of Winter Squash
The Health Benefits of Winter Squash

A common ingredient in cozy winter recipes, winter squash is one of our favorite foods this time of year. Read on to learn more about how it can benefit your health.

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The NutriSense Holiday Gift Guide: Stocking Stuffers We Love
The NutriSense Holiday Gift Guide: Stocking Stuffers We Love

Haven't finished your holiday shopping yet? Pick from this list of NutriSense-approved holiday gifts to find some great last-minute stocking stuffers for everyone on your list!

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The NutriSense Holiday Gift Guide: Health-Focused Gifts They’ll Love
The NutriSense Holiday Gift Guide: Health-Focused Gifts They’ll Love

Still haven't bought all your holiday gifts this year? Don't worry—there's still time to find the perfect gift for everyone on your list. Read our guide for some great ideas!

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9
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The Link Between Inflammation and Blood Glucose
The Link Between Inflammation and Blood Glucose

Learn more about inflammation, how it affects blood glucose levels and what you can do to prevent and manage it.

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9
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The Health Benefits of Adding Fermented Foods to Your Diet
The Health Benefits of Adding Fermented Foods to Your Diet

Fermented foods have a range of health benefits. Read on to learn more about what they are and why you should be adding them to your diet.

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The Health Benefits of Potatoes, Yams, and Sweet Potatoes
The Health Benefits of Potatoes, Yams, and Sweet Potatoes

Potatoes, yams, and sweet potatoes are similar in usage, but pretty distinct in taste, texture, appearance, and even nutritional content! Read on to find out more about each one.

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The Health Benefits of Living With Pets
The Health Benefits of Living With Pets

Did you know that living with a pet can do more than just put a smile on your face? Read on to learn all the ways living with pets improves your wellbeing.

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The Health Benefits of Cooking With Herbs and Spices
The Health Benefits of Cooking With Herbs and Spices

Herbs and spices are a great way to add flavor to dishes, and also have a range of health benefits. Learn more about a few of our favorites.

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12
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The Health Benefits of Beans
The Health Benefits of Beans

Learn about the health benefits of beans and how they can help you live a healthier, longer life.

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6
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The Guide to Metabolic Diets: What Are They, Do They Work, And Who Should Try Them?
The Guide to Metabolic Diets: What Are They, Do They Work, And Who Should Try Them?

Review our guide to metabolic diets to help get a better understanding of what they are and whether they might be right for you.

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The Foods and Traditions of Kwanzaa
The Foods and Traditions of Kwanzaa

Learn about the traditions and nutrient-dense food commonly enjoyed during Kwanzaa. 

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9
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The Blood Sugar and Joint Pain Connection
The Blood Sugar and Joint Pain Connection

Have you ever wondered how your glucose levels might be connected to joint pain? We'll take a deep dive into this connection and share tips for reducing pain.

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10
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The Best Diet for Non-Diabetic Hypoglycemia
The Best Diet for Non-Diabetic Hypoglycemia

This article explores hypoglycemia in non-diabetics, how to manage symptoms through diet, and the advantages of glucose monitoring.

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The Effect of Aging on Your Blood Glucose Levels
The Effect of Aging on Your Blood Glucose Levels

Take a look at how aging can affect your blood glucose levels.

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9
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The Best Diet to Increase Your Vitamin D Levels
The Best Diet to Increase Your Vitamin D Levels

Read on to learn more about vitamin D-rich foods and what you should include in your diet to make the most of this vitamin’s health benefits.

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10
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The Best Diet for Menstruation
The Best Diet for Menstruation

When it comes to your menstrual cycle, what you eat can significantly impact how you feel. Read on to learn more about the best foods to add to your diet to help during that time of the month.

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8
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The Benefits and Risks of Popular Ayurvedic Herbs and Spices
The Benefits and Risks of Popular Ayurvedic Herbs and Spices

Ayurveda is an ancient Indian holistic healing system that dates back over 5,000 years. In the second installment of our series on the practice, review the benefits and risks associated with popular Ayurvedic herbs and spices.

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The Beginner’s Guide to the Low FODMAP Diet
The Beginner’s Guide to the Low FODMAP Diet

In this article, we break down what a low FODMAP diet looks like for beginners, and its potential benefits and drawbacks for gastrointestinal health.

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The 6 Worst Foods for Osteoporosis
The 6 Worst Foods for Osteoporosis

When it comes to bone health, good nutrition is absolutely critical. Read on to learn what osteoporosis is and why some foods may increase your risk of or worsen the condition.

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Taking Mental Health Online: Tips & Tools for Self-Care
Taking Mental Health Online: Tips & Tools for Self-Care

Mental health has a significant impact on your overall health; here are tips, tools, and apps to improve your mental wellbeing.

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12
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Tea, Blood Sugar Levels and Your Health
Tea, Blood Sugar Levels and Your Health

Different types of tea have different benefits for your health. Learn more about a few popular types, and see how tea can help you maintain healthy blood sugar levels.

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14
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Summer Soup Recipes: An Expert Weighs in on 13 Healthy Soup Options
Summer Soup Recipes: An Expert Weighs in on 13 Healthy Soup Options

To help you make the most of the warmer weather, we asked Carlee Hayes, RDN, CD, and Nutrition Manager here at NutriSense, to share a few of her favorite summer soup recipes.