I’m not exactly obsessed with checking my blood sugar, but I’ve certainly become more diligent about it since returning from the low-carb cruise. As I mentioned in a previous post, Dr. William Davis gave an excellent presentation on why we should monitor blood-sugar levels. Here’s a quote from one of his blog posts on the subject:
If you’re not a diabetic, why bother checking blood sugar? New studies have documented the increased likelihood of cardiovascular events with increased postprandial blood sugars well below the ranges regarded as diabetic. A blood sugar level of 140 mg/dl after a meal carries 30-60% increased (relative) risk for heart attack and other events. The increase in risk begins at even lower levels, perhaps 110 mg/dl or lower after eating.
We use a one-hour after eating blood sugar to gauge the effects of a meal. If, for instance, your dinner of baked chicken, asparagus brushed with olive oil, sauteed mushrooms, mashed potatoes, and a piece of Italian bread yields a one-hour blood sugar of 155 mg/dl, you know that something is wrong. (This is far more common than most people think.)
This makes perfect sense to me, for all kinds of reasons. We know that high blood sugar damages organs and blood vessels, and yes, that includes the coronary arteries. That’s why diabetics can lose limbs, suffer kidney failure, or go blind. It’s why they have such a high rate of heart disease. We also know that glucose feeds cancer and accelerates the aging process by encouraging the formation of advanced glycation end-products, or AGEs.
Dr. Uffe Ravsnkov, who believes heart disease begins with infections, pointed out in our interview that glucose competes with vitamin C and depresses the immune system. Even if you don’t buy the hypothesis that infections cause heart disease, you don’t want your immune system depressed. One source I checked online stated that when your blood sugar reaches 120 mg/dl, your body’s ability to swallow up viruses, bacteria and cancer cells is reduced by 75%.
How high is too high? That depends on who you ask. I’ve read articles that claim anytime your blood sugar is over 200 mg/dl, you’re being damaged — and by the way, it’s common for people to reach that level after a bowl of Cheerios. Others put the number at 140. Dr. Davis prefers to see post-meal blood-sugar levels below 125, and ideally closer to 100.
So after returning home from the cruise, I bought a blood-sugar meter to check my response to different meals. There’s good news and bad news.
The good news is that most of the meals I now enjoy don’t have much of an impact. I’ve checked my fasting blood sugar a few times in the morning, and it’s consistently in the 85-90 range. A little lower might be better, but that’s where I’m at. So with that as a baseline, here are the one-hour results after some meals:
- Chopped ham & three eggs scrambled in butter: 92
- Two burger patties with raw-milk cheese and sautéed onions, mustard, a dollop of mayonnaise: 101
- Homemade stew (beef, onions, carrots, red wine, beef bullion): 105
- Chicken and broccoli with pesto sauce: 109
- Protein shake with whey protein and heavy cream: 102
- Sausage with whipped cauliflower “fauxtatoes” (my low-carb version of bangers ‘n’ mash): 98
I was also pleased to learn that low-carb ice cream doesn’t produce much of a spike. When I first switched to a low-carb diet, I consumed a bowl of Carb Smart ice cream or a couple of their ice cream bars at least a few nights per week. Since then, I’ve lost much of my taste for desserts, so I rarely eat the stuff. I’ve also read that sugar alcohols can produce a bit of a blood-sugar spike some people.
I don’t plan to become a regular ice-cream eater again, but as an experiment, I had a full cup of Carb Smart ice cream earlier today. An hour later, my blood sugar stood at 112. That’s not great, but it’s less than I would’ve predicted. I’ve also found that iced tea sweetened with three packets of Truvia has virtually no effect on my blood sugar … the meter showed 93 mg/dl when I checked.
That’s the good news. The bad news is that I don’t seem to tolerate sugars and starches very well at all. As I mentioned in an earlier post, on St. Patrick’s Day I added one small potato to my meal of corned beef, carrots and cabbage. An hour later, the meter showed a blood-sugar level of 162 mg/dl.
I had an even bigger surprise a couple of days ago. I was busy and didn’t feel like cooking, so I threw together a meal of Costco meatballs with a 1/2 cup of marinara sauce and a wee small serving of spaghetti left over from a meal my wife had served to my daughters and my niece. (My niece doesn’t like most meats, but loves pasta.) By “wee small,” I mean perhaps 1/2 cup of cooked spaghetti. The meatballs also had a few carbs in them thanks to the bread crumbs. Adding up the counts from the labels, I estimated that my meal included about 40 grams of carbohydrate.
The result: an hour later my blood sugar stood at 174 mg/dl. Back when I thought meat and fat were bad, I used to live on pasta and potatoes. No wonder I started showing signs of pre-diabetes and felt lousy so often. I suppose if I hadn’t screwed up my metabolism with too much sugar as a kid and too much starch as a vegetarian adult, small servings of potatoes and pasta wouldn’t produce such dramatic spikes, but they do. I just shouldn’t be eating them.
That’s why it’s important to test your own reactions to various foods: we’re all different. What’s right for you may not work for me, and vice versa.
I saw an example of that last night. My sister-in-law was in town to pick up her daughter. Like my wife, my sister-in-law is naturally thin … if anything, she’d like to gain a few pounds. She saw me testing my blood sugar, and it piqued her curiosity, especially since their naturally-thin father is a type 2 diabetic. So an hour after dinner — which for her included chicken, a sweet potato, and a generous serving of pasta — I gave her the finger stick. Her blood sugar was only 112 mg/dl. Feed me the same dinner, and I’d probably be looking at something closer to 200.
So the bottom line for me: no starchy foods. And I’m perfectly happy living without them.
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very interesting stuff, been reading your blog for a while now and am always entertained by your writing.
my mother was diagnosed diabetic type 2 diet controlled and then found out that my sister has serious wheat allergy (previously diagnosed as IBS).
when wheat was cut out she found improved health generally and a year later the doctor retested her and found she was no longer diabetic…said it was the first time he’d even heard of reversal of diabetes!
thanks t=for the update, might get me a tester kit!
Wheat seems to produce autoimmune reactions in some people, beyond just the damage from the carb load. I pretty much avoid it altogether, save for a rare pizza indulgence. And when I do eat the pizza, I have to take an ibuprofen within two hours because my joints start to ache, especially my surgically-repaired shoulder.
I am noticing the same thing this week. I am on week one of a two week vacation. I do not measure my glucose at all, and the past 4 months I have been trying to lay off of the carbage that I would normally eat. Especially beer. Now in my day, 8 beers was a normal serving when the weekend rolled around or it was vacation time. Now, after a week of having bread, and some candy, and some potatoes, and 4 beers in one day…I felt like sh%% last night before going to bed. My body ached. I was in a lousy mood. Not a good way to feel on vacation. This was the third night of feeling like this too. So today, it’s back to eating the right way. It will be tough to do in a resort area, but it needs to be done.
Maybe it is a good thing to know how good I feel not eating the carbage.
I drank red wine on the low-carb cruise — and more of it than I drink at home — and felt fine. I think beer provides too much sugar in addition to the alcohol.
The reason why you react that strongly to eating carbs is that you’ve been low-carb for so long. I’d bet that after a month of high-carb, your reaction to a potato would be within the normal range.
There is a nice paper online about Steffansson’s one-year-only-meat experiment. They did glucose-tolerance-tests with them right after the experiment, where they had pretty much diabetic responses to any form of carbs. A few weeks later on a “normal” diet (higher in carbs, I guess), their carb metabolism caught up again and they had normal blood glucose levels after carb-eating again.
Here’s the link:
http://www.jbc.org/content/83/3/747.full.pdf
This falls in line with Julian Whitaker’s book “Reversing Diabetes”, where he treats type-2 diabetics with a low-fat high-carb diet, based on the idea that it’s not the carbs, but the insulin-resistance that causes high-blood sugars by keeping the glucose in the blood. Apparently a high-carb low-fat diet lowers this condition with success if you judge by the Amazon Reviews. Same goes for guys like Terry Shintani, who has published papers on the very same phenomenon.
I doubt this would works with type-1 diabetics, though, since they don’t make insulin at all.
So there are two schools with completely opposite views on the subject, which both have success in treating diabetes. This is still strange to me.
To make things even worse, I’ve personally lowered my fasting glucose from 103 to 95 through a High-Everything-Diet within a month and lowered it to around 85 by incorporating sugar, refined carbs and Omega-6, too, which meant unrestricted high-calorie eating. I still can’t wrap my head around this…
Okay, I’ve gained about 30 pounds during the experiment (I’ve lost 15 again, already, so that’s no problem), but it was still interesting (and tasty – in the name of science, of course
).
So, I’m pretty much disillusioned about healthy eating right now.
I should get a glucose test-set again to see where I’m at now. Those damn strips are more expensive than a starter-kit.
I think it’s possible a high-everything diet would retrain my body to handle the carbs, but I don’t see any compelling reason to try it. Starches make me hungry and always did, so I’m happy to live without them. I also don’t seem to have much of a tolerance for wheat; I get arthritic pains if I eat more than a little bit, so there’s no reason to eat any at all.
Really interesting to see your various levels with different foods.
Since Dr. Davis article I know about the importance and will buy also a BS meter. Till now I oriented my food choice in regard to binge attack. But I think if you´re extremly sensitive you might even collapse with too much protein or even fatty coconut cream.
I´m keto since 6 months and never want to return to starchy, fruity or alcohol binge attacks. HDL is 200, trygliceride 35. No question what is healthier. Have a nice weekend.
That’s why I checked my reaction to the protein shake, which provides 50 grams of protein. I know for some people, a big serving of protein can produce a bit of a spike.
Hi Tom,
Yes, it is a good idea to check how our bodies react to carbs …I’m also naturally thin, but my grandfather was diabetic, so I reduced the amount of carbs in my diet in order to prevent the disease….
Did you ever check what the effect on your blood sugar is, when you add a salad with fresh vegetables to your meal? I remember that I read in a Montignac book that a raw carrot has a glycemic index of 30, but a cooked carrot has a glycemic index of 80…. Also, some say that fibers have a good effect on the glycemic impact of a meal because sugar is passing into the blood more slowly….
Returning to your example with the small potato on St. Patrick’s Day, I wonder what difference would make on your blood sugar adding a small raw salad (let’s say one small carrot, a piece of celery, a small piece of apple and olive oil) to your meal ….
I will check it after a fresh salad sometime. A few bits of cooked carrots don’t seem to have a dramatic impact. My wife puts carrots in her (awesomely delicious) beef stew, and I don’t get any spikes from it.
I wonder what your blood sugar would look like if you tried eating according to the Ornishes and Furhmans of the world?
I’d try it on myself but it looks like it might hurt!
Judging by the mood swings I experienced on lowfat diets, I’d say it would look like a roller-coaster ride.
We went to the town health fair last night, which boasted “Learn all about healthy snacking with FREE SAMPLES!”
Their idea of healthy?
*Popcorn
* Pretzels
* Teddy Grahams (?? oh they are made with whole grains….now I see.)
*Reduced fat wheat thins
* Sugar free, low fat yogurt
*Apples
Next year I might have my own booth and give out free bones so people can suck the marrow out.
If you do, my daughters would be happy to work as demonstrators.
I suspect the pancreas is like skeletal muscle in that if you don’t use it, you lose it. After I lost my taste for sweets (natural or artificial), my pancreas took off to Cancun, where it’s sipping on a Corona. I received a postcard from it yesterday.
If my pancreas spots yours on the beach, I’ll make sure it says hi.
Just remember that there are always two ways to look at an “intolerance” or “weakness.” What drives me and my research is identifying that your blood sugar spikes too high after eating carbohydrate, figure out what is the cause of your glucose metabolism problems, and then implement strategies that help you overcome the core problem and get to a point where carbohydrates can be consumed without ill effect. To me, the true sign of improvement is being able to watch your blood sugar reaction to a meal where glucose once spiked at 174 fall to 170, then 160, then 140… All the way back to 110 or less. I DO think this is achievable, and have had many reports from my followers that this precise improvement has been witnessed.
I’ve wondered about that myself. One theory is that if I ate more carbs, I’d retrain my body to handle them. The other theory is that I severely damaged my ability to handle them a long time ago, so eating more of them now would be like trying to heal my hearing problem by listening to loud music. Since I feel better burning mostly fat for fuel, and since carbohydrates always seem to ramp up my appetite, I’ll just limit them for now.
I think I’m the same way Tom. A couple of weeks ago I went out to buy fresh testing strips for my meter, then have spent the time since trying to find my meter. It’s been so long since I’ve used it that I can’t remember where I put it. I do know that I feel pretty icky after any meal containing starches or grains. If I ever find my meter, I’ll run some tests to see exactly what is happening. I spent so many years on low-fat or fat-free foods that my body will probably never recover from the damage. But I’m happy with the way I eat now, so I’m not disappointed at all that I can’t eat carby foods.
It’s worth picking up another meter. I was surprised to learn, for example, that the gyros salad I order at a local fast-food Greek place pushes my blood sugar to 152. There’s sugar or starch in there somewhere.
Hmmmm I’m thinking I should pick up a tester and check my diet too.
You may need to test the low carb ice cream later than one hour. The sugar alcohols break down in the gut later than real sugar so any spike may come several hours later.
I wasn’t aware of that. Good idea; I’ll give it a two-hour check next time.
Hi Tom!
Great post! I am a Type 2 myself, and when I first started testing blood sugars, it was quite a suprise to me also, what different foods could do to my readings. I follow low-carb to keep those numbers in line.
One thing I have heard about, from various sources, one may have been Dr Eades, is when you don’t eat carbohydrate often, your body down-regulates it’s production of enzymes. (or something like that) If you do then eat some carb, your body will not handle it well at all, alot worse than if you ate carbs regularly. Thats why, if you are going for an Oral Glucose Tolerance Test, they tell you to make sure you eat 150g carbs for at least 3 days before. Now, if you normally don’t eat much carbs, like you and I, then you really don’t have to worry what might happen when you do.
Just my 2 cents
That sounds right. I’d rather just avoid the carbs instead of trying to train my body to handle them.
The timing of the post-prandial test matters, as was mentioned above. The ice cream also combined fat with sugar which might also delay the rise in glucose. Similarly, a pizza will have a much larger effect 2 to 4 hours after a meal than earlier. Diabetics are advised to check around 2 hours after a meal because their phase 1 insulin response is not the same as a healthy person’s. As for potatoes, I would have a lower glycemic response to pure sugar than I would to a baked potato (I’m a diabetic of 25 years).
I may run the ice cream test again and check the two-hour response as well. For starches, I had the big peak at one hour. The two-hour results were back down near 100, so at least my glucose wasn’t elevated for a long stretch.
I have never tested my blood sugar, but maybe I will start. My husband (a pharmacist) was given a few free testing meters from a drug rep. I do know that I can’t handle wheat, though. I tried Dreamfields pasta the other day and my intestines were in knots for two days. Same happens with low-carb tortillas. For the longest time I thought I had IBS and then thought I was lactose intollerant. Not true at all. Since I have gone low carb, I can eat cheese with no side effects.
It’s amazing how much better I feel eating low carb. No stomach cramping, no gas, no bad breath (trust me, my husband lets me know!). I feel like I have so much energy following low carb. I would never try to retrain my body to eat lots of carbs again.
The sound engineer for Fat Head gave up bread and cereal after watching the film, and his IBS went away. He’d been on Prilosec for years.
I echo the sentiments of a few of the other posters urging caution. I think this is a risky strategy. By eating progressively fewer carbs, your body could get even worse at handling them than it already is. You may not handle potatoes now, next it could be carrots and onions. Plus what is eating fewer carbs going to do to your thyroid? I would be very careful with this strategy. You’re may find yourself having to restrict more and more…not a way to live.
If that happens, I’ll re-evaluate. In the meantime, it means giving up wheat, which doesn’t agree with me anyway, and giving up potatoes, which I don’t need to be healthy.
One other point of interest, at least to me. Its possible to have normal blood sugars but still have an impaired insulin function. As you become more insulin resistant, in many cases the pancreas pumps out more and more insulin to achieve normal sugars. So if one suspects they are having issues, testing the amount of insulin in the blood stream can also be useful, though most people don’t need to do this.
Very good point. A reading of 100 doesn’t tell you how hard your body is working to achieve that level. But when you get a reading of 174, you know you’ve eaten something you don’t handle very well.
One thing to consider when getting a meter…
Check the insert for the accuracy. I have one (one of those tiny ones that fits on the top of the strip bottle) that says it’s accurate to within 15%. So a reading of 115 might in reality be 100. I know it reads high because I was getting afternoon readings of high 90′s, and then had a random glucose done at a lab in the afternoon where is measured 80.
I have another one (Advance microdraw) that is more accurate. I’ve done a fingerstick seconds before the actual lab draw and it was only 5 points different. I stopped using the small one. Too inaccurate.
Then there’s blood glucose as opposed to plasma glucose. Some meters measure one, some the other. Most newer ones do the plasma level. Plasma will measure a bit higher than whole blood glucose.
A good bet is to get an A1C, which will measure your glucose as an average over the past 30-90 days. The ADA recommends no more than 7 for diabetics (which in my opinion is suicidally high. If it’s abnormal for me, why is it OK for diabetics?) I believe a 5 is an average of 90. Add 3 points for each tenth. For example a 5.2 would translate to 96 as an average.
I tried one of those tiny meters and the results varied rather dramatically. I’ve since picked up a more expensive unit, which seems to be more consistent.
My understanding is that all food converts to glucose, albeit at different rates, depending.
However, I occasionally work for a pharmacy school as a simulated patient, and when I posited my glucose theory, I was told by one doctor/professor that only the fat in a steak will convert to glucose, whereas the remaining protein will not. Huh?
I also took a glucose tolerance test many years ago to discover that I’m hypoglycemic. Such a test requires drinking eight ounces of pure glucose on an empty stomach! As you can imagine, I fell asleep after two hours with a waking butt-kick hangover.
Suffice it to say, if I indulge in high carbs (rare), or sugar (rarer), my blood sugar will rise dramatically, then crash, lower that when I started.
The timing of the insulin response may also be something to consider for some folks when measuring blood sugar levels.
Say whuuuut? Fat turns to glucose but protein doesn’t? Has the doctor never heard of gluconeogenesis? From Wikipedia:
Fatty acids cannot be converted into glucose in animals with the exception of odd-chain fatty acids, which yield propionyl CoA, a precursor for succinyl CoA. … Glycerol, which is a part of all triacylglycerols, can also be used in gluconeogenesis. In organisms in which glycerol is derived from glucose (e.g., humans and other mammals), glycerol is sometimes not considered a true gluconeogenic substrate, as it cannot be used to generate new glucose.
I live my life now with testing blood sugar. I was recently diagnosed with type 1 diabetes, so I test test test. I test before I eat something, 1 hour after, then 2 hours after.
With that, I have discovered what it is that spikes my glucose. When I was diagnosed, my level was 38 (the equivilent of 960 I believe) my A1C was 17.0%. (That means I was hovering around 850)
I never really bought into low carb until it was too late. Now I live low carb, and I have gained control of glucose. I now enjoy an average of 6.1 (I believe that is 118)
To the tolerance of carbs, your body (moreso your pancreas and liver) work together to eat glucose. Living low carb actually gives your body a break. The most important thing is preserve the function of your beta cells. Once they are gone, that is it. They never come back. I know that as truth.
I feel it is criminal how “heart smart” items are really carbs. There are so many ways that carbs are disguised. They are filler in our foods, a way to cut costs. A scary statistic is that 1 iin 6 are diabetic, and 66% don’t know it yet.
That number is bound to rise, and we will then be told that we need more and more carbs. (I have been told that I need them to survive. Bah!)
We have been domesticated by the companies selling us these products. We are too stupid to cook, or so they have us believe. It is now convenient to consume their pre-made product. It is cut with carbs to cut costs, but no matter, they get rich by cutting their bottom line while we get sick.
Finally, diagnosis of diabetes is unreliable with A1C. An oral glucose tolerance test is the best way. How you deal with starch after a meal is the best diagnosis.
Tom, you need to be careful. You were pre-diabetic, so control is vital. See, pancreatic function fails by a threshold. Once you pass it, there is no going back.
Absolutely, Jason. That’s why I’m not interested in trying out any theories that I could regain my tolerance for carbs by eating more of them. If that theory is wrong (at least in my case), I would just be doing more damage. Not worth the risk. I live on meats, eggs, vegetables, raw-milk cheese, low-sugar fruits and nuts. That’s enough variety to keep me healthy.
The theory of regaining your tolerance by slowly putting the carbs back into your diet, as mentioned in the comments, I think really depends on your own personal history.
I was raised with fruit juices, canned crap and soda pop. Some people tolerate that stuff better and if you look at your genetic background I’m sure the answer is there!
I don’t think I’ll ever be able to incorporate wheat, most dairy, and sugars back into my diet regularly again, as I come from a heritage where the main staple of the diet was things like organ meats, fat and cow tongues. Those were delicacies for them and much valued.
Thanks for pointing out the importance of blood sugar testing, I’ve done it before and always tested in the okay range mostly, but I don’t do it at home regularly!
Oh I also wanted to mention
Isn’t it possible that being on a “high everything diet” could also eventually have the reverse effect over time where you again become sensitive to carbs as it builds up in your system again as inflammation?
That’s one of the things that would worry me. I had a lot more aches and pains, some arthritis, a bit of asthma, etc. when I was a starch-eater. If a big dose of starch does that, I’m afraid smaller portions may just cause inflammation that I don’t actually feel as pain.
#1: do you think how starch and sugar effect blood sugar levels in people can depend on metabolic types? Undergroundwellness’ sean croxton recommends doing a metabolic typing test/diet since everyone is different. although based on the fact that starch makes me go pretty much insane, breaks me out, and makes me eat more, and my bloodlines are mostly european (irish, scottish, german, polish, english, italian (hence why I miss spaghetti…)) that low-carb is right for me. I don’t think going on the “Japanese diet” is really very smart for me.
#2: You should totally put your recipe for fauxtatoes up!
Yes, I believe the degree to which you can tolerate starches is probably based on your ancestry.
One head cauliflower, chopped up. Put it in a covered microwave-safe dish with a little water, nuke it for 10 minutes. Drain the water. Put it in a bowl with 1/2 stick butter, a couple tablespoons of sour cream, a pinch of garlic salt, and beat it up. Adjust ingredients to taste. It’s also good if you add some feta or parmesan cheese while mixing.
Hey Tom. I’m beginning to wonder if there is not a connection between a damaged intestine and carb tolerance. Most people like yourself who are carb intolerant seem to suffer cealiac like symptoms from wheat (ie the arthritic pains) and if someone like Matt Stone is saying he has seen people eventually be able to eat carbs again after a period of time avoiding them it seems similar to results found using the Specific Carbohydrate Diet.
I think that’s a definite possiblity. I used to reach for the Pepto-Bismal fairly regularly when I ate grains. I remember being doubled up with stomach pains as a teenager, which I wrote off as a “weak constitution.” Now I literally can’t remember the last time I took anything for a digestive upset. If I ever add more carbohydrates back into my diet, they won’t come from grains.
Have you heard about the insulin index?
http://terveys.blogspot.com/2006/08/insulin-index.html
It’s like the glycaemic index, but foods are ranked by how much insulin the body creates as a result.
There’s an interesting part in there saying that carb heavy foods like potatoes and pasta, produce very different insulin responses, with the potato’s one being huge, and the pasta having a much lower insulin response.
Even more interesting, beef and cheese, with no carbs in them, had a higher insulin score than the pasta.
Yup, I’ve seen those figures before. Protein raises insulin, but it also raises glucagon, insulin’s counter-regulatory hormone. More importantly, at least for my interests, beef doesn’t spike my blood sugar, but pasta does.
Great experiment, Tom! I may do this sometime soon myself, although my reactive hypoglycemia will never allow my blood sugar levels to rise above around 100. I think that’s a good thing.
At least you know you’re not suffering vascular damage from too much blood sugar.
Tom, the response to the high carb. meals that you experienced is probably because your body has been primed for fat-burning; a physiological (benign) insulin resistance response.
If you carb.-load for a few days or so, my guess is that you’ll see much lower blood glucose levels postprandially in response to high-carb. meals.
The physiological insulin resistance response I mentioned above seems to be dependent on your level of glycogen depletion.
If you are showing ketones in the urine, your body should be tuned to fat burning; meaning your muscle cells would be rejecting glucose and taking in ketones and free fatty acids.
This response makes perfect evolutionary sense. Otherwise half-empty glycogen stores would be consumed too quickly, and your brain would not like it at all, possibly putting in a coma!
Yes, it occurred to me that since I rarely eat starch, I may have a stronger reaction to the stuff. But I don’t see any reason to “fix” that problem (not that you’re suggesting I should). When I was a big drinker, I could tolerate a lot more alcohol. Now I don’t tolerate it as well, but nobody would suggest I need to retrain my body to reach its former level of alcohol tolerance.
Have you ever seen this study: http://www.jacn.org/cgi/content/full/23/4/351 “Effects of Acute Chromium Supplementation on Postprandial Metabolism in Healthy Young Men”. Basically, 400 mcg. of chromium picolinate taken about 30 minutes before each meal lowers postprandial blood sugar substantially for a “responder” by greatly increasing muscle glycogen synthesis. This works for me, and helped me to figure out several aspects of my response to carbohydrate. For instance, if I have high fasting insulin, this chromium regimen gives me a headache until I lower the carb level and thereby reduce fasting insulin. If I keep carbs very low, my mood is poor as the chromium gradually increases my insulin sensitivity and thereby “demands” more carbohydrate. Thus I can titrate my carbohydrate intake to achieve an optimal result, and I find my mood and exercise tolerance are far better this way.
Interesting. I take 200 mcg chromium as part of my daily supplementation.
> I don’t see any reason to “fix” that problem …
I think you are absolutely right. Nothing to fix.
Some people with high concentrations of ketones early in the morning experience high fasting glucose levels, again, due to physiological insulin resistance.
Growth hormone peaks just before dawn, increasing blood glucose levels. Since the body is tuned to ketones and fat as sources of energy, due to low glycogen levels, blood glucose goes up. It is like trying force someone who is not thirsty to drink water.
The nonsensical advice we see often to “fix” this problem is to eat some carbs. right before going to bed, to avoid this benign version of the “dawn effect”. Those who follow this advice lose the opportunity to burn some fat from night till dawn, and also end up with a higher area under the glucose curve during that period, which generally means a bit more glycation.
Just improve their fasting glucose numbers …
Tom
Do you know whether or not having elevated blood sugar responses from foods is in any way connected with having high blood pressure? Thanks
I haven’t heard anything about that. (If anyone else has, chime in.) I clearly react pretty dramatically to starch, but my blood pressure is consistently on the low side, usually around 110/75.
You can see the effect most sugar alcohols have on your blood sugar here:
http://lowcarbdiets.about.com/od/whattoeat/a/sugaralcohols.htm
Erythritol is the only sugar alcohol which has no effect on blood sugar. It’s the primary sugar alcohol in Truvia. Maltitol is the primary sugar alcohol in the sugar-free candies that are produced, and it’s really just another sugar.
Glad to know my afternoon iced tea isn’t raising my blood sugar. I avoid maltitol completely because it gives me a rumbly stomach.
All this is very interesting. I was getting inflammation of my mucus membranes, and could not find a reason (and the doctors couldn’t either). I felt like I had “metabolic syndrome”, but had none of the markers (no belly fat, I had low blood pressure and low triglycerides -49). My fasting blood sugar was 122, but the A1C was 5.6, which concerned me, but not my doctor). I was eating well, with mainly brown rice as my carbs, but low protein and low fat. I already knew that wheat and dairy (and fruit) caused problems and usually avoided them since I don’t like being sick.
Finally found a doctor that confirmed the gluten/lactose intolerance and the candida I suspected I had. I cut out all carbs for about 6 months, then spent about 6 months trying to add in the non-gluten grains. No success.
Since adding more good quality protein and fat, and forgetting the grains and potatoes, I feel great, my energy is up, and the constant anxiety is gone. I still react on occasion (get bloated and then some inflammation). Maybe the glucose meter would help me figure it out.
Glad you figured it out, but isn’t it a shame your doctor didn’t figure it out for you?
Interesting. I don’t see why one should retrain their bodies to be able to tolerate more carbs though. After all, most of us on low-carb now got here because our tolerance lowered to the point where we were gaining weight/were overweight, etc. At some point between the ages of 9 and 10 my body started reacting to carbs badly – I craved them totally, ate way too much, was always ‘hungry’ (ie not real hunger, as I ate all the time, but carb hunger) – and was 185 pounds by the time I was 15 as a result.
I definitely have a strong reaction when I eat carbs now, usually – I feel nauseous if I have a lot of sugar, and get a weird taste/sensation in my mouth, and bloated and uncomfortable if I eat a lot of starches. When I was pregnant, I unfortunately ended up eating lots of carbs because it was all I could tolerate I was so sick – and eventually I didn’t get that weird nauseous sugar reaction. But I also gained 30 pounds I still haven’t managed to get rid of, and if I hadn’t gone back to low-carb half way through the pregnancy when the nausea abated, I’d probably be 100 pounds heavier by now. And since *something* in my genetics/metabolism made me react that strongly in the first place when I was 9/10, how would I be able to change that now, after decades of yo-yo dieting/tired metabolism?
I’ll stay with my 8 years plus of low-carbing, thank you very much!
One thing I did find interesting this past month – although I am generally very strict with low-carb, when Passover was here I did eat the ritual amounts of matza – and also had a couple of days when I didn’t restrict my carbs, with all the festivities and family gatherings, etc. What was interesting was that for some reason, although I ate a fair amount, with carbs in there, I didn’t find that I ended up bingeing on carbs, which is what I’d normally do if I indulged in that way. I ate relatively ‘normal’ amounts for someone who isn’t a low carber. Even more interesting is that two days after returning to full low-carb eating, I got on the scale and discovered I was basically the same weight I was before the 2 or 3 days of indulging. I expected to be at least a couple of pounds heavier. Not sure why that happened.
As a totally unrelated aside, I wanted to tell you, Tom, that whenever my husband and I are trying to find a parking space in a mall, if we find one far away from the entrance, we remark that “Tom would be proud”… and if we find one nearby, it’s “Tom would be disappointed in us”
So you, and Fathead, are invoked pretty much every time we visit a mall or need to find parking somewhere!
That’s hilarious! If I’ve changed parking behavior, I’ve done a good deed. I made it a habit years ago to just head for the back of the parking lot. I’m already in the store while the people who insist on parking as close as possible are still hunting.
I think we can definitely lose our tolerance for refined carbs if we avoid them for long periods, but I also consider that a positive development, not a negative one. If a little bit of white flour or sugar makes you feel ill, you’ll stop sooner. My wife feels lousy if she has more than one drink, so she never has two, ever. I’m certainly not going to convince her she needs to improve her alcohol tolerance.
Mitch said: “Do you know whether or not having elevated blood sugar responses from foods is in any way connected with having high blood pressure? Thanks”
According to the Drs. Eades, yes – but indirectly. High insulin levels are associated with a number of “diseases of civilization,” including diabetes, high blood pressure, heart disease and stroke. High blood sugar will, by definition, elevate insulin. Elevate insulin high enough and you’ll probably develop high BP. They talk about it in Protein Power and a couple of their other books.
So what you’re saying is when you ate Double Quarter Pounders With Cheese (and the 46g of carbohydrates they contain) almost every day for a month your health improved, but when you cut starches out entirely with occasional exceptions for tiny portions of pasta or potatoes you wind up doing your body damage? Reading back over your Fat Head food log with this blog post in mind has turned me off low carb eating entirely. The message you have inadvertently sent is that a fairly consistent low to moderate carb diet is better than a low carb diet with occasional exceptions. It frightens me that you’re practically boasting about your body’s inability to cope with moderate amounts of carb. I wonder what would happen if you did a 28 day exact repeat of your fast food diet now…
I never checked my blood sugar on the fast-food diet, so I don’t know was happening. When I went on that diet, I reduced my carbs from probably 200-300 per day to around 100 … more on some days, fewer on others. So compared with my previous diet, it was an improvement.
Now I’ve reduced my carb intake even more and cut refined carbs to nearly zero, which is another improvement. If as a result I now get bigger spikes when I do eat starch (which may or may not be the case, since I have no previous measurements to go by), I don’t consider that a sign that something is wrong. It just means I’m no longer acclimated to foods I shouldn’t be eating in the first place. As I said in an earlier comment, when I drank a lot of alcohol in my younger days, I could drink a lot more without feeling drunk or hungover than I can now, but no one would suggest that my lower tolerance for alcohol now is a negative development.
“As I mentioned in an earlier post, on St. Patrick’s Day I added one small potato to my meal of corned beef, carrots and cabbage. An hour later, the meter showed a blood-sugar level of 162 mg/dl.”
Could the beef have been corned with sugar?
If so, it was a teensy amount. The nutrition label listed 1 carb per serving.
Great discussions! This whole idea of “training your body” to deal with higher carb loads……….would tend to make one wonder about the “best” approach………except for this IMPORTANT bit of information/advice from Dr. Davis……..
What to Eat: The diet is defined by small LDL
I approach diet from the perspective of small LDL particles. Small LDL particles have exploded in frequency and severity in Americans. It is not at all uncommon to see 70% or more small LDL particles (i.e., 70% of total LDL particle number or Apo B) on lipoprotein testing. (I saw two people today who began with over 95% small LDL.) Small LDL particles are: –More likely to persist in the bloodstream longer than large LDL particles. –More likely to adhere to components of atherosclerotic plaque. –More likely to gain entry to plaque. –More likely to be taken up by inflammatory white blood cells which, in turn, become the mast cells that fill coronary plaque. –More likely to be oxidized. –More likely to be glycated (8-fold more likely than large) To add insult to injury, foods that trigger small LDL formation–i.e., carbohydrates–also cause high postprandial blood sugars. High postprandial blood sugars, in turn, glycate small LDL. That combination of events accelerates 1) plaque growth, 2) plaque instability, and 3) aging. So carbohydrates trigger this sequence, carbohydrates of all stripes and colors. Not just “white” carbohydrates, but ALL carbohydrates. It’s all a matter of degree and quantity. So, yes, even quinoa, bulghur, and sorghum trigger this process. I’ve only recently appreciated just how bad oats and oatmeal are in this regard–really bad. Foods that trigger small LDL also trigger higher blood sugars; foods that trigger higher blood sugars also trigger small LDL. Small LDL and blood sugar are two different things, but they track each other very closely. So, in the Track Your Plaque approach to diet, we craft diet based on these simple principles: 1) Eliminate wheat, cornstarch, and sugars–These are the most flagrant triggers of small LDL, blood sugar, and, therefore, LDL glycation. 2) The inclusion of other carbohydrates, such as oatmeal, quinoa, rye, etc. depends on individual sensitivity. Individual sensitivity is best gauged by assessing one-hour postprandial glucose.
Like Dr. Davis points out, there are other good reasons to avoid carbohydrates besides blood-sugar spikes, especially for those of us who seem to be sensitive to them. There’s simply no compelling reason I’ve heard or read for trying to “fix” my body’s inability to handle starch when I can just skip the stuff.
I’m so glad you posted this! I have been tempted to do this for awhile. I was going to postpone this for a year while doing strict SCD. It’s kinda tempting now to just try it now anyways. My husband still eats gluten foods outside of the home and has sodas. It would be fun to stick him and see what shows up. He’s never had the flu in his life and rarely gets so much as a sniffle, so I’m curious how much effect a Dr. Pepper would have on him.
I hope you warn him before you stick him.
Snowdog:
Erythritol does elevate my blood sugar levels. You really have to test to know for sure. It does have the least effect of all the sugar alcohols, but I still need to avoid it. Even among us diabetics, the insulin response differs from one to another.
Tom – aren’t people like Dean Ornish literally committing malpractice by advocating their high-carb diets?
Well, I wouldn’t go quite that far. Compared to the awful diets a lot of people consume, full of sugar and white flour and other nastiness, the Ornish diet is probably an improvement. If anyone is guilty of malfeasance, it’s the USDA and FDA.
I’ve never found an answer to the question, which is worse, high insulin? or high blood sugar? High blood sugar is easy to detect, but since you don’t know what insulin is doing behind the scenes, many people tend to overlook it.
When your blood sugar spikes on pasta, is that because your insulin isn’t over producing? At least with low carb eating, you can be relatively sure that even if insulin production is stimulated, it’s not due to the ingestion of excess sugar (and therefore, hopefully, both numbers stay low-ish).
I asked Dr. Eades that question during one of our interviews: is it high blood sugar that’s damaging, or high insulin? He said both. If I were to pick which one is worse, I’d guess high blood sugar, since our bodies are willing to endure high insulin to bring it down.
Another thought – the purpose of ‘carb loading’ is to prime your insulin pump (pancreas) to produce as much insulin as it can. (I’ve taken the OGTT tests multiple times, this is the requirement and the explanations). But allegedly, according to the insulin index, many low carb foods (meat, eggs, etc) DO promote increased insulin out put. So, why doesn’t that count to deal with the carbs? Why would the absence of glucogen on a high carb diet cause the insulin (already elevated by all that protein) to be less effective at rushing the glucose/fructoses out of the bloodstream? It begs the question, is all insulin created equal?
Good question, but I’m not sure about the answer.
I just don’t understand. If you can re-train your body to accept carbs, why did you develop insulin resistance in the first place? I am a Type 2 diabetic and was able to reduce my A1C from 6.5 to 6.0 this past year (still working on it, of course) by eating low carb as much as possible. BTW, my doctor didn’t even give me a pat on the back – she is trying to get me on a statin drug because my cholesterol is over 250. I told her, been there, done that, will never, ever do so again. My brother was able to get off 10 years of Prilosec after six months of serious low carb and lost 40 pounds as well. I am happy for people who can digest carbs without serious harm, but I really think I am better off without. As soon as I get sloppy (by eating bread, mostly) I gain weight immediately and my BS goes up.
Hey, I’m going to try that KFC sandwich next time I get a hunger for junk food.
I think I’m better off without as well. There’s no biological need for starch, so why retrain myself. Smart move, ignoring your doctor on the statins. Totally worthless for women.
Hi Tom,
20% of thin people who are diagnosed with Type 2 diabetes actually suffer from LADA (Latent autoimmune diabetes) also known as Type 1.5 diabetes. It is similar to type I diabetes in which the body produces anti-bodies that attack the pancreas until it loses it’s ability to produce insulin.
However, unlike Type I diabetes which occurs suddenly, LADA develops overtime and symptoms mimic those of Type 2 diabetes, especially glucose levels that increase overtime.
A lot of people with LADA are initially diagnosed with Type 2 diabetes, until they re-diagnosed with LADA when they stop responding to diabetes medications and their glucose levels worsen.
Given the fact that you have been on a low carb diet and still see spikes in your glucose levels when you eat a little carbs, you might want to consider getting tested for LADA.
There is more info on LADA http://en.wikipedia.org/wiki/Latent_autoimmune_diabetes
Treatment includes insulin injections if glucose levels get out of control. Prevention or slowing down progression of the disease is possible by making lifestyle changes and treatment with western and alternative medicines, mentioned in a few books that cover autoimmune diseases
It’s a good thing you are monitoring your glucose levels. I’m doing the same.
Thanks for the info. I’ll keep checking my glucose and definitely get myself tested if it starts going out of control.
Cool.
By the way, here’s a list of problems/damage that even the so called “normal glucose levels” can cause http://www.phlaunt.com/diabetes/14045678.php
More reasons to stay away from starchy foods and to monitor glucose levels regularly.
Yup, I’ve read those summaries. Made a believer out of me.
I was catching up on your April Blogs and couldn’t help but laugh at this one- I’ve been trying to cut out as many obvious carbs as possible but yesterday was right out the window (and as I’m eating, I’m thinking how many carbs…)- white buns, chips, icecream cake. As I’m feeling incredibly horrible and can’t get to sleep at 3:30am this morning, and feel like a massive head cold is taking residence, all i can do is kick myself!
After seeing FatHead, I decided that my boys and I are going to experiment this summer checking blood sugar levels 1 hour after eating different things. (of course, using the urine strips since the boys freak out at any needle like objects- but will give a general idea.)
Off I go to get my Vitamin D…
Take a knockout dose of that vitamin D and feel better soon.
You know what’s silly? Using measuring units like ounces, feet, pounds, quarts, gallons etc. In Europe we use kilos, millilitres, litres, centilitres etc. which is much wiser (at least in my mind
)
But what’s even sillier is that in the USA you use blood sugar measurement devices that measure mg/dl (milligram/desilitre) while in Europe (at least Norway) we use something called mmol (millimole).
What kind of mole? I have a few moles on my body and a mole in my backyard, but this kind of mole… ???
It’s a strange world, isn’t it?
I agree that I don’t want any mole parts in my blood. When I was in grade school in the 1960s, we learned the metric system and were told the U.S. would be switching over to it by the time we were adults. Never happened, but I’m not sure why not.
Hmmm, the mole is part of the metric system (better called SI). Accorded, you have to be a chemist to appreciate that unit, but it is part of the metric system.
A mole is the quantity of a substance that contain the same number of molecules as 12 gram of carbon-12, or exactly 6.0221415×10^23 molecules.
http://en.wikipedia.org/wiki/Mole_%28unit%29
As long as it’s not a furry mole, I’m happy. I wish we’d gone metric in the U.S., which was the plan at one time. A base-10 system just makes more sense. Instead we’ve got 12 inches per foot, 5280 feet per mile, 32 liquid ounces per quart, 16 ounces per pound … not exactly stuff you want to multiply in your head.
Ha, it’s even one of the 7 base units of the SI units
http://en.wikipedia.org/wiki/SI_base_unit
Rats … I accidentally deleted a comment by Michael, about all the hubub over what is essentially a low-carb meal. No way to undelete that I can find. Michael, feel free to post it again and I’ll click more carefully.