I started following her because I loved her format but I noticed quickly that her whole YT channel is built to support the sale of her books. A lot of good information but again scaremongering as well.
Too much marketing.. It's not helping people but making money on problems .. the basic concept is valid but exaggerated ..with a lot of fear ..and mental strategy
It’s refreshing to see both of you together fighting for science. Both of you , I follow religiously and have learned a wealth of information which I now share with my followers . I have almost 10,000 members on a Facebook diabetic platform called life as a diabetic which I started 3 years ago. We only allow science based info and that’s it . Thank you to both of you ! God bless you both
The best part of this interview is refuting absolutes. Some forms of carbs are good, some glucose excursions are normal. That's a healthy way to think, and we should apply it to all aspects of our lives.
he nailed it at 58:00 - if you go only by your cgm, you’ll conclude that you should never eat any fruit, beans, whole grains, or other healthy plant foods. I tried a cgm out of curiosity as an otherwise metabolically healthy person, and I felt like I was being pushed to eat high fat/protein foods and a lot of meat instead of my usual diet of fruit, veggies, beans, etc.
Wonderful discussion. The maze of contradicting influencer “wisdom” just leads to more stress. The main goal is general health and fitness. Special diets and medication may play a role but the individual has a creative role to play to optimizing their own health, in partnership with medical professionals. Having cogent analyses such as what you two have offered here is very empowering.
I learn a lot from this fine doctor. As an airline pilot, I find it tough to keep on a consistent eating/sleeping regimen. Up all night(sometimes), multiple time zones, hotels without refrigerators, all add up to interfere with my program. A video for travelers, especially professional travelers would be of interest to me. Thank you!
Great interview! Thanks for inviting Mario Kratz, his channel is so good and he explains everything so clearly. Whole plant foods for the win! I am eating a high carb diet (mostly from whole foods) since my early childhood, and people wonder why I always stay lean, and assume I won the genetic lottery. But my personal anecdotal experience is backed by so much science. And then I see friends avoiding all carbs to lose weight, and the pounds just add up year after year. The low carb craze is really so strong, for so many decades.
As an endocrinologist inwould like to thank you for explaining these complex topics very effectively.... summary is....hyper insulinemia precedes all glycemic markers . this is the period where significant damage happens... many glucose spikes are not harmful to interpret in the light of cpeptide levels is better
Great interview! I have the same issue as the lady he talked about who got the shakes after eating oatmeal in the morning. If I eat eggs I don’t have that problem.
Fantastic video, thanks! With a CGM I learned that eating order for carbs and protein is key. I have smoothed out my spikes with reordering my food and exercising after. CGMs gave me definite answers on how my body works with different foods and taught me how to eat better. It got expensive after 6 months so I stopped using CGMs, but I have a lot of factual lessons learned.
Protein first. Unfortunately at restaurants they typically serve the yummy bread first, or chips and salsa. Eat your proteins first and it should reduce the spike by a lot. At least for me, it was very repeatable.
If you consume the protein first the overall max of your spike is cut in half. If I know that i will be eating something carby at a dinner I typically take a protein mix with water first. That definitely helps me. Instead of a 180+ spike it may be 140 or less. Again, for me anyway. That's the great part of a CGM even if its just for a few months. You can learn what works and what doesn't. Blueberries for example have a good GI rating, but they spike my sugars. Now, I mix in high protein yogurt with my breakfast cereal and I'm good. Oh, and before discovering the added protein trick. I would run around the block 15 minutes after eating my breakfast and that would also reduce the magnitude of the spike. The high protein yogurt worked great as the neighbors didn't have to wonder anymore why I did such a short run in the morning. Haha
Many thanks for putting this together and sharing Dr Carvalho. And a very big thank you to Dr Kratz for his input. I have a genetic predisposition to T2D. In Canada, doctors do not and will not prescribe a CGM until/unless you are diagnosed with T2D. My focus is on resistance training, cardio, and following food order eating as described by Dr Kratz. My last HBA1C was 5.3. While I eat healthy for the most part I still tend to have those days where I cave into junk food eating/binge The metrics that I keep a close eye on is my body composition. Specifically, my weight, lean mass, total bf%, subcutaneous fat % and visceral fat % ratio and how they change over time. Not surprisingly, I invariably notice when I do binge, the weight and correponding bf% increase manifests first and most as a visceral fat increase. The needle on subcutaneous fat % hardly if at all moves during those periods. For me that is a hint/red flag that I tend to more easily and first and foremost store fat visceral. That means I have a low personal fat threshold. All the reason I need to be extra cautious with any bf% increase to keep T2D, prediabetes, insulin resistance, and subsequent T2D at bay.
The constant fear mongering over glucose spikes never made sense to me. We understand that short term acute stress through resistence training is good for skeletal muscle. We understand that short term acute stress through cardio exercises is good for the heart and cardiovascular system. We understand that short term acute stress like learning a new language or musical instrument or new activity is good for brain health. But we're supposed to believe that the pancreas and endocrine system are supposed to lay constantly dormant and never activated? Why would it not follow the same hormetic effect of acute stress and adaptation benefits of every other organ? Use it or lose it, as the saying goes!
There is zero benefit to hyperglycemic / hypoglycemic roller coasters. Your pancreas is responding to virtually all foods, constantly being "used", but the relatively modern dietary element of processed simple carbs is something we simply aren't biologically equipped for.
@@DennisForbes but as we know the total amount of insulin is what matters. And overall calorie intake is the king here. We got research where participants ate 3 or 14 times per day. Same food, different portions. Total amount of insulin produced by pancreas was the same.
@@Trener_Artem - Fair point, though I'm not sure how it relates to my comment. Insulin production isn't really the contention here (in fact I was actually making the same point -- your pancreas is still producing largely the same amount of insulin, and is being "used" per the root comment), but rather its effectiveness on blood sugars is what matters. Foods and behaviours that lead to rapid ingestion of glucose (simple carbs in processed foods) yield a blood spike far quicker than the body is capable of reacting. Then when the wave of insulin finally comes in such a case it is too effective and pushes blood sugars below the norm (making us tired, and paradoxically hungry). Rinse and repeat. For whole foods and low GI foods (which include many carbohydrate rich foods like veggies and beans) as much insulin is used over the term of it, but moderated out and much more effective.
@@DennisForbesknow why he said use it or lose it? because in every study where low carb diet is tested. All participants lost the glucose challenge or performed worse than they did before joining the study
Been with you since the beginning. I am a vegan and your educated approach has helped be become a non-fanatical vegan. I still believe this is what works for me, but I also now acknowledge it may not work for everyone. It's nice to have someone sane in this borderline insane nutritional/diet part of youtube.
Wow the coincidence, I put on a CGM yesterday for fun because I got it for free and I saw quite high spikes, nice to see that its normal. This calmed me down a lot
There was a 41 year old male type 1 diabetic on CZcams who said when he eats steak his blood sugar doesn't change until four hours when it goes through the roof.
I used to be on low-ish carb diet. Even with around only 100 grams of carbs per day (i'm lean and active) my morning glucose still wasn't ideal. Not to mention i craved carbs all the time! The worst diet that's almost impossible to maintain long term. AND saturated fat intake was too high even if i didn't eat too many fatty animal foods nor coconut oil, and my LDL increased also. I stopped eating that idiotic diet and now eat all healthy foods/carbs.
We know spikes happen with carbs. But people with insulin resistance will have different types of both glucose and insulin spikes than those who are metabolically healthy. Thoughts on the Kraft Insulin Survey?
180 mg/dL, 10 mmol/L… But should not be at that level, or even at 140 or higher, two hours after eating. The confusion comes in to play of blood sugars up to 180 that occur well before two hours after a meal. Those are the “spikes” not to worry about
Below 180 mg/dL (10 mmol/L), but yes, at least at this time, we have no evidence linking spikes that peak below 180 mg/dL to negative health outcomes. Best, Mario
An interesting discussion. There are too many things to consider. Eg, a person who has porridge for breakfast, a cookie or two at 10am, a sandwich plus a big of chips and a sugar sweetened beverage for lunch, a banana mid afternoon then a big bowl of pasta for dinner. That is not at all an unusual pattern for a working person. You might then have 6 big spikes every day. This is a very different discussion to the occasional spike. This is why CGM can be helpful. Next is of course ‘time under the curve’. There is probably only A1C that accurately tells us. Is this relevant for T2D progression (and is the curve insulin or glucose - or both). Finally, there is lots of hypothesis that Insulin Resistance is simply adaptive rather than a pathology. Should we seek to ‘treat’ it or relieve the pressure by introducing less glucose. I heard that bears specifically become insulin resistant in response to fructose as it is the trigger that they need to overeat as much as possible to get ready for winter. One can make the same logical argument for Western Europeans. Fruit was only plentiful during a small period of the year and so absolutely get as much of it as you can inside you as soon it will be cold and dark for a few months.
I hear this argument about fruit, fructose, insulin and glucose often. However you are missing the fact that 1. In tropical countries fruit is present year round
@@marcdaniels9079 absolutely correct. This is why I explicitly said Western Europeans in my original response. Traditionally, Asians were smaller framed and carried less fat - perhaps because the adaptive response to fructose is blunted given that food would be plentiful year round. Certainly, there are many physiological differences across humans from different parts of the planet. Some of these I’m sure influenced by adaptation to the food environment (amongst other things). Sadly, of course, obesity is a rising problem in Asia now. Their food environment is getting very similar to ours. Supermarkets contain the same UPF, candy, sweetened drinks, seed oils as British ones (frequently the same brands) and diabetes and other ‘western’ diseases are climbing steeply.
@@marcdaniels9079 So what? Most people live nowhere near tropical countries. And their ancestors didn't either. This means that most humans are not and have never adapted to eat fruit other than seasonal fruit when they put on weight and fat to help survive winters.
A healthy plantbased diet doesn’t have to be low fat if you include nuts seeds avocado and olive oil. Eating fat and carbs together is a problem only in the case of ultraprocessed foods -not when what you are combining is whole foods like berries and nuts or slicing some avocado on your beans and rice.
The first time ive heard about the genetic fat storage differences! This seems to explain (at least partially) my pre-diabetic resultsabout 10 years ago. Im 5'1 and at that time about 110 lbs. Most of my life ive been under 100 lbs!. And, have a small frame. Now, at age 82, im back under 100 and normal blood sugar levels. And normal triglyceride also. I felt very overweight at 110 and, of course, no doctor ever said to loose weight! The challenge is gaining muscle! I do resistance training and am stronger than 10 years ago. Thank you for this very helpful information.
"The challenge is gaining muscle!" Yes, that is an important part of the equation. But without reducing or balancing your calorie intake, you will never reduce weight (e.g. one hour swimming! burns "only" 480 kcal)
As a dietitian I was taught that it's important to stop weight gain in children since they develop more fat cells leading them to have an easier time storing subcutaneous fat (and that being a bad thing). I just realized that it might be a misstake since more cells specialized for storing fat subcutaneously could lead to less tendency to store fat vicerally. Are there any studies looking at people who are overweight, obese, normal weight or under weight at an early age comparing their tendency to store fat vicerally after ouberty at any given body fat percentage??
On Pre-Pre-Diabetes, Look to the World Health Organization which says "The expected values for normal fasting blood glucose concentration are between 70 mg/dL (3.9 mmol/L) and 100 mg/dL (5.6 mmol/L). When fasting blood glucose is between 100 to 125 mg/dL (5.6 to 6.9 mmol/L) changes in lifestyle and monitoring glycemia are recommended." 100mg/dl fasting equates to an A1c of 5.1!
Prior to going vegan for ethical reasons in 2011 I was developing visceral fat like my father and his father and so on. I can only imagine I would have some semblance of a chronic disease by now had I not changed my ways. All I did was stop eating animals and the visceral fat effortlessly vanished. As a result I returned to the same weight I had in my late teens, early twenties and have maintained it perfectly since going vegan. Now if in the rare event I do gain excess weight it's just subcutaneous, a little on the love handles instead of firm in the front. But I haven't had that for a long time now, maybe once for a stint before I started editing with a stand-up desk and taking the time to prepare whole vegan foods better on my own. But I totally went vegan for ethical reasons, upon watching Gary Yourofsky's "Best Speech...". I guess I was fortunate because I already was use to eating legumes, greens, grains, fruits, veggies, mushrooms, nuts and seeds. I just wasn't very good in the kitchen until recently. So I was kind of on the lazy/ processed and junk food side and improved my health health. On top of excess weight loss blood work improved as well, e.g. my total cholesterol dropping from 168 in late 2010 pre-vegan to 121 five years later of being vegan. Plus I don't get sick anymore. I was getting sick twice a year pre-vegan. Now I think I might have only been sick once or twice in almost 14 years, so mild and so long ago I don't even recall. Yet I can vividly recall being so sick so frequently and so bad pre-vegan with a biannual sore throat, relentlessly runny nose, then not being able to sleep with a stopped up nose, getting to the point where I was wheezing when I was sick which is why they took my blood work before I went vegan. I didn't need my blood work again for 5 years and that was just to save money on forced insurance through Obamacare... There's just so many benefits to being vegan and doing it right. Once you care enough about doing what's morally right everything just comes together in the most beautiful, healthy and quintessentially ethical ways.
Maybe you would have chronic disease or maybe not - the point is nobody knows and your n=1 vegan conversion is not science. A lot of your claimed health improvements could be the result of losing weight and eating more healthy food and not ultra-processed. I do wonder when I read a food tribe comment saying I don’t get sick anymore… I have seen these claims by Carnivore , Low carb, Keto, Paleo etc etc. Great that you are healthy and happy. Peace ✌️
As someone who has eaten low carb for years and has measured my glucose many times per day at times in self-experimentation, I’ve found it helpful to see how different foods affect my glucose levels. I think a CGM might drive me crazy though. I care more about large trends over time.
@@davidflorez1196sure! Probably easier than doing it “manually” like I’ve done. But I think this video is intended to address people who may wear them longer and who tend to obsess too much on a single variable.
@@RoScoHutch I don't think there's much people that are obsessed monitoring their glucose levels, I personally wear one CGM at the beginning of the year and it was enough for me to look my response to some foods. I actually think more people should start using them to prevent, just for 14 days, since the majority of people doesn't seem to care much about their metabolic health. In this channel of course there will be more people that is concern about that but that's not the general population
@@davidflorez1196 I don’t disagree about it being good for more people to understand their blood glucose, but I think people could get the gist of what they need from a regular glucose test kit. And for people like me who tend to obsess about numbers like this (not making any statements about the general population), that might even be better….less worrying about the minutiae, less expensive, etc.
@@davidflorez1196 "I actually think more people should start using them [continuous glucose monitors] ..." Why? It's possible that most/many people would be drawn to unhealthy "solutions" to their glucose spikes. Perhaps it's good overall but for most people focusing on simpler things (like following a healthy dietary pattern like Harvard's Healthy Eating Plate) would be more beneficial. ... I don't know what's good for the average/most/many persons to do (because we don't have resp. I'm not aware of data how people act having that information). There are anecdotes (Drew Harrisberg talked about his story and similar stories of clients, ...) of negative health outcomes. I'm waiting for data on how people act.
Luckily, I was just prediabetic. I’m going to take blood tests soon, so I hope the numbers have changed. I’ve changed my diet drastically to be healthier and I’ve lost 20lbs. I eat carbs, but I try to keep that low (100-130g per day), it’s not keto low, but I wouldn’t do that unless I had to. I am not afraid of fat and I eat a lot of protein and veggies. I don’t eat sugar or fruit, unless it’s veggie fruit. I eat less than 30g of sugar everyday. Hopefully, my cholesterol goes down. If I have to change my diet more then I will.
Insulin always spikes after a meal, mostly depending on the absorption rate of macronutrients, carbohydrates absorb the fastest protein after, and fats the slowest, and therefore, if you eat a lean protein, Insulin will spike without having carbohydrates in the meal.. fiber is the only thing that can slow down the absorption rate, and therefore, insulin secretion
You can estimate your level of insulin resistance by measuring your fasting gluose and insulin levels, and calculating a biomarker of insulin resistance called HOMA-IR. On my channel, I have a video on how to do it and interpret the results. This is helpful because if someone is insulin resistant, they will secrete a lot more insulin than someone who is insulin sensitive, and I agree that long-term insulin resistance and hyperinsulinemia are not ideal. Best, Mario
Gil always deep dives into topics, so much great info. I've seen other videos discussing Glucose/Insulin and that short term spikes are fine and how it's all about chronic elevations. But how do you get to chronic elevation? Is it not from a string of short term spikes? Is it only when someone gains too much weight and is too inactive that the spikes do damage and begin to become chronic? So if an individual is at ideal weight, diet, muscle mass, cardio fitness, blood lipid and A1C levels, etc., except that they might have a few fresh baked cookies every day to the tune of 30-50 grams of sugar at some point in the day, so long as their insulin response is optimal then no damage is being done to the body? Or another person with that same profile, except they have moderate amounts of heart disease/plaque (but is on a statin), so long as they too have an optimal insulin response, then no damage is being done? When people say stay away from refined sugars, is that only if youre over weight, inactive, and with low muscle mass and low cardio fitness?
Subcutaneous fat seems protective, and probably why females seem to do better health wise. As long as the Subcutaneous fat tank has enough space to absorb. How to increase the Subcutaneous fat tank is the most important, it seems. Autophagy seems to decrease the tank and appears to be bad. Losing some fat whilst keeping all the fat cells in the tank and gaining some muscle, seems like a win win win.
My understanding is frequent flyers have a higher risk of DVT. I’m curious if certain foods would be more beneficial in preventing DVT events. For us who travel a lot, maybe consideration should be given to taking a baby aspirin prior to a flight?
celiac, hashimoto and I wore a cgm just out of curiosity. I don’t eat processed food or added sugar or alcohol (at all) and no gf pasta or bread, only whole food, whole cereals/grain/veg/legumes, fish and rarely meat. My glucose goes up 30 min after eating and come down within 2 hours. With carbs (like rice) the glucose goes up to 180 (depending on how much fat/protein goes with it) and it comes back quickly to normal. “the second meal effect” works as described by Dr Kartz. Fasting (16+ hours) and then eating carbs have been spling my glucose up more than the same meal with priming to carbs. Caffeine enhance any spike. I am looking out at pattern for now and I have never spiked above 180 even when eating to much dry fruit like figs, dates and such. At this point I think this is how my body reacts to carbs. all these attention to glucose, keeping in mind the deal is about insulin.. so it is not a direct measure for now but pretty interesting. interesting also that just moving around after a meal reduces “spikes” by a lot. gcm at night, if pressed against the mattress, will show false readings (below normal) and that is a limitation of the device. I can vouche also that I had one bad device that was not close to the 20% accuracy tolerance that was claimed for the device
I start the day by drinking a cup of water mixed with my personal fiber blend. This blend includes a large percentage of resistant starch as well as psyllium, ground flax and chia, and many other ingredients which I'm hoping will attenuate my blood sugar spikes.
Great video. I'm struggling with this currently. High-side fasting glucose and 6 A1c. Two weeks whole food plant based. I won't get into it all, but have about a cup of lentils a day. Lots of veggies, no sugars (whites). Still get spikes. Earlier this week I subbed out the beans for 3-4 ounces of animal protein and my fasting glucose went to 80 after 3 days. I've cut calories to 1,500/day too. Losing weight currently but I'd rather NOT have animal protein and be in ketosis. Not sure if I should ride out the ketosis for a month then slowly go back to lentils and cut out the animal protein. I only have a cup a day of lentils so I'm not over doing it. I'm a little confused. I also do the ACV before meals and now walk after meals.
Diet and nutrition expert Jesse Inchauspe, says that preceding a high glycemic index meal with protein, fat and some vinegar - MITIGATES the sugar spike.
One thing that appears to be confusing relates to fasting glucose and fasting insulin. I have read that in the morning (as a person wakes) the body naturally increases the glucose level in the blood (presumably to cater for the energy requirement of waking and physical movement). Hence , if fasting blood samples are taken first thing in the morning is the glucose level likely to be higher than samples taken late in the day after fasting all day for say 12 hrs? I would guess that most people (,myself included) get these fasting bloods taken in the morning because overnight fasting is convenient and relatively easy also the blood collection centres open around 8 am. Taking samples at the end of the day would be more difficult as the collection centres close relatively earlier , say 4 to 5 pm. hence you would have to have your last meal at 4 or 5 am to get in a 12 hr fast. I recently used a CGM and got the impression that fasting early morning glucose levels tend be high (around 6 mmol for me ) whereas I have seen levels in the afternoon in the low fives even without fasting. I have had an OGTT which came back in the normal range but the lab results of blood draws at 8am are almost always 6 or 6.1 mmol. Could the simple timing of fasting blood draws cause significant differences in glucose levels?? Very Interested in your comments. Thanks for your informative video.
Pleased that reactive hypoglycaemia was briefly mentioned. I often get hypoglycaemic episodes a couple of hours after eating after exercise (running). I've tried eating more complex carbs along with fat and protein without much improvement. Does anyone else have suggestions to avoid my blood glucose plummeting?
Hello. I just found you channel and watched already a few videos. Your videos are great and I think and hope they can help me to research and read studys by myself. I just have no confidence and I believe I'm not smart enough to do so :( Can I maybe ask you some question? (Sorry for my english, it isn't my native language)
Hi Gil! I’m sure you’ve heard of the book “Glucose Revolution” , written by the French author and biochemist, Jessie Inschaupé. She also has a very popular youtube channel - The Glucose Goddess. It would be awesome to hear your review of her writings, recommendations and methods!
So much of the discussion is about peak glucose levels "good or bad?" But what about the shape and timing of the glucose response curve and the area under the curve during the post prandial response cycle? Isn't that likely to also be an important factor in determining a prediabetic condition? I realize A1C is sort of that over a long period of time. But it would seem important to dig into the science of response frequency and areas under these curves within the immediate post prandial cycle vs various foods. Also, for the lag the CGM experiences, is there a rule of thumb correction factor that can be applied to the data afterwards to display a closer approximation of what actual serum glucose levels were vs time?
Very interesting talk. Going to send it to everyone. About the gap in research around what causes higher disease risk in people with diabetes, I think it's it's both the elevated blood sugar and the underlying factors driving insulin that are driving it. I base this on what we know of the injuries the blood sugar causes for diabetics with poor sugar control on the nerves and capillaries of the whole body. And the other part I base on the research indicating that people with DM2 that have good blood sugar control still have an increased risk of heart disease compared to healthy controls. (Not a big difference in risk but statistically significant) the big question in my mind is how big effect do they have by themselves? We are pretty sure that viceral fat is a driver of disease in an of itself, right? But is blood sugar spikes really a driver for disease for a person with low amount of fat in and around their organs?
so i’m little confused, don’t you determine whether you’re diabetic or not from the result of a1c blood test and not from the daily blood tests? i only use my daily blood test to control my dietary intake
My wife is Type 1 Diabetic and we're Canadian. I'm just in the first 6 minutes but I keep having to convert mg/dL to mmol/L...Why does the US always have to be "special" with units of measurement?
@@drott150I never said it wasn’t metric. Just annoyed that we can’t agree on which units to use. I almost always see mmol/L on PubMed, which is the focus of this channel.
There is no single definition of what low-carb means. Generall, under 20% of total calories can be considered low-carb. For a women eating 2,000 kcal per day, that would be equivalent to 100 g of carbs per day. For a man eating 3,000 kcal per day, it's more like 150 g per day. However, most people following low-carb diets probably eat less than half of these amounts. Cheers Mario
While people shouldn't sweat acute spikes too much, almost every single action you can take to avoid those spikes has *enormous* proven benefits. Avoid simple carbs and ultra-processed foods. Be active. Layer foods. Even if you're willing to completely ignore glucose spikes, all of these lifestyle choices can only possibly be beneficial. It's also a bit weird how this video strawmans a bit in the seeming assumption that avoiding glucose spikes requires a low carb diet (e.g. the example of eating salami instead of beans). Beans do not lead to appreciable glucose spikes. Nor do basically any whole vegetables. Nor do most whole fruits. Someone actively avoiding insulin spikes can be eating a high carb diet and still fully achieve that goal. Even ice cream doesn't lead to much of a glucose spike.
I think you're already looking at it with knowledge beyond the average person. You're bounding it in reasonable actions (see _@FreeFromAllThings'_ responses). You're bounding it in taking it not too far (beans vs. salami) and taking other measures into account. I've heard intelligent people (Drew Harrisberg - who mentioned he heard multiple such stories from clients) obsess over glucose curves and ending up with problems even in that metric. Very analogous to people fixated on (current) weight turning to "solutions" that are unhealthy and sometimes even counterproductive for their weight long-term.
Could you please comment on this new study? Thank you. "Millions of U.S. adults should no longer take cholesterol-lowering drugs under updated guidelines released by the American Heart Association (AHA) late last year, research indicates".
Is there any evidence that those who really go all the way in preventing sugar spikes that they could be harming their pancreas? Like, in those that go on truly fat free diets, I have heard the gallbladder can become congested with stagnant bile which may cause or exacerbate stone formation and other issues. If the pancreas is "sheltered" in a similar fashion from occasional glucose spikes, are there potential long-term risks associated with this scenario? {and I don't mean stone growth, but whatever the pancreatic analog may be for "stagnant insulin"}.
I hope he answers this sometime. If the pancreas adapts to low carb by producing low insulin, can the pancreas lose its ability to make enough insulin in the future. Most advice hovers around lowering insulin.
When we eat a low-carb diet, the pancreas keeps less pre-made insulin in storage, and that lowers the amount of insulin that can be secreted in the so-called first-phase insulin response. That is thought to be transient, however, and once peope start eating carbs again, a normal first-phase insulin response can be recovered within a few weeks. What this suggestions, however, is that it is not wise to eat high-carb meals occasionally when generally doing low-carb. Cheers Mario
Food swaps are okay to address high excursions, but as they say later in the video, exercise is even better. Shoiuld have been much earlier in the video!
- Mario says there's no clinical range definition of a glucose spike. i'm like, wut? surely there are ranges that are excessive. 8:22 he just said that a healthy young adult never has glucose spikes above 170-180 mg/dL. he goes on to say iiuc that blood glucose levels should never reach 180 mg/dL. 9:48 Gil just said iiuc that common tests for diabetes diagnosis are (1) fasting glucose and (2) glucose 2 hours after a meal. he goes on to say that normally there's a glucose spike 20-30 minutes after a meal, then the body should resolve it, and by 2 hours the levels should be much lower (in a healthy individual). 11:13 watched until here.
What we say is that it’s normal for blood sugar to rise after a meal, and that’s Ok as long as the peak doesn’t reach 180 mg/dL and is back to around baseline by two hours.
Can someone please answer this one big question!!! I eat fruits, meat, honey, some butter. I can eat honey and have a glucose spike to 200 within a hour, then jts headed back down. Same with some fruits and stuff. My a1c is normal and my fasting glucose has been around 105-110 for almost 10 years. My fasting insulin is usually always around 3 something. Since my fasting insulin is good, should I worry about them spikes? I mean maybe i just spike higher then normal, but my fasting insulin is always good 🤷♂️
Both of you are national treasures, but you have to up your design and branding. Science has to be sexier to connect with a wider audience (the edits, background, and general look and feel) Im sure it’s easier said than done, but it’s a disservice to your amazing work. Really enjoyed the podcast. Thanks!
What a combo! My two favourite, fair, unbiased experts coming together. Thanks so much. 😊
An immediate thumbs up for having Mario Kratz!! The two people I trust the most, when it comes to understanding the science, in one place!
First the physionic video, now this! What a treat! ❤
Someone should send this masterclass to glucosegoddess. She's been building a whole career by scaring people with glucose spikes misinformation.
I started following her because I loved her format but I noticed quickly that her whole YT channel is built to support the sale of her books. A lot of good information but again scaremongering as well.
Too much marketing.. It's not helping people but making money on problems .. the basic concept is valid but exaggerated ..with a lot of fear ..and mental strategy
It’s refreshing to see both of you together fighting for science. Both of you , I follow religiously and have learned a wealth of information which I now share with my followers . I have almost 10,000 members on a Facebook diabetic platform called life as a diabetic which I started 3 years ago. We only allow science based info and that’s it . Thank you to both of you ! God bless you both
That's great to hear. Thank you for sharing evidence-based information in your group.
Cheers
Mario
The best part of this interview is refuting absolutes. Some forms of carbs are good, some glucose excursions are normal. That's a healthy way to think, and we should apply it to all aspects of our lives.
he nailed it at 58:00 - if you go only by your cgm, you’ll conclude that you should never eat any fruit, beans, whole grains, or other healthy plant foods. I tried a cgm out of curiosity as an otherwise metabolically healthy person, and I felt like I was being pushed to eat high fat/protein foods and a lot of meat instead of my usual diet of fruit, veggies, beans, etc.
My two favorite scientist nutritionists.... Let's go 😱
Came to say same!
Wonderful discussion. The maze of contradicting influencer “wisdom” just leads to more stress. The main goal is general health and fitness. Special diets and medication may play a role but the individual has a creative role to play to optimizing their own health, in partnership with medical professionals. Having cogent analyses such as what you two have offered here is very empowering.
I learn a lot from this fine doctor. As an airline pilot, I find it tough to keep on a consistent eating/sleeping regimen. Up all night(sometimes), multiple time zones, hotels without refrigerators, all add up to interfere with my program. A video for travelers, especially professional travelers would be of interest to me. Thank you!
Thank you for bringing Mario Kratz to this conversation. I never knew if him before. Very informative.
Awesome balanced discussion.
excellent information. It has shown me that I have probably been wasting a lot of time probably for not a good reason.
Great interview! Thanks for inviting Mario Kratz, his channel is so good and he explains everything so clearly. Whole plant foods for the win! I am eating a high carb diet (mostly from whole foods) since my early childhood, and people wonder why I always stay lean, and assume I won the genetic lottery. But my personal anecdotal experience is backed by so much science. And then I see friends avoiding all carbs to lose weight, and the pounds just add up year after year. The low carb craze is really so strong, for so many decades.
Good conversation by two people interested in fact-based information. Great, a must-listen for all who are interested in the subject.
As an endocrinologist inwould like to thank you for explaining these complex topics very effectively....
summary is....hyper insulinemia precedes all glycemic markers .
this is the period where significant damage happens...
many glucose spikes are not harmful
to interpret in the light of cpeptide levels is better
So with out of normal cpeptide along with Homa IR? Better at determining risk of developing metabolic syndrome?
Homa ir is the best marker
Great interview! I have the same issue as the lady he talked about who got the shakes after eating oatmeal in the morning. If I eat eggs I don’t have that problem.
Two of my favorite scientists in a long video chock full of clear analysis and information.
This is a great and timely video. Thank you.
A really exceptional exposition on this complex topic - thank you, Gil and Mario!
OMG! I love Mario’s channel. It’s helped me so much.
Fantastic video, thanks!
With a CGM I learned that eating order for carbs and protein is key. I have smoothed out my spikes with reordering my food and exercising after. CGMs gave me definite answers on how my body works with different foods and taught me how to eat better. It got expensive after 6 months so I stopped using CGMs, but I have a lot of factual lessons learned.
Okay but why is a smoother glucose curve better?
What is the correct eating order?
Protein first. Unfortunately at restaurants they typically serve the yummy bread first, or chips and salsa. Eat your proteins first and it should reduce the spike by a lot. At least for me, it was very repeatable.
If you consume the protein first the overall max of your spike is cut in half. If I know that i will be eating something carby at a dinner I typically take a protein mix with water first. That definitely helps me. Instead of a 180+ spike it may be 140 or less. Again, for me anyway. That's the great part of a CGM even if its just for a few months. You can learn what works and what doesn't. Blueberries for example have a good GI rating, but they spike my sugars. Now, I mix in high protein yogurt with my breakfast cereal and I'm good. Oh, and before discovering the added protein trick. I would run around the block 15 minutes after eating my breakfast and that would also reduce the magnitude of the spike. The high protein yogurt worked great as the neighbors didn't have to wonder anymore why I did such a short run in the morning. Haha
@@michaelvadney5803 Interesting. Thanks for replying.
Many thanks for putting this together and sharing Dr Carvalho. And a very big thank you to Dr Kratz for his input. I have a genetic predisposition to T2D. In Canada, doctors do not and will not prescribe a CGM until/unless you are diagnosed with T2D. My focus is on resistance training, cardio, and following food order eating as described by Dr Kratz. My last HBA1C was 5.3. While I eat healthy for the most part I still tend to have those days where I cave into junk food eating/binge The metrics that I keep a close eye on is my body composition. Specifically, my weight, lean mass, total bf%, subcutaneous fat % and visceral fat % ratio and how they change over time. Not surprisingly, I invariably notice when I do binge, the weight and correponding bf% increase manifests first and most as a visceral fat increase. The needle on subcutaneous fat % hardly if at all moves during those periods. For me that is a hint/red flag that I tend to more easily and first and foremost store fat visceral. That means I have a low personal fat threshold. All the reason I need to be extra cautious with any bf% increase to keep T2D, prediabetes, insulin resistance, and subsequent T2D at bay.
The constant fear mongering over glucose spikes never made sense to me. We understand that short term acute stress through resistence training is good for skeletal muscle. We understand that short term acute stress through cardio exercises is good for the heart and cardiovascular system. We understand that short term acute stress like learning a new language or musical instrument or new activity is good for brain health. But we're supposed to believe that the pancreas and endocrine system are supposed to lay constantly dormant and never activated? Why would it not follow the same hormetic effect of acute stress and adaptation benefits of every other organ? Use it or lose it, as the saying goes!
There is zero benefit to hyperglycemic / hypoglycemic roller coasters. Your pancreas is responding to virtually all foods, constantly being "used", but the relatively modern dietary element of processed simple carbs is something we simply aren't biologically equipped for.
@@DennisForbes but as we know the total amount of insulin is what matters. And overall calorie intake is the king here. We got research where participants ate 3 or 14 times per day. Same food, different portions. Total amount of insulin produced by pancreas was the same.
@@Trener_Artem - Fair point, though I'm not sure how it relates to my comment. Insulin production isn't really the contention here (in fact I was actually making the same point -- your pancreas is still producing largely the same amount of insulin, and is being "used" per the root comment), but rather its effectiveness on blood sugars is what matters. Foods and behaviours that lead to rapid ingestion of glucose (simple carbs in processed foods) yield a blood spike far quicker than the body is capable of reacting. Then when the wave of insulin finally comes in such a case it is too effective and pushes blood sugars below the norm (making us tired, and paradoxically hungry). Rinse and repeat.
For whole foods and low GI foods (which include many carbohydrate rich foods like veggies and beans) as much insulin is used over the term of it, but moderated out and much more effective.
@@Trener_Artem what study by chance? Name of it to search?
@@DennisForbesknow why he said use it or lose it? because in every study where low carb diet is tested. All participants lost the glucose challenge or performed worse than they did before joining the study
VERY GOOD VIDEO. MANY MYTHS DIMiSTIFIED. Kudos
Been with you since the beginning. I am a vegan and your educated approach has helped be become a non-fanatical vegan. I still believe this is what works for me, but I also now acknowledge it may not work for everyone. It's nice to have someone sane in this borderline insane nutritional/diet part of youtube.
Thank you Drs. Carvalho and Kratz. 🙏
Thanks guys for sharing your valued experience and observations regarding this topic!
Thank you for the vidéo and the fact that I discovereda new non biased YT channel!
Wow the coincidence, I put on a CGM yesterday for fun because I got it for free and I saw quite high spikes, nice to see that its normal. This calmed me down a lot
I guess you are not prediabetic? How high were your spikes? What’s your average numbers?
Happy Monday both my favourites😊
There was a 41 year old male type 1 diabetic on CZcams who said when he eats steak his blood sugar doesn't change until four hours when it goes through the roof.
Thank you for this video 🙏
My 2 favorites! Can’t wait to watch.
Great video but not the best to watch after I've just been out for a bonding gelato with my daughter! Still worth it for the social/mental benefits 😊
I used to be on low-ish carb diet. Even with around only 100 grams of carbs per day (i'm lean and active) my morning glucose still wasn't ideal. Not to mention i craved carbs all the time! The worst diet that's almost impossible to maintain long term. AND saturated fat intake was too high even if i didn't eat too many fatty animal foods nor coconut oil, and my LDL increased also. I stopped eating that idiotic diet and now eat all healthy foods/carbs.
Love the deep dives thank u!!❤️
We know spikes happen with carbs. But people with insulin resistance will have different types of both glucose and insulin spikes than those who are metabolically healthy. Thoughts on the Kraft Insulin Survey?
Thank you! I'm binging on your videos.
What a great session! Learned so much about what CGMs do and don’t tell us… wow! Thank you!
I think this video just convinced an enormous amount of people that glucose spikes below 190 mg/dl are nothing to worry about.
180 mg/dL, 10 mmol/L… But should not be at that level, or even at 140 or higher, two hours after eating. The confusion comes in to play of blood sugars up to 180 that occur well before two hours after a meal. Those are the “spikes” not to worry about
Below 180 mg/dL (10 mmol/L), but yes, at least at this time, we have no evidence linking spikes that peak below 180 mg/dL to negative health outcomes.
Best,
Mario
@@Caladcholgcan you clarify what you mean?
An interesting discussion. There are too many things to consider. Eg, a person who has porridge for breakfast, a cookie or two at 10am, a sandwich plus a big of chips and a sugar sweetened beverage for lunch, a banana mid afternoon then a big bowl of pasta for dinner. That is not at all an unusual pattern for a working person. You might then have 6 big spikes every day. This is a very different discussion to the occasional spike. This is why CGM can be helpful.
Next is of course ‘time under the curve’. There is probably only A1C that accurately tells us. Is this relevant for T2D progression (and is the curve insulin or glucose - or both).
Finally, there is lots of hypothesis that Insulin Resistance is simply adaptive rather than a pathology. Should we seek to ‘treat’ it or relieve the pressure by introducing less glucose. I heard that bears specifically become insulin resistant in response to fructose as it is the trigger that they need to overeat as much as possible to get ready for winter. One can make the same logical argument for Western Europeans. Fruit was only plentiful during a small period of the year and so absolutely get as much of it as you can inside you as soon it will be cold and dark for a few months.
Too much fruit , especially on top of high-fructose corn syrup (found in much highly processed food), can lead to fatty liver.
I hear this argument about fruit, fructose, insulin and glucose often. However you are missing the fact that
1. In tropical countries fruit is present year round
@@marcdaniels9079 absolutely correct. This is why I explicitly said Western Europeans in my original response. Traditionally, Asians were smaller framed and carried less fat - perhaps because the adaptive response to fructose is blunted given that food would be plentiful year round. Certainly, there are many physiological differences across humans from different parts of the planet. Some of these I’m sure influenced by adaptation to the food environment (amongst other things).
Sadly, of course, obesity is a rising problem in Asia now. Their food environment is getting very similar to ours. Supermarkets contain the same UPF, candy, sweetened drinks, seed oils as British ones (frequently the same brands) and diabetes and other ‘western’ diseases are climbing steeply.
@@marcdaniels9079 So what? Most people live nowhere near tropical countries. And their ancestors didn't either. This means that most humans are not and have never adapted to eat fruit other than seasonal fruit when they put on weight and fat to help survive winters.
A healthy plantbased diet doesn’t have to be low fat if you include nuts seeds avocado and olive oil. Eating fat and carbs together is a problem only in the case of ultraprocessed foods -not when what you are combining is whole foods like berries and nuts or slicing some avocado on your beans and rice.
Yes, absolutely.
one of your best shows Doc
The first time ive heard about the genetic fat storage differences! This seems to explain (at least partially) my pre-diabetic resultsabout 10 years ago. Im 5'1 and at that time about 110 lbs. Most of my life ive been under 100 lbs!. And, have a small frame.
Now, at age 82, im back under 100 and normal blood sugar levels. And normal triglyceride also. I felt very overweight at 110 and, of course, no doctor ever said to loose weight! The challenge is gaining muscle! I do resistance training and am stronger than 10 years ago.
Thank you for this very helpful information.
"The challenge is gaining muscle!"
Yes, that is an important part of the equation. But without reducing or balancing your calorie intake, you will never reduce weight (e.g. one hour swimming! burns "only" 480 kcal)
Wow what a great video. It took me a while to get through it but I really am the level of nuance in your analysis!
Excellent. This clarified and integrated a lot of topics I kinda thought I understood before but now I have a much clearer grasp. Thank you.
As a dietitian I was taught that it's important to stop weight gain in children since they develop more fat cells leading them to have an easier time storing subcutaneous fat (and that being a bad thing). I just realized that it might be a misstake since more cells specialized for storing fat subcutaneously could lead to less tendency to store fat vicerally. Are there any studies looking at people who are overweight, obese, normal weight or under weight at an early age comparing their tendency to store fat vicerally after ouberty at any given body fat percentage??
Christmas? Again?
Thank you Gil!
On Pre-Pre-Diabetes, Look to the World Health Organization which says "The expected values for normal fasting blood glucose concentration are between 70 mg/dL (3.9 mmol/L) and 100 mg/dL (5.6 mmol/L). When fasting blood glucose is between 100 to 125 mg/dL (5.6 to 6.9 mmol/L) changes in lifestyle and monitoring glycemia are recommended."
100mg/dl fasting equates to an A1c of 5.1!
A very informative video. Thank you
Great video, I would like to see you two collab again in the future😊
Amazing interview! You should upload these longer episodes on spotify as a podcast, would make it easier to listen to.
Why? It works for me. Maybe you meant "you should also upload...".
Prior to going vegan for ethical reasons in 2011 I was developing visceral fat like my father and his father and so on. I can only imagine I would have some semblance of a chronic disease by now had I not changed my ways. All I did was stop eating animals and the visceral fat effortlessly vanished. As a result I returned to the same weight I had in my late teens, early twenties and have maintained it perfectly since going vegan. Now if in the rare event I do gain excess weight it's just subcutaneous, a little on the love handles instead of firm in the front. But I haven't had that for a long time now, maybe once for a stint before I started editing with a stand-up desk and taking the time to prepare whole vegan foods better on my own.
But I totally went vegan for ethical reasons, upon watching Gary Yourofsky's "Best Speech...". I guess I was fortunate because I already was use to eating legumes, greens, grains, fruits, veggies, mushrooms, nuts and seeds. I just wasn't very good in the kitchen until recently. So I was kind of on the lazy/ processed and junk food side and improved my health health. On top of excess weight loss blood work improved as well, e.g. my total cholesterol dropping from 168 in late 2010 pre-vegan to 121 five years later of being vegan.
Plus I don't get sick anymore. I was getting sick twice a year pre-vegan. Now I think I might have only been sick once or twice in almost 14 years, so mild and so long ago I don't even recall. Yet I can vividly recall being so sick so frequently and so bad pre-vegan with a biannual sore throat, relentlessly runny nose, then not being able to sleep with a stopped up nose, getting to the point where I was wheezing when I was sick which is why they took my blood work before I went vegan. I didn't need my blood work again for 5 years and that was just to save money on forced insurance through Obamacare...
There's just so many benefits to being vegan and doing it right. Once you care enough about doing what's morally right everything just comes together in the most beautiful, healthy and quintessentially ethical ways.
Maybe you would have chronic disease or maybe not - the point is nobody knows and your n=1 vegan conversion is not science. A lot of your claimed health improvements could be the result of losing weight and eating more healthy food and not ultra-processed. I do wonder when I read a food tribe comment saying I don’t get sick anymore… I have seen these claims by Carnivore , Low carb, Keto, Paleo etc etc.
Great that you are healthy and happy. Peace ✌️
yay! these two guys!❤
Excellent episode, thank you!
Excellent stuff! I need to go back and finish watching Physionics recent video about glucose spikes now...
extremely informative; this context is missing from basically all other dialogue on this subject. thank you 🙏
Great discussion. Thank you both very much
As someone who has eaten low carb for years and has measured my glucose many times per day at times in self-experimentation, I’ve found it helpful to see how different foods affect my glucose levels. I think a CGM might drive me crazy though. I care more about large trends over time.
But you only have to wear it for 14 days one time when you test some the response to your common meals, no?
@@davidflorez1196sure! Probably easier than doing it “manually” like I’ve done. But I think this video is intended to address people who may wear them longer and who tend to obsess too much on a single variable.
@@RoScoHutch I don't think there's much people that are obsessed monitoring their glucose levels, I personally wear one CGM at the beginning of the year and it was enough for me to look my response to some foods. I actually think more people should start using them to prevent, just for 14 days, since the majority of people doesn't seem to care much about their metabolic health.
In this channel of course there will be more people that is concern about that but that's not the general population
@@davidflorez1196 I don’t disagree about it being good for more people to understand their blood glucose, but I think people could get the gist of what they need from a regular glucose test kit. And for people like me who tend to obsess about numbers like this (not making any statements about the general population), that might even be better….less worrying about the minutiae, less expensive, etc.
@@davidflorez1196
"I actually think more people should start using them [continuous glucose monitors] ..."
Why?
It's possible that most/many people would be drawn to unhealthy "solutions" to their glucose spikes.
Perhaps it's good overall but for most people focusing on simpler things (like following a healthy dietary pattern like Harvard's Healthy Eating Plate) would be more beneficial.
...
I don't know what's good for the average/most/many persons to do (because we don't have resp. I'm not aware of data how people act having that information).
There are anecdotes (Drew Harrisberg talked about his story and similar stories of clients, ...) of negative health outcomes.
I'm waiting for data on how people act.
Luckily, I was just prediabetic. I’m going to take blood tests soon, so I hope the numbers have changed. I’ve changed my diet drastically to be healthier and I’ve lost 20lbs. I eat carbs, but I try to keep that low (100-130g per day), it’s not keto low, but I wouldn’t do that unless I had to. I am not afraid of fat and I eat a lot of protein and veggies. I don’t eat sugar or fruit, unless it’s veggie fruit. I eat less than 30g of sugar everyday. Hopefully, my cholesterol goes down. If I have to change my diet more then I will.
I'm so much more concerned about insulin spikes. Is there a way to test for that?
Insulin always spikes after a meal, mostly depending on the absorption rate of macronutrients, carbohydrates absorb the fastest protein after, and fats the slowest, and therefore, if you eat a lean protein, Insulin will spike without having carbohydrates in the meal.. fiber is the only thing that can slow down the absorption rate, and therefore, insulin secretion
You can estimate your level of insulin resistance by measuring your fasting gluose and insulin levels, and calculating a biomarker of insulin resistance called HOMA-IR. On my channel, I have a video on how to do it and interpret the results.
This is helpful because if someone is insulin resistant, they will secrete a lot more insulin than someone who is insulin sensitive, and I agree that long-term insulin resistance and hyperinsulinemia are not ideal.
Best,
Mario
Would be awesome if you included these in Spotify or Apple Music.
Gil always deep dives into topics, so much great info. I've seen other videos discussing Glucose/Insulin and that short term spikes are fine and how it's all about chronic elevations. But how do you get to chronic elevation? Is it not from a string of short term spikes? Is it only when someone gains too much weight and is too inactive that the spikes do damage and begin to become chronic? So if an individual is at ideal weight, diet, muscle mass, cardio fitness, blood lipid and A1C levels, etc., except that they might have a few fresh baked cookies every day to the tune of 30-50 grams of sugar at some point in the day, so long as their insulin response is optimal then no damage is being done to the body? Or another person with that same profile, except they have moderate amounts of heart disease/plaque (but is on a statin), so long as they too have an optimal insulin response, then no damage is being done? When people say stay away from refined sugars, is that only if youre over weight, inactive, and with low muscle mass and low cardio fitness?
Subcutaneous fat seems protective, and probably why females seem to do better health wise. As long as the Subcutaneous fat tank has enough space to absorb. How to increase the Subcutaneous fat tank is the most important, it seems. Autophagy seems to decrease the tank and appears to be bad. Losing some fat whilst keeping all the fat cells in the tank and gaining some muscle, seems like a win win win.
My understanding is frequent flyers have a higher risk of DVT. I’m curious if certain foods would be more beneficial in preventing DVT events. For us who travel a lot, maybe consideration should be given to taking a baby aspirin prior to a flight?
Excellent! Thank you 😊
This was very interesting and informative. Thank you!
Is there a way to estimate the total harm that all these social media influencers have caused with their clickbait claims?
This needs research. I bet it evidence would show influencers have harmed many people.
celiac, hashimoto and I wore a cgm just out of curiosity. I don’t eat processed food or added sugar or alcohol (at all) and no gf pasta or bread, only whole food, whole cereals/grain/veg/legumes, fish and rarely meat.
My glucose goes up 30 min after eating and come down within 2 hours. With carbs (like rice) the glucose goes up to 180 (depending on how much fat/protein goes with it) and it comes back quickly to normal. “the second meal effect” works as described by Dr Kartz. Fasting (16+ hours) and then eating carbs have been spling my glucose up more than the same meal with priming to carbs. Caffeine enhance any spike.
I am looking out at pattern for now and I have never spiked above 180 even when eating to much dry fruit like figs, dates and such. At this point I think this is how my body reacts to carbs.
all these attention to glucose, keeping in mind the deal is about insulin.. so it is not a direct measure for now but pretty interesting.
interesting also that just moving around after a meal reduces “spikes” by a lot.
gcm at night, if pressed against the mattress, will show false readings (below normal) and that is a limitation of the device.
I can vouche also that I had one bad device that was not close to the 20% accuracy tolerance that was claimed for the device
Very interesting, I will definitely listen to this again.
Such an excellent video! Thank you!
I start the day by drinking a cup of water mixed with my personal fiber blend. This blend includes a large percentage of resistant starch as well as psyllium, ground flax and chia, and many other ingredients which I'm hoping will attenuate my blood sugar spikes.
Wow, very informative! Thanks!
Could you do a video on the effect of reducing processed foods and intermittent fasting on anxiety and depression?
Oh I see you did one last year.
Great video. I'm struggling with this currently. High-side fasting glucose and 6 A1c. Two weeks whole food plant based. I won't get into it all, but have about a cup of lentils a day. Lots of veggies, no sugars (whites). Still get spikes. Earlier this week I subbed out the beans for 3-4 ounces of animal protein and my fasting glucose went to 80 after 3 days. I've cut calories to 1,500/day too. Losing weight currently but I'd rather NOT have animal protein and be in ketosis. Not sure if I should ride out the ketosis for a month then slowly go back to lentils and cut out the animal protein. I only have a cup a day of lentils so I'm not over doing it. I'm a little confused. I also do the ACV before meals and now walk after meals.
Diet and nutrition expert Jesse Inchauspe, says that preceding a high glycemic index meal with protein, fat and some vinegar - MITIGATES the sugar spike.
She has zero qualifications.
It could be incredible if you could have the guys from mastering diabètes on this topic on your Channel !
One thing that appears to be confusing relates to fasting glucose and fasting insulin. I have read that in the morning (as a person wakes) the body naturally increases the glucose level in the blood (presumably to cater for the energy requirement of waking and physical movement). Hence , if fasting blood samples are taken first thing in the morning is the glucose level likely to be higher than samples taken late in the day after fasting all day for say 12 hrs?
I would guess that most people (,myself included) get these fasting bloods taken in the morning because overnight fasting is convenient and relatively easy also the blood collection centres open around 8 am. Taking samples at the end of the day would be more difficult as the collection centres close relatively earlier , say 4 to 5 pm. hence you would have to have your last meal at 4 or 5 am to get in a 12 hr fast. I recently used a CGM and got the impression that fasting early morning glucose levels tend be high (around 6 mmol for me ) whereas I have seen levels in the afternoon in the low fives even without fasting. I have had an OGTT which came back in the normal range but the lab results of blood draws at 8am are almost always 6 or 6.1 mmol.
Could the simple timing of fasting blood draws cause significant differences in glucose levels?? Very Interested in your comments. Thanks for your informative video.
Pleased that reactive hypoglycaemia was briefly mentioned. I often get hypoglycaemic episodes a couple of hours after eating after exercise (running). I've tried eating more complex carbs along with fat and protein without much improvement. Does anyone else have suggestions to avoid my blood glucose plummeting?
Hello. I just found you channel and watched already a few videos.
Your videos are great and I think and hope they can help me to research and read studys by myself.
I just have no confidence and I believe I'm not smart enough to do so :(
Can I maybe ask you some question?
(Sorry for my english, it isn't my native language)
On this channel, there is a video called "Scientist teaches **How to do Your Own Research**". That would be a good place to start.
Can you do a video on how to lower uric acid and prevent gout?
Hi Gil! I’m sure you’ve heard of the book “Glucose Revolution” , written by the French author and biochemist, Jessie Inschaupé. She also has a very popular youtube channel - The Glucose Goddess. It would be awesome to hear your review of her writings, recommendations and methods!
Thanks for this
So much of the discussion is about peak glucose levels "good or bad?" But what about the shape and timing of the glucose response curve and the area under the curve during the post prandial response cycle? Isn't that likely to also be an important factor in determining a prediabetic condition? I realize A1C is sort of that over a long period of time. But it would seem important to dig into the science of response frequency and areas under these curves within the immediate post prandial cycle vs various foods.
Also, for the lag the CGM experiences, is there a rule of thumb correction factor that can be applied to the data afterwards to display a closer approximation of what actual serum glucose levels were vs time?
Very interesting talk. Going to send it to everyone. About the gap in research around what causes higher disease risk in people with diabetes, I think it's it's both the elevated blood sugar and the underlying factors driving insulin that are driving it. I base this on what we know of the injuries the blood sugar causes for diabetics with poor sugar control on the nerves and capillaries of the whole body. And the other part I base on the research indicating that people with DM2 that have good blood sugar control still have an increased risk of heart disease compared to healthy controls. (Not a big difference in risk but statistically significant) the big question in my mind is how big effect do they have by themselves? We are pretty sure that viceral fat is a driver of disease in an of itself, right? But is blood sugar spikes really a driver for disease for a person with low amount of fat in and around their organs?
so i’m little confused, don’t you determine whether you’re diabetic or not from the result of a1c blood test and not from the daily blood tests? i only use my daily blood test to control my dietary intake
My wife is Type 1 Diabetic and we're Canadian. I'm just in the first 6 minutes but I keep having to convert mg/dL to mmol/L...Why does the US always have to be "special" with units of measurement?
Because we do whatever we want and want to be different. Now get lost, peasant 🤣
About as many countries use mg/dl than use mmol/L.
mg/dL is still metric bruh.
The first blood glucose meter (Ames Reflectance Meter) was invented in the US and measured in mg/dL. You're the "special" ones.
@@drott150I never said it wasn’t metric. Just annoyed that we can’t agree on which units to use. I almost always see mmol/L on PubMed, which is the focus of this channel.
Thanks for this video, it would be helpful to know the definition of a low carb diet is it below 50g per day or 150g per day or what ?
I think it depends on the individual and there is no clear cut off
I would quantify it by % of your total energy intake or by the state of ketosis
Usually under 50 but some ppl can't have even more than 10.
There is no single definition of what low-carb means. Generall, under 20% of total calories can be considered low-carb. For a women eating 2,000 kcal per day, that would be equivalent to 100 g of carbs per day. For a man eating 3,000 kcal per day, it's more like 150 g per day.
However, most people following low-carb diets probably eat less than half of these amounts.
Cheers
Mario
@@nourishedbyscience that’s helpful many thanks Jeff
While people shouldn't sweat acute spikes too much, almost every single action you can take to avoid those spikes has *enormous* proven benefits.
Avoid simple carbs and ultra-processed foods. Be active. Layer foods.
Even if you're willing to completely ignore glucose spikes, all of these lifestyle choices can only possibly be beneficial. It's also a bit weird how this video strawmans a bit in the seeming assumption that avoiding glucose spikes requires a low carb diet (e.g. the example of eating salami instead of beans).
Beans do not lead to appreciable glucose spikes. Nor do basically any whole vegetables. Nor do most whole fruits. Someone actively avoiding insulin spikes can be eating a high carb diet and still fully achieve that goal. Even ice cream doesn't lead to much of a glucose spike.
Drink more alcohol for example.
Don't exercise.
Exactly what I was thinking. It also depends on the quantity of food consumed and level of refinement
I think you're already looking at it with knowledge beyond the average person.
You're bounding it in reasonable actions (see _@FreeFromAllThings'_ responses).
You're bounding it in taking it not too far (beans vs. salami) and taking other measures into account.
I've heard intelligent people (Drew Harrisberg - who mentioned he heard multiple such stories from clients) obsess over glucose curves and ending up with problems even in that metric.
Very analogous to people fixated on (current) weight turning to "solutions" that are unhealthy and sometimes even counterproductive for their weight long-term.
@@tofu-munchingCoalition.ofChaos😊
Have you made a video on raw milk yet?
Could you please comment on this new study? Thank you. "Millions of U.S. adults should no longer take cholesterol-lowering drugs under updated guidelines released by the American Heart Association (AHA) late last year, research indicates".
Is there any evidence that those who really go all the way in preventing sugar spikes that they could be harming their pancreas? Like, in those that go on truly fat free diets, I have heard the gallbladder can become congested with stagnant bile which may cause or exacerbate stone formation and other issues. If the pancreas is "sheltered" in a similar fashion from occasional glucose spikes, are there potential long-term risks associated with this scenario? {and I don't mean stone growth, but whatever the pancreatic analog may be for "stagnant insulin"}.
I hope he answers this sometime. If the pancreas adapts to low carb by producing low insulin, can the pancreas lose its ability to make enough insulin in the future. Most advice hovers around lowering insulin.
When we eat a low-carb diet, the pancreas keeps less pre-made insulin in storage, and that lowers the amount of insulin that can be secreted in the so-called first-phase insulin response. That is thought to be transient, however, and once peope start eating carbs again, a normal first-phase insulin response can be recovered within a few weeks. What this suggestions, however, is that it is not wise to eat high-carb meals occasionally when generally doing low-carb.
Cheers
Mario
I wonder what your thoughts on Ezekiel bread is?
Food swaps are okay to address high excursions, but as they say later in the video, exercise is even better. Shoiuld have been much earlier in the video!
- Mario says there's no clinical range definition of a glucose spike. i'm like, wut? surely there are ranges that are excessive.
8:22 he just said that a healthy young adult never has glucose spikes above 170-180 mg/dL. he goes on to say iiuc that blood glucose levels should never reach 180 mg/dL.
9:48 Gil just said iiuc that common tests for diabetes diagnosis are (1) fasting glucose and (2) glucose 2 hours after a meal. he goes on to say that normally there's a glucose spike 20-30 minutes after a meal, then the body should resolve it, and by 2 hours the levels should be much lower (in a healthy individual).
11:13 watched until here.
What we say is that it’s normal for blood sugar to rise after a meal, and that’s Ok as long as the peak doesn’t reach 180 mg/dL and is back to around baseline by two hours.
Very interesting
Can someone please answer this one big question!!!
I eat fruits, meat, honey, some butter.
I can eat honey and have a glucose spike to 200 within a hour, then jts headed back down.
Same with some fruits and stuff.
My a1c is normal and my fasting glucose has been around 105-110 for almost 10 years.
My fasting insulin is usually always around 3 something.
Since my fasting insulin is good, should I worry about them spikes?
I mean maybe i just spike higher then normal, but my fasting insulin is always good 🤷♂️
Both of you are national treasures, but you have to up your design and branding.
Science has to be sexier to connect with a wider audience (the edits, background, and general look and feel)
Im sure it’s easier said than done, but it’s a disservice to your amazing work.
Really enjoyed the podcast. Thanks!
Results: Sensor glucose concentrations were 71-120 mg/dl for 91% of the day.