@@jimyhendrix492 Gil offers great commentary, advice and an almost perfect non-bias take on complex nutrition topics. Those points keep me coming back!
Simply changing the form of food into powder= DOUBLED abdominal adipose & 85% more fat/body mass ratio (I think of pasta, cereal, crackers& chips, pancakes, bagels, biscuits, rolls, or even smoothies etc). Also 4x the leptin , likely a quick route to leptin resistance. www.ncbi.nlm.nih.gov/pmc/articles/PMC3148648/ More gradual (36.7% less) postprandial glucose curve at the 1hr mark if you eat veggies & protein FIRST! www.ncbi.nlm.nih.gov/pmc/articles/PMC4876745/ Lastly, I know you're a dietitian but you just have to emphasize the benefits of strength training + walks after meals for improved glucose disposal & weight control. Resistance training produces myokines which are anti inflammatory too! Exercise is effective in preventing 35 chronic diseases www.ncbi.nlm.nih.gov/pmc/articles/PMC4241367/#:~:text=Many%20of%20the%2035%20conditions,and%20diseases%2C%20bone%20and%20connective
You have all those that are not producing any where near enough insulin effecting the results. Also chewing your food properly will spike insulin more. Don't think it's the spike that matters too much, in healthy people, it's where blood sugar is 2hrs after eating
I can eat 1.5-2 pounds of dates in one meal and my blood sugar 2 hours after I finish eating it is under 110. My fasting insulin when I last had it tested was 2.3 and my a1c was 5.0. Low carbers and zero carbers have no clue what they are talking about.
@@dj-fe4ckI think low carb as a way to reduce calorie consumption while keeping the minimum protein and fat soluble vitamins is reasonable, I think insulin sensitive individuals can have some carbs. But how the heck do you eat two pounds of dates as a meal? That's kind of nuts.
@mikafoxx2717 usually 1-1.5 pounds is the most that I eat in one meal. I don't eat them that often because they're too sweet for me. But they are certainly safe to eat in any amount that you feel like. I do eat 2 one pound bags of pasta in one meal or 5-6 pounds of potatoes in one meal all the time. I ate almost 2.5 pounds of sourdough bread last night.
An obvious question would be - how does insulin spikes correlate to insulin resistance? Given the fact that we have been told many times that the majority of americans are pre diabetic, it would seen this study contradicts that information. Please do a video from your point of view on this question
Thank you! I saw an interview of your with this woman diabetes doctor from England, I remembered one thing clearly that she said. "who says that your glucose levels have to be a flatliner all the time" The body was created in such a way to handle glucose.Of course, diet etc is important and it doesn't mean you have to eat sugars and processed foods. Clean healthy eating, exercise and living! I would really appreciate more data/information on this subject.
While I have more questions after watching this video than I had before, it is undoubtedly the kind of information we need more of. We need to question the common sense truths regularly to get better information to make better decisions.
8:10-9:00 Am I the only one NOT surprised by this chart? All the food mentioned there seems to have an appropriate insulin reaction based on my understanding. Jellybeans being the highest makes sense since they're mostly just raw glucose, right? Then donut being pretty high but not as high as jellybeans also makes sense, due to the dough slowing down digestion, which is also the reason pasta ranks lower than potatoes, which are starchier and become much more digestible during cooking. With chips, I think the argument would be that the nutritional value is greatly reduced, and therefore probably the carbohydrate contents compared to full potatoes.. Then lentils vs beans is also not surprising as well. Beans are MUCH starchier than lentils, so it makes sense for them to rank higher. And as for oats being really low, I thought this was known? High fiber and relatively high protein (for a mainly carb-type food), makes perfect sense. And as for beef/fish being roughly the same as apples, that's another pretty obvious one to me. Apples are known to be a low glycemic food (fiber & pectin), and fish/beef are high in protein, which, especially when consumed with minimal carbs, some of which gets converted into glucose...
Well I was surprised by the legumes' scores, so I checked the linked study! And it turned out that "lentils" were lentils in tomato sauce! Furthermore "beans" were pre-canned baked beans in tomato sauce with 4times more sugar then "lentils"! For me that means that most lilely contained added sugar. I think the score of the lentils and beans would be different if they were cooked in water.
No, Jelly beans did not not make sense when the study came out. At that time jelly beans had mostly sucrose plus coloring, flavour and a couple of amino acids (the jelly in JB). Pure sucrose generally has lower insulin response than glucose - often lower than potato and pasta. The actual reason jelly beans had a very high insulin response was the unique combination of a couple of amino acids plus sucrose. If it had been glucose the response might have been higher. The aminos are now gone - modern jelly beans have no gelatin (they claim to be vegan friendly).
It would be interesting, but should be relatively clear - insulin spike helps you reduce a glucose spike, so as the video suggest, an insulin spike is... good? But how many consecutive insulin spikes are good? Nothing was mentioned about developing insulin resistance...
@@bigi_111I think most have concluded that fatty intrusions in the pancreas is what causes it to lose the ability to create insulin over time, and you lose the fast acting insulin spike first. So overall it's mostly down to visceral fat from overeating, which is influenced by food types but also genetics a lot, if you get obesogenic with plentiful subcutaneous fat or if you get visceral fat more easily. It's still nuanced, but.
Love the videos Dr. I was wondering if you could make a video some time that sort of aggregates your general health advice, of course using and stressing your level of skepticism and rational thinking. Sort of like a best practices guide that also accounts for level of certainty, say if some advice you are only 80% sure of for example. Cheers!
WHat is your view on the Kraft Test? Because Dr. Joseph Kraft did a way better study and identified 5 insulin patterns that give a lot of information. These patterns are: Pattern I: Normal insulin sensitivity and response. Insulin levels rise and fall appropriately after glucose ingestion. Pattern II: Insulin levels rise higher than normal but return to baseline within a reasonable time. This pattern indicates insulin resistance but not as severe as in later patterns. Pattern III: Similar to Pattern II but with insulin levels staying elevated for a longer period, indicating more significant insulin resistance. Pattern IV: Characterized by very high initial insulin responses and prolonged elevated insulin levels, indicating severe insulin resistance. Pattern V: This pattern was later added to describe individuals with high fasting insulin levels and an exaggerated response to glucose ingestion, indicating severe insulin resistance and dysfunction. Would you consider doing a video on the Kraft Test? I am sure your audience would really appreciate it.
All very interesting. I wore a cgm on and off for about 6 months, as a non diabetic trying to help various symptoms. I found that I felt worst, headaches, palpitations, when my glucose levels were flatter. My doctor agreed that it was best to go with my symptoms rather than trying to control the spikes. I stopped wearing the cgm and have learnt enough to greatly improve my symptoms, less frequent urination, no bedtime loo visits and sleeping all night, but I’ve still got plenty of big glucose spikes!
As somebody who has stubborn genetic glucose problems despite being skinny, avoiding junk food and getting lots of exercise, I had taken particular interest in this video. Heard just about every suggestion and had taken the advice: 1. reduce refined carb intake (I rarely had any). 2. get more exercise (been lifting weights since 1995 and do five hours a week of cardio). 3. lose weight (so much that my ribs show). 4. don't eat naked carbs * the endocrinologist had said always have protein, fat and fiber with your meal to try and reduce the blood sugar spike. I used to think that eating a number of small meals over the course of the day was preferable to "stabilize blood sugar levels". After having viewed this video and, earlier, the video with Nicola Guess, I had started moving back to three meals a day and with only light snacking in btwn (but not overeating). In particular, I have reduced the size of my dinners, and eating in the evening. Let's see if my morning fasting glucose improves any.
My HOMA-IR value had come in low. I would recommend that test to anyone who has had high A1C numbers that hadn't dropped with weight loss. Those people, aren't like most of the affected people. Note that test, can only look at liver function. c-peptide level test looks at beta cell function. Note that the clamp is a better way of measuring insulin resistance, but not something I would likely be able to access (especially in the US where the insurance company would balk at paying for that). If the person has elevated blood sugar, but insulin resistance and beta cell dysfunction isn't shown, the problem is likely a genetic one.
I just clicked play. If the answer to this question in the title is NO I'm gonna lose it. This is all I've learned in the last two years of YT watching and following doctors online.
That's because many of the doctors online, may appear to be credible sources, but are in fact, unqualified people using fear based tactics to spread misinformation to the vulnerable. When I was younger, I really believed that "diabetes is something that happens to you when you eat too many desserts and too much white flour; your body can't handle it and the excess sugar just piles up in your blood, you know": the ability of the individual to tolerate poor quality food, can vary. Millions of Americans can't afford to go to the doctor and so their sole medical advice could be anecdotes from friends and family, and watching YT videos. People say, "I'm not attacking their credentials" during the criticism videos, but the fact of the matter is, endocrinologists have formal education in blood sugar control, and have licenses. They are obligated to not spread misinformation, understand the finer details specific to each patient, and to admit it when they make a mistake. Diabetes is a complex, multifactorial condition for which one-size-fits-all advice may work for the majority of the population but not the individual. As it affect you personally, I believe the idea that insulin in itself causes fat storage is wrong. This only happens when we overeat. It is also wrong to claim limiting carb intake alone will lower insulin levels and thus fat storage. People who habitually overeat will continue to have problems losing weight.
The very first study was referring to glucose spikes... A food rarely contains only 1 type of sugar, or insulinogenic response independent of sugars, so the overall body response is what we should be looking for.
Great video, but I'm afraid some people in the comment section are conflating insulin spikes with glucose spikes. Simply because insulin spikes don't seem to be particularly harmful, doesn't mean that glucose spikes are harmless.
@@donwinstonthe ups and downs of blood sugar matter a lot. Excessive and repeated blood sugar spikes, in the short term, cause a sugar rush, followed by a sugar crash, accompanied by lethargy and hunger. "In the long term, repeated spikes in your blood sugar can cause heart problems, kidney problems, problems with eyesight, and nerve issues like neuropathy". "Glucose spikes cause an increase in reactive oxygen species (ROS). The increase in ROS leads to oxidative stress, which then impacts the endothelial cells. This increases the risk that plaques will develop, and more plaque means a higher risk of heart disease.", as well as increasing the risk for type 2 diabetes in the longterm. Insulin is simply a hormone that helps regulates blood sugar levels.
@@sundiataq No. You didn't pay attention to what I said. "Excessive" spikes won't happen if you are not diabetic. Normal ups and downs are not harmful to your health. There is no evidence what so ever that normal fluctuations in blood sugar cause heart and kidney problems. You are talking about people who have diabetes! You are talking about people who are unhealthy. A healthy person will not become unhealthy by eating carbohydrates, refined carbohydrates, or sugar that temporarily increase their blood sugar levels. If they eat too much food and accumulate excess fat, especially visceral fat, and become insulin resistant for a decade or more then these problems are indeed likely to occur.
@jerry9635 well for one, there is type 2 and type 1 diabetes. If they are type 1 and it's genetic then they deal with it without having years of the bad diet and accumulation of fat associated with type 2 diabetes. People with type 1 are usually smaller cause they have had to deal with it from the start. Type 2 is developed over time i.e. chronic blood sugar elevation and damage. Even then, it's about the chronic elevation plus lifestyle + diet that determines when the body becomes diabetic. So a person can still not be what we think of as "big & fat" and have diabetes, likewise a person can have accumulated the fat and not be diabetic depending (always depending) on other lifestyle factors. So obviously because every person is different, why it always comes back to seek Medical professional educated by the standard of data from seeing patients and cases, to properly diagnose an Individuals' circumstances for a path to health. So the good Dr's out there will be the one who acknowledge the variables and why it applies to you based on what we know...not razzle you with a story of "this is it and that's that" like one size fits all. It will sound more like "this is what we know and here is why you May be experiencing any of these symptoms". It's frustrating because it "sounds" like not getting a "straight answer", but it's the scientific answer to acknowledge the unknowns(which is inherent because, Everyone is going to be different). Otherwise every patient would have to have the Exact same body and conditions for the Doctor to give everyone the same answer to everything health related. So if a Doctor sounds like "God" with one answer, that's The red flag to look for as you hear information that may not be good and contradicts other information, to assist in not being as confused when it come to health data. Hope I said something that helped!🖖
@@MichaelMedeiros-qn3qnfructose and other fast or slow sugars dont enter the bloodstream. They are all changed to glucose in the digestive system. Then it gets into the bloodstream.
@@krism6260intestinal cells has only some capacity to metabolise fructose for own energy supply. After reaching threshold fructose get to the bloodstream (
@@krism6260they are changed in the LIVER primarily, and it's a very similar procedure to the passivation of alcohol, which is why high fructose corn syrup and sugar can wreak havoc on your liver, especially in a great surplus
I don't think it does, this is just about the amplitude of the spikes it isn't about spikes frequency or the effects after the spikes. To me it seems just as a test of a vital strong pancreas and it makes sense to me when the pancreas still can react fast releasing a lot of Insulin when your glucose spikes that it is a sign of a healthy pancreas.
Hi Dr. Carvalho, how about consistently spiked insulin levels throughout the day via multiple smaller meals ? In comparison to fewer meals per day. So lets say 2000 kcal spread out over 5 meals in regular intervals in comparison to it being spread out over 3 meals.
good question. see our videos on intermittent fasting for content on this. in general it doesn´t seem to make a huge difference whether meals are consumed spaced out or in a shorter time frame. however, what often happens is people who avoid eating for long periods of time end up eating less overall, and that can have an effect. another aspect is a circadian effect of eating earlier vs later in the day which may also play a role. if you search the channel page for "fasting" we have 4 or 5 videos on it that touch on all of this
Wouldn't fewer meals be beneficial? If you keep eating every 2-3 hours, you potentially would have a constant high of glucose and insulin, vs a spike that goes back to normal levels 2-3 hours post meal?
I am 78, pre diabetic, and just recently got a CGM to test for myself which foods cause my blood sugar to rise or spike more than others. and at what time of day as well. For sure it is an interesting experiment, and I feel is worth the hundred or so dollars. And yes I am more comfortable avoiding the spikes and trying too keep it somewhat stable. Enjoy your videos.
I'm left a bit confused by this. So, the dietary priority for T2D remains avoiding prolonged post- prandial high blood sugar levels by avoiding high-glycemic foods, correct? Not necessarily avoiding foods that cause high insulin spikes, correct?
James - We are not, don't worry. Dr Gil makes it very clear what he is referring to, many, many times - no confusion. Maybe you should try watching again.
I could be wrong, but i think the main benefit of low glycemic foods is hunger management. Less hunger=less calories consumed=weight loss for an overweight individual. Blood sugar/insulin spikes aren't necessarily a bad thing if you're healthy and active, but you might feel hungry sooner once blood sugar drops back down(compared to low glycemic foods which will contribute to more stable blood sugar)
This looked at insulin spikes, not blood glucose. I do believe it does make a difference if cells receive a large amount of glucose all at once or slowly over time in terms of energy and hunger levels. In terms of insulin resistance - insulin is the wrong culprit here. It‘s fat, saturated fat. You can induce IR with it as shown in several studies. We have two sources - dietary or de novo lipogenesis from glucose. They have one thing in common. They are caloric excess and that‘s the real issue in my eyes. No idea if GI makes a difference in that regard. I think it might, but maybe satiety plays the bigger role in preventing it.
@@joerenner8334 An I am literally countering that. 1) He was talking about insulin spikes. They are absolutely necessary and appropriate to counter the glycemic load. 2) Blood glucose spikes are problematic. That is why we respond with insulin. There is other research, and evidence that is not research, that he is not talking about. yeah "there is nothing to see here"
It may be against some people’s ideas but it makes sense that a good insulin response indicates proper function of pancreatic cells. Most people who follow glucose goddess are worried about glucose spikes and less about insulin spikes. But there are keto doctors who think insulin is the devil.
The Keto guys are being misled by their own debunked hypothesis (CIM). It's the prolonged hyperglycemia that's harmful, not simply the insulin spikes by themselves.
But even those who preach insulin spikes are bad, tend to use the glycemic index to rate healthiness of foods, rather that the "insulin index" shown in the chart at the end of this video. And the glycemic index is actually effective for this, is it not? My only question would be why the glycemic index and "insulin index" diverge so much? I would have expected the glucose spike and the insulin spike to be correlated to each other.
The part about differents foods and their correlating insulin spikes is really weird to me. I have type 1 diabetes and therefore I have to inject insulin for every meal and I can say you barely need to take any insulin for fish, beef, vegetables. Beans you need to take a little. Lentils are quite similar to beans. White pasta? You need to take a lot of insulin, same thing with fruit.
I have been subscribed for some time now, with All Notifications turned on, but I have not seen anybof your videos turn up in my UA-cam Notifications list for 3 months... what is going on here?
It's interesting to wear a CGM for 2 weeks and observe own body how it reacts, I did that and saved my graphs results for later. Some foods are not so intuitive, for example I had a piece of cake and expected massive spike, but nothing happened, maybe because of fats. It's cool to see how soon (literally 30 mins) after eating oats the glucose begins to raise and how quick it takes to drop back to baseline. Or what it looks like during the night and morning before breakfast - totally flat line. Or how it spikes at the beginning of a workout, without even eating anything. But I'm counting calories, so that changes things.
It should be at its lowest half way through the night and the raise by the time you get up. Similarly even without eating it should raise before you workout, but probably not that much, if it does maybe chill a bit more before going for it
@@brucejensen3081 yes second half of night was slightly lower and there was the lowest point there, then by 6-7am began to raise. Workout spike - yea it's not actually a "spike", much less than after eating, but very noticeable on the chart, I guess maybe some release from glycogen stores.
I asked this question too. Gil said glycemic index is what's important with T2D. Avoid prolonged hyperglycemia by continuing to choose low-glycemic foods, not by choosing foods that spike, or don't spike, insulin.
Spiking blood sugar, and spiking insulin are two different responses. Limiting blood sugar spikes in intensity and duration is what's important. This can be done by following the glycemic index, and eating low-glycemic foods. Nevermind about insulin spikes.
1. Glycemic index does not predict an individual's glycemic response to a food, but can be used as a tool to assess the insulin response burden of a food, averaged across a studied population. Individual responses vary greatly. 2. The glycemic index is usually applied in the context of the quantity of the food and the amount of carbohydrate in the food that is actually consumed. A related measure, the glycemic load (GL), factors this in by multiplying the glycemic index of the food in question by the carbohydrate content of the actual serving. 3. Depending on quantities, the number of grams of carbohydrate in a food can have a bigger impact on blood sugar levels than the glycemic index does. Consuming less dietary energy, losing weight, and carbohydrate counting can be better for lowering the blood sugar level. Carbohydrates impact glucose levels most profoundly, and two foods with the same carbohydrate content are, in general, comparable in their effects on blood sugar. A food with a low glycemic index can have a high carbohydrate content or vice versa; this can be accounted for with the glycemic load (GL) where GL = GI% × grams of carbohydrate per serving. (from the Wikipedia)
They must be different because the chart shown in this video is very different from what you would expect based on the glycemic index of those foods...
One of the best doctors / researchers on You tube. No extremes and very documented and rational scientific comments. Keep going like that Dr. Gil ! This is real science. Thank you !
The comparison chart at 8:56 is super confusing to me. How does this foods & insulin spikes chart relate to the glucose spike? This chart looks nothing like the glycemic index. Don't high glycemic foods and insulin spikes go hand in hand? To prevent ailments, we are supposed to avoid foods that cause a high glucose spike (otherwise why do people including some doctors wear CGM?) but does this insulin study give any insight into whether this notion is also misguided?
The symptom I have with glucose spikes is extreme tiredness and then reactive hypoglycaemia caused by the accompanying insulin spikes driving the glucose level down well below fasting levels. The major symptom of hypoglycaemia is deteriated vision.
I've heard many scientists say it is very personal to individuals too. For example some people have more salivary amylase that breaks down carbs into glucose before it even reaches the stomach, and also some have microbiomes that seem to inhibit glucose spikes. (over on ZOE youtube channel) Also how about what happens when the glucose is all stored away? Couldn't a larger amount of insulin make the blood-glucose drop too low because it is reactionary and lags behind current blood-glucose levels?
Is there any evidence on which of the following is better: 1) food that causes a short, high glucose spike 2) food that causes sustained lower glucose spike? Or is it just the AUC (area under the curve) that matters? I have found that taking fiber supplement with with most foods flattens the curve.
In general higher fiber foods are more healthy. An apple is better than candy or a donut. And yes, we know that fiber flattens the curve, because it slows glucose absorption. However, adding a fiber supplement is going to be less healthy than eating a high fiber diet, in other words: a diet high in plants (beans, lentils, vegetables, fruit and nuts &seeds). Many unhealthy foods do cause a short high glucose spike. In the video it was jelly beans, I think. However, as the video says, it's not a good marker of unhealthy food.
@@k.h.6991 I would like to echo that buying fiber supplements is totally idiotic. I am NOT saying that those who think about doing this are idiots, but rather the action itself is a fool's errand. Why buy fiber supplements when the over whelming amount of Whole Foods, whole complex carbohydrates, plant foods, fruits, vegetables , whole grains, and so on are packing way more fiber with vastly more nutrients ?? FIBER IS THE KEY , fiber with nutrients is an uber concept.
So T2D first phase insulin response is weak, correct? A healthy response would be a robust first phase insulin response, correct? So what happens when a T2D eats something that usually triggers a large insulin response then? Like black beans? FPIR is low, and therefore post-prandial BG stays high for a longtime? So should T2D avoid black beans??
According to some diabetes doctors on youtube like Neal Barnard swapping stuff like black beans for , at least saturated, fat might be bad long term even if you have less of a glucose response acutely.
Some diabetics don't produce enough insulin due to problems with pancreas mainly I guess. Others have insulin resistance, so have super high glucose spike, even when insulin is at a normal level, I guess the body keeps excreting more insulin to cope. Would black beans be better than white pasta to reverse insulin resistance in a complete package, I would think so. I don't really like black beans but.
I liked the discussion but based on previous videos that you've released, it would have been good to give context by including some discussion of the factors that cause chronic insulin resistance and pancreatic dysfunction, such as weight gain and saturated fat consumption. Also, it would have been nice to hear you comment on how frequently eating a type of food can lead to a semi-chronic metabolic state. Measuring markers while fasted can indicate a chronic state, but so can measuring biomarkers post-meal if that meal is eaten frequently (although, a similar result would need to be interpreted differently in these two states).
7:56 thats really fascinating. Unedcuated questions: Do glucose levels even correlate with this? Or does the pancreas use a completely different metric as a signal to produce insulin?
Ironically the ad pre and post this video is a continuous glucose monitor, that will recommend meal plans based on the response after meals exercise etc
Awesome discussion. The CGMs I was wearing for several months were always so inconsistent, some days the exact same food would cause way different results, it never made any sense to me.
Your response to food will greatly influenced by factors such as: do you sleep well the night before? (if not, then your body’s ability to control blood sugar level is reduced) Do you exercise before or after a meal, even as simple as a leisurely walk? (if yes, both helps regulate blood sugar levels).
I got a bit heavy some years back and was somewhat precipitously labelled "diabetic" ... I quickly lost the first 10 kilos and figured that a few hundred kcals of reheated precooked unsweetened whole wheat berries would be the perfect breakfast food for several reasons, but even a small quantity would hit me like a train an hour or so later.. feeling faint and sweating.....though I never actually measured my blood glucose... Curiously 500kcals worth of wholewheat bread with peanut butter had no such effect ..
Sounds like you took Dr Gabe Mirkin's advice. He was way ahead of his time regarding H-Pylori, and the whole grain versus processed grains. But he never recommended eating a bowl full of wheat berries, just some sprinkled on your salad.
yes, metabolic flexibility is good. but if your insulin level is continuously elevated, welp your pancreas only has so much capacity, and won't be able to cover a glucose spike with the appropriate spike of insulin. Refined whey protein doesn't raise blood glucose much, but will produce an insulin spike. It comes in a container with a bar code. Get your protein from real, whole food.
What if we eat carb meal 4 times per day and have high blood sugar during that period but normal fasting glucose. Still the damage has been done? Its like 8 hours we have "diabetes"
As a teenager, I had an OGTT 62 mg/dl reactive hypoglycemic. Then, in my 20s, it became worse. That OGTT 52 mg/dl. I'd have to treat nondiabetic hypos do to an overactive pancreas. And 30 years later of course now diabetic.
People are afraid of insulin spikes in relation to snacking when people eat often eat cookies , fro example, and keep their insulin constantly elevated. So in regards to that i would like to know smth. Are insulin spikes from different foods additive, or would i have lower insulin spike, if i eat my cookie and healthy meal together rather than separately?
There is no simple answer to that. I think it can be gleaned that in moderation there is nothing necessarily unhealthy about high GI foods. It's simple and pretty much common sense. Mix up the diet with healthy foods. Stay away from McDonald's junk. Cook at home as much as possible.
@@joerenner8334 Except a lot of high GI foods are refined carbs, consumption of which is statistically correlated with chronic diseases. Whether or not insulin spikes are the mechanism by which they are unhealthy, is another issue.
Maybe the spike is exactly what is not the problem. Maybe it is the gradual clearance which is different between individuals, being affected by other enzyme and hormone levels.... and in turn, affecting later food intake.
I think more interesting would be to have a comparision which foods cause glucose dips .Like for big dips food raises blood level, insuline kicks in, stops release of glucose very quickly and remaining insuline drives it down to very low levels. Also response to particular foods can be personal, depending on particular enzymes secretion etc.
The graph and talk at the start show glucose raising not dipping below normal level. Judging by the timeline looks like a nice meal with different foods :-)@@donwinston
I haven't read that study but I think that the interpretation of those results should also include the overall diet and physical activity of those women, to put it into a context. Studying their genetics would also help to separate those having these results and those having the opposite. I have half of the genes of my mother's side where almost everyone ended with abdominal obesity and type 2 DM. I am in middle age and no sign of either. I have a carb rich diet, but I watch the energy balance, exercise, and don't bake cakes or deep fry food. My lifestyle is different. I even experience symptoms of hypoglycaemia sometimes, I clear glucose fast after eating, even if healthy porrige, especially if overheating myself by activity, other times I can go for hours without eating after a good lunch. I prefer wholesome carb sources instead of ultraprocessed ones. And I am not shy of butter, in moderation. Fairly balanced diet I would say.
I found out about Dr. Gregor through this channel. He indicated that eating processed carbs such as white rice and flour should be avoided, since they cause a large spike in blood-glucose levels. Couldn’t this problem be circumvented by eating these high GI foods with fiber-rich foods and healthy fats to lower the glycemic load of the meal, thereby making these ‘bad carbs’ not so bad?
I've been trying the glucose goddess diet and I feel like just eating a LOT more vegetables has been great for my energy levels, but the timing thing (veg first, carbs last) I'm not too sure about. Still, this 1 study you looked at doesnt really test whether it reduces feeling fatigued without a reason, which is what I'm doing it for.
What about reactive hypoglycaemia when glucose levels rise steeply and then crash below base level? This can happen in people without diabetes. What is the root cause? I know it happens in response to carbs, and can be eliminated with a low carb diet, but that’s just treating the symptom not the root cause.
Maybe i am a bit slow, but are insulin spikes and glucose spikes the same ,... Or are they different things,... I don t quit get it 😢😊 ,... great Video ❤🎉
Hey Gil thank you so much for taking the time to answer my question,.. I really appreciate it......😊 What I understand and take from that is ,....that scientifically there's not much evidence that would support the thesis that high glucose spikes and insulin spikes (which of course stand in relation to each other ) are harmful in healthy individuals and if anything even beneficial,.... 😊,.. @@NutritionMadeSimple
there's some debate regarding supra-physiological glucose spikes but in general, yes, glucose excursions per se don't appear to be a problem@@emanuelgy729
Thank you so much, you cleared this really up for me,...and in general ,..I am big fan of your channel ,..follow for years now,...here I learned how to look for studies ,....and more often now,..i take a look myself into scientific papers,..so thanks for that , too 😊
I think a lot of people conflate insulin spikes and glucose spikes and it can lead to contusion. A high insulin spike after a meal means something different than a high glucose spike after a meal, tho not all glucose spikes are dangerous or indicative of pathology.
No not really. If you do not have diabetes then glucose spikes are not unhealthy. What is unhealthy is CHRONICALLY high blood sugar not spikes unless they are super high like over 180. But that will not happen if you do not have diabetes.
You're not going to eat just white pasta. Interesting to see it was low. The combinations that people eat, like which pasta dishes are higher/lower. If you are in the hypoglycemic range, does like higher lipids stop you from comatosing?
What about frequent, habitual spikes because of a high carb diet? I always thought that having high glucose levels lead to inflammation which in turn causes logon terms health issues? Thank you so much for the video!
What do you mean by "high"? It's considered not ideal if your glucose levels reach over 180mg/dL after a meal. It doesn't mean that lower is always necessarily better even below that point. The channel "Nourished By Science" has some great vids on that topic btw.
Thanks. What if your A1-C tests out between 5.5 and 5.7 through the past few years? I have gotten rid of a lot of carbs, but I still have enough i guess. Even when I drop pretty much all for a 3 month period it only brought it down to 5.4-5.5. That was a bit disappointing for sure. I used a CGM for a year and that taught me about meal order, timing, and adding protein to lessen spikes.
I eat a very high carb very low fat diet and my fasting insulin when I last had it tested was 2.3 and my a1c was 5.0. I can eat an enormous meal of plain white rice and my 2 hour blood sugar after I finish eating it is under 110.
How long was the fast? Sounds like your insulin response is good once you eat again. There's a lot of misinformation on here including the idea that blood sugar levels drop when we avoid eating carbs or when we fast or lose weight. Not for everybody. One size fits all solutions are bad for endocrinology.
This isn't about insulin spikes causing all of this issue right? This is about the amplitude of the spikes. I thought the bad thing is frequent glucose spikes because of the demand of the pancreas. The insulin spikes in all cases and to me it makes sense that a vital pancreas would match the glucose spikes faster. I never heard people talk about the amplitude of the spikes because that is of course hard to know unless you really use a glucose tracker in your arm.
There are actually lots of videos of so called health influencers wearing glucose trackers and freaking out about spikes after eating things like oatmeal on tiktok.
I think it ok with people that have optimal metabolic health. If you are insulin resistant the pancreas would be working harder to produce more insulin to drop the glucose levels
I am confused by this... so, there is indication that insulin spikes are normal, and that healthy people may have insulin spikes to "aggressive" stimuli (like pure glucose on empty stomach, for study purposes). There are, however, many questions left unanswered... Are all insulin spikes equal? In quality and duration? Some proteins raise insulin... is it identical to glucose induced spikes in all metrics? We can cause insulin spikes all day with pure sugars (like fruit juices) and it won't mess up the insulin/glucose mechanism in otherwise healthy people? How confident are we with the data?
After a health scare about 5 years ago, I watched so many UA-cam health videos. Now, I am a confirmed omnivore. Let me put it this way, if I were to be wrong in my diet, at least it tasted fine.
Watching UA-cam videos alone is guaranteed to confuse people. Read eg the Canadian dietary guidelines, the World Cancer Research Fund report on cancer prevention, professional medical association guidelines etc
Thanks for the video. Doesn’t type two diabetes significantly increase CVD or the risk of CVD? Why? What causes the risk? What mechanism causes this increase? Is it high glucose? Or high insulin?
My guess would be because CIR is an easier measurement to get, only requiring 30-min insulin and 30-min glucose. Using an easier to get measurement makes the study easier to run and the results easier to apply to the real world.
I may have missed a point but assuming that none of the women developed or were pre-diabetic or diabetic during the study duration, perhaps the association between higher IR, waist circumference....with higher insulin spikes indicates the early stages of the pancreas sensing more insulin is needed to shuttle nutrients into cells and still having enough beta-cell function to do so. I'm as surprised as anyone with oats and doughnuts not producing more of a spike than meat and fish but perhaps the fiber and fat content of these respectively blunt the response.
I am a little surprised that you relied on one study that is now more than 25 years old to discuss the effect of different foods on insulin. Surely there are more recent studies? I also understand from listening to the CGM people that different people can react very differently to the same food, so I wonder how whether a single bar for oats or fish or jelly beans is really meaningful. I understand the ZOE organization in the UK and several in the US have been gathering insulin spike data on people who use CGM devices. I wonder if they have any studies?
from what I´ve seen they focus on glucose not insulin peaks. but if they have systematic analyses of insulin excursions that´d be interesting. individual variability is very likely
@@NutritionMadeSimple You are correct, the devices measure glucose. I guess I was assuming that high variability of glucose between individuals would also lead to variability of insulin. Seems like this is something that really should be studied!
The redults were not very surprising. What was very surprising is that the researcher thought the theory that a diet that causes bigger insulin spikes causes more weight gain is tested by measuring just the insulin reaction of the body. Or in other words: if the theory is that the stick that is bend the most breaks more likely and you measure how bendable a stick is then of course the most bendable sticks break the least.
Young healthy people have glucose level between 70-180 mg/dl 90% of the time. And Average glucose between 90 and 120 (hba1c). These two are good metrics to think about glycemic control. Fasting glucose and fasting insulin can be 3rd and 4th.
180 is terrible for anybody at any age. Average glucose and hba1c aren't the same thing. Your post did prompt me to find out what the official healthy ranges are
great info as always. Off topic question, The women's health initiative supposedly used equine vs human estrogen, does it make the conclusions invalid?
This is one of my favorite channels. I need to watch more! Thanks for what you do.
@@jimyhendrix492 Gil offers great commentary, advice and an almost perfect non-bias take on complex nutrition topics. Those points keep me coming back!
I'm a newgrad dietitian and I really appreciate the way you fairly break down research in a concise manner. Thanks for helping us all!
Simply changing the form of food into powder= DOUBLED abdominal adipose & 85% more fat/body mass ratio (I think of pasta, cereal, crackers& chips, pancakes, bagels, biscuits, rolls, or even smoothies etc). Also 4x the leptin , likely a quick route to leptin resistance. www.ncbi.nlm.nih.gov/pmc/articles/PMC3148648/
More gradual (36.7% less) postprandial glucose curve at the 1hr mark if you eat veggies & protein FIRST!
www.ncbi.nlm.nih.gov/pmc/articles/PMC4876745/
Lastly, I know you're a dietitian but you just have to emphasize the benefits of strength training + walks after meals for improved glucose disposal & weight control. Resistance training produces myokines which are anti inflammatory too! Exercise is effective in preventing 35 chronic diseases
www.ncbi.nlm.nih.gov/pmc/articles/PMC4241367/#:~:text=Many%20of%20the%2035%20conditions,and%20diseases%2C%20bone%20and%20connective
Really eye-opening. I've been assuming large insulin spikes after meals are always bad. Makes me rethink things. Thank you.
Really? Wow. It's always been normal.
You have all those that are not producing any where near enough insulin effecting the results. Also chewing your food properly will spike insulin more. Don't think it's the spike that matters too much, in healthy people, it's where blood sugar is 2hrs after eating
I can eat 1.5-2 pounds of dates in one meal and my blood sugar 2 hours after I finish eating it is under 110. My fasting insulin when I last had it tested was 2.3 and my a1c was 5.0. Low carbers and zero carbers have no clue what they are talking about.
@@dj-fe4ckI think low carb as a way to reduce calorie consumption while keeping the minimum protein and fat soluble vitamins is reasonable, I think insulin sensitive individuals can have some carbs.
But how the heck do you eat two pounds of dates as a meal? That's kind of nuts.
@mikafoxx2717 usually 1-1.5 pounds is the most that I eat in one meal. I don't eat them that often because they're too sweet for me. But they are certainly safe to eat in any amount that you feel like. I do eat 2 one pound bags of pasta in one meal or 5-6 pounds of potatoes in one meal all the time. I ate almost 2.5 pounds of sourdough bread last night.
An obvious question would be - how does insulin spikes correlate to insulin resistance? Given the fact that we have been told many times that the majority of americans are pre diabetic, it would seen this study contradicts that information. Please do a video from your point of view on this question
Thank you! I saw an interview of your with this woman diabetes doctor from England, I remembered one thing clearly that she said. "who says that your glucose levels have to be a flatliner all the time" The body was created in such a way to handle glucose.Of course, diet etc is important and it doesn't mean you have to eat sugars and processed foods. Clean healthy eating, exercise and living! I would really appreciate more data/information on this subject.
While I have more questions after watching this video than I had before, it is undoubtedly the kind of information we need more of. We need to question the common sense truths regularly to get better information to make better decisions.
8:10-9:00
Am I the only one NOT surprised by this chart? All the food mentioned there seems to have an appropriate insulin reaction based on my understanding. Jellybeans being the highest makes sense since they're mostly just raw glucose, right? Then donut being pretty high but not as high as jellybeans also makes sense, due to the dough slowing down digestion, which is also the reason pasta ranks lower than potatoes, which are starchier and become much more digestible during cooking. With chips, I think the argument would be that the nutritional value is greatly reduced, and therefore probably the carbohydrate contents compared to full potatoes.. Then lentils vs beans is also not surprising as well. Beans are MUCH starchier than lentils, so it makes sense for them to rank higher. And as for oats being really low, I thought this was known? High fiber and relatively high protein (for a mainly carb-type food), makes perfect sense. And as for beef/fish being roughly the same as apples, that's another pretty obvious one to me. Apples are known to be a low glycemic food (fiber & pectin), and fish/beef are high in
protein, which, especially when consumed with minimal carbs, some of which gets converted into glucose...
Well I was surprised by the legumes' scores, so I checked the linked study!
And it turned out that "lentils" were lentils in tomato sauce!
Furthermore "beans" were pre-canned baked beans in tomato sauce with 4times more sugar then "lentils"! For me that means that most lilely contained added sugar.
I think the score of the lentils and beans would be different if they were cooked in water.
No, Jelly beans did not not make sense when the study came out. At that time jelly beans had mostly sucrose plus coloring, flavour and a couple of amino acids (the jelly in JB).
Pure sucrose generally has lower insulin response than glucose - often lower than potato and pasta.
The actual reason jelly beans had a very high insulin response was the unique combination of a couple of amino acids plus sucrose. If it had been glucose the response might have been higher.
The aminos are now gone - modern jelly beans have no gelatin (they claim to be vegan friendly).
Could you do the same video but on glucose spikes?
Yes please
It would be interesting, but should be relatively clear - insulin spike helps you reduce a glucose spike, so as the video suggest, an insulin spike is... good? But how many consecutive insulin spikes are good? Nothing was mentioned about developing insulin resistance...
@@bigi_111I think most have concluded that fatty intrusions in the pancreas is what causes it to lose the ability to create insulin over time, and you lose the fast acting insulin spike first. So overall it's mostly down to visceral fat from overeating, which is influenced by food types but also genetics a lot, if you get obesogenic with plentiful subcutaneous fat or if you get visceral fat more easily. It's still nuanced, but.
Love the videos Dr. I was wondering if you could make a video some time that sort of aggregates your general health advice, of course using and stressing your level of skepticism and rational thinking. Sort of like a best practices guide that also accounts for level of certainty, say if some advice you are only 80% sure of for example. Cheers!
Fantastic video and info as always Gil!
WHat is your view on the Kraft Test?
Because Dr. Joseph Kraft did a way better study and identified 5 insulin patterns that give a lot of information. These patterns are:
Pattern I: Normal insulin sensitivity and response. Insulin levels rise and fall appropriately after glucose ingestion.
Pattern II: Insulin levels rise higher than normal but return to baseline within a reasonable time. This pattern indicates insulin resistance but not as severe as in later patterns.
Pattern III: Similar to Pattern II but with insulin levels staying elevated for a longer period, indicating more significant insulin resistance.
Pattern IV: Characterized by very high initial insulin responses and prolonged elevated insulin levels, indicating severe insulin resistance.
Pattern V: This pattern was later added to describe individuals with high fasting insulin levels and an exaggerated response to glucose ingestion, indicating severe insulin resistance and dysfunction.
Would you consider doing a video on the Kraft Test? I am sure your audience would really appreciate it.
All very interesting. I wore a cgm on and off for about 6 months, as a non diabetic trying to help various symptoms. I found that I felt worst, headaches, palpitations, when my glucose levels were flatter. My doctor agreed that it was best to go with my symptoms rather than trying to control the spikes.
I stopped wearing the cgm and have learnt enough to greatly improve my symptoms, less frequent urination, no bedtime loo visits and sleeping all night, but I’ve still got plenty of big glucose spikes!
Very intelligent and honest review of this study, and good advice.
Thank you!!! 👍🧡
As somebody who has stubborn genetic glucose problems despite being skinny, avoiding junk food and getting lots of exercise, I had taken particular interest in this video. Heard just about every suggestion and had taken the advice: 1. reduce refined carb intake (I rarely had any). 2. get more exercise (been lifting weights since 1995 and do five hours a week of cardio). 3. lose weight (so much that my ribs show). 4. don't eat naked carbs * the endocrinologist had said always have protein, fat and fiber with your meal to try and reduce the blood sugar spike. I used to think that eating a number of small meals over the course of the day was preferable to "stabilize blood sugar levels". After having viewed this video and, earlier, the video with Nicola Guess, I had started moving back to three meals a day and with only light snacking in btwn (but not overeating). In particular, I have reduced the size of my dinners, and eating in the evening. Let's see if my morning fasting glucose improves any.
My HOMA-IR value had come in low. I would recommend that test to anyone who has had high A1C numbers that hadn't dropped with weight loss. Those people, aren't like most of the affected people. Note that test, can only look at liver function. c-peptide level test looks at beta cell function. Note that the clamp is a better way of measuring insulin resistance, but not something I would likely be able to access (especially in the US where the insurance company would balk at paying for that). If the person has elevated blood sugar, but insulin resistance and beta cell dysfunction isn't shown, the problem is likely a genetic one.
Have you had your c-peptide levels measured?
I just clicked play. If the answer to this question in the title is NO I'm gonna lose it. This is all I've learned in the last two years of YT watching and following doctors online.
That's because many of the doctors online, may appear to be credible sources, but are in fact, unqualified people using fear based tactics to spread misinformation to the vulnerable. When I was younger, I really believed that "diabetes is something that happens to you when you eat too many desserts and too much white flour; your body can't handle it and the excess sugar just piles up in your blood, you know": the ability of the individual to tolerate poor quality food, can vary. Millions of Americans can't afford to go to the doctor and so their sole medical advice could be anecdotes from friends and family, and watching YT videos. People say, "I'm not attacking their credentials" during the criticism videos, but the fact of the matter is, endocrinologists have formal education in blood sugar control, and have licenses. They are obligated to not spread misinformation, understand the finer details specific to each patient, and to admit it when they make a mistake. Diabetes is a complex, multifactorial condition for which one-size-fits-all advice may work for the majority of the population but not the individual. As it affect you personally, I believe the idea that insulin in itself causes fat storage is wrong. This only happens when we overeat. It is also wrong to claim limiting carb intake alone will lower insulin levels and thus fat storage. People who habitually overeat will continue to have problems losing weight.
What about glucose spikes?
It would've been interesting to see the blood sugar levels in the same diagrams as the insulin levels.
The very first study was referring to glucose spikes... A food rarely contains only 1 type of sugar, or insulinogenic response independent of sugars, so the overall body response is what we should be looking for.
Great video, but I'm afraid some people in the comment section are conflating insulin spikes with glucose spikes. Simply because insulin spikes don't seem to be particularly harmful, doesn't mean that glucose spikes are harmless.
Please. Why would it be any different? If you do not have diabetes then the ups and down of blood sugar and insulin do not matter.
@@donwinstonthe ups and downs of blood sugar matter a lot. Excessive and repeated blood sugar spikes, in the short term, cause a sugar rush, followed by a sugar crash, accompanied by lethargy and hunger. "In the long term, repeated spikes in your blood sugar can cause heart problems, kidney problems, problems with eyesight, and nerve issues like neuropathy". "Glucose spikes cause an increase in reactive oxygen species (ROS). The increase in ROS leads to oxidative stress, which then impacts the endothelial cells. This increases the risk that plaques will develop, and more plaque means a higher risk of heart disease.", as well as increasing the risk for type 2 diabetes in the longterm. Insulin is simply a hormone that helps regulates blood sugar levels.
@@sundiataq No. You didn't pay attention to what I said. "Excessive" spikes won't happen if you are not diabetic. Normal ups and downs are not harmful to your health. There is no evidence what so ever that normal fluctuations in blood sugar cause heart and kidney problems. You are talking about people who have diabetes! You are talking about people who are unhealthy. A healthy person will not become unhealthy by eating carbohydrates, refined carbohydrates, or sugar that temporarily increase their blood sugar levels. If they eat too much food and accumulate excess fat, especially visceral fat, and become insulin resistant for a decade or more then these problems are indeed likely to occur.
I have an extra 30 pounds and I am not diabetic. But no several people that are skinny and diabetic. So I am confused.
@jerry9635 well for one, there is type 2 and type 1 diabetes. If they are type 1 and it's genetic then they deal with it without having years of the bad diet and accumulation of fat associated with type 2 diabetes. People with type 1 are usually smaller cause they have had to deal with it from the start. Type 2 is developed over time i.e. chronic blood sugar elevation and damage. Even then, it's about the chronic elevation plus lifestyle + diet that determines when the body becomes diabetic. So a person can still not be what we think of as "big & fat" and have diabetes, likewise a person can have accumulated the fat and not be diabetic depending (always depending) on other lifestyle factors.
So obviously because every person is different, why it always comes back to seek Medical professional educated by the standard of data from seeing patients and cases, to properly diagnose an Individuals' circumstances for a path to health. So the good Dr's out there will be the one who acknowledge the variables and why it applies to you based on what we know...not razzle you with a story of "this is it and that's that" like one size fits all. It will sound more like "this is what we know and here is why you May be experiencing any of these symptoms". It's frustrating because it "sounds" like not getting a "straight answer", but it's the scientific answer to acknowledge the unknowns(which is inherent because, Everyone is going to be different). Otherwise every patient would have to have the Exact same body and conditions for the Doctor to give everyone the same answer to everything health related. So if a Doctor sounds like "God" with one answer, that's The red flag to look for as you hear information that may not be good and contradicts other information, to assist in not being as confused when it come to health data. Hope I said something that helped!🖖
The problem with morning fasting blood sugar is you have the Dawn Effect, does this ever get taken into consideration?
This is great news. Going back to eating some of my favorite foods. Another great informative video.
What would that be? The study specifies GLUCOSE not fructose or processed forms of sugar in the foods you're probably talking about.
@@MichaelMedeiros-qn3qnfructose and other fast or slow sugars dont enter the bloodstream. They are all changed to glucose in the digestive system. Then it gets into the bloodstream.
@@krism6260intestinal cells has only some capacity to metabolise fructose for own energy supply. After reaching threshold fructose get to the bloodstream (
@@krism6260they are changed in the LIVER primarily, and it's a very similar procedure to the passivation of alcohol, which is why high fructose corn syrup and sugar can wreak havoc on your liver, especially in a great surplus
Pathologizing a normal process... The results of the pasta was surprising.
Indeed.
As always fantastic work Gil,Hat 's off to you
Does this contradict the traditional teaching about the pathophysiology of Reactive Hypoglycemia?
I don't think it does, this is just about the amplitude of the spikes it isn't about spikes frequency or the effects after the spikes.
To me it seems just as a test of a vital strong pancreas and it makes sense to me when the pancreas still can react fast releasing a lot of Insulin when your glucose spikes that it is a sign of a healthy pancreas.
Hi Dr. Carvalho, how about consistently spiked insulin levels throughout the day via multiple smaller meals ? In comparison to fewer meals per day.
So lets say 2000 kcal spread out over 5 meals in regular intervals in comparison to it being spread out over 3 meals.
good question. see our videos on intermittent fasting for content on this. in general it doesn´t seem to make a huge difference whether meals are consumed spaced out or in a shorter time frame. however, what often happens is people who avoid eating for long periods of time end up eating less overall, and that can have an effect. another aspect is a circadian effect of eating earlier vs later in the day which may also play a role. if you search the channel page for "fasting" we have 4 or 5 videos on it that touch on all of this
Wouldn't fewer meals be beneficial? If you keep eating every 2-3 hours, you potentially would have a constant high of glucose and insulin, vs a spike that goes back to normal levels 2-3 hours post meal?
I am 78, pre diabetic, and just recently got a CGM to test for myself which foods cause my blood sugar to rise or spike more than others. and at what time of day as well. For sure it is an interesting experiment, and I feel is worth the hundred or so dollars. And yes I am more comfortable avoiding the spikes and trying too keep it somewhat stable. Enjoy your videos.
Really great, thought-provoking scientifically sound information. Thank you for providing it!
~ Let's not confuse insulin with blood glucose spike ❌️
I'm left a bit confused by this. So, the dietary priority for T2D remains avoiding prolonged post- prandial high blood sugar levels by avoiding high-glycemic foods, correct? Not necessarily avoiding foods that cause high insulin spikes, correct?
James - We are not, don't worry. Dr Gil makes it very clear what he is referring to, many, many times - no confusion. Maybe you should try watching again.
Love your presentation format. Great channel and like that you gently put forth the "subscribe" aspect .
So... Preferencially eating low glycemic index foods is bogus?
I could be wrong, but i think the main benefit of low glycemic foods is hunger management. Less hunger=less calories consumed=weight loss for an overweight individual.
Blood sugar/insulin spikes aren't necessarily a bad thing if you're healthy and active, but you might feel hungry sooner once blood sugar drops back down(compared to low glycemic foods which will contribute to more stable blood sugar)
This looked at insulin spikes, not blood glucose. I do believe it does make a difference if cells receive a large amount of glucose all at once or slowly over time in terms of energy and hunger levels.
In terms of insulin resistance - insulin is the wrong culprit here. It‘s fat, saturated fat. You can induce IR with it as shown in several studies. We have two sources - dietary or de novo lipogenesis from glucose. They have one thing in common. They are caloric excess and that‘s the real issue in my eyes. No idea if GI makes a difference in that regard. I think it might, but maybe satiety plays the bigger role in preventing it.
He literally said there isn't enough research yet. And to NOT look at the foods and their acute GI spikes.
@@joerenner8334 An I am literally countering that.
1) He was talking about insulin spikes. They are absolutely necessary and appropriate to counter the glycemic load.
2) Blood glucose spikes are problematic. That is why we respond with insulin.
There is other research, and evidence that is not research, that he is not talking about.
yeah "there is nothing to see here"
@@jamesalles139 No. They are only a problem if you have diabetes.
This answered a lot of unanswered questions I had about this. Many thanks for sharing Dr Carvalho
It may be against some people’s ideas but it makes sense that a good insulin response indicates proper function of pancreatic cells.
Most people who follow glucose goddess are worried about glucose spikes and less about insulin spikes. But there are keto doctors who think insulin is the devil.
The Keto guys are being misled by their own debunked hypothesis (CIM).
It's the prolonged hyperglycemia that's harmful, not simply the insulin spikes by themselves.
But even those who preach insulin spikes are bad, tend to use the glycemic index to rate healthiness of foods, rather that the "insulin index" shown in the chart at the end of this video. And the glycemic index is actually effective for this, is it not?
My only question would be why the glycemic index and "insulin index" diverge so much? I would have expected the glucose spike and the insulin spike to be correlated to each other.
But even here, it's so different for every person...
Awesome video again!
You are one of my 3 sources on YT I know I can rely on to get accurate information with Physionic and Layne Norton
The part about differents foods and their correlating insulin spikes is really weird to me. I have type 1 diabetes and therefore I have to inject insulin for every meal and I can say you barely need to take any insulin for fish, beef, vegetables. Beans you need to take a little. Lentils are quite similar to beans. White pasta? You need to take a lot of insulin, same thing with fruit.
I'll take your observation over his.🤔🤫😉😇
What if my fasting blood sugar is 4.5 and 1-2-3 hours after eating 4.7-5 is this good or normal
Is it the area under the curve of insulin levels that matters not so much the peak level? You could have a high, short spike or long lower spike.
Hello Gill, how much of the atherosclerotic plaque is made up of cholesterol or lipoproteins? What percentage?
I have been subscribed for some time now, with All Notifications turned on, but I have not seen anybof your videos turn up in my UA-cam Notifications list for 3 months... what is going on here?
not sure... :(
It's interesting to wear a CGM for 2 weeks and observe own body how it reacts, I did that and saved my graphs results for later. Some foods are not so intuitive, for example I had a piece of cake and expected massive spike, but nothing happened, maybe because of fats. It's cool to see how soon (literally 30 mins) after eating oats the glucose begins to raise and how quick it takes to drop back to baseline. Or what it looks like during the night and morning before breakfast - totally flat line. Or how it spikes at the beginning of a workout, without even eating anything. But I'm counting calories, so that changes things.
It should be at its lowest half way through the night and the raise by the time you get up. Similarly even without eating it should raise before you workout, but probably not that much, if it does maybe chill a bit more before going for it
Hmmm. After a day or two that must get really boring, especially sense it doesn't mean anything in regards to your health.
@@brucejensen3081 yes second half of night was slightly lower and there was the lowest point there, then by 6-7am began to raise. Workout spike - yea it's not actually a "spike", much less than after eating, but very noticeable on the chart, I guess maybe some release from glycogen stores.
Hit it out of the ballpark once again.
Interesting. What about insulin levels at the two hour mark which is usually the end of a standardised "glucose tolerance test"? Was this measured?
it's not the spikes it's the constant elevated levels for almost all waking hours and even into sleep because of frequent eating.
What does this say about the glycemic index then?
I asked this question too. Gil said glycemic index is what's important with T2D. Avoid prolonged hyperglycemia by continuing to choose low-glycemic foods, not by choosing foods that spike, or don't spike, insulin.
@@jondel3304 thanks for sharing. But I thought when you spike a blood sugar response, you spike insulin. Wonder if he’s saying there is a difference?
Spiking blood sugar, and spiking insulin are two different responses. Limiting blood sugar spikes in intensity and duration is what's important. This can be done by following the glycemic index, and eating low-glycemic foods. Nevermind about insulin spikes.
1. Glycemic index does not predict an individual's glycemic response to a food, but can be used as a tool to assess the insulin response burden of a food, averaged across a studied population. Individual responses vary greatly. 2. The glycemic index is usually applied in the context of the quantity of the food and the amount of carbohydrate in the food that is actually consumed. A related measure, the glycemic load (GL), factors this in by multiplying the glycemic index of the food in question by the carbohydrate content of the actual serving. 3. Depending on quantities, the number of grams of carbohydrate in a food can have a bigger impact on blood sugar levels than the glycemic index does. Consuming less dietary energy, losing weight, and carbohydrate counting can be better for lowering the blood sugar level. Carbohydrates impact glucose levels most profoundly, and two foods with the same carbohydrate content are, in general, comparable in their effects on blood sugar. A food with a low glycemic index can have a high carbohydrate content or vice versa; this can be accounted for with the glycemic load (GL) where GL = GI% × grams of carbohydrate per serving. (from the Wikipedia)
is there a difference between a glucose spikes and an insulin spike or are they used interchangeably?
They must be different because the chart shown in this video is very different from what you would expect based on the glycemic index of those foods...
Fascinating studies. Thanks.
Great video! Very interesting topic
One of the best doctors / researchers on You tube. No extremes and very documented and rational scientific comments. Keep going like that Dr. Gil !
This is real science. Thank you !
I watched your videos on oils and wondered about oil in the diet vs. no oil in the diet.
The comparison chart at 8:56 is super confusing to me. How does this foods & insulin spikes chart relate to the glucose spike? This chart looks nothing like the glycemic index. Don't high glycemic foods and insulin spikes go hand in hand?
To prevent ailments, we are supposed to avoid foods that cause a high glucose spike (otherwise why do people including some doctors wear CGM?) but does this insulin study give any insight into whether this notion is also misguided?
The symptom I have with glucose spikes is extreme tiredness and then reactive hypoglycaemia caused by the accompanying insulin spikes driving the glucose level down well below fasting levels. The major symptom of hypoglycaemia is deteriated vision.
I've heard many scientists say it is very personal to individuals too. For example some people have more salivary amylase that breaks down carbs into glucose before it even reaches the stomach, and also some have microbiomes that seem to inhibit glucose spikes. (over on ZOE youtube channel)
Also how about what happens when the glucose is all stored away? Couldn't a larger amount of insulin make the blood-glucose drop too low because it is reactionary and lags behind current blood-glucose levels?
This is excellent stuff but should be called Nutrition Made Accurate rather than Nutrition Made Simple.
Is there any evidence on which of the following is better: 1) food that causes a short, high glucose spike 2) food that causes sustained lower glucose spike?
Or is it just the AUC (area under the curve) that matters? I have found that taking fiber supplement with with most foods flattens the curve.
or is it neither of the three? The video suggests that.
In general higher fiber foods are more healthy. An apple is better than candy or a donut. And yes, we know that fiber flattens the curve, because it slows glucose absorption. However, adding a fiber supplement is going to be less healthy than eating a high fiber diet, in other words: a diet high in plants (beans, lentils, vegetables, fruit and nuts &seeds).
Many unhealthy foods do cause a short high glucose spike. In the video it was jelly beans, I think. However, as the video says, it's not a good marker of unhealthy food.
@@k.h.6991 I would like to echo that buying fiber supplements is totally idiotic. I am NOT saying that those who think about doing this are idiots, but rather the action itself is a fool's errand. Why buy fiber supplements when the over whelming amount of Whole Foods, whole complex carbohydrates, plant foods, fruits, vegetables , whole grains, and so on are packing way more fiber with vastly more nutrients ??
FIBER IS THE KEY , fiber with nutrients is an uber concept.
Might have more to do with amount eaten, how much chewed and amount of fluid consumed as well
A donut is not a carb. It's a fat.
That was helpful. Thank you!
So T2D first phase insulin response is weak, correct? A healthy response would be a robust first phase insulin response, correct? So what happens when a T2D eats something that usually triggers a large insulin response then? Like black beans? FPIR is low, and therefore post-prandial BG stays high for a longtime? So should T2D avoid black beans??
According to some diabetes doctors on youtube like Neal Barnard swapping stuff like black beans for , at least saturated, fat might be bad long term even if you have less of a glucose response acutely.
Some diabetics don't produce enough insulin due to problems with pancreas mainly I guess. Others have insulin resistance, so have super high glucose spike, even when insulin is at a normal level, I guess the body keeps excreting more insulin to cope. Would black beans be better than white pasta to reverse insulin resistance in a complete package, I would think so. I don't really like black beans but.
I liked the discussion but based on previous videos that you've released, it would have been good to give context by including some discussion of the factors that cause chronic insulin resistance and pancreatic dysfunction, such as weight gain and saturated fat consumption. Also, it would have been nice to hear you comment on how frequently eating a type of food can lead to a semi-chronic metabolic state. Measuring markers while fasted can indicate a chronic state, but so can measuring biomarkers post-meal if that meal is eaten frequently (although, a similar result would need to be interpreted differently in these two states).
Good video man
7:56 thats really fascinating. Unedcuated questions: Do glucose levels even correlate with this? Or does the pancreas use a completely different metric as a signal to produce insulin?
Ironically the ad pre and post this video is a continuous glucose monitor, that will recommend meal plans based on the response after meals exercise etc
Thank You Doctor! There are so many diet scams on these social media platforms!
Awesome discussion. The CGMs I was wearing for several months were always so inconsistent, some days the exact same food would cause way different results, it never made any sense to me.
Your response to food will greatly influenced by factors such as: do you sleep well the night before? (if not, then your body’s ability to control blood sugar level is reduced) Do you exercise before or after a meal, even as simple as a leisurely walk? (if yes, both helps regulate blood sugar levels).
I got a bit heavy some years back and was somewhat precipitously labelled "diabetic" ...
I quickly lost the first 10 kilos and figured that a few hundred kcals of reheated precooked unsweetened whole wheat berries would be the perfect breakfast food for several reasons, but even a small quantity would hit me like a train an hour or so later.. feeling faint and sweating.....though I never actually measured my blood glucose...
Curiously 500kcals worth of wholewheat bread with peanut butter had no such effect ..
Sounds like you took Dr Gabe Mirkin's advice. He was way ahead of his time regarding H-Pylori, and the whole grain versus processed grains. But he never recommended eating a bowl full of wheat berries, just some sprinkled on your salad.
I would think that those wheat berries would be a very healthy food. I wonder if your response would be the same now.
@@k.h.6991 yes I need to try again - 4 years later and 15 kilos lighter..
Carbs without fats and protein cause reactive hypoglycemia in me.
@@rey3472not for me. I can eat an enormous meal of plain white rice and still not get reactive hypoglycemia.
yes, metabolic flexibility is good.
but if your insulin level is continuously elevated, welp your pancreas only has so much capacity, and won't be able to cover a glucose spike with the appropriate spike of insulin.
Refined whey protein doesn't raise blood glucose much, but will produce an insulin spike. It comes in a container with a bar code.
Get your protein from real, whole food.
What if we eat carb meal 4 times per day and have high blood sugar during that period but normal fasting glucose.
Still the damage has been done?
Its like 8 hours we have "diabetes"
Can you make a video about antinutrients? I've searched your whole channel and don't see anything dedicated to this highly-popular topic. Thank you!
we have one on oxalates and one that touches on lectins:
ua-cam.com/video/qq1nkGqo69E/v-deo.html
ua-cam.com/video/bY7of8J2s7g/v-deo.html
As a teenager, I had an OGTT 62 mg/dl reactive hypoglycemic. Then, in my 20s, it became worse. That OGTT 52 mg/dl. I'd have to treat nondiabetic hypos do to an overactive pancreas. And 30 years later of course now diabetic.
9:08 What would make potato chips lower than potatoes? Are the latter boiled potatoes? If so, the fat in chips could explain it.
People are afraid of insulin spikes in relation to snacking when people eat often eat cookies , fro example, and keep their insulin constantly elevated. So in regards to that i would like to know smth. Are insulin spikes from different foods additive, or would i have lower insulin spike, if i eat my cookie and healthy meal together rather than separately?
Dr Gill please start making podcasts audio recordings on Spotify. I am a big fan and would love to hear your podcast.
Is a good idea to combine protein with foods known to create a spike.
Thank you for the video. Does this mean glycemic index is not a good indicator of how healthy a food is?
There is no simple answer to that. I think it can be gleaned that in moderation there is nothing necessarily unhealthy about high GI foods. It's simple and pretty much common sense. Mix up the diet with healthy foods. Stay away from McDonald's junk. Cook at home as much as possible.
It depends wheter or not you have diabetes. If you do not have diabetes then it does NOT matter.
Yes. The glycemic index is garbage.
@@joerenner8334 Except a lot of high GI foods are refined carbs, consumption of which is statistically correlated with chronic diseases. Whether or not insulin spikes are the mechanism by which they are unhealthy, is another issue.
@@Raphael4722 Yes. Like I said. No McDonald's and other garbage like that.
Maybe the spike is exactly what is not the problem. Maybe it is the gradual clearance which is different between individuals, being affected by other enzyme and hormone levels.... and in turn, affecting later food intake.
Great Video!
I think more interesting would be to have a comparision which foods cause glucose dips .Like for big dips food raises blood level, insuline kicks in, stops release of glucose very quickly and remaining insuline drives it down to very low levels. Also response to particular foods can be personal, depending on particular enzymes secretion etc.
The video was stated that sort of thing DOES NOT MATTER. It may matter to someone who is not healthy, i.e., has diabetes.
The graph and talk at the start show glucose raising not dipping below normal level. Judging by the timeline looks like a nice meal with different foods :-)@@donwinston
I haven't read that study but I think that the interpretation of those results should also include the overall diet and physical activity of those women, to put it into a context. Studying their genetics would also help to separate those having these results and those having the opposite. I have half of the genes of my mother's side where almost everyone ended with abdominal obesity and type 2 DM. I am in middle age and no sign of either. I have a carb rich diet, but I watch the energy balance, exercise, and don't bake cakes or deep fry food. My lifestyle is different. I even experience symptoms of hypoglycaemia sometimes, I clear glucose fast after eating, even if healthy porrige, especially if overheating myself by activity, other times I can go for hours without eating after a good lunch. I prefer wholesome carb sources instead of ultraprocessed ones. And I am not shy of butter, in moderation. Fairly balanced diet I would say.
what about glucose spike after meal for non diabetics. I sometimes get spikes up to 180mg/dl about after eating bread or heavy carb meal.
180mgdl is the number that type 2 diabetics are recommended to stay within.
I found out about Dr. Gregor through this channel. He indicated that eating processed carbs such as white rice and flour should be avoided, since they cause a large spike in blood-glucose levels. Couldn’t this problem be circumvented by eating these high GI foods with fiber-rich foods and healthy fats to lower the glycemic load of the meal, thereby making these ‘bad carbs’ not so bad?
very informative thanks !
I've been trying the glucose goddess diet and I feel like just eating a LOT more vegetables has been great for my energy levels, but the timing thing (veg first, carbs last) I'm not too sure about. Still, this 1 study you looked at doesnt really test whether it reduces feeling fatigued without a reason, which is what I'm doing it for.
Good info, thank you!
What about reactive hypoglycaemia when glucose levels rise steeply and then crash below base level? This can happen in people without diabetes. What is the root cause? I know it happens in response to carbs, and can be eliminated with a low carb diet, but that’s just treating the symptom not the root cause.
Wonder what small hits of sugar all day do? Sipping soda, coffee, etc. lots of us do that
Maybe i am a bit slow, but are insulin spikes and glucose spikes the same ,... Or are they different things,... I don t quit get it 😢😊 ,... great Video ❤🎉
different but related. insulin is secreted in response to glucose levels (as well as other factors). insulin spikes follow glucose spikes
Hey Gil thank you so much for taking the time to answer my question,.. I really appreciate it......😊
What I understand and take from that is ,....that scientifically there's not much evidence that would support the thesis that high glucose spikes and insulin spikes (which of course stand in relation to each other ) are harmful in healthy individuals and if anything even beneficial,.... 😊,..
@@NutritionMadeSimple
there's some debate regarding supra-physiological glucose spikes but in general, yes, glucose excursions per se don't appear to be a problem@@emanuelgy729
Thank you so much, you cleared this really up for me,...and in general ,..I am big fan of your channel ,..follow for years now,...here I learned how to look for studies ,....and more often now,..i take a look myself into scientific papers,..so thanks for that , too 😊
I think a lot of people conflate insulin spikes and glucose spikes and it can lead to contusion. A high insulin spike after a meal means something different than a high glucose spike after a meal, tho not all glucose spikes are dangerous or indicative of pathology.
No not really. If you do not have diabetes then glucose spikes are not unhealthy. What is unhealthy is CHRONICALLY high blood sugar not spikes unless they are super high like over 180. But that will not happen if you do not have diabetes.
You're not going to eat just white pasta. Interesting to see it was low. The combinations that people eat, like which pasta dishes are higher/lower. If you are in the hypoglycemic range, does like higher lipids stop you from comatosing?
What about frequent, habitual spikes because of a high carb diet? I always thought that having high glucose levels lead to inflammation which in turn causes logon terms health issues?
Thank you so much for the video!
What do you mean by "high"? It's considered not ideal if your glucose levels reach over 180mg/dL after a meal. It doesn't mean that lower is always necessarily better even below that point.
The channel "Nourished By Science" has some great vids on that topic btw.
Doesn't seem to be much of an issue with those with optimal metabolic health
Thanks. What if your A1-C tests out between 5.5 and 5.7 through the past few years? I have gotten rid of a lot of carbs, but I still have enough i guess. Even when I drop pretty much all for a 3 month period it only brought it down to 5.4-5.5. That was a bit disappointing for sure. I used a CGM for a year and that taught me about meal order, timing, and adding protein to lessen spikes.
I eat a very high carb very low fat diet and my fasting insulin when I last had it tested was 2.3 and my a1c was 5.0. I can eat an enormous meal of plain white rice and my 2 hour blood sugar after I finish eating it is under 110.
Nice A1-C I think, but a glucose over 100 I thought was not great.
What does it mean when your A1C is less than 5 but your resting glucose level is at 125?
Are you on a HFLC diet?
How long was the fast? Sounds like your insulin response is good once you eat again. There's a lot of misinformation on here including the idea that blood sugar levels drop when we avoid eating carbs or when we fast or lose weight. Not for everybody. One size fits all solutions are bad for endocrinology.
Must be having extremely intense dreams just before waking then have a boring time when awake. Lol
How many hours ago did you last eat when it was 125?
This isn't about insulin spikes causing all of this issue right? This is about the amplitude of the spikes. I thought the bad thing is frequent glucose spikes because of the demand of the pancreas.
The insulin spikes in all cases and to me it makes sense that a vital pancreas would match the glucose spikes faster.
I never heard people talk about the amplitude of the spikes because that is of course hard to know unless you really use a glucose tracker in your arm.
There are actually lots of videos of so called health influencers wearing glucose trackers and freaking out about spikes after eating things like oatmeal on tiktok.
I think it ok with people that have optimal metabolic health. If you are insulin resistant the pancreas would be working harder to produce more insulin to drop the glucose levels
@@pomberry3591yes, but they are glucose spikes, not insuline spikes ;-)
I am confused by this... so, there is indication that insulin spikes are normal, and that healthy people may have insulin spikes to "aggressive" stimuli (like pure glucose on empty stomach, for study purposes). There are, however, many questions left unanswered... Are all insulin spikes equal? In quality and duration? Some proteins raise insulin... is it identical to glucose induced spikes in all metrics? We can cause insulin spikes all day with pure sugars (like fruit juices) and it won't mess up the insulin/glucose mechanism in otherwise healthy people? How confident are we with the data?
After a health scare about 5 years ago, I watched so many UA-cam health videos. Now, I am a confirmed omnivore. Let me put it this way, if I were to be wrong in my diet, at least it tasted fine.
Watching UA-cam videos alone is guaranteed to confuse people. Read eg the Canadian dietary guidelines, the World Cancer Research Fund report on cancer prevention, professional medical association guidelines etc
Thanks for the video. Doesn’t type two diabetes significantly increase CVD or the risk of CVD? Why? What causes the risk? What mechanism causes this increase? Is it high glucose? Or high insulin?
Wouldn’t this go along with Walter kempners high carb rice diet results?
Why no under the curve data? I understand that the study was about spikes, but how hard could it be?
My guess would be because CIR is an easier measurement to get, only requiring 30-min insulin and 30-min glucose. Using an easier to get measurement makes the study easier to run and the results easier to apply to the real world.
@willgd6666 sorry, what does "under the curve data" mean? Thanks
I can’t wait when they come out with an insulin continuous monitor, it will be a game changer!
I may have missed a point but assuming that none of the women developed or were pre-diabetic or diabetic during the study duration, perhaps the association between higher IR, waist circumference....with higher insulin spikes indicates the early stages of the pancreas sensing more insulin is needed to shuttle nutrients into cells and still having enough beta-cell function to do so. I'm as surprised as anyone with oats and doughnuts not producing more of a spike than meat and fish but perhaps the fiber and fat content of these respectively blunt the response.
I am a little surprised that you relied on one study that is now more than 25 years old to discuss the effect of different foods on insulin. Surely there are more recent studies? I also understand from listening to the CGM people that different people can react very differently to the same food, so I wonder how whether a single bar for oats or fish or jelly beans is really meaningful. I understand the ZOE organization in the UK and several in the US have been gathering insulin spike data on people who use CGM devices. I wonder if they have any studies?
from what I´ve seen they focus on glucose not insulin peaks. but if they have systematic analyses of insulin excursions that´d be interesting. individual variability is very likely
@@NutritionMadeSimple You are correct, the devices measure glucose. I guess I was assuming that high variability of glucose between individuals would also lead to variability of insulin. Seems like this is something that really should be studied!
This is very interesting, especially considering what the Glucose Goddess has said about it.
The redults were not very surprising.
What was very surprising is that the researcher thought the theory that a diet that causes bigger insulin spikes causes more weight gain is tested by measuring just the insulin reaction of the body.
Or in other words: if the theory is that the stick that is bend the most breaks more likely and you measure how bendable a stick is then of course the most bendable sticks break the least.
Young healthy people have glucose level between 70-180 mg/dl 90% of the time. And Average glucose between 90 and 120 (hba1c). These two are good metrics to think about glycemic control. Fasting glucose and fasting insulin can be 3rd and 4th.
180 is terrible for anybody at any age. Average glucose and hba1c aren't the same thing. Your post did prompt me to find out what the official healthy ranges are
great info as always.
Off topic question, The women's health initiative supposedly used equine vs human estrogen, does it make the conclusions invalid?
At about 511 liked the line about pancreatic vigor