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
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!
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.
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 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
@@fridadeivizsla2729everyone makes money off of other people problems. Not that i follow glucosehoddess but, taken to its logical extent you wouldn’t visit a grocery store as they are making money out of your hunge problems. Don’t use the AC, buy gas, get proscription drugs, buy clothes and never use Amazon.
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.
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.
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
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.
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.
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.
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
You guys are great. I just got a CGM just out of curiosity, and I wanted information. I found out that my savory breakfast of steel cut oats with a veggie topping along with tea and honey does not even move my levels - yay! I also have learned that white pasta (even post refrigeration) sends me up into the 165 range. If I ever eat pasta again, it will be at lunch (with a lot of protein) when I can go for a long walk right after eating.
There was a 41 year old male type 1 diabetic on UA-cam who said when he eats steak his blood sugar doesn't change until four hours when it goes through the roof.
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
Great conversation! Thank you Gil and Dr. Kratz. I am a T2D controlled by low carb lifestyle. 2 years ago I developed a heart arrhythmia (Afib) which I believe was due to an electrolyte imbalance. This was before I knew I was prediabetic. Found out my cortisol levels were out of control. As I began my search for the root cause, I discovered other influencers saying a low carb diet wrecks your metabolism, lowers body temperature and causes problems with stress hormones ie cortisol. So, while I think low carb is a way for me to manage my diabetes, did it wreck my metabolism causing my diabetes, cortisol and heart issues?
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.
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.
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
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??
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.
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
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 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.
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 ✌️
I tend to think so. Not all the time, but maybe once every few years. A CGM can be very useful to identify early shifts towards glucose intolerance that standardized clinical tests often miss, and in that way can help people prevent progression to prediabetes or diabetes sooner. I talk about this here: ua-cam.com/video/DVND90vQ0xI/v-deo.htmlsi=4-SVtd7k8bkUUdDT
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.
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
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?
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.
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.
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.
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?
@11:00. Interesting observation that I found out about when wearing a CGM: my blood sugar was elevated more by exercise (lifting heavy weights, deadlifts and squats) and reaches it's highes levels more so than it did after I ate. I was very surprised and shocked the 1st time it happened. But it happens every time.
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
Diet and nutrition expert Jesse Inchauspe, says that preceding a high glycemic index meal with protein, fat and some vinegar - MITIGATES the sugar spike.
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)
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?
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 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
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.
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
I would apply the same threshold, independent of age. It is understood that HbA1c often increases as we age, but that doesn't make it innocent, i.e., having chronically elevated blood glucose is a risk factor for chronic disease indepdent your age. Cheers Mario
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?
- 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.
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!
What a combo! My two favourite, fair, unbiased experts coming together. Thanks so much. 😊
First the physionic video, now this! What a treat! ❤
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
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.
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.
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.
This is a great and timely video. Thank you.
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
I follow her tips and feel so much better and my blood sugar has less spikes. Is it all in my head??
Thank you, thank you, thank you. The insane following she has is really irritating. She’s a fearmonger.
@@fridadeivizsla2729everyone makes money off of other people problems. Not that i follow glucosehoddess but, taken to its logical extent you wouldn’t visit a grocery store as they are making money out of your hunge problems. Don’t use the AC, buy gas, get proscription drugs, buy clothes and never use Amazon.
Thank you Drs. Carvalho and Kratz. 🙏
Thank you both for this very helpful talk.
OMG! I love Mario’s channel. It’s helped me so much.
Awesome balanced discussion.
Two of my favorite scientists in a long video chock full of clear analysis and information.
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.
A really exceptional exposition on this complex topic - thank you, Gil and Mario!
My two favorite scientist nutritionists.... Let's go 😱
Came to say same!
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.
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.
VERY GOOD VIDEO. MANY MYTHS DIMiSTIFIED. Kudos
Good conversation by two people interested in fact-based information. Great, a must-listen for all who are interested in the subject.
excellent information. It has shown me that I have probably been wasting a lot of time probably for not a good reason.
Brilliant video, thanks for your efforts !
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 2 favorites! Can’t wait to watch.
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.
What a great session! Learned so much about what CGMs do and don’t tell us… wow! Thank you!
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.
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!
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
Love the deep dives thank u!!❤️
Thank you for this video 🙏
Excellent presentation!
extremely informative; this context is missing from basically all other dialogue on this subject. thank you 🙏
You guys are great. I just got a CGM just out of curiosity, and I wanted information. I found out that my savory breakfast of steel cut oats with a veggie topping along with tea and honey does not even move my levels - yay! I also have learned that white pasta (even post refrigeration) sends me up into the 165 range. If I ever eat pasta again, it will be at lunch (with a lot of protein) when I can go for a long walk right after eating.
Same for me with the steel cut oats, agree on the pasta treatment too.
i've measured both pasta from America and from Italy.Italian pasta does not raise my BS but American pasta does.
one of your best shows Doc
Great conversation!
Happy Monday both my favourites😊
Excellent episode, thank you!
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!
Thank you! I'm binging on your videos.
There was a 41 year old male type 1 diabetic on UA-cam who said when he eats steak his blood sugar doesn't change until four hours when it goes through the roof.
A very informative video. Thank you
Great discussion. Thank you both very much
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.
Great video, I would like to see you two collab again in the future😊
This was very interesting and informative. Thank you!
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 😊
yay! these two guys!❤
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
Great conversation! Thank you Gil and Dr.
Kratz. I am a T2D controlled by low carb
lifestyle. 2 years ago I developed a heart arrhythmia (Afib) which I believe was due to an electrolyte imbalance. This was before I knew I was prediabetic. Found out my cortisol levels were out of control. As I began my search for the root cause, I discovered other influencers saying a low carb diet wrecks your metabolism, lowers body temperature and causes problems with stress hormones ie cortisol. So, while I think low carb is a way for me to manage my diabetes, did it wreck my metabolism causing my diabetes, cortisol and heart issues?
Christmas? Again?
Thank you Gil!
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.
Such an excellent video! Thank you!
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.
DId your FBS go down?
Excellent! Thank you 😊
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...".
@@gsp0819kri Thats what I meant, sorry!
@@gsp0819kriWhat a pointless comment.
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?
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??
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.
Wow, very informative! Thanks!
Very interesting, I will definitely listen to this again.
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?
Excellent stuff! I need to go back and finish watching Physionics recent video about glucose spikes now...
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!
Would be awesome if you included these in Spotify or Apple Music.
Thanks for this
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.
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.
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 ✌️
This was all very interesting, but are CGMs even worth it for healthy people?
I tend to think so. Not all the time, but maybe once every few years. A CGM can be very useful to identify early shifts towards glucose intolerance that standardized clinical tests often miss, and in that way can help people prevent progression to prediabetes or diabetes sooner. I talk about this here:
ua-cam.com/video/DVND90vQ0xI/v-deo.htmlsi=4-SVtd7k8bkUUdDT
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.
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
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?
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.
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?
These are the two only figures you need in case you have diabetes issues. Period.
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.
dry, clinical and to the point, that's how you know this guy is the real deal 😂 love these scientific breakdowns though👍
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.
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.
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?
@11:00. Interesting observation that I found out about when wearing a CGM: my blood sugar was elevated more by exercise (lifting heavy weights, deadlifts and squats) and reaches it's highes levels more so than it did after I ate. I was very surprised and shocked the 1st time it happened. But it happens every time.
Can you do a video on how to lower uric acid and prevent gout?
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
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.
Very interesting
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.
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?
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 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
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.
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
Results: Sensor glucose concentrations were 71-120 mg/dl for 91% of the day.
I understand an A1C below 5.7 is optimal; however does this range change with age? Is this range the same for a 68 year old? Thank you.
I would apply the same threshold, independent of age. It is understood that HbA1c often increases as we age, but that doesn't make it innocent, i.e., having chronically elevated blood glucose is a risk factor for chronic disease indepdent your age.
Cheers
Mario
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?
- 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.
It could be incredible if you could have the guys from mastering diabètes on this topic on your Channel !