going back to the glucose thing I I've heard I would say very well respected Physicians one physician in particular say I'm paraphrasing him but he's basically said if I put a continuous glucose monitor on you you can eat whatever you want as long as your blood sugar doesn't go above a certain threshold he has set the average blood sugar at 85 with a standard deviation of 10. so that and that that to me is just like my my hair stands on end I'm just like smoke comes out of my ears and I think what are you talking about there's no attention to dietary quality there and that statement assumes that there's good data for a predictive value for glycemic index glycemic load of our foods which there isn't I mean before we get into the science check out G sauce there's a buy one get one free link down below this is literally the best sauce that I have found so if you've ever had [ __ ] and sauce it's from the people that originally brought you [ __ ] and sauce except they branched off and 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a variety pack of these six flavors nice I've got an abstract pulled up here it's a 2018 study the relevance of glycemic index and glycemic load for body weight diabetes and cardiovascular disease uh the lost last author is Joanne slavin and the the conclusion is that GI and GL so glycemic index glycemic load have essentially no predictive value when it comes to cardiovascular disease or diabetes so I'll hear people say this all the time oh my blood sugar went to 140 and they just get why they're like oh my God that's like a volcano it's just so high it's like 140 milligrams per deciliter is not you know that's not a sinful blood sugar for humans that's a normal physiologic blood sugar that a lot of humans should be getting after their meal and so this this this Shin with keeping your blood sugar below 110 as a peak or an average of 85 with a standard deviation of 10 milligrams a deciliter for me this hurts people because it's much too tight control it doesn't allow you to get that postprandial insulin Spike which you need which will be accompanied by a glucose Peak after your meal that's fine but understand that you can look at a continuous glucose monitor and calculate glucose area under the Curve which would be some indication of insulin area under the curve and this this physician says that he wants to minimize insulin area under the curl and I'm thinking that's the wrong thing to do uh insulin area under the curve is not what is causing metabolic dysfunction and insulin resistance in my opinion I also think there's some real misunderstanding in the communities in the nutrition community that about the prevalence of insulin-induced insulin resistance I think it's extremely rare in humans and we don't need to be as strict about about absolute levels of insulin or insulin area under the curve that were that were sort of abstracting from glucose area under the curve so in my strong belief it's fine to have a post perennial blood sugar of 140 because if you are insulin sensitive and if you have a continuous glucose monitor what you will see is the blood sugar goes up and it comes right back down and the glucose area under the curve is very small and so that to me this is there's not enough understanding of this and sort of wrapped into that is what I was talking about earlier unless there is a central appreciation and focus on food quality I don't think any diet is going to lead to Optimal Health for humans long term and to be able to say to someone or to say I don't care what you eat just keep your blood sugar below this level is in my opinion like there's no focus on nutrients no focus on food quality and this gets right back to the place where you know the calories in calories out crowd um says essentially that that statement is suggesting that all calories are created equally and we know that if you look at just within fat molecules whether you have an 18 carbon saturated fat which is stearic acid which we can talk about or an 18 carbon omega-6 polyunsaturated fat those do massively different things in the human body those are both 18 carbons right they're the exact same amount of carbons they're the they're very similar molecules they're just different by three or two double bonds you know and so yeah that's all that's different it's just a few electrons in different orbitals on the molecule but they do massively different things in the body because these fat molecules we know essentially have hormone-like effects in the human body with the polyunsaturated fat being linoleic acid the saturated fat being stearic acid doing completely opposite things in our metabolism so I think that as a broken record I will say we must focus on food quality um in any sort of dietary approach as a human and my goal with what I'm helping people understand is that if you can get to a place where you can eat as much of a certain set of foods as you want you're going to win and that I believe that if you select those Foods properly this is a pretty bold statement if you select those Foods properly by looking at Food quality and the absence of things that will destroy your metabolism or break it you can eat as much of those Foods as you want Society will come and you will lose weight and become anabolically healthy and life is good yeah that's such an interesting way of putting it and to give people something pragmatic let's say people are wearing a CGM and they do want to monitor these things you mentioned okay that postprandial spike in glucose is obviously a natural response postprandial spike in insulin natural response so do you think people should look at maybe what happens two hours after they eat a meal and if they're still elevated and having issues then then there might be something to look at because like for me for example I'll use you know anecdotally like I Spike pretty high and a lot of it you know I generally do now I have a long history of ketogenic diet and a long history of intermittent fasting and prolonged fasting where I probably have a degree of peripheral insulin resistance that I'm not tripping out about right and uh I I just don't get the concerned My fasting glucose is around 100 it's not the end of the world for me right and I try to explain that uh when I eat carbohydrates I might Spike to 140 but I do generally come down pretty quick now if I spiked to 140 and I'm asking you and this isn't this isn't necessarily uh circling back to what I believe or not I'm just curious if I checked two hours later and I was still at 140.
Then it sounds like that might be an issue exactly um yeah I mean so there's a couple things wrapped up in there that we should talk about which is physiologic insulin resistance which happens in a low carbohydrate state which is a really interesting discussion and it's normal human physiology quote unquote normal and it gets often conflated with pathological insulin resistance which are completely different processes High insulin versus low insulin in those two states and so but if you're talking about your CGM yeah like elevation of your blood sugar after two hours is a problem and I love continuous glucose monitors but there's a much easier way to get at this issue which is just get a freaking fasting insulin I think that people should get fasting insulin every month and in my opinion this single blood test which probably costs 35 dollars would change the medical system would change the Horizon would change the landscape I mean it should be less than five micro IU per ml it'd probably be less than three mine was recently 2.4 micro IU per ML and I eat between 250 and 300 grams of carbohydrates a day so if anyone believes yeah if anyone believes it's just this is my n of one but I've seen it over and over and over it's I've seen it all the people I work with it doesn't it doesn't work like this right so carbohydrates do not cause insulin resistance not all carbohydrates are created equally but a fasting insulin should be low you can get a sense of how your fasting insulin is going to be by using a CGM and I think these two go hand in hand they really complete the picture looking the phenotype so the actual way that you're postprandial glucose looks can also indicate insulin sensitivity versus insulin resistance and the pattern that you want to see in your insulin is a spike excuse me the pattern you want to see in your glucose if you're eating carbohydrates in a meal is a spike up to whatever 130 140 probably even 150 is fine when you get to 180 or 200 that's pathological but 140 145 no big deal and then a quick return to Baseline within an hour preferentially and that Baseline can be something that you understand when you're wearing a CGM
