Understanding Glucose Spikes | ft. Mario Kratz PhD

What are Glucose Spikes? What causes Glucose Spikes? Are Glucose Spikes unhealthy? What are some tips and hacks to keep Glucose Spikes under control?
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KZbin: / @nourishedbyscience
Web: nourishedbyscience.com
Twitter: @mario_kratz
Connect with me:
Facebook: / drgilcarvalho
Twitter: / nutritionmades3
Animations: Even Topland @toplandmedia
References:
CGMs in healthy people:
www.ncbi.nlm.nih.gov/pmc/arti...
pubmed.ncbi.nlm.nih.gov/20215...
pubmed.ncbi.nlm.nih.gov/18473...
journals.plos.org/plosbiology...
Glucose Spikes Q&A:
nourishedbyscience.com/blood-...
Insulin, 2 Phases of secretion:
journals.physiology.org/doi/f...
pubmed.ncbi.nlm.nih.gov/22834...
Carb intake and glucose/insulin responses:
academic.oup.com/jes/article/...
pubmed.ncbi.nlm.nih.gov/35108...
Food order & glucose spikes:
www.sciencedirect.com/science...
www.ncbi.nlm.nih.gov/pmc/arti...
www.jstage.jst.go.jp/article/...
1,5-AG:
pubmed.ncbi.nlm.nih.gov/16731...
www.ncbi.nlm.nih.gov/pmc/arti...
pubmed.ncbi.nlm.nih.gov/28535...
pubmed.ncbi.nlm.nih.gov/32792...
CGM vs plasma glucose readings:
diabetesjournals.org/care/art...
Disclaimer: The contents of this video are for informational purposes only and are not intended to be medical advice, diagnosis, or treatment, nor to replace medical care. The information presented herein is accurate and conforms to the available scientific evidence to the best of the author's knowledge as of the time of posting. Always seek the advice of your physician or other qualified health provider with any questions regarding any medical condition. Never disregard professional medical advice or delay seeking it because of information contained in Nutrition Made Simple!.
#NutritionMadeSimple #GilCarvalho
0:00 Are Glucose Spikes unhealthy?
15:50 What causes Glucose Spikes?
25:01 When Glucose Spikes go wrong
42:16 Are CGMs reliable?
44:52 Are Glucose Spikes natural?
54:33 Foods & Diets
1:08:10 Glucose red flags
1:11:00 A marker of glucose spikes
1:15:22 Healthy food swaps
1:23:13 Treatment vs prevention

[@HorslandFilms]

Someone should send this masterclass to glucosegoddess. She's been building a whole career by scaring people with glucose spikes misinformation.

[@versatilecraft]

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.

[@fridadeivizsla2729]

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

[@markpearce9200]

What a combo! My two favourite, fair, unbiased experts coming together. Thanks so much. 😊

[@Sparkling-Cyanide]

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!

[@471444a]

First the physionic video, now this! What a treat! ❤

[@chet5165]

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

[@nourishedbyscience]

That's great to hear. Thank you for sharing evidence-based information in your group. Cheers Mario

[@atoms.channel]

what happens when the science contradicts itself? or just isn't there? Just curious. BTW awesome for fostering such a community!

[@drbachimanchi]

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

[@methanial73]

So with out of normal cpeptide along with Homa IR? Better at determining risk of developing metabolic syndrome?

[@drbachimanchi]

Homa ir is the best marker

[@amarug]

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

[@danielsijuade4696]

My two favorite scientist nutritionists.... Let's go 😱

[@chewiewins]

Came to say same!

[@nanduthalange7736]

A really exceptional exposition on this complex topic - thank you, Gil and Mario!

[@elmeric7086]

Awesome balanced discussion.

[@dronepilot7659]

I think this video just convinced an enormous amount of people that glucose spikes below 190 mg/dl are nothing to worry about.

[@DrTomMD]

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

[@nourishedbyscience]

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

[@Caladcholg]

​@@nourishedbyscienceso how many people need to get sick before you have enough 'evidence'?

[@nourishedbyscience]

@@Caladcholgcan you clarify what you mean?

[@Caladcholg]

@@nourishedbyscience how many people that never have an 'excision' over 180 mg/dl that get pre-diabetes would it take for you to consider sufficient evidence? There are a lot of us, and this is getting really serious.

[@aprilblossoms4]

My 2 favorites! Can’t wait to watch.

[@Jupiter_Crash]

OMG! I love Mario’s channel. It’s helped me so much.

[@BartBVanBockstaele]

Good conversation by two people interested in fact-based information. Great, a must-listen for all who are interested in the subject.

[@mountaingoattaichi]

This is a great and timely video. Thank you.

[@rafaelgelpi2718]

Two of my favorite scientists in a long video chock full of clear analysis and information.

[@uphillbill]

excellent information. It has shown me that I have probably been wasting a lot of time probably for not a good reason.

[@karentodd2678]

Thank you for bringing Mario Kratz to this conversation. I never knew if him before. Very informative.

[@jenniferchapman9645]

Happy Monday both my favourites😊

[@eddieduplessis1145]

Thanks guys for sharing your valued experience and observations regarding this topic!

[@kshiteeshsn263]

Thank you for this video 🙏

[@maarten7]

Thank you Drs. Carvalho and Kratz. 🙏

[@jjjames6894]

Love the deep dives thank u!!❤️

[@Ian-io3yt]

Great discussion. Thank you both very much

[@MrFlasher666]

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.

[@heathercoey4690]

Excellent! Thank you 😊

[@cgillit]

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!

[@DennisForbes]

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.

[@Trener_Artem]

@@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.

[@DennisForbes]

@@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.

[@Broken4forever]

​@@Trener_Artem what study by chance? Name of it to search?

[@lenguyenngoc479]

​@@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

[@anthonydatel3685]

What a great session! Learned so much about what CGMs do and don’t tell us… wow! Thank you!

[@lynnmunson564]

Such an excellent video! Thank you!

[@kellyburek1751]

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.

[@monikakress3867]

yay! these two guys!❤

[@virginiemazy7054]

Thank you for the vidéo and the fact that I discovereda new non biased YT channel!

[@Joy80JJ]

A very informative video. Thank you

[@michaelvadney5803]

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.

[@evangephone-two7877]

Okay but why is a smoother glucose curve better?

[@wackthegood8884]

What is the correct eating order?

[@michaelvadney5803]

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.

[@wackthegood8884]

@@michaelvadney5803 Interesting. Thanks for replying.

[@jussi3378]

@@michaelvadney5803 Fat smoothens the curve also

[@carinaekstrom1]

Wow, very informative! Thanks!

[@mattkojetin8198]

Very interesting, I will definitely listen to this again.

[@christinebowman90]

one of your best shows Doc

[@VeganLinked]

Excellent stuff! I need to go back and finish watching Physionics recent video about glucose spikes now...

[@jasonblome5287]

This was very interesting and informative. Thank you!

[@reason3581]

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.

[@SBqwerty]

Thanks for this

[@azdhan]

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.

[@atoms.channel]

I don't recall from Dr Kratz's videos what his recommendation regarding "derailing" T2D before it begins, but have you looked into the Fast Mimicking Diet, specifically the DIY FMD since the pay-for protocol is rather expensive?

[@rmtb9204]

Type 2 diabetes is not genetic every single person can get it.

[@RogerHyam]

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 😊

[@Anima7e]

Would be awesome if you included these in Spotify or Apple Music.

[@LinusBerglund]

Christmas? Again? Thank you Gil!

[@karolina8367]

Great video, I would like to see you two collab again in the future😊

[@TommysPianoCorner]

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.

[@dennisward43]

Too much fruit , especially on top of high-fructose corn syrup (found in much highly processed food), can lead to fatty liver.

[@marcdaniels9079]

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

[@atoms.channel]

@@marcdaniels9079 googled "is fruit available year round in tropics".... ANSWER: "Even in the tropical area where the temperature is relatively constant year-round, fruits are harvested seasonally." also "Tropical fruits can be available almost year-round in some places, but many are seasonal and only available for a short time each year." care to elaborate? ie simply present doesn't mean abundant. Also, that's a vary narrow band geographically, so if ancestors expanded outside this, they experienced less and less all-year availability.

[@dennisward43]

@@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.

[@danger_pig]

extremely informative; this context is missing from basically all other dialogue on this subject. thank you 🙏

[@jonwumkes]

Very refreshingly informative ! I'll need to watch again to really understand on how i can apply this to the belly fat that I can not get rid of.

[@catlyn777]

I suggest a healthy vegan diet. When they did scans on some of the people who ate vegan in that Netflix documentary, their visceral fat was melting away.

[@jensschreiner5351]

It's simple. Less is always better. No matter if subcutaneous or atopic. In general the biggest health benefit nowadays is a well balanced lack of energy consumption from time to time. It's the opposite to the third world. They "need more to eat", we need breaks where our systems get a pause

[@andreasrydstrom9112]

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??

[@SensitiveBreath]

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)

[@sabby123456789]

Can you do a video on how to lower uric acid and prevent gout?

[@JC-ct4yc]

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?

[@RoScoHutch]

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.

[@davidflorez1196]

But you only have to wear it for 14 days one time when you test some the response to your common meals, no?

[@RoScoHutch]

@@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.

[@davidflorez1196]

@@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

[@RoScoHutch]

@@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.

[@tofu-munchingCoalition.ofChaos]

​@@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.

[@andreasrydstrom9112]

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?

[@vince1229]

There was a 41 year old male type 1 diabetic on KZbin who said when he eats steak his blood sugar doesn't change until four hours when it goes through the roof.

[@atoms.channel]

a case of gluconeogenesis? Protein can make insulin go up... also/and when body is starved of carbs, it will produce glucose from protein.

[@drott150]

So much of the discussion is about peak glucose levels "good or bad?" But what about the shape and timing of the glucose response curve and the area under the curve during the post prandial response cycle? Isn't that likely to also be an important factor in determining a prediabetic condition? I realize A1C is sort of that over a long period of time. But it would seem important to dig into the science of response frequency and areas under these curves within the immediate post prandial cycle vs various foods. Also, for the lag the CGM experiences, is there a rule of thumb correction factor that can be applied to the data afterwards to display a closer approximation of what actual serum glucose levels were vs time?

[@VeganLinked]

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.

[@marcdaniels9079]

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 ✌️

[@jakobw135]

Diet and nutrition expert Jesse Inchauspe, says that preceding a high glycemic index meal with protein, fat and some vinegar - MITIGATES the sugar spike.

[@YaYippieYeah]

She has zero qualifications.

[@atoms.channel]

I would personally try to replicate the effect and see if, when, how it works for you.

[@brucejensen3081]

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.

[@cheese7119]

Have you made a video on raw milk yet?

[@anathardayaldar]

Is there a way to estimate the total harm that all these social media influencers have caused with their clickbait claims?

[@catlyn777]

This needs research. I bet it evidence would show influencers have harmed many people.

[@atoms.channel]

show us on the doll where you were harmed... seriously? I think the harm comes from half-*ssed commenters thinking they had all their ducks in a row.

[@jce2024]

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 ?

[@medi_michi]

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

[@Broken4forever]

Usually under 50 but some ppl can't have even more than 10.

[@nourishedbyscience]

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

[@jce2024]

@@nourishedbyscience that’s helpful many thanks Jeff

[@Primetime_dads]

Can someone please answer this one big question!!! I eat fruits, meat, honey, some butter. I can eat honey and have a glucose spike to 200 within a hour, then jts headed back down. Same with some fruits and stuff. My a1c is normal and my fasting glucose has been around 105-110 for almost 10 years. My fasting insulin is usually always around 3 something. Since my fasting insulin is good, should I worry about them spikes? I mean maybe i just spike higher then normal, but my fasting insulin is always good 🤷‍♂️

[@bgrune1]

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.

[@atoms.channel]

It won't attenuate later meals, but if you ate not long after taking those, maybe it would attenuate your 1st meal.

[@oxoelfoxo]

love bread with jam and other sweet food for breakfast (and as a snack), tsk. if only it wasn't so much easier to obtain/prepare and a whole lot cheaper than veg and meat

[@gymjoedude]

I do oatmeal, Chia, flax pancakes. Maybe 30-40 and place in freezer. I cook breakfast everyday in under 6 minutes. Premade pancakes with eggs, nuts, avocado, berries. Day, easy, healthy.

[@ScrapPalletMan]

I'm so much more concerned about insulin spikes. Is there a way to test for that?

[@lotembenatar7163]

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

[@nourishedbyscience]

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

[@atoms.channel]

@@lotembenatar7163 it doesn't always spike after a meal, it will rise, but not necessarily spike.

[@atoms.channel]

kinda like Dr Kratz said, you'll also need to have a fasting insulin test too to get your HOMA-IR. I really wish they also made a continuous insulin monitor... that and the glucose would be most rewarding. Supposedly insulin levels rise well in advance of glucose, so seeing that right away as a signal would be profound in alerting you to insulin sensitivity.

[@atoms.channel]

@@lotembenatar7163 BTW some study I saw mentioned that carbs and proteins together synergistically raise insulin, ie insulin raise is more than just that protein and carb amount when added individually. This makes me a little suspicious of outright backing the glucose hacks like eating veg, protein then carb (yes I know veg is a carb of sorts, but carbs are the sugar or starchy carb vs the fiber dense carb, ie veg)

[@sharkair2839]

Results: Sensor glucose concentrations were 71-120 mg/dl for 91% of the day.

[@petervafeades4095]

Great and very informative. However, many view glucose levels as a proxy for insulin levels and consequently a fasting insulin or HOMA-IR may be more telling. Nevertheess, great advice for metabolically healthy yet weary CGM werers

[@nourishedbyscience]

I would not say that HOMA-IR is more telling. Both glucose and insulin are important, and elevations in both are linked to an increased chronic disease risk. Best, Mario

[@josephremenar3117]

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.

[@nourishedbyscience]

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

[@tommynickels4570]

Glucose spike or Insulin spike? Big difference between the two.

[@DennisForbes]

While people shouldn't sweat acute spikes too much, almost every single action you can take to avoid those spikes has *enormous* proven benefits. Avoid simple carbs and ultra-processed foods. Be active. Layer foods. Even if you're willing to completely ignore glucose spikes, all of these lifestyle choices can only possibly be beneficial. It's also a bit weird how this video strawmans a bit in the seeming assumption that avoiding glucose spikes requires a low carb diet (e.g. the example of eating salami instead of beans). Beans do not lead to appreciable glucose spikes. Nor do basically any whole vegetables. Nor do most whole fruits. Someone actively avoiding insulin spikes can be eating a high carb diet and still fully achieve that goal. Even ice cream doesn't lead to much of a glucose spike.

[@FreeFromAllThings]

Drink more alcohol for example.

[@FreeFromAllThings]

Don't exercise.

[@zene2550]

Exactly what I was thinking. It also depends on the quantity of food consumed and level of refinement

[@tofu-munchingCoalition.ofChaos]

I think you're already looking at it with knowledge beyond the average person. You're bounding it in reasonable actions (see _@FreeFromAllThings'_ responses). You're bounding it in taking it not too far (beans vs. salami) and taking other measures into account. I've heard intelligent people (Drew Harrisberg - who mentioned he heard multiple such stories from clients) obsess over glucose curves and ending up with problems even in that metric. Very analogous to people fixated on (current) weight turning to "solutions" that are unhealthy and sometimes even counterproductive for their weight long-term.

[@Daniel_Maxin]

Could you comment on the diminished first phase insulin response due to low carb diet (minute 19 or so). Is it reversible if the person starts eating more carbs or is it a danger of permanently causing the pancreas to produce less insulin in the first phase?. Reducing carbs seems sensible to lower blood sugar in general but then it seems this can cause larger spikes. It is a damned if you do damned if you don't kind of situation

[@nourishedbyscience]

No, the reduction in the first-phase insulin response is temporary. However, in someone on a low-carb diet, it can take up to 2-3 weeks on a higher-carb diet until the first-phase insulin response has normalized. Therefore, it would seem best to eat only low-carb meals when on a low-carb diet, and to re-introduce high-carb foods only gradually.

[@Daniel_Maxin]

@@nourishedbyscience Thanks. That helps a lot

[@drott150]

Is there any evidence that those who really go all the way in preventing sugar spikes that they could be harming their pancreas? Like, in those that go on truly fat free diets, I have heard the gallbladder can become congested with stagnant bile which may cause or exacerbate stone formation and other issues. If the pancreas is "sheltered" in a similar fashion from occasional glucose spikes, are there potential long-term risks associated with this scenario? {and I don't mean stone growth, but whatever the pancreatic analog may be for "stagnant insulin"}.

[@Daniel_Maxin]

I hope he answers this sometime. If the pancreas adapts to low carb by producing low insulin, can the pancreas lose its ability to make enough insulin in the future. Most advice hovers around lowering insulin.

[@nourishedbyscience]

When we eat a low-carb diet, the pancreas keeps less pre-made insulin in storage, and that lowers the amount of insulin that can be secreted in the so-called first-phase insulin response. That is thought to be transient, however, and once peope start eating carbs again, a normal first-phase insulin response can be recovered within a few weeks. What this suggestions, however, is that it is not wise to eat high-carb meals occasionally when generally doing low-carb. Cheers Mario

[@pdblouin]

My wife is Type 1 Diabetic and we're Canadian. I'm just in the first 6 minutes but I keep having to convert mg/dL to mmol/L...Why does the US always have to be "special" with units of measurement?

[@naturetrails8217]

Because we do whatever we want and want to be different. Now get lost, peasant 🤣

[@DennisForbes]

About as many countries use mg/dl than use mmol/L.

[@drott150]

mg/dL is still metric bruh.

[@nichtsistkostenlos6565]

The first blood glucose meter (Ames Reflectance Meter) was invented in the US and measured in mg/dL. You're the "special" ones.

[@pdblouin]

@@drott150I never said it wasn’t metric. Just annoyed that we can’t agree on which units to use. I almost always see mmol/L on PubMed, which is the focus of this channel.

[@HakuCell]

- 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.

[@nourishedbyscience]

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.

[@anathardayaldar]

Should all diabetics be on a CGM?

[@nourishedbyscience]

Don't think anyone needs to be on a CGM all the time, even though it us very useful particularly for patients with type 1 diabetes. For patients with type 2 diabetes or prediabetes, it can be very informative to wear a CGM once or twice to learn which foods you respond to, and to experiment with making changes to your meal to avoid regular spikes. The detailed data a CGM provides can also be usefult to help someone figure out why they are glucose intolerant, so that they can target that aspect to improve and ideally normalize their glucose tolerance. Cheers Mario

[@vince1229]

Blood sugar levels that would be diabetic in 20 year olds are considered "normal" in over 50's.

[@nourishedbyscience]

No, that's not correct. We define diabetes and prediabetes exactly the same way in 20 year olds and 90 year olds. Best, Mario

[@infinitum5425]

Whilst I agree with most of the content of this video ( commenting as a former type2 ) I am incredibly incredulous that a high-carb + low fat diet puts type2 into remission!! From a personal experience real world perspective, that sounds incredibly dangerous for anyone who is diagnosed as type2 to follow as a long term efficacious solution.

[@nourishedbyscience]

I agree it‘s counterintuitive. However, if someone is insulin resistant and glucose intolerant because of excess visceral and ectopic fat (one of the most common causes), and they lose a bunch of weight on a low fat, high carb diet, then they can certainly improve or even normalize both insulin sensitivity and glucose tolerance. That’s the exact same mechanism through which other interventions, including low-carb diets, can improve glucose tolerance.

[@NutritionMadeSimple]

powerful reminder that our intuition can only go so far. otherwise we wouldn't need to test anything ever - in fact, many ground-breaking scientific discoveries start as counter-intuitive observations :)

[@eunicechica8927]

Recently had a glucose tolerance test, my baseline was at 99 (in vacation, eating more carbs than usual, and lots of ice cream), 1 hour at 80, and 2 hour at 77. My Basal insulin at 4.5, 1 hour at 26.8, 2 hour at 13. What could have made my glucose go down instead of up? I understand this is not medical advice…

[@seitanbeatsyourmeat666]

Reactive hypoglycemia, sometimes called postprandial hypoglycemia? Also could be too much alcohol, untreated hypothyroidism, some genetic disorders Idk though, see an endocrinologist if you can

[@nichtsistkostenlos6565]

Your blood glucose is driven by literally every single biological process in your body. Even if we had given you every test known to man in that timeframe, nobody would be able to tell you with anything close 100% confidence what exactly happened.

[@nourishedbyscience]

Your glucose almost certainly went up, probably reaching a peak around 30-45 min, but then probably dropped steeply before the 1 hour mark. It's not possible to know from these few data points what happened. May be helpful to repeat the test with a blood draw at 30 min, or wearing a CGM would be even better. Cheers Mario

[@eunicechica8927]

@@nourishedbyscience I was wearing a Libre and the numbers were SO off they sent me a replacement. The CGM didn’t show what happened 😢

[@MarcoMeile]

Could someone here define "frequent spike over 180mg/dL"? what is "frequent" once a day? once a week?

[@nourishedbyscience]

It's important to understand that in someone with perfect glucose tolerance, spikes to 180 mg/dL never occur, no matter what they eat. If someone has a spike like that in response to a particularly highly glycemic meal once in a 2-week period (while wearing a CGM), I also wouldn't worry too much about it. Anything more frequent than once a week, however, I would pay attention, as we discuss in the video. Obviously, the more frequent these occur, the more important it is to do something about it. Cheers Mario

[@MarcoMeile]

@@nourishedbyscience thank you!

[@vince1229]

Athletes on high carb diets can have normal blood sugar because their pancreas is cranking out insulin. Then years later the pancreas is out of juice and they are now diabetic.

[@nourishedbyscience]

Don't think there is good evidence supporting this. We used to think that the pancreas 'burns out' or 'gets tired' if it is forced to produce too much insulin. I personally don't think this theory ever had a lot of merrit. Best, Mario

[@peterbedford2610]

A spike is a healthy reaction. Glucose escalates and insulin responds. The hype about it being dangerous is not supported.

[@davidflorez1196]

I think is like stress is a healthy reaction yes, we need it to increase focus yes but not in high chronic quantities. If you are in a sympathetic state all day, every day your health will crash, same with glucose intake I'd say you should not trigger it chronically and in huge quantities IMO

[@nourishedbyscience]

It all depends how you define spike. I'd say at some point, if it's high enough, a blood glucose spike is associated with negative health consequences. Where exactly that threshold is that we call "too high" is not clearly defined, but I'd say it's around 180 mg/dL (10 mmol/L) or higher. That is never seen in people with optimal glucose tolerance, suggesting that the body usually tries to keep blood glucose levels below that threshold.

[@Chriscrusty]

putting in slow-mo stock footage of what's being talked about is just extra work to make the video worse

[@nourishedbyscience]

I am afraid the b-roll may have been inserted to cover up my verbal stumblings ...;-)