I stopped eating sugar/processed foods/seed oils and all I can say is it's life changing. Down 50 lbs in 11 months and exercising like a mofo! I'm 58 yrs old. Couldn't find the motivation to exercise until I stopped easting the American junk. Unfortunately, I have ASCVD (CAC = 600 discovered a few months ago) and so now I'm simply trying to stop the progression of plaque. I eat foods with 1 ingredient, that's it. Mostly meat and veg. Wish me luck, Nic!
@@s.wilson5675 Yes, very much so. I've read the books by Esselstyn, TC Campbell and Greger. Haven't read Ornish's book yet. I just think they are wrong about animal protein. I've read books with the complete opposite views such as Toxic Superfoods by Sally Norton, The Big Fat Surprise by Nina Teicholz, Good Calories Bad Calories by Gary Taubes, and Why We Get Sick by Ben Bikman. Bottom line is this.... from what I can tell, we are designed to eat meat and some veggies. We are definitely NOT designed to eat 95% of the crap in the grocery stores. So after reading all these books and doing basically a master's degree's worth of study on this stuff, I have been able to improve my health drastically. However, I will get another CAC scan next year and if it's not what I think it should be then I may switch it up a bit. I mean what else can I do?
@@BillyBoy66 You've defo done your research. I do believe animal products, assuming no chemicals/antibiotics, etc, can be eaten in small amounts with plenty of vegetables, fruits, whole grains, fungi, herbs, etc, making up the majority of what we eat. Keep hydrated, get enough exercise and sleep and practice some kung fu maybe. Choose an art that has breathing, internal/chi energy. Good luck BB66!
@@s.wilson5675 Thanks! I hear ya. Problem with veggies is if I eat too much I get bloated and gassy :-) , not to mention I stay hungry. With meat, I eat once a day, sometimes twice, and I do not think of food at all. Veggies make me want snacks in between meals. It's def a balancing act. Don't want too much meat or too much veg. I'll figure it out.
All I know for sure is that I definitely feel much healthier and just better the more stable I keep my blood sugar (vs eating sugary foods on an empty stomach).
Anecdotal: I have spinal arthritis. (couldn't walk properly for many years). Randomly I found out that when I avoid glocose spikes (spikes from sugar and meals of carbs) the arthritis disapears. And when the arthistis is gone - just a couple of big spikes is enough - and it comes back. Just throwing it out there...
This is what scientists don't account for when doing these narrow-minded studies. So many variables. They need to figure out what foods age the body faster. Then we can understand how to correct our nutrition. These studies are short sighted.
I love how you tackle these kind of concerns straight away and explain it in more simple, understandable terms. Even when I think you've just lost me, I often hear you say: "What do I mean?" and then I think: Yes, thank you! Once again, great content Nic.
Hey I'm a med student and i really enjoy your content, especially because you provide references for your topic. I would really love a video on how you conduct your research step by step as a video idea. Would really help me get better at research!
Don’t take this as fact but I’ve heard that the calf muscles don’t have a proper storage of glucose molecules like other muscles so they have to take it directly from the bloodstream. So doing jumps or slow raises or even moving your legs up & down under the table might help. There’s a study who measured blood glucose clearing after a meal for sitting subjects vs subjects that sat down while constantly rocking their soles on the ball of their feet
@@oolala53 programmer. got a walking treadmill desk. put it together for cheap. i think both are from the walmart site. you get a chinese walking treadmill for about 200 bucks (the kind that can fold down and slide under a bed) and a standing desk for another about 200 bucks.
Excellent summary. It's also worth noting that one of the reasons that there is an absence of compelling data is for simple functional reasons -- the appearance of continuous glucose monitors is a very recent invention, and any sort of large-scale, long-term study cannot possibly come out for probably years. So in a few years we may learn that controlling glucose spikes is the key to health. Or we won't. But here's the thing -- almost every action to prevent glucose spikes also just happen to be extremely well proven health factors regardless, so it's essentially just good choices regardless. Avoiding highly processed foods, for instance. To wit, follow Michael Pollan's advice and "Just try to eat as much real food as you can, and try not to eat too much of it, and try to eat mostly plants." People who eat mostly whole foods, avoid highly processed foods, just naturally avoid glucose spikes. And it's interesting that great health benefits can be shown for completely orthogonal diets such as a carnivore diet vs a vegetarian diet, when the common element to both is the avoidance of highly processed foods (e.g. simple carbs).
@@tomgoff7887 habitually high average glucose is the biggest issue obviously. A healthy resting average glucose should be below 100 no matter age, gender, etc. max spike should be around 145 in metabolically healthy individuals.
@@GregariousAntithesis I'm aware of the idea that fasting glucose should be below 100 mg/dL but whare are you getting the 145 number? What's your source?
My limited understanding on elevated insulin/glucose is that it's not so much the amount of spiking at a specific point in time but rather sustained elevation or long periods of time with multiple spiking events throughout the day that is cause for concern on the human condition. I'm probably misinformed like most people. DD
I think you are correct. Prolonged spikes of glucose, and therefore insulin, over the course of years/decades could very well be the problem. I mean common sense would suggest it anyway.
Insulin resistance is like drug addiction. It can happen from a high dose, or from sustained use. But small amounts with large intervals is your best bet at not creating resistance.
Hi, have to give you what I know between each meal is 50 t0 75 points my blood sugar used to run 3 to 400 but I was eating three meals a day plus now that I only eat one meal a day. I don’t have a blood sugar problem. I took about three months to stabilize. I’ve been around 100. 150 which is pretty good for me, I eat a lot of rice because it’s cheap. I prefer steak but can’t afford the protein when I have the money. I can have a salad for breakfast a steak for lunch and some kind of blueberries or raspberries strawberries for dinner. This is what I typically eat a lot of times I grab a chicken at Sam’s because they’re under six dollars cooked, I hope this helps you. We all eat three meals a day is a lot.
Dear Dr. Nocolas, congratulations on the recent doctorship! Suggestion/Request for an episode on ‘Dry Fasting’. Would be great to have an in depth look. Is it really like water fasting but on turbo? Is it really ‘fat + oxygen from air -> water’? Does this happen in the body and produces water at a rate to sustain us, or even at all? Would be great to know. Sounds too good to be true :) Thanks for your consideration!
I asked a doctor in the Cardiac ICU why my dad, who has had his cholesterol managed for decades is here and had a triple bypass. He said, "Everyone who comes in here does not have high cholesterol but almost everyone has type 2 diabetes or are pre-diabetic.".
Yeah, I think it's only a matter of time before more and more doctors realize this. Cholesterol, while 100% involved in atherosclerosis, is not the cause. Managing overall metabolic health is the most important thing we can do IMO to avoid ASCVD. Problem is, most people don't want to do what it takes to stay metabolically healthy because it involves 1: eating a diet that doesn't include the standard American processed garbage and 2: exercising and staying active.
Some of this reminds me of things Dr. McDougall (who passed away last month) would say from time to time. He would have said the same thing about insulin spikes, particularly in response to his favorite subject of starches. He would have begun by pointing out the advice should be different for Type 1 vs. Type 2 (obviously) and (less obviously) versus Insulin resistant versus an individual with no metabolic disorder.
I really enjoy your breakdowns, and I believe this point of view can be related to many other studies and topics. Running fast and long is good for muscle development and cardiovascular health. Running too long and fast will break down your connective tissue and possibly give you a heart-attack. With each topic, every individual needs to discover their personal sweet spot for optimal health.
@Physionic I have stopped listening to all of the keto/carnivore channels. Fung, Delauer, Berry, Boz, Cywes etc. I've started counting my calories as well as being mindful of the nutrition of foods. I'm a bit ashamed to say that as a nurse who cared for homebound patients, I did give some advice to my diabetics using a lot of that partial information I believed.
Everyone is learning - don’t feel ashamed. It’s incredible you have the self reflection to change your mind where you see evidence. That is not common. Thrilled you’re in the profession.
@@Lacuna1122 Keto/carnivore diets are changing peoples lives, mine included. Not sure why you would stop listening to them altogether. Sure, Dr. Berry can be an a-hole and Delauer never really gives many answers, but that's no reason to throw off the entire Keto/carnivore movement. Dr. Cywes is as genuine as they come, and very smart. He holds an MD and a PhD. Nic would be wise to interview him. Nic only analyzes research.... Dr. Cywes has actually done research (his PhD is on the liver) and he actively treats patients and helps them reverse things like type 2 diabetes and insulin resistance. Don't throw the baby out with the bathwater.
Anecdotal: If I eat dessert, my resting heart rate is up a beat or two the next day and continues to increase up to about 66 if eating sugar continues. With no sugar, it goes back down two around 57 over a few weeks. Because the association is so predictable, I have concluded that eating sugar makes my heart have to work harder. Maybe it's due to an inflammatory response, which may also be why it increased a few beats after my recent COVID booster but went down two days later. This association is unsettling enough to get my attention and really, really limit sugar-consumption occasions. Thanks for what you do. Amazing content from a trusted, credible expert.
Been a lot of talk about this recently. Glad to see tou do a video on it. Nutrition made simple recently had a long interview on his channel about this topic. I think in metabolically healthy people theres not much to worry about, however interestingly I used to get very high spikes (above 180mg/dL) but i wonder if this was due to not consuming carbs untill my evening meal thus a reduced first phase insulin response.
@@Physionic This was with a CGM so it was within the two hour post meal window, it would usually go down after two hours but it wouls still be in the prediabetic/impaired glucose tolerance range after two hours at times. Unusual as I'm in my twenties, low bf and exercise regularly. I'm a medical Dr with an undergraduate in physiology so like to think I know what I'm doing but maybe not :') thanks for the engagement
Giving a name like RAGE to a receptor is like giving a Doom Guy title to the doorman in your condo; he might just be the person who lets other know thing are happening, but is secretly a monster annihilator
very interested in the subject. some of the commenters have pointed out that if you stay away from seed oils and sugar and eat unprocessed foods and not too much you shouldn't have sugar spikes . I have high fasting glucose after doing all of these things for many years. started wearing a CGM and my glucose looks like a roller coaster whether I'm eating or not. trying to figure it out.
as a side note I noticed it goes up during any stressful activity even if I don't feel stressed at all. hot bath or shower, while driving, household chores, even spiking about 140 while sleeping
Some biscuits and bars with no sugar contain hydrogenated oil that is not from seed oils, but palm oil. Studies have shown hydrogenated oil cause diabetes 2.
Coming from a family of type 1 and 2 diabetics I bought Jess’s hacks hook, line and sinker and really really appreciate your two informative erudite scientific analysis of spikes and eating order. You are just as good looking as Jessie but a lot smarter and ethical. Thank you
Im not really concerned about glucose causing spikes, ( the body will always try to auto correct with glucose coming in and process it), i am more concerned about aging prematurely and faster due to excess carbs causing glycation. Im not trying to age faster. I know when i eat alot of carbs my skin looks dull, aged, and saggy. People will say it depends on type of carbs coming in, but all carbs turn to sugar eventually. That is what needs to be figured out. If your skin is impacted your cells will def be impacted.
Speculation: Insulin resistance contributes to high/prolonged blood glucose levels which causes poor functioning small blood vessels, in turn raising blood pressure which causes atherosclerosis.
Insulin increases can have various positive effects, not just with lowering glucose. Glucose 'spikes' are never good, and your body knows it, so it is doing its best to get the glucose lower. I prefer bumps rather than spikes for both glucose and insulin.
Hi Dr. Phsy, are there studies of the relation of glucose spikes to fatigue, feeling too tired, lethargic, etc? The Glucose Queen lady said that her own "fatigue syndrome" went away after she controled her glucose spikes. Thanks Doc!
The end test of a large dose (single) of glucose would not be the same as the sugar rich grazing of the standard american diet which is over a long time. We are pretty sure the body can cope with even high single doses same as alcohol, long long years of the same however would most likely in some cause big issues, how else can we explain America's rates of diabetes with the UK not far behind and the weight gains for both.
Honestly, I thank you a lot. The last months i was very concerned about my BG. My A1C was 5,5, but im doing everything i can do. Walk After meals, vegetables first. Carbs last. But i dont get, why my a1c was still 5,5. I expected it to be much lower. Then i started to be worried about my BG going over 140 Dome meals. Even with Health meals. This Video helped me, to be more relaxed and Not get a eating disorder. Thanks
Too much sugar, especially processed free glucose, is a carbon substrate for microorganism growth. Most people today always have digestive process on the front side. They don't allow the bowel to go into rest phase. Allowing the whole process or 3/4 to at least a bolo before consuming more food is the best cycle. Rest phase between meals makes sure all available glucose or other saccharides are removed from the streams. Not spikes. No rest stresses the nutrient cycle because the body is always in consumption phase.
@@donaldhenderson1870 Yes, I wonder if this would benefit humans even if you are insulin sensitive and only eat whole food carbs. I know that Bryan Johnsson takes Acarbose.
Thanks so much for your balanced approach to study analysis! 🙌🙌 Can we learn more about all the mechanisms that kick in after a glucose spike to bring our bodies back to homeostasis? I get that insulin releases but what other mechanisms does it recruit? What is the glucose spike threshold in which those mechanisms can become dysregulated?
You are going to destroy the continuous glucose monitoring trend. All that money and time people spent. All the graphs that they made and talk to their other friends that are also monitoring their glucose 24/7. Nice work!
Appreciate the info. I wore a CGM for a month just to see the effects certain foods had on my glucose. I'm not sure there were any huge suprises. Of course if I had somethink like orange juice and nothing else I would get quite a spike...and if I had with some eggs(for example) the 'spike' was much less noticeable. It made me think about how each situation would effect me and to what length.
One main thing of glucose spikes is elevated insulin levels, so much so it even causes hypo-glycemia craving after a few hours. And such high insulin production puts pressure on beta cells of the pancreas too.
For 30 years I ate muesli and fruit for breakfast. But when I tried out a glucose monitor (I was curious) I found my blood sugar was spiking to 14mMol/L (250mg/dl). So the precautionary principle wins out. I enjoy my alternate cooked breakfasts anyway, so I'm not losing.. but it would indeed be good to see more scientific evidence as to whether or not there is any point to my efforts.
I participated in a group that views any rise in glucose more than 30 pts at any point after the meal above the premeal measure as dangerous. I do not enjoy the meals that keep that tight a range, even after two years of experimentation. I am giving another week when I can get retested after a three-month effort to bring me out of very recent rise into prediabetes. If it's not down, and especially if LDL-C is up, I am abandoning low carb. Doesn't mean I am going to run to UPF's as I have dropped most of them in 2020. I plan to increase exercise and do some IF. NB, please. I had been maintaining a 40-lb weight loss for eleven years and have been in good BMI range- yeah, I know a lot of people think it's bunk- for all that time. But didn't have consistent exercise program and was to some degree self-sidelined from arthritic hip. Several sessions with a personal trainer has improved that more than I expected, though walking for more than 10 minutes brings on an ache. I am cautiously optimistic and really glad to hear this video because I was scared since I could not imagine restricting my diet even more.
My cardiologist says AGEs (advanced glycation end products) are very bad and has me in a low AGE diet. First, have to stop eating processed food. It is FULL of AGEs. Then you have to cook/prep with slow, moisture methods like crock pot, poaching, or braising. High, dry heat like grilling is the worst. Charring and browning the meat makes AGEs the most. Bacon is the worst. Anyway, I spent 30 years learning to cook with high heat, and now I have to ramp that back.
@@michaelhimes8778 he just saved my dad's life 6 months ago in a 3 hour long cardiac Cath and stenting. I owe that man for keeping my father around! I follow his advice like gospel!
Since it takes years, decades even, to develop insulin resistance, then how can anyone (Nic) say that there are many causes of it? Fact of the matter is that we do not know exactly what causes it but the best guess is the constant bombardment of processed carbs/sugar on our liver that in turn produces higher levels of serum glucose, which in turn requires the pancreas to produce insulin to dispose of it. Seems logical that decades high insulin secretion would lead to insulin resistance, wouldn't it, Nic?
When the science isn't conclusive yet, one should be conservative & assume a linear progression. Keep blood glucose spikes low, within tolerable manner. Keep the time period when BG is elevated as short as possible. How is that done? Diet & lifestyle modifications, do many things that take one's metabolism in the best direction.
Having a CGM (continuous glucose monitor) for training as a runner, I notice that on my cheat days, my glucose levels spike to 140+ like an electrocardiogram. On my regular days, I keep those spikes under 120 all the time with a balanced macronutrient diet. Just my personal experience. Swett treats are my Hell Priests.
What a wonderful video! at video time 6:12 my sugar does not end with a horizontal line like this chart shows at 120 min, my sugar continues downward with increasing time. Wonderful video! Thanks
Nutritional carbs like an apple 🍎🍏 equals not sugar from a cake , I thought that debate was long over ! People are obsessed with glucose spikes. For tens of thousands of years we had fruits
This is very informative stuff. I can offer an individual experience. When I swapped from a high carb to a low carb diet I found I had more steady energy through the day and no longer suffered from the dreaded afternoon slump. I also lost all my excess weight over about 3 months. Obviously that doesn't tell me whether I have an increased or decreased cardiovascular disease risk but I can say that I feel better.
Great video. Thank you! I would assume, that based on evolution, healthy humans evolved to handle the occasional glucose spike for the times they found carb rich foods. The glucose spike may not be as benign in someone with diabetes or insulin resistance - and the worse the condition, the better off not inducing the spike. Even in these people though, the occasional spike is likely to not cause damage but the repeated spikes, which likely caused the diseased condition, is likely to be problematic. As you mentioned nuance is important. Thanks for a great video!
Glucose is not just sugar.Glucose is all high carbohydrate, high glycemic index foods.They can all spike your glucose and they can all cause headaches when your glucose comes down
Another video that makes you think, Thank you. Same basic subject, but how much does higher fasting insulin levels affect CV health? Type 2 here, controlled (a1c normally ~5.3) by low carb for 10 years, but “base” insulin still average around 10 nmol/L…
Good “influencers” know that it’s not the spikes it’s the area under the curve. Dr Ben Bikman has the best explanation for how this works and influences insulin resistance
My understanding is that low carb diets actually worsen insulin resistance. Your glucose spikes might look better since there’s not as much glucose in your diet, but in the event you do eat some carbohydrates, you’ll be even worse at processing them than you were before the diet. What do you think?
1%? Dipping a teeny, tiny toe? Sir! 1% of my body weight is over 2 lbs -- I'm submerging my entire foot in that bucket, at 1% (but your point is made).
Dr pradip jamnadas talks about AGEs and how to avoid them. Yes gluclose Spikes are dangerous they create oxidative stress and damage vascular endothelial cells.
Not directly on topic, but I’d love for you to do a video on what can drive artificially high HbA1c. RBC turnover is fairly well known, but I am most interested in Hb variants that interfere with the test. My A1c implies an average glucose level that is above my postprandial peak, so way off.
Request Doctor , in laboratory testing there are many I mean 100s of people with high CA 19-9, but all other associated marker like CEA, inflammation markers are normal. CT MRI nothing! Over 2 years patients have high CA 19-9 ( around 200 ) then it drops down to normal or near normal. Why ?
If glucose spikes (high and/or long elevated glucose) isn’t a problem, then why does keto tend to help diabetics so much? You don’t think the minimization of glucose spikes is what helps them?
the science has a ways to go here however the anecdotal evidence for cutting sugar and excessive carbs vs typical current western trends is broad and deep. Improvements in a broad number of metrics and by significant degrees. Thats what signals for my attention.
I always felt there was too much emphasis on spikes. I guess if you're eating your meals then grazing constantly between them, that could be a problem as insulin doesn't get a chance to come down to baseline. Sugar was always highly sought after by hunter gatherers and when they came across bees nests, they'd gorge on the honey. I'm sure insulin spiked, but was it deleterious to their health? probably not.
We need an amendment on this one at 2:39 you said you wanted to talk about the Rage pathway because its high activated from glucose spikes BUT WE KNOW THE REAL ANSWER IS YOU WANTED TO DO THE DOOM VOICE
Yes. Context. In other words, whole plant foods like fruit probably don’t cause heart disease. Glucose spikes from eating refined carbs and ultraprocessed foods might be a problem.
After reaching the end of the video I’m not sure I understand the point of the video. You say the data doesn’t support the idea that insulin resistance can be caused by glucose spikes and then at the end you suggest a well formulated low carb diet to improve insulin resistance to which the diet is designed to minimize if not eliminate glucose spikes. So which is the point of the video; Are glucose spikes good or bad? I know the real answer but this is the question I was left with in your video.
Nailed it 4sure Content matters but influencers make it slippery through style matters most even dere is no consensus on spike insulin140mg/dl is high enough to cause r consider it significantly high for adverse effects, top of dat glucose accompanied by antioxidants didn't raise inflation & tumor factors, again it's not content which governs day to day life but it's da style which is making life & death decisions much thanks to influencers& Quacks vry shocking sellers
Why is a spike in hormones a problem? You see it with every other type of hormone that is secreted. Cortisone spike in the morning, adrenaline spike when aroused. Hormone levels increase rapidly then go back to baseline. Perfectly normal
I stopped eating sugar/processed foods/seed oils and all I can say is it's life changing. Down 50 lbs in 11 months and exercising like a mofo! I'm 58 yrs old. Couldn't find the motivation to exercise until I stopped easting the American junk. Unfortunately, I have ASCVD (CAC = 600 discovered a few months ago) and so now I'm simply trying to stop the progression of plaque. I eat foods with 1 ingredient, that's it. Mostly meat and veg. Wish me luck, Nic!
Cool , research CX8 product for heart health. The owner has a similar phase. Look into Infrared sauna and 100 percent cacao and Extra virgin olive 🫒
Are you familiar with Dr. Ornish and Dr. Esselstyn?
@@s.wilson5675 Yes, very much so. I've read the books by Esselstyn, TC Campbell and Greger. Haven't read Ornish's book yet. I just think they are wrong about animal protein. I've read books with the complete opposite views such as Toxic Superfoods by Sally Norton, The Big Fat Surprise by Nina Teicholz, Good Calories Bad Calories by Gary Taubes, and Why We Get Sick by Ben Bikman. Bottom line is this.... from what I can tell, we are designed to eat meat and some veggies. We are definitely NOT designed to eat 95% of the crap in the grocery stores. So after reading all these books and doing basically a master's degree's worth of study on this stuff, I have been able to improve my health drastically. However, I will get another CAC scan next year and if it's not what I think it should be then I may switch it up a bit. I mean what else can I do?
@@BillyBoy66 You've defo done your research. I do believe animal products, assuming no chemicals/antibiotics, etc, can be eaten in small amounts with plenty of vegetables, fruits, whole grains, fungi, herbs, etc, making up the majority of what we eat. Keep hydrated, get enough exercise and sleep and practice some kung fu maybe. Choose an art that has breathing, internal/chi energy. Good luck BB66!
@@s.wilson5675 Thanks! I hear ya. Problem with veggies is if I eat too much I get bloated and gassy :-) , not to mention I stay hungry. With meat, I eat once a day, sometimes twice, and I do not think of food at all. Veggies make me want snacks in between meals. It's def a balancing act. Don't want too much meat or too much veg. I'll figure it out.
All I know for sure is that I definitely feel much healthier and just better the more stable I keep my blood sugar (vs eating sugary foods on an empty stomach).
another excellent YT from my #1 trusted health source. thank you Dr Nic
Thanks, JP :)
Anecdotal: I have spinal arthritis. (couldn't walk properly for many years). Randomly I found out that when I avoid glocose spikes (spikes from sugar and meals of carbs) the arthritis disapears. And when the arthistis is gone - just a couple of big spikes is enough - and it comes back. Just throwing it out there...
This is what scientists don't account for when doing these narrow-minded studies. So many variables. They need to figure out what foods age the body faster. Then we can understand how to correct our nutrition. These studies are short sighted.
What do you call a big spike? I was on low carb for months. made zero difference in arthritis pain.
@@michaelwatts1186 many long lived cultures eat foods that would "spike" glucose by some influencers' standards.
*That doom reference made me lol. Nice video, mate* 💪👍
Doom 3 freaked the hell out of me (literally)
@@Physionic lol Only played that one for a little, I'm back on Fallout 4 after the TV show lol
Could never get into Fallout, but I acknowledge it's a great game. I watch my friend play it from time to time, he's obsessed.
@@Physionic Seriously? oh mate, its awesome, I've been playing since the original. What didn't you like about it?
Put Dr. in front of your channel name, Dr. Physionic, it's an extra 500k subscribers for sure.
Nah - I'm happy with the name. Thanks for suggestion, though :)
Dr. Physionic also sounds like a super villain
it worked for Dr Jill Biden... I only got my 38th booster because of her impeccable credentials
Just like "Dr" Berg who, as we all know, isn't even a real Doctor 😆
@@LordVictorHalgaard yes, the new subs amount will be mostly due to the supervillain resemblance 😂
So happy to hear this shorter video! Some are just too long to keep me in:)
I love how you tackle these kind of concerns straight away and explain it in more simple, understandable terms. Even when I think you've just lost me, I often hear you say: "What do I mean?" and then I think: Yes, thank you! Once again, great content Nic.
Thanks, Sharon - that means a ton to me as an educator. :)
Hey I'm a med student and i really enjoy your content, especially because you provide references for your topic. I would really love a video on how you conduct your research step by step as a video idea. Would really help me get better at research!
here's a tip: I've noticed that if I just walk at a slow pace after a meal, the glucose does not spike up so high.
Good evidence for that :)
Don’t take this as fact but I’ve heard that the calf muscles don’t have a proper storage of glucose molecules like other muscles so they have to take it directly from the bloodstream. So doing jumps or slow raises or even moving your legs up & down under the table might help. There’s a study who measured blood glucose clearing after a meal for sitting subjects vs subjects that sat down while constantly rocking their soles on the ball of their feet
What kind of job do you have that you can take a slow walk after breakfast and lunch?
@@oolala53 programmer. got a walking treadmill desk. put it together for cheap. i think both are from the walmart site. you get a chinese walking treadmill for about 200 bucks (the kind that can fold down and slide under a bed) and a standing desk for another about 200 bucks.
Excellent summary. It's also worth noting that one of the reasons that there is an absence of compelling data is for simple functional reasons -- the appearance of continuous glucose monitors is a very recent invention, and any sort of large-scale, long-term study cannot possibly come out for probably years. So in a few years we may learn that controlling glucose spikes is the key to health. Or we won't.
But here's the thing -- almost every action to prevent glucose spikes also just happen to be extremely well proven health factors regardless, so it's essentially just good choices regardless. Avoiding highly processed foods, for instance. To wit, follow Michael Pollan's advice and "Just try to eat as much real food as you can, and try not to eat too much of it, and try to eat mostly plants."
People who eat mostly whole foods, avoid highly processed foods, just naturally avoid glucose spikes. And it's interesting that great health benefits can be shown for completely orthogonal diets such as a carnivore diet vs a vegetarian diet, when the common element to both is the avoidance of highly processed foods (e.g. simple carbs).
You dont need a study to see what high blood glucose does to diabetics.
@@GregariousAntithesis Fasting glucose or glucose spikes?
@@tomgoff7887 habitually high average glucose is the biggest issue obviously. A healthy resting average glucose should be below 100 no matter age, gender, etc. max spike should be around 145 in metabolically healthy individuals.
@@tomgoff7887 you can see time in zone averages of diabetics versus non diabetics in a search. Hence where i came up with my numbers.
@@GregariousAntithesis I'm aware of the idea that fasting glucose should be below 100 mg/dL but whare are you getting the 145 number? What's your source?
My limited understanding on elevated insulin/glucose is that it's not so much the amount of spiking at a specific point in time but rather sustained elevation or long periods of time with multiple spiking events throughout the day that is cause for concern on the human condition. I'm probably misinformed like most people. DD
I think you are correct. Prolonged spikes of glucose, and therefore insulin, over the course of years/decades could very well be the problem. I mean common sense would suggest it anyway.
Insulin resistance is like drug addiction. It can happen from a high dose, or from sustained use. But small amounts with large intervals is your best bet at not creating resistance.
Hi, have to give you what I know between each meal is 50 t0 75 points my blood sugar used to run 3 to 400 but I was eating three meals a day plus now that I only eat one meal a day. I don’t have a blood sugar problem. I took about three months to stabilize. I’ve been around 100. 150 which is pretty good for me, I eat a lot of rice because it’s cheap. I prefer steak but can’t afford the protein when I have the money. I can have a salad for breakfast a steak for lunch and some kind of blueberries or raspberries strawberries for dinner. This is what I typically eat a lot of times I grab a chicken at Sam’s because they’re under six dollars cooked, I hope this helps you. We all eat three meals a day is a lot.
You may have been overeating before you switched to one meal a day. It's harder to overeat when you have one meal vs say 4
Great video! Hard to find topic with with a higher difficulty to find a trustworthy answer
Dear Dr. Nocolas, congratulations on the recent doctorship!
Suggestion/Request for an episode on ‘Dry Fasting’. Would be great to have an in depth look. Is it really like water fasting but on turbo? Is it really ‘fat + oxygen from air -> water’? Does this happen in the body and produces water at a rate to sustain us, or even at all? Would be great to know. Sounds too good to be true :)
Thanks for your consideration!
I asked a doctor in the Cardiac ICU why my dad, who has had his cholesterol managed for decades is here and had a triple bypass. He said, "Everyone who comes in here does not have high cholesterol but almost everyone has type 2 diabetes or are pre-diabetic.".
Yeah, I think it's only a matter of time before more and more doctors realize this. Cholesterol, while 100% involved in atherosclerosis, is not the cause. Managing overall metabolic health is the most important thing we can do IMO to avoid ASCVD. Problem is, most people don't want to do what it takes to stay metabolically healthy because it involves 1: eating a diet that doesn't include the standard American processed garbage and 2: exercising and staying active.
Some of this reminds me of things Dr. McDougall (who passed away last month) would say from time to time. He would have said the same thing about insulin spikes, particularly in response to his favorite subject of starches. He would have begun by pointing out the advice should be different for Type 1 vs. Type 2 (obviously) and (less obviously) versus Insulin resistant versus an individual with no metabolic disorder.
As I got older, even whole grains and legumes spike my glucose.
I really enjoy your breakdowns, and I believe this point of view can be related to many other studies and topics. Running fast and long is good for muscle development and cardiovascular health. Running too long and fast will break down your connective tissue and possibly give you a heart-attack. With each topic, every individual needs to discover their personal sweet spot for optimal health.
Defining "too long and fast" is easier said than done re injuries. As to heart attacks, to what evidence do you refer?
Nick is rewriting all the diet info i had consumed over the last 20 years
Hopefully not a bad thing :)
@Physionic I have stopped listening to all of the keto/carnivore channels. Fung, Delauer, Berry, Boz, Cywes etc. I've started counting my calories as well as being mindful of the nutrition of foods. I'm a bit ashamed to say that as a nurse who cared for homebound patients, I did give some advice to my diabetics using a lot of that partial information I believed.
Everyone is learning - don’t feel ashamed. It’s incredible you have the self reflection to change your mind where you see evidence. That is not common. Thrilled you’re in the profession.
@@Lacuna1122 Keto/carnivore diets are changing peoples lives, mine included. Not sure why you would stop listening to them altogether. Sure, Dr. Berry can be an a-hole and Delauer never really gives many answers, but that's no reason to throw off the entire Keto/carnivore movement. Dr. Cywes is as genuine as they come, and very smart. He holds an MD and a PhD. Nic would be wise to interview him. Nic only analyzes research.... Dr. Cywes has actually done research (his PhD is on the liver) and he actively treats patients and helps them reverse things like type 2 diabetes and insulin resistance. Don't throw the baby out with the bathwater.
Anecdotal: If I eat dessert, my resting heart rate is up a beat or two the next day and continues to increase up to about 66 if eating sugar continues. With no sugar, it goes back down two around 57 over a few weeks. Because the association is so predictable, I have concluded that eating sugar makes my heart have to work harder. Maybe it's due to an inflammatory response, which may also be why it increased a few beats after my recent COVID booster but went down two days later. This association is unsettling enough to get my attention and really, really limit sugar-consumption occasions. Thanks for what you do. Amazing content from a trusted, credible expert.
Been a lot of talk about this recently. Glad to see tou do a video on it. Nutrition made simple recently had a long interview on his channel about this topic. I think in metabolically healthy people theres not much to worry about, however interestingly I used to get very high spikes (above 180mg/dL) but i wonder if this was due to not consuming carbs untill my evening meal thus a reduced first phase insulin response.
Good observation - and, yes, that's a possibility, but when are you measuring your glucose spike?
@@Physionic This was with a CGM so it was within the two hour post meal window, it would usually go down after two hours but it wouls still be in the prediabetic/impaired glucose tolerance range after two hours at times. Unusual as I'm in my twenties, low bf and exercise regularly. I'm a medical Dr with an undergraduate in physiology so like to think I know what I'm doing but maybe not :') thanks for the engagement
You got me in "DOOM", love that game
Thank you for calmly taking on this topic with facts and not fear tactics.
I appreciate your videos and the insights you bring to folks like me. Keep up the good works
Thanks!
You are pretty good with what you do! Bravo!
Thanks :)
Giving a name like RAGE to a receptor is like giving a Doom Guy title to the doorman in your condo; he might just be the person who lets other know thing are happening, but is secretly a monster annihilator
very interested in the subject. some of the commenters have pointed out that if you stay away from seed oils and sugar and eat unprocessed foods and not too much you shouldn't have sugar spikes . I have high fasting glucose after doing all of these things for many years. started wearing a CGM and my glucose looks like a roller coaster whether I'm eating or not. trying to figure it out.
as a side note I noticed it goes up during any stressful activity even if I don't feel stressed at all. hot bath or shower, while driving, household chores, even spiking about 140 while sleeping
Some biscuits and bars with no sugar contain hydrogenated oil that is not from seed oils, but palm oil. Studies have shown hydrogenated oil cause diabetes 2.
Coming from a family of type 1 and 2 diabetics I bought Jess’s hacks hook, line and sinker and really really appreciate your two informative erudite scientific analysis of spikes and eating order.
You are just as good looking as Jessie but a lot smarter and ethical. Thank you
Im not really concerned about glucose causing spikes, ( the body will always try to auto correct with glucose coming in and process it), i am more concerned about aging prematurely and faster due to excess carbs causing glycation. Im not trying to age faster. I know when i eat alot of carbs my skin looks dull, aged, and saggy. People will say it depends on type of carbs coming in, but all carbs turn to sugar eventually. That is what needs to be figured out. If your skin is impacted your cells will def be impacted.
What happens when someone consumes carbs and have continuous sugar spikes? How many sugar spikes are safe? What is the upper safe limit for a spike?
amazing you are! thank you for all you do to straighten stuff out.
Speculation: Insulin resistance contributes to high/prolonged blood glucose levels which causes poor functioning small blood vessels, in turn raising blood pressure which causes atherosclerosis.
Could you please talk about the difference between glucose spikes and insulin spikes. Which is more important?
Insulin increases can have various positive effects, not just with lowering glucose. Glucose 'spikes' are never good, and your body knows it, so it is doing its best to get the glucose lower. I prefer bumps rather than spikes for both glucose and insulin.
Hi Dr. Phsy, are there studies of the relation of glucose spikes to fatigue, feeling too tired, lethargic, etc? The Glucose Queen lady said that her own "fatigue syndrome" went away after she controled her glucose spikes. Thanks Doc!
The end test of a large dose (single) of glucose would not be the same as the sugar rich grazing of the standard american diet which is over a long time. We are pretty sure the body can cope with even high single doses same as alcohol, long long years of the same however would most likely in some cause big issues, how else can we explain America's rates of diabetes with the UK not far behind and the weight gains for both.
Excellent video!
Honestly, I thank you a lot. The last months i was very concerned about my BG. My A1C was 5,5, but im doing everything i can do. Walk After meals, vegetables first. Carbs last. But i dont get, why my a1c was still 5,5. I expected it to be much lower. Then i started to be worried about my BG going over 140 Dome meals. Even with Health meals. This Video helped me, to be more relaxed and Not get a eating disorder. Thanks
Too much sugar, especially processed free glucose, is a carbon substrate for microorganism growth. Most people today always have digestive process on the front side. They don't allow the bowel to go into rest phase. Allowing the whole process or 3/4 to at least a bolo before consuming more food is the best cycle. Rest phase between meals makes sure all available glucose or other saccharides are removed from the streams. Not spikes. No rest stresses the nutrient cycle because the body is always in consumption phase.
I don't know if glucose spikes causes heart problems but glucose spikes cause headaches when you glucose comes down afterwards
Acarbose also reduces spikes and has been shown to extend lifespan in ICP mice.
@@donaldhenderson1870 Yes, I wonder if this would benefit humans even if you are insulin sensitive and only eat whole food carbs. I know that Bryan Johnsson takes Acarbose.
Amazing content!
Thanks so much for your balanced approach to study analysis! 🙌🙌 Can we learn more about all the mechanisms that kick in after a glucose spike to bring our bodies back to homeostasis? I get that insulin releases but what other mechanisms does it recruit? What is the glucose spike threshold in which those mechanisms can become dysregulated?
You are going to destroy the continuous glucose monitoring trend.
All that money and time people spent.
All the graphs that they made and talk to their other friends that are also monitoring their glucose 24/7.
Nice work!
In the past, i saw Dr Perlmutter share research on the damage of blood sugar spikes on the brain. Please can you cover this topic?
You’re growing on me, Nick
Appreciate the info. I wore a CGM for a month just to see the effects certain foods had on my glucose. I'm not sure there were any huge suprises. Of course if I had somethink like orange juice and nothing else I would get quite a spike...and if I had with some eggs(for example) the 'spike' was much less noticeable. It made me think about how each situation would effect me and to what length.
One main thing of glucose spikes is elevated insulin levels, so much so it even causes hypo-glycemia craving after a few hours. And such high insulin production puts pressure on beta cells of the pancreas too.
Glucose variability is a symptom of insulin resistance and prediabetes so it is linked to a lot of metabolic diseases. But is it causal ?
For 30 years I ate muesli and fruit for breakfast. But when I tried out a glucose monitor (I was curious) I found my blood sugar was spiking to 14mMol/L (250mg/dl). So the precautionary principle wins out. I enjoy my alternate cooked breakfasts anyway, so I'm not losing.. but it would indeed be good to see more scientific evidence as to whether or not there is any point to my efforts.
I participated in a group that views any rise in glucose more than 30 pts at any point after the meal above the premeal measure as dangerous. I do not enjoy the meals that keep that tight a range, even after two years of experimentation. I am giving another week when I can get retested after a three-month effort to bring me out of very recent rise into prediabetes. If it's not down, and especially if LDL-C is up, I am abandoning low carb. Doesn't mean I am going to run to UPF's as I have dropped most of them in 2020. I plan to increase exercise and do some IF. NB, please. I had been maintaining a 40-lb weight loss for eleven years and have been in good BMI range- yeah, I know a lot of people think it's bunk- for all that time. But didn't have consistent exercise program and was to some degree self-sidelined from arthritic hip. Several sessions with a personal trainer has improved that more than I expected, though walking for more than 10 minutes brings on an ache. I am cautiously optimistic and really glad to hear this video because I was scared since I could not imagine restricting my diet even more.
My cardiologist says AGEs (advanced glycation end products) are very bad and has me in a low AGE diet.
First, have to stop eating processed food. It is FULL of AGEs. Then you have to cook/prep with slow, moisture methods like crock pot, poaching, or braising.
High, dry heat like grilling is the worst. Charring and browning the meat makes AGEs the most. Bacon is the worst.
Anyway, I spent 30 years learning to cook with high heat, and now I have to ramp that back.
Dr. Jamnadas?
@@nickd5446 yes!
@@michaelhimes8778 he just saved my dad's life 6 months ago in a 3 hour long cardiac Cath and stenting. I owe that man for keeping my father around! I follow his advice like gospel!
Does anyone know what we should eat?🤔
Eat natural food. Next question - what is human's natural food?
Not really. It's a bit like at the end of Back to the Future, where Doc feeds a banana peel and random garbage into the new version of flux capacitor.
meat and the fat that comes with it, to start.
Just don't eat too much ultra processed food.
eat single ingredient foods. no sugar or processed foods, minimize bread and pasta.
Since it takes years, decades even, to develop insulin resistance, then how can anyone (Nic) say that there are many causes of it? Fact of the matter is that we do not know exactly what causes it but the best guess is the constant bombardment of processed carbs/sugar on our liver that in turn produces higher levels of serum glucose, which in turn requires the pancreas to produce insulin to dispose of it. Seems logical that decades high insulin secretion would lead to insulin resistance, wouldn't it, Nic?
You are just too funny! But so intelligent😆
When the science isn't conclusive yet, one should be conservative & assume a linear progression. Keep blood glucose spikes low, within tolerable manner. Keep the time period when BG is elevated as short as possible. How is that done? Diet & lifestyle modifications, do many things that take one's metabolism in the best direction.
Having a CGM (continuous glucose monitor) for training as a runner, I notice that on my cheat days, my glucose levels spike to 140+ like an electrocardiogram. On my regular days, I keep those spikes under 120 all the time with a balanced macronutrient diet. Just my personal experience. Swett treats are my Hell Priests.
What a wonderful video! at video time 6:12 my sugar does not end with a horizontal line like this chart shows at 120 min, my sugar continues downward with increasing time. Wonderful video! Thanks
Just an illustration - your results are far more realistic :)
Overlapping mechanisms cause variability in results, so complex. Hard to process without AI
How to I join insiders ?
Link in description
Nutritional carbs like an apple 🍎🍏 equals not sugar from a cake , I thought that debate was long over ! People are obsessed with glucose spikes. For tens of thousands of years we had fruits
Ever eaten a wild apple? Ancestral banana? Not very sweet
Only locally and seasonally.
Most people have longer lasting if not that high of a spike. Also spikes are associated mostly with unhealthy foods anyways...
This is very informative stuff. I can offer an individual experience. When I swapped from a high carb to a low carb diet I found I had more steady energy through the day and no longer suffered from the dreaded afternoon slump. I also lost all my excess weight over about 3 months. Obviously that doesn't tell me whether I have an increased or decreased cardiovascular disease risk but I can say that I feel better.
Dr Pradip Jamnadas says you need to look at insulin response with glucose tolerance test. Kraft test does this
Great video. Thank you! I would assume, that based on evolution, healthy humans evolved to handle the occasional glucose spike for the times they found carb rich foods. The glucose spike may not be as benign in someone with diabetes or insulin resistance - and the worse the condition, the better off not inducing the spike. Even in these people though, the occasional spike is likely to not cause damage but the repeated spikes, which likely caused the diseased condition, is likely to be problematic. As you mentioned nuance is important. Thanks for a great video!
What are your thoughts on the Kraft Insulin surgery to determine insulin resistance long before elevated a1c?
Glucose is not just sugar.Glucose is all high carbohydrate, high glycemic index foods.They can all spike your glucose and they can all cause headaches when your glucose comes down
Another video that makes you think, Thank you. Same basic subject, but how much does higher fasting insulin levels affect CV health? Type 2 here, controlled (a1c normally ~5.3) by low carb for 10 years, but “base” insulin still average around 10 nmol/L…
Well since most ppl do have IR nowadays, glucose spikes are matter of concern.
Did you see the long form video where the Dr on Nutrition Made Simple interviewed Mario Kratz on this topic?
Good “influencers” know that it’s not the spikes it’s the area under the curve. Dr Ben Bikman has the best explanation for how this works and influences insulin resistance
My understanding is that low carb diets actually worsen insulin resistance. Your glucose spikes might look better since there’s not as much glucose in your diet, but in the event you do eat some carbohydrates, you’ll be even worse at processing them than you were before the diet. What do you think?
Depends on the low carb diet - they aren't all the same
thank you much Doc!
Corn syrup (glucose, karo) does seem to cause an increase in inflammation. I've noticed that for awhile.
OMG, whats grows out of your left ear? Rip and tear, until it is done.
Thank you -- this is very useful information. Maybe I should start being less obsessive and cut down on the number if finger-sticks per day. ●
Rage reminds me of the movie the next 28 days.
1%? Dipping a teeny, tiny toe? Sir! 1% of my body weight is over 2 lbs -- I'm submerging my entire foot in that bucket, at 1% (but your point is made).
+1 for the Doom reference
Doesn't frequent and intntense glucos spikes lead to insuline resistance after some time and increase risk of developing diabetes?
Dr pradip jamnadas talks about AGEs and how to avoid them. Yes gluclose Spikes are dangerous they create oxidative stress and damage vascular endothelial cells.
Not directly on topic, but I’d love for you to do a video on what can drive artificially high HbA1c. RBC turnover is fairly well known, but I am most interested in Hb variants that interfere with the test. My A1c implies an average glucose level that is above my postprandial peak, so way off.
Need a vid on ik11
Can you talk about uridine monophosphate, also with a method of usage like 5 days 2 days off or other idea
Request Doctor , in laboratory testing there are many I mean 100s of people with high CA 19-9, but all other associated marker like CEA, inflammation markers are normal. CT MRI nothing! Over 2 years patients have high CA 19-9 ( around 200 ) then it drops down to normal or near normal. Why ?
Verhoeven is a Flemish name. Are you of Dutch or Belgian descent?
If glucose spikes (high and/or long elevated glucose) isn’t a problem, then why does keto tend to help diabetics so much? You don’t think the minimization of glucose spikes is what helps them?
the science has a ways to go here however the anecdotal evidence for cutting sugar and excessive carbs vs typical current western trends is broad and deep. Improvements in a broad number of metrics and by significant degrees. Thats what signals for my attention.
Sample size of 1. The negative reaction of my OA to sugar is as bad as the reaction to curcumin is good…
I always felt there was too much emphasis on spikes. I guess if you're eating your meals then grazing constantly between them, that could be a problem as insulin doesn't get a chance to come down to baseline. Sugar was always highly sought after by hunter gatherers and when they came across bees nests, they'd gorge on the honey. I'm sure insulin spiked, but was it deleterious to their health? probably not.
We need an amendment on this one at 2:39 you said you wanted to talk about the Rage pathway because its high activated from glucose spikes BUT WE KNOW THE REAL ANSWER IS YOU WANTED TO DO THE DOOM VOICE
Yes. Context. In other words, whole plant foods like fruit probably don’t cause heart disease. Glucose spikes from eating refined carbs and ultraprocessed foods might be a problem.
Technically you whole fruit doesn't give the same glucose spike as a pop drink, we know this already, and nobody claims it's a problem.
@@josephpchajek2685 Keto youtubers: -Hold my beer.
Im thinking thats why dessert comes after a meal so the full belly dampens any potential glucose spikes...
After reaching the end of the video I’m not sure I understand the point of the video. You say the data doesn’t support the idea that insulin resistance can be caused by glucose spikes and then at the end you suggest a well formulated low carb diet to improve insulin resistance to which the diet is designed to minimize if not eliminate glucose spikes. So which is the point of the video; Are glucose spikes good or bad? I know the real answer but this is the question I was left with in your video.
Thanks for the feedback, S&C. I’ll work on clarity.
WOW I DID NOT KNOW I HAD RAGE AGAINST THE MACHINE RECEPTORS
I should have used that reference... :)
Nailed it 4sure Content matters but influencers make it slippery through style matters most even dere is no consensus on spike insulin140mg/dl is high enough to cause r consider it significantly high for adverse effects, top of dat glucose accompanied by antioxidants didn't raise inflation & tumor factors, again it's not content which governs day to day life but it's da style which is making life & death decisions much thanks to influencers& Quacks vry shocking sellers
Why is a spike in hormones a problem? You see it with every other type of hormone that is secreted. Cortisone spike in the morning, adrenaline spike when aroused. Hormone levels increase rapidly then go back to baseline. Perfectly normal
Before we even had glucose monitors no one worried about glucose spikes and very few people had t2d so, just wtf ?!!!!
I wonder if Berberine assists with these issues.
Yes they are
Antioxidants Pog