Carbohydrate Metabolism 101
Annual refined sugar consumption in the United States:
1750: 4 pounds per person, per year
1850: 20 pounds per person, per year
1994: 120 pounds per person, per year
1996: 160 pounds per person, per year
According to the USDA's Economic Research Service, global sugar consumption continues to increase by about 2 percent per annum, and in 2006 and 2007 was expected to reach almost 154 million tons. Note: This does not include the use of other industrial sweeteners such as high fructose corn syrup!
High fructose corn syrup is now estimated to be the number-one source of calories in the American diet\ Increases in obesity, heart disease, cancer, and diabetes correlate almost perfectly with the introduction of HFCS nearly thirty years ago.
The average person is consuming 1/3 of a pound of sugar each and every day, which is 5 ounces or 150 grams— half of which is fructose (sucrose is made up half and half of glucose and fructose). This is roughly 300 percent more than the amount that can trigger biochemical chaos. Our physiology has no defense against this sort of onslaught. Fully 90 cents out of every US food dollar is spent on processed food, and HFCS (the most glycating sugar of them all) is in nearly every single processed food product. Remember, too, that these sugar consumption amounts are considered average and that many consume more than twice this amount. ...
None of these statistics begins to include the amount of sugar in our diets from other sources of dietary carbohydrate—starches such as cereals, bread, pasta, grains, potatoes, rice, or so-called natural sweeteners such as honey, maple syrup, agave, or others—or from excess protein consumption (which significantly converts to sugar). ...
All nonfibrous forms of carbohydrates (from grains, rice, potatoes, and other starch-based foods) in addition to refined sugar and natural and industrial sweeteners (such as high fructose corn syrup) are sugar once they are metabolized by the body. {Here she misses the important point that all vegetables are also carbohydrates.}
The dietary carbohydrate load in the human diet has grown unnaturally, exponentially, and grotesquely from what our Paleolithic ancestors once knew. This includes starchy or complex forms, with the exception of indigestible forms such as fiber, as well as simple carbohydrates found in fruit. {Here she DOES mention the complex carbs! So she knows!}
Wild fruit was a very different food from the modern cultivated varieties (often more tart than sweet, usually much smaller, lower in sugar, and very fibrous) and was only seasonally available, at best.
All nonfibrous carbohydrates stimulate the secretion of insulin, {again, she says it!} which is the fat storage hormone, or damage the body and brain via a process known as glycation (in which sugars in the bloodstream react with proteins and fats and cause them to deteriorate). Among examples of carbohydrate foods in this context are bread, pasta, cereal, rice, potatoes, granola, dried fruit, juices, candy, chocolate, desserts, alcoholic beverages, and even most fresh fruit (an exception being something like avocados). {And here, she tries to separate the starches from all other vegetables. Weird!}
Fructose, the simple sugar in fruit, may not impact insulin much (except when it's in high fructose corn syrup), but it is extremely glycating and damaging. {Actually, I've read elsewhere that fructose has pretty much the same impact on insulin production as table sugar does.} It is also more likely to raise uric acid levels (such as with metabolic syndrome and gout). In this context, the carbohydrates we are talking about here don't include fibrous vegetables and greens, which are very beneficial and have negligible sugar or starch content. {Either she is being deliberately obtuse, or she is pandering to the mainstream diet thought police. A carb is a carb is a carb.}
The body is obsessed with maintaining glucose levels within a minimally necessary range, which can differ from person to person in relative terms, varying on how dependent they have become on glucose for energy and how insulin resistant they are.
There are actually several hormones designed to raise glucose levels and only one that actually lowers them. This is because carbohydrates tended to be an extremely limited commodity in primitive diets, and as such, our ancestors very rarely had an "emergency" need to lower blood glucose levels, as is so common today. The ability to hormonally raise blood glucose levels in an emergency situation, however, is essential to survival.
It is fairly optimal for healthy, insulin- and leptin-sensitive humans to have a blood glucose value of no more than roughly 70 to 85 mg/dL at any given time (without any symptoms of hypoglycemia). The available scientific evidence from studies of human longevity and caloric restriction points to this range as optimal. Some current functionally healthy ranges are established as being more typically between 85 and 100 mg/dL, which is considered more the norm, though lower ranges are by far more desirable for people who normally maintain low insulin levels, even if the higher range is more common in many individuals.
Fasting blood sugar, from a functional standpoint, in excess of 100 mg/dL, is already reflective of dysregulation. The most current human longevity studies indicate that the ability to maintain a fasting blood glucose level between 70 and 85 mg/dL—without accompanying symptoms of hypoglycemia—and not allowing glucose to spike higher than 40 mg/dL over your fasting value following meals has a favorable effect in activating sirtuins (our longevity genes).
A study of nearly two thousand men over a period of twenty-two years showed the startling results that men with fasting glucose levels over 85 mg/dL had a 40 percent increase in risk of death from cardiovascular disease! The researchers conducting this study stated that "fasting blood glucose values in the upper normal range appear to be an important independent predictor of cardiovascular death in non-diabetic apparently healthy middle aged men" (Bjornholt et al. 1999).
What is referred to as hypoglycemia or even reactive hypoglycemia becomes a relative thing, depending on the context. A fasting glucose level of 90 or 100 may feel like marked hypoglycemia and may even induce seizures in someone who is used to levels of 400 mg/dL, as with some diabetics. Someone used to functioning between 85 and 100 mg/ dL may feel reactively hypoglycemic (foggy, emotionally volatile, shaky, fatigued, or irritable) at 70 mg/dL.
A healthy person maintaining consistently low glucose and insulin levels may not exceed 90 or 100 mg/ dL, even following a meal, and may feel absolutely comfortable and symptom-free with fasting blood glucose levels at 70 mg/dL. Again, it is relative and contextual.
{This may explain why so many of us feel tired and lethargic on strictly reduced carbs... we are used to very high levels of blood glucose and all the body's systems are geared to that.}
The rule of thumb is the lower you can maintain your blood glucose levels in a healthy and functional way (that is, without experiencing low- blood-sugar symptoms), the better off you are.
{So maybe those who feel tired and sluggish should increase their carbs slightly and go along for awhile at that level and then try to lower them again later?}
Those people who are more optimally healthy should maintain a range between 70 and 85 mg/dL or lower; this is equivalent to no more than 1 teaspoon of sugar, or about 5 g or 20 kcal, total.
Keep in mind that the body is adamant about maintaining the minimal necessary levels of glucose at any given time because glucose is inherently damaging to vessels, organs, and tissues in the body. The less glucose that is absolutely necessary, the better.
Two slices of bread or a single small bagel contain about 6 teaspoons of glucose—six times the amount normally allowed in the bloodstream! Dietary carbohydrates, with the exception of fiber, are all absorbed by the liver and converted to the simple monosaccharide glucose, which is then released into the bloodstream. {Including vegetables.}
Cereals and potatoes can raise blood sugar levels even faster than a candy bar!
Glucose (and other sugars) in the bloodstream auto-oxidizes, which, in excess, produces potent free-radical activity that damages arterial walls and forms cross-links with proteins called advanced glycosylation (also known as glycation) end products (AGEs). AGEs are known to accelerate the age-associated declines in the functioning of cells and tissues and to cause mutations in DNA. Also, AGEs bind with certain receptors in the bloodstream, appropriately called RAGEs, and induce widespread inflammation, leading to more advanced cardiovascular disease. A simple, inexpensive blood test that can measure up to a three-month window of glycation of red blood cells is called a hemoglobin-Ale test, and it can be used to more accurately monitor these glycation tendencies over time. Fasting blood sugar as a marker is not sufficiently accurate for this.
Glucose is what ages (or AGEs) us. It is an irony that a thing we all need to stay alive, to feed our red blood cells, and to fuel anaerobic processes is what science has discovered is ultimately what degenerates and kills us. We have to have some sugar to fuel our red blood cells, but not so much for our brains, as many people think. Remember, our brain can run beautifully—in fact, better—with mostly ketones, which are the energy units of fat.
Ketones are a much more steady, reliable, and abundant source of fuel for our brain and organs to depend on. Our red blood cells, however, need to burn sugar (glucose) for fuel anaerobically to preserve their precious cargo, which is oxygen, so they burn sugar instead of fats.
Unfortunately, in the end, we pay a price for what is somewhat inevitable. Aging is now being understood by people researching longevity as essentially a gradual process of glycation of all tissues, including the brain. Chronic diseases associated with aging and certain forms of mental decline may be directly associated with these processes. The lower we maintain our blood sugar levels, the slower this process occurs and the longer and healthier we live—and the more gracefully we age.
A more pronounced and advanced state of the consequences of glycation effects can be seen in people with full-blown diabetes. The irony is that, given our most current understanding of how aging (which is now being viewed as a disease process) actually occurs, we can all be technically viewed as having diabetes—only to varying degrees. And the current evidence that even modestly elevated "normal" glucose levels significantly increase disease risk cannot be ignored.
Looking at it this way can really shift your perspective and hopefully your dietary habits. In a study of 33,230 men, high glucose levels were independently associated with a 38 percent increase in deaths from digestive tract cancers (Matthews et al. 2010).
Other studies certainly show that diabetics have even greater increases in cancer risks! What is clear and irrefutable from the current understanding of antiaging medicine and how degenerative processes and DNA mutation (leading to cancer) develop is that the lower the levels of blood sugar we are able to maintain and the less insulin we produce, the longer and healthier we live and the "kinder" and slower the aging process will be. (Note: Glycation and its damage is ultimately a cumulative process, so every bit of sugar or starch we eat eventually counts. Every piece of candy, cookie, bread, or potato, every spoonful of honey, and every drop of soda effectively shortens your life—something to think about. Though some glycation and its effects can be reversed, some cannot. It's all a matter of what you choose to prioritize.)
Another consequence of chronic dietary carbohydrate consumption is Candida yeast overgrowth. Yeast overgrowth is extremely common in those people in the U.S. population eating a high-carbohydrate diet. It is especially common in diabetics and is created by an imbalance of organisms in the gastrointestinal tract as well as antibiotic use, poor diet, and certain exogenous hormone use. Most people with Candida overgrowth have an allergy to yeast, as well. Both can provoke symptoms. Symptoms of yeast overgrowth can include postnasal drip, rectal itching, chronic sinus infections, sinus headaches, congestion, gas, bloating and heartburn, brain fog or spaciness, white tongue, vaginal yeast symptoms, frequent urination, constipation or diarrhea, skin eruptions, water retention, and cravings for sweet, starchy, or "yeasty" foods like breads, alcohol, and pizza. Complete avoidance of sugar- and starch- based foods in addition to most cheeses and sour cream, pickled or fermented foods (including soy sauce), and vinegars is often necessary to get Candida under control.
The Relationship between Insulin and Blood Sugar
Following a meal, significant levels of blood sugar generated above homeostasis stimulate the release of insulin, which works rapidly to remove glucose from the blood. Whatever glucose is not needed immediately—for outrunning, say, a hungry lion via anaerobic energy (i.e., peak, turbo- charged energy output or exertion)—converts rapidly either to glycogen, which is stored in very limited amounts in the liver and muscle tissue for times of extreme anaerobic exertion, or to triglycerides through the activation of an enzyme called glycerol-3-phosphate dehydrogenase, which converts blood sugar into fat, which is then moved into storage via lipoprotein lipase as adipose tissue (body fat).
We need to understand a certain rather major point: our ancient ancestors never really had an emergency need to lower their blood sugar levels. It's critical you understand this.
And here's a news flash: Something even many doctors do not understand is that insulin's actual biological function and purpose is not, in fact, to regulate blood sugar. We have several other hormones actually designed for blood-sugar regulation: glucagon, epinephrine, norepinephrine, cortisone, and growth hormone. The regulation of blood sugar by these hormones is designed to increase blood glucose when we need it.
Insulin, by default, does lower blood sugar (very crudely), but insulin's primary purposes are actually to simply store away excess nutrients in case of a famine and to regulate the coordination of energy stores with life span and reproduction (Rosedale 1999). Blood sugar lowering is a trivial sideline for insulin, a key hormone that has much bigger fish to fry. This is hugely important to understand and a key factor in new understandings by scientists in the quest for advancing human longevity....
The Need for Steady Fuel
Where fueling the fire of our brain and body's metabolism is concerned, carbohydrates can best be described as kindling. Whole grains and legumes are somewhat like twigs; starch, such as in cereals and potatoes, and simple sugars are like paper on the fire; and alcohol might best be described as gasoline on the fire.
If you're relying on carbohydrates as your primary source of fuel, you need to feed that fire often, regularly, and consistently. You will be craving that fuel. Unfortunately, most people today have forcibly adapted their bodies to this sort of an unnatural dependence by overconsuming carbohydrates in their diet.
Most, if not all, alcoholics (for instance) have severe issues with dysglycemia and sugar addiction. Alcoholics are utterly dependent on and regularly seek fast sources of sugar—alcohol being the fastest. This is one reason why they say "once an alcoholic, always an alcoholic." This is because the problem in alcoholism, in fact, isn't really alcohol, per se, but severe carbohydrate addiction. By merely giving up alcohol, one is still left with the real underlying problem: sugar addiction. The typical Alcoholics Anonymous meeting is replete with doughnuts, coffee, and people standing around smoking cigarettes. Even though they may not be drinking alcohol, the damaging, often unconscious, sugar addiction in recovering alcoholics continues.
Alcoholics are typically what I refer to as "carbovores," eating diets largely consisting of carbohydrate-rich foods, relentlessly craving sweets, and additionally relying on stimulants such as caffeine and nicotine to constantly keep blood sugar levels up. The "sweet tooth" doesn't just go away with abstinence from beer, wine, and liquor, hence the ongoing vulnerability to relapse.
Once the cravings for carbohydrates and the dependence on carbohydrates as the primary source of fuel are eliminated, so are the alcohol cravings.
Training the body to depend on ketones rather than sugar for fuel is key to this equation. This essentially means eliminating sugar and starch from the diet entirely.
For those having a greater difficulty adapting to a fat-based metabolism, supplements such as L-glutamine (which the brain can use in lieu of glucose) can help the brain transition away from sugar (sort of like training wheels) while the body adapts to its new, more stable, and long-sustaining source of fuel.
Botanicals such as Gymnema sylvestre can help knock out carb cravings when taken in more-concentrated doses of between 4 and 8 g, three times per day for a month or so while dietary changes are being made. Supplying additional nutrients that have been greatly depleted by alcohol and carbohydrate abuse is also essential to recovery.
One might get a burst or a ball of flame with respect to energy from many carbohydrate sources, but no one can get long-term, sustainable energy. As soon as the flame starts to die out, which doesn't take long, you're stuck with cravings for fuel or stimulants again. It can be quite a roller-coaster ride.
This is why some dietary experts are always telling you to eat every two hours or to eat "numerous small meals throughout the day," If you're sugar dependent—and almost everyone in this culture is victim to that unnecessary reality—then frequent small meals become necessary to maintain an even keel.
If you have ever heated your home with a woodstove, then you know what I mean with the following analogy: If you had to heat your home with that woodstove using paper, twigs, and lighter fluid all day, you'd be a slave to that fire, and you'd need a mountain of fuel handy to constantly feed that hungry beast. You'd be forever preoccupied with keeping that fire going, and you'd have little other life.
In effect, most people in this culture are similarly enslaved by the preoccupation with where their next meal or snack (or caffeinated boost) is coming from.
The food industry and big agribusiness are only too happy to support that enslavement and the perpetuation of the notion that glucose is essential as a primary source of fuel and that frequent eating, snacking, and carbohydrate intake are somehow important to maintain healthy blood sugar levels. This even gets taught in medical schools. It is a lie.
Nature would never have intended for us to constantly live this way. It is a terribly impractical metabolic state to maintain, particularly if you view this from the primitive perspective of ongoing survival in a less certain world where food wasn't constantly available. Our primitive (particularly ice age) ancestors would never have made it this far if carbohydrates were essential to the diet or if glucose (an anaerobic source of rocketlike fuel) were necessary as a primary source of energy all of the time. Nature isn't that crazy or stupid.
Mind you, it is possible to live in a state of primary glucose dependence. People do it all the time. The idea that we are necessarily dependent on sugar as our primary source of fuel is true only conditionally, only if we've metabolicallv adapted ourselves to that unnatural dependence. Most people in this culture are metabolically adapted to that very state. {And that is clearly what we need to un-adapt ourselves to!} And you can go on managing your blood sugar levels all day with frequent meals, snacking, and the eating of more complex carbohydrates {like most vegetables} (i.e., piles of twigs, "eleven servings a day") to keep the fire burning more steadily, but I personally have far better things to do than live my life tending to that woodstove. It isn't necessary or essential at all, and it will age you faster (and cost you much more in grocery bills and health care costs). There is a far better, healthier, and more natural way to live and eat.
Dietary fat, in the absence of carbohydrates, is like putting a nice big log on the fire. Fat's flame burns at a regular, even rate, and is easily kept going. Protein, consumed in moderate quantities, is mainly diverted toward structural repair and maintenance. Only in excess does it convert to sugar.
Fat's even flame keeps the hormone leptin under control, keeps insulin quiet, and keeps our appetite satisfied. Blood sugar, when one learns to depend on this steadier source of fuel, becomes a trivial concern. You become free to live your life instead of being constantly preoccupied with where your next meal or snack is coming from. One can go many, many hours on this longer-burning type of fuel without experiencing any discomfort or cravings at all. You may eventually get hungry if you really go a long time without eating, which is normal, but you are far less likely to experience irritability, dizziness, brain fog, cravings, fatigue, jitteriness, or mood swings because of it.
This is the way it's supposed to be!
What We Have Here Is a Failure to Communicate
Less than 1 percent of the pancreas is devoted to insulin production. Excessive demands for insulin can initially result in gradually reduced sensitivity of insulin receptors, leading to more and more insulin release needed to accomplish the same job.
This is what is termed insulin resistance. In the earlier stages of the pathogenesis of glucose dysregulation, a tendency toward hypoglycemia may be the result. Over time, however, one's cell receptors become increasingly resistant to insulin's constant message, and type 2 diabetes becomes the problem. In more advanced cases, the overtaxed pancreas may ultimately lose its ability to produce sufficient amounts of insulin, and one may actually end up requiring insulin injections. Once thought to be a disease of older adults, type 2 diabetes is increasingly becoming prevalent in young children.
In fact, type 2 diabetes is really a disease not of blood sugar, but of insulin resistance— meaning the breakdown of communication between insulin and glucose. This is important to realize, as drugs that are designed to manage diabetes completely fail to address this issue and instead focus on lowering blood glucose, typically stimulating more storage of sugar as body fat. This does nothing to restore healthy cellular communication or reduce mortality from the disease. Diabetes drugs, though they may lower blood glucose levels initially, ultimately worsen the progression of the disease.
The recent Action to Control Cardiovascular Risk in Diabetes (ACCORD) study was published in The New England Journal of Medicine (Gerstein et al. 2008). Researchers who were following the effects of using insulin to lower blood glucose levels in diabetic patients were surprised to find that increased insulin use (to lower blood sugar levels) caused an increase in death from heart attack and stroke. The study was actually stopped short due to these alarming findings. This unfortunately continues to be the standard in diabetic care—a focus on blood sugar instead of insulin resistance.
Obesity, in many ways, can be viewed as the price we pay for our body trying to stave off diabetes. In the end, however, the issue is one of communication breakdown and insulin resistance. The key is the restoration of insulin sensitivity and cellular communication.
So, how do we do that, you ask?
If you want to change the way any organization works, first you have to go talk to the boss