Target anti-aging post-prandial blood sugar / lipids?

[sirtuin]

I'm curious, from an anti-aging / disease-preventative stance, what's an ideal target range for post-prandial glucose (45m-1hr post-meal spike in blood sugar) and post-prandial elevated triglycerides?

[Dean Pomerleau]

Sirtuin,

 

Our former Chief Science Officer (Paul McGlothin), thinks the lower the better, often aiming to keep is post-meal glucose peak below 100 mg/dL, or even below 90 mg/dL. But I don't think Paul has any evidence that this tight control is necessary, or even beneficial.

 

Normal (non-diabetic) peak glucose levels post-meal are often around 140mg/dL. I try to keep mine below 125 mg/dL, despite eating all my calories for the day in one big meal.

 

I do not endorse the Perfect Health Diet, but this blog post from that website has a pretty good analysis of post-meal glucose and its relation to mortality. Looking at a bunch of studies, it concludes that adverse effects of glucose appear to kick in only as a result of excursions above 120mg/dL, and perhaps not until those above 140mg/dL. It also points to evidence for a U-shaped mortality curve for HbA1c - with the optimal being between 5.0 and 5.4%.

 

--Dean

[sirtuin]

Our former Chief Science Officer (Paul McGlothin), thinks the lower the better, often aiming to keep is post-meal glucose peak below 100 mg/dL, or even below 90 mg/dL. But I don't think Paul has any evidence that this tight control is necessary, or even beneficial.

 

Normal (non-diabetic) peak glucose levels post-meal are often around 140mg/dL. I try to keep mine below 125 mg/dL, despite eating all my calories for the day in one big meal.

Hmm, looking into this more closely I might measure mine more frequently and investigate the response to different foods / meals.  This was an interesting recent paper on the variances between individual responses: 

 

http://news.meta.com/2015/11/19/cell-nutrition-is-personal-identical-foods-produce-healthy-and-unhealthy-responses-in-different-individuals/

 

So, tonight for dinner I had lima beans (boiled), green beans (boiled), tomatoes (boiled), celery (boiled), leeks (boiled), cauliflower (lightly baked at 275F) with 1.5Tbs olive oil, a small handful of cherries, a few grams of flax, a small frozen green (not sweet) banana generously dusted with ceylon cinnamon, a tiny handful of blueberries, a raw carrot, and some fermented nuts.  I also had a little bit of chicken.  On the side, I had a tall glass of matcha green tea.  By my rough calculations, this adds up to around 64.3 net carbohydrates and ~40g of fat.  1hr post-prandial glucose reads 129 mg/dL.  Checking it a couple hours later, it reads 74 mg/dL.  While eating higher amounts of starch, I've seen spikes up over 160 mg/dL.

 

For lunch today, I had some whey protein, dark chocolate, a banana, 2 kiwis, a raw carrot, almond milk, coconut water, krill oil, a large avocado, and some macadamia nuts.  This meal was around 48% fat by calories with 75g net carbs.  45m post-prandial glucose read 68 mg/dL, and 90m post-prandial glucose read 78 mg/dL. 

 

What's the trick for staying under 125 mg/dL, if not under 100 mg/dL or < 90mg /dL -- does this imply a high fat low carb diet?  I've read you often exercise after eating, where it's not quite practical for me to excuse myself from the dinner table to quickly start exercising (it's already somewhat socially odd enough to be eating a calorie restricted diet and avoiding all processed foods.)

[Dean Pomerleau]

Sirtuin,

 

I'm afraid without post-meal exercise you're pretty much out of luck. I (and others) have found it to be pretty much the only effective way of quickly and effectively curtailing glucose excursions after eating a meal with significant amounts of carbs.

 

--Dean

[sirtuin]

Sirtuin,

 

I'm afraid without post-meal exercise you're pretty much out of luck. I (and others) have found it to be pretty much the only effective way of quickly and effectively curtailing glucose excursions after eating a meal with significant amounts of carbs.

 

--Dean

As an experiment (testing a hypothesis that I might be more insulin-sensitive in the morning), I had a small amount of rice and seaweed + a small amount of ripe fruit (<350 calories in this snack-sized meal), and within 15 minutes from the start of my meal, my glucose measured just over 140 mg/dL.  At +30m from the start of my meal, glucose measured 156 mg/dL.  At +45m from taking the first bite, glucose measured 171 mg/dL.  At +60m, glucose measured 125 mg/dL.  At +75m (which might otherwise be 15m to 25m after finishing a meal), glucose measured 87 mg/dL.  Do you exercise while you're eating?

 

It often takes me 30-60m to eat a normal-sized meal, where this spike is happening while I'm eating, and I'm very likely up over 90-100 mg/dL within the first few minutes of the first few carbohydrate-rich bites.

 

My fasting glucose in the morning is around 83 mg/dL, and between meals and after exercise I'm usually around 75-77 mg/dL, occasionally a bit lower.  I have low triglycerides, low body fat, some lean muscle mass, and very little abdominal fat, and an A1C around 5.3%, which should all correlate with decent insulin sensitivity.  It appears as though I'm not necessarily more insulin-sensitive in the morning, but I'm perhaps seeing lower rises in blood glucose following meals rich in insulinogenic protein like whey, possibly also beneficially affected by pre-breakfast exercise (or maybe I'm measuring too late or missing the spike, which only lasts for ~15 minutes out of a potential 1hr window or so -- its not practical to take many readings.)  If I start a meal with whey protein, then consume and a greater amount of carbohydrate than what I consumed this morning, glucose seems to stay under the target 90-100mg/dL (if not under 70-80 mg/dL) when measured around 45m postprandially, although this also likely elevates IGF1 / mTor and I might be missing peak glucose, which seems difficult to catch on a single reading after finishing a meal.

[nicholson]

Hi Sirtuin:

 

If you are able to, you might want to get your *fasting*  *insulin* (FI) measured.  NO, I DON'T MEAN GLUCOSE.  When I recently requested this test at a major clinical centre in Canada, they - the medical professional - filled in a requisition for a fasting glucose test.  They seem not to understand the significance of fasting insulin, and around here (Canada) they prefer not to order a test for which there isn't a pill they can prescribe if the result turns out to be out-of-range. 

 

Others here (MR, for example) can provide much more information about this than I can, but it appears to be very sensitive to highly effective CR practice, and an excellent measure of overall health, in a manner perhaps rather similar to hsCRP (in which case, since most disease seems to be accompanied by inflammation, if your inflammation is negligible then perhaps your disease risk may be too?) which is also enormously sensitive to effective CR.  So the result of a FI test may provide you with very good input about whether you are doing things right.  In both cases - FI and CRP - low is good.  Last time my FI was tested about ten years ago the result was below the lab's ability to measure.  The lab thought they must have made a mistake, repeated the test on a remaining sample and got the same result.  I have been trying to get another one done recently, now that I am ten years older.  I will have to pay for it and hope the lab doing it knows what they are doing (i.e. have done it more than once before, etc..).  

 

In US units 2.0 is a very good number which is the equivalent, I believe, of about 14 in SI units.

 

Corrections, or additional information, more than welcome of course.

 

Rodney.

 

===========

 

"The unverified conventional wisdom is almost invariably mistaken."

[Dean Pomerleau]

Sirtuin,

 

I didn't say I kept my glucose below 100 (or esp. 90) mg/dL post meal - that is (or was) Paul McGlothin's practice.

 

Mine regularly rises to around 120-130 during / shortly after my meal. Then I go for a mile run immediately finishing eating and it has dropped to around 100-105 mg/dL. I continue with various exercises for 1.5 hours after that, and it hovers in that range for a while and eventually drops to around 85-90 mg/dL.

 

--Dean

[sirtuin]

Sirtuin,

 

I didn't say I kept my glucose below 100 (or esp. 90) mg/dL post meal - that is (or was) Paul McGlothin's practice.

 

Mine regularly rises to around 120-130 during / shortly after my meal. Then I go for a mile run immediately finishing eating and it has dropped to around 100-105 mg/dL. I continue with various exercises for 1.5 hours after that, and it hovers in that range for a while and eventually drops to around 85-90 mg/dL.

 

--Dean

I'm impressed you can eat all of your calories for the day (at 100+ grams of fiber and up over 3,000kcal, and over 500 grams of carbohydrates) and then start running and exercising immediately upon finishing -- wow.

 

Looking at dinner tonight, I had approximately 60 net grams of carbohydrates -- a big plate of steamed broccoli, lightly food-processed cauliflower "rice" (supposedly the GI is <15), lots of bok choy, leeks, capers, endive, ginger, onion, aged black garlic, a handful of cashews, lots of red dandelion greens, maitake mushrooms, with some olive oil and a little bit of shirataki tofu noodle (supposedly almost entirely fiber) with a few large scallops, followed by a small bowl of fresh cherries (~24 dark red cherries, apparently with a glycemic index of just 22 63.)  +30m post-prandial glucose reads 142 mg/dL.  +45m post-prandial glucose reads 175 mg/dL.  +60m post-prandial glucose reads 177 mg/dL -- what's going on here?  I'm full of fiber and low-GI food as a relatively small amount of carbohydrates with fats, and I'm much too full to start exercising for at least another 30 minutes or so (running with a full stomach makes me a little nauseous, and I'm too full for deep squats.)  This meal was fairly low in protein.  Perhaps a higher amount of protein would help to secrete more insulin, or more fat might help to try to slow this thing down?  I don't get where all this glucose is coming from so quickly after eating primarily fibrous vegetables, I'm guessing the ripe cherries did me in?

 

I'm kind of glad that I'm looking at this more closely now, as I can't really feel my glucose going up into the 170's and routine lab work seems to come back looking pretty nice.  At +75m, post-prandial glucose hits 158 mg/dL (yay, insulin.)  +90m reads 142 mg/dL.  +120m (2hr post-prandial) reads 109 mg/dL.

 

I'm envious of your safe 120-130 mg/dL zone while eating 500+ grams of carbohydrates.  You're doing something right.  

 

Right now, I'm only eating around 125-150g net carbs per day (BHB ketones come up around 0.4-0.6 mmol/L in the afternoons, which I believe correlates with low fasting insulin?)  Perhaps this is inducing some sort of insulin resistance?  Maybe more dietary carbohydrates would paradoxically decrease postprandial glucose? It seems as though first-phase insulin secretion isn't doing it's job.

 

My fingertips are a little banged up from today's extensive testing.

[Dean Pomerleau]

I don't know what to tell you except that people do vary in their in glucose / insulin response to particular foods, at least if the study you pointed to is to be believed. Plus, as you suggest, there is evidence that eating a low-carb diet reduces insulin sensitivity and thereby increases fasting glucose and the spike after a glucose challenge. This is discussed in the blog post I referenced above. Here is the most relevant section:

 

Studies confirm that high-carb diets tend to lower fasting glucose and to lower the blood glucose response to a glucose challenge. CarbSane forwarded me some illustrative studies:

• “High-carbohydrate, high-fiber diets increase peripheral insulin sensitivity in healthy young and old adults,” http://pmid.us/2168124. Switching healthy adults to a higher carb diet reduced fasting blood glucose from 5.3 to 5.1 mmol/L (95.5 to 91.9 mg/dl) and reduced fasting insulin from 66 to 49.5 pmol/l.

• “Effect of high glucose and high sucrose diets on glucose tolerance of normal men,”http://pmid.us/4707966. On diets with glucose as the only carb source, 2-hr plasma glucose after a glucose challenge was 184 mg/dl on a 20% carb diet, 183 mg/dl on a 40% carb diet, 127 mg/dl on a 60% carb diet, and 116 mg/dl on an 80% carb diet. The 80% carb diet was the only one on which blood glucose never went above 140 mg/dl.

This last study did not report fasting glucose, but did track blood glucose for 4 hours after the glucose challenge. If we take the 4-hr blood glucose reading as representative of fasting glucose, we find that dieters eating 60% or 80% carb diets had fasting glucose of 76 and 68 mg/dl, respectively.

 

I thought this study [1] (reference above) was most interesting. It switched healthy adults to a high-carb, high-fiber diet for 3 weeks and measured a bunch of things. Their fasting glucose and  fasting insulin went down, the glucose clearance rate went up, and their cholesterol improved to boot. 

 

So in short, it could be your relatively low-carb diet (although nowhere near as low as what true low-carbers consume) may be impairing your insulin sensitivity, causing your blood glucose to rise by an unusual amount in response to a glucose challenge.

 

But I'm just speculating.

 

--Dean

------------

[1] Am J Clin Nutr. 1990 Sep;52(3):524-8.

High-carbohydrate, high-fiber diets increase peripheral insulin sensitivity in
healthy young and old adults.

Fukagawa NK(1), Anderson JW, Hageman G, Young VR, Minaker KL.

Author information:
(1)Clinical Research Center, Massachusetts Institute of Technology, Cambridge.

To examine extra-alimentary effects of high-carbohydrate, high-fiber (HCF) diets,
insulin-mediated glucose disposal employing the euglycemic clamp and hepatic
glucose output (HGO) employing [6,6-2H2]glucose were measured in 12 healthy young
and old individuals before and after 21-28 d of an HCF diet. Diet lowered fasting
concentrations of glucose from 5.3 +/- 0.2 to 5.1 +/- 0.1 mmol/L (p less than
0.01) and insulin from 66.0 +/- 7.9 to 49.5 +/- 5.7 pmol/L (p less than 0.01).
Fasting serum cholesterol decreased from 5.17 +/- 0.18 to 3.80 +/- 0.20 mmol/L (p
less than 0.01) in young individuals and from 6.15 +/- 0.52 to 4.99 +/- 0.49
mmol/L (p less than 0.01) in elderly individuals. Fasting serum triglyceride
concentrations, basal HGO, and insulin suppression of HGO were unchanged by the
diet. Glucose disposal rates increased from 18.87 +/- 1.66 before 23.87 +/- 2.78
mumol.kg-1.min-1 after the diet (p less than 0.02). Therefore, HCF diets may
improve carbohydrate economy by enhanced peripheral sensitivity to insulin.

PMID: 2168124

[sirtuin]

So, this morning I increased carbs to 140g+ (a little over 100g net) with ~53g fat.  I went with more ripe cherries as a sort of control (20x), white rice (126g), seaweed, a banana + cinnamon, some fermented almonds + almond milk sweetened with white sugar (5g sugar), a kiwi, half an avocado, some flax, some sesame seed, some coconut flour mixed with ground pecans and fresh cinnamon, a brazil nut, and a splash of coconut water.  For a trick, I preceded this meal with 20m of HIIT kettlebell swings, a little under a scoop of whey, and a little taurine + gelatin and a chromium GTF supplement.

 

+30m post-prandial glucose, sitting at my desk reads 98 mg/dL.  +45m post-prandial glucose reads 97 mg/dL.  +60m post-prandial glucose reads 98 mg/dL.  With post-meal exercise, I suppose this would be even lower?

 

I find it strange that I can eat high-GI white rice, sugar, ripe fruit, and more carbohydrates (at a higher glycemic index), and I get a minimal blood sugar spike with only 8 sets of exercise + protein powder.  Whereas a meal comprised of mostly vegetables and fewer carbs (primarily low-GI) with less protein after no exercise has me up approaching 180 mg/dL.

 

I wonder how much of this is attributable to the protein vs exercise vs increased carbs + fat in the meal.  Interesting n=1 stuff.  I'll have to try again without the protein but keep the pre-meal exercise.

[Dean Pomerleau]

Sirtuin,

 

Great data! Thanks for sharing.

 

I've found that pre-meal exercise has relatively little effect on post-meal glucose excursions, so I suspect it might be the insulinogenic effects of the pre-meal protein you ingested that kept your glucose down. But I'll be curious to see what you find in your experiment to try to tease them apart.

 

Whey protein in particular, and dairy products in general, are well known for boosting insulin release [1]. The question is whether you want more circulating insulin, or greater insulin sensitivity. Personally I'd prefer the latter, and shy away from isolated protein powders for that reason. 

 

--Dean

 

------------

[1] Am J Clin Nutr. 2005 Jul;82(1):69-75.

Effect of whey on blood glucose and insulin responses to composite breakfast and
lunch meals in type 2 diabetic subjects.

Frid AH(1), Nilsson M, Holst JJ, Björck IM.

Author information:
(1)Clinic of Endocrinology, University Hospital MAS, Malmö, Sweden.

BACKGROUND: Whey proteins have insulinotropic effects and reduce the postprandial
glycemia in healthy subjects. The mechanism is not known, but insulinogenic amino
acids and the incretin hormones seem to be involved.
OBJECTIVE: The aim was to evaluate whether supplementation of meals with a high
glycemic index (GI) with whey proteins may increase insulin secretion and improve
blood glucose control in type 2 diabetic subjects.
DESIGN: Fourteen diet-treated subjects with type 2 diabetes were served a high-GI
breakfast (white bread) and subsequent high-GI lunch (mashed potatoes with
meatballs). The breakfast and lunch meals were supplemented with whey on one day;
whey was exchanged for lean ham and lactose on another day. Venous blood samples
were drawn before and during 4 h after breakfast and 3 h after lunch for the
measurement of blood glucose, serum insulin, glucose-dependent insulinotropic
polypeptide (GIP), and glucagon-like peptide 1 (GLP-1).
RESULTS: The insulin responses were higher after both breakfast (31%) and lunch
(57%) when whey was included in the meal than when whey was not included. After
lunch, the blood glucose response was significantly reduced [-21%; 120 min area
under the curve (AUC)] after whey ingestion. Postprandial GIP responses were
higher after whey ingestion, whereas no differences were found in GLP-1 between
the reference and test meals.
CONCLUSIONS: It can be concluded that the addition of whey to meals with rapidly
digested and absorbed carbohydrates stimulates insulin release and reduces
postprandial blood glucose excursion after a lunch meal consisting of mashed
potatoes and meatballs in type 2 diabetic subjects.

PMID: 16002802

[sirtuin]

Whey protein in particular, and dairy products in general, are well known for boosting insulin release [1]. The question is whether you want more circulating insulin, or greater insulin sensitivity. Personally I'd prefer the latter, and shy away from isolated protein powders for that reason. 

I'm curious if this is some sort of physiological insulin resistance at the muscle level, from dipping into ketosis between meals on a relatively low carb intake (repaired by eating more carbs + high-GI starches in my meals) ?  Or perhaps there's a decent degree of insulin sensitivity, but low beta-cell stores of insulin.  Then again, my carbohydrate intake isn't that low, and I do seem to get a nice amount BG attenuating response from protein.  I'm not on that high fat of a diet, usually getting around 80-90g in a day.

 

On the plus side, I've read that protein intake might not have too much of an effect on the benefits of CR, and that these effects are largely attributable to total caloric intake?  I don't like the idea of using dairy / protein-powders as an insulinogenic crutch, especially not twice a day, although perhaps it's useful for maintaining and building lean mass and boosting glutathione while attenuating the GI spike for a high-carb post-workout meal.  I usually get around 80g of protein in a day.

 

http://www.ncbi.nlm.nih.gov/pubmed/2692897

a whey protein diet appears to enhance the liver and heart glutathione concentration in aging mice and to increase longevity over a 6.3 month observation period.

 

http://www.ncbi.nlm.nih.gov/pubmed/3059144

mean and maximal longevity of hamsters fed a 20% whey protein diet is increased in comparison with those fed commercial laboratory feed

 

http://www.fasebj.org/cgi/content/meeting_abstract/25/1_MeetingAbstracts/528.2

In 8% or 12% GS rats, median lifespan increased from 88 weeks (w) to 113 w, and maximum lifespan increased from 91 w to 119 w v CF

 

http://www.lifeextension.com/magazine/2013/9/New-Longevity-Benefits-of-Whey-Protein/Page-01

 

Hmmmm.

[Dean Pomerleau]

Sirtuin wrote:

 

 

On the plus side, I've read that protein intake might not have too much of an effect on the benefits of CR, and that these effects are largely attributable to total caloric intake?

 

Hmmm... I think there is some pretty good evidence for the exact opposite - i.e. that protein restriction, and in particularly the methionine restriction, may be a major contributor to the beneficial effects of CR. See this thread, and the Dr. Greger video it references (along with this one), for discussion of the CR-mimetic effects of protein, and especially methionine and/or cysteine restriction.

 

Whey protein isolate has about twice the methionine per gram as plant-based protein like pea protein isolate.

 

--Dean

[sirtuin]

Sirtuin wrote:

 

 

On the plus side, I've read that protein intake might not have too much of an effect on the benefits of CR, and that these effects are largely attributable to total caloric intake?

 

Hmmm... I think there is some pretty good evidence for the exact opposite - i.e. that protein restriction, and in particularly the methionine restriction, may be a major contributor to the beneficial effects of CR. See this thread, and the Dr. Greger video it references (along with this one), for discussion of the CR-mimetic effects of protein, and especially methionine and/or cysteine restriction.

 

Whey protein isolate has about twice the methionine per gram as plant-based protein like pea protein isolate.

 

--Dean

Looking at my protein intake yesterday, it looks like I ate one gram of methionine, 0.7 grams of cysteine, and 4.2 grams of glycine.  Today, I'm at 600 milligrams so far of methionine, 500 milligrams of cysteine, and 2.6 grams of glycine out of an intake so far of 48g protein.  I wonder what the ideal ranges are here?  Is more protein relative to the methionine+cysteine content ideal?  Somewhat off topic.  Perhaps I could eat more protein (I wouldn't mind putting on more muscle mass, although I would have to eat at a caloric surplus to pull that off.)  Lots of dials to try to tweak into ideal balance.  Tonight, I'm having more scallops, but I have lentils soaked ready to go -- I'll probably peak a little over a gram of methionine by the end of the day, primarily from the bivalves.

 

I do have a pea protein powder that I occasionally use, but I end up having to use lots of sugary fruits or a sugary-liquid to make it palatable (although I'm still playing with some different recipe ideas, and perhaps a higher carb intake might actually work better for my goals.)  It's probably easier to enjoy split pea soup.  Whey protein, I really enjoy the taste of, like a milkshake without the casein / fat / cholesterol.

 

It looks like I can probably do just 1 blood sugar measurement at 60m after a 45m eating window and get a good sense of what's going on under the hood.

[Dean Pomerleau]

Sirtuin,

 

 Whey protein, I really enjoy the taste of, like a milkshake without the casein / fat / cholesterol.

 

The good taste of your whey protein powder is very probably due to sweetener / flavoring added to it. From my recollection (admittedly many years back), pure whey protein powder tastes very bland and isn't very palatable. 

 

--Dean

[sirtuin]

Sirtuin,

 

 Whey protein, I really enjoy the taste of, like a milkshake without the casein / fat / cholesterol.

 

The good taste of your whey protein powder is very probably due to sweetener / flavoring added to it. From my recollection (admittedly many years back), pure whey protein powder tastes very bland and isn't very palatable. 

 

--Dean

I've used this one in the past:

http://www.wellwisdom.com/product/vital-whey-natural-21oz600g-grass-fed-whey-protein/

 

The ingredients there are "whey".  If I added this to something like a nut butter, I generally felt like the flavor had improved, while increasing the protein content -- win / win.  I do think I actually enjoy the taste of whey.  I would often combine vanilla bean powder, cacao powder, fresh cracked coconut water, and sweeten the 100% unsweetened raw cacao powder + pure whey with a few drops of stevia.  This was more to sweeten the cacao than anything else -- I still like it minimally sweetened, but without any oomph, it's a bit like a dirt-shake.  With the right ratios, it's a fantastic drink.

 

Lately, I just go with Jay Robb's unflavored whey isolate to dodge the cholesterol / fatty acids.  This one is micronized with lecithin rather than pure, which might be a good thing, as I'm always coming up low on choline.  The isolate tastes pretty good to me, although maybe not as good as a smooth whey concentrate.

 

Where whey protein can be enhanced with flavors and create a very delicious product, tastier than any of the isolated ingredients, with pea protein I find myself working to bury the overbearing taste of play doh.  Perhaps I haven't had a good pea protein.  I enjoy the taste of hemp protein (tastes like hemp seeds), but it seems very high in phosphorus and polyunsaturated fats (processed / dehydrated / powdered) and I'm not convinced that's not un-healthy and potentially oxidized.

 

Measuring my serum ketone levels before dinner after a 140g+ carb breakfast meal with whey protein, it looks like I'm at 0.3mmol/L of beta-hydroxybutyrate (which should correlate with low levels of serum insulin?)  I'm curious if you've measured your ketone levels with your large carb intake (but larger fasting interval).

[sirtuin]

I did another test today with no whey / animal protein, but using pre-breakfast kettlebell swings (I don't foresee being able to do these every morning before breakfast, but maybe pre-breakfast exercise is useful.)

 

I ate 150g cooked rice (~1 cup), 225g of cooked black lentils, some macadamia nuts, an orange, 2 kiwi fruits, and a bunch of leftover vegetable stir fry (half a dozen plants.)  On cronometer, this stacks up to a just over 100 net carbohydrates.  *slight confounding variable -- the rice and black lentils were cooked, cooled, and reheated.

 

30m post-prandial glucose read 105 mg/dL, 45m read 102 mg/dL, and 60m read 101 mg/dL.  Again, almost no blood sugar spike and I'm eating high-GI starches, where I've seen much crazier responses recently just eating vegetables and berries with fewer carbohydrates in the meal.

 

I'm not sure if I'm seeing the effects of HIIT style exercise increasing GLUT4 activity, or if increasing my net carbs from 100-150g/d to just over 200g/d (which seems like a small difference) has reversed some sort of physiological insulin resistance.  Or, perhaps this is from moving more in the direction of consistency in the glycemic load of my meals allowing the second-meal effect to better predict insulin needs.  I'll have to look around and see what happens at dinner times and compare more exercise vs non-exercise days.  It seems paradoxical that adding starches to all of my meals and eating more carbohydrates would help to lower my average post-prandial glucose response.

[Dean Pomerleau]

Wow Sirtuin,

 

That is a much better post-meal glucose response to pre-meal exercise than I've personally observed in the past. I've only found that post-meal exercise makes a big difference in glucose excursion. But it would certainly be easier to exercise pre-meal than post-meal, so I hope that continues to work for you. You are right, it might be due to the intensity of your exercise - I usually don't work out that hard either pre-meal or post-meal.

 

--Dean

[sirtuin]

Wow Sirtuin,

 

That is a much better post-meal glucose response to pre-meal exercise than I've personally observed in the past. I've only found that post-meal exercise makes a big difference in glucose excursion. But it would certainly be easier to exercise pre-meal than post-meal, so I hope that continues to work for you. You are right, it might be due to the intensity of your exercise - I usually don't work out that hard either pre-meal or post-meal.

 

--Dean

So far so good, it's amazing how these metrics can often be tweaked when you're able to measure them and mess with the dials.

 

I could probably use a heavier weight, here's what I'm looking at:

 

20m of exercise consisting of 11 sets spiking to ~89% calculated max HR and recovering to a comfortable <120bpm HR between sets, totaling 8,525lb lifted (4.26 tons)

[Brett Black]

Interesting recent study investigating many variables (including gut microbiota) that may impact glycemic response to meals, suggesting that the use of stock glycemic index food tables may provide limited predictive power:

 

1. Cell. 2015 Nov 19;163(5):1079-94. doi: 10.1016/j.cell.2015.11.001.

 

Personalized Nutrition by Prediction of Glycemic Responses.

 

Zeevi D(1), Korem T(1), Zmora N(2), Israeli D(3), Rothschild D(1), Weinberger

A(1), Ben-Yacov O(1), Lador D(1), Avnit-Sagi T(1), Lotan-Pompan M(1), Suez J(4),

Mahdi JA(4), Matot E(1), Malka G(1), Kosower N(1), Rein M(1), Zilberman-Schapira

G(4), Dohnalová L(4), Pevsner-Fischer M(4), Bikovsky R(1), Halpern Z(5), Elinav

E(6), Segal E(7).

 

Author information:

(1)Department of Computer Science and Applied Mathematics, Weizmann Institute of

Science, Rehovot 7610001, Israel; Department of Molecular Cell Biology, Weizmann

Institute of Science, Rehovot 7610001, Israel. (2)Immunology Department, Weizmann

Institute of Science, Rehovot 7610001, Israel; Internal Medicine Department, Tel

Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel; Research Center for

Digestive Tract and Liver Diseases, Tel Aviv Sourasky Medical Center, Sackler

Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel. (3)Day Care

Unit and the Laboratory of Imaging and Brain Stimulation, Kfar Shaul Hospital,

Jerusalem Center for Mental Health, Jerusalem 9106000, Israel. (4)Immunology

Department, Weizmann Institute of Science, Rehovot 7610001, Israel. (5)Research

Center for Digestive Tract and Liver Diseases, Tel Aviv Sourasky Medical Center,

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel;

Digestive Center, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel.

(6)Immunology Department, Weizmann Institute of Science, Rehovot 7610001, Israel.

Electronic address: eran.elinav@weizmann.ac.il. (7)Department of Computer Science

and Applied Mathematics, Weizmann Institute of Science, Rehovot 7610001, Israel;

Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot

7610001, Israel. Electronic address: eran.segal@weizmann.ac.il.

 

Elevated postprandial blood glucose levels constitute a global epidemic and a

major risk factor for prediabetes and type II diabetes, but existing dietary

methods for controlling them have limited efficacy. Here, we continuously

monitored week-long glucose levels in an 800-person cohort, measured responses to

46,898 meals, and found high variability in the response to identical meals,

suggesting that universal dietary recommendations may have limited utility. We

devised a machine-learning algorithm that integrates blood parameters, dietary

habits, anthropometrics, physical activity, and gut microbiota measured in this

cohort and showed that it accurately predicts personalized postprandial glycemic

response to real-life meals. We validated these predictions in an independent

100-person cohort. Finally, a blinded randomized controlled dietary intervention

based on this algorithm resulted in significantly lower postprandial responses

and consistent alterations to gut microbiota configuration. Together, our results

suggest that personalized diets may successfully modify elevated postprandial

blood glucose and its metabolic consequences. VIDEO ABSTRACT.

 

Copyright © 2015 Elsevier Inc. All rights reserved.

 

PMID: 26590418 [PubMed - in process]

 

http://www.ncbi.nlm.nih.gov/pubmed/26590418

http://www.cell.com/cell/abstract/S0092-8674(15)01481-6

[Dean Pomerleau]

Brett,

 

Yes, that was the study (PMID: 26590418) Sirtuin referenced in this post earlier in this thread. It is very curious to me how many factors seem to impact the glycemic response to a meal even within a single individual, to say nothing of across individuals.

 

--Dean

[sirtuin]

I'm thinking the trick here is improving my consistency across meals, slightly increasing my carbohydrate intake up from 100g-150g net (occasionally down around 70g) to a consistent ~200g intake, including daily exercise (for now, it seems effective before my meal), then avoiding sitting down for an hour or so after a meal.  And possibly increasing my caloric intake slightly.

 

As far as I can tell, it was counter-productive to try to stay in a more "fat-burning mode" with lower carbs at breakfast producing a fluctuation in insulin needs between meals while avoiding high-GI carbs as much as possible, combined with fluctuations in caloric / total carbohydrate intakes between days.  Including some starches, fruits, and fats in fairly consistent amounts across meals luckily makes for some tasty balanced meals.

 

Today, looking at post-prandial glucose, I'm seeing 126 mg/dL immediately taking glucose after the last bite of breakfast (it took me around 30m to eat the meal.) +15m glucose read 104 mg/dL, +40m post-prandial glucose read 89 mg/dL, and +90m post-prandial read 106 mg/dL.  I did a bunch of pushups before I ate.

 

Next, I'm curious to see what a minimum effective dose for exercise might be.  I tend to see higher glucose numbers after dinner, likely due to less activity around that meal (yesterday's dinner read 119 mg/dL at the +45m spot, while yesterday's breakfast read +98mg /dL at the 45m spot and 110 mg/dL at the +1hr post prandial spot.)

 

I think that I've just about figured this out well enough for my current goals.

[Dean Pomerleau]

Sirtuin,

 

Congratulations - Very impressive improvement over the numbers you reported earlier in this thread! 

 

I think this should be a good lesson for people about the value of measuring post-meal glucose to facilitate tweaking their diet / exercise habits to optimize glucose excursions.

 

--Dean

[sirtuin]

Experimenting with fine-tuning this regimen a bit more seems to be working well:

 

I have morning exercise (~20mins) with 2x 1hr square meals per day of relatively equal carbs (~35-40% CHO macro.)  Meals start with a small snack with ~10g of fat (eg. a handful of nuts or some sauteed veg or salad), followed by ~5g net carb of a fast-digesting carbohydrates (eg. a handful of berries or a small piece of fruit / starch) to anticipate insulin needs, then I go prepare the meal (which might only take me 5-15mins.)  The meal starts with leisurely filling up on vegetables & protein (eg. salad / steamed veg / legumes / meat), then finishes with satisfying starches & fruits (often cold with added fats.)  I'm generally not hungry again for 6-16hrs between meals, which should provide enough time to metabolize post-prandial triglycerides back down close to fasting levels.  I usually have matcha or coffee between breakfast / dinner which should further ramp up fat-burning and post-prandial triglyceride clearance, although I've read this can increase post-prandial glucose and raise overall glucose levels by ~8%.  After a meal, I do a bit of housework before sitting back down.  At this slow pace with fat slowing the absorption of the starches and an early signal for insulin production, I'm looking at peak glucose values of close to 95-105 mg/dL after morning exercise with breakfast, and peak post-prandial dinner readings of around 105-115 mg/dL.  With dairy or vegan protein powder, I'm soon down in the 85-95 mg/dL zone by the 30-45m mark.  By my rough estimates, this should add up to a 4.8-4.9% (or lower?) A1C or so.

 

It might soon get sort of monotonous eating this way (and it's probably not necessary), and potentially sub-optimal (fats + starches = more insulin?)  This is probably even a little OCD and overly micro-managed, haha.  But, it seems to be relatively effective for the moment.  It feels fairly natural to grab a quick snack before I throw together a meal, start with a salad, dig into the veg + protein, and finish with a type of dessert.  I read that starting a meal with fats has an added effect of increasing fullness and satiety (reduced gastric emptying via pyloric valve).  In other studies, dietary fiber was mentioned to reduce amylase activity and slow the rate of starch hydrolysis, and eating slower then finishing with starches + brief low-level activity decreased peak glucose values.  Vinegar / acids were also mentioned to be useful.  I occasionally toss in a chromium supplement to boot.

[sirtuin]

I found this article on coffee consumption interesting:

http://www.ncbi.nlm.nih.gov/pubmed/19114405

 

10g of carbohydrates 1hr before a meal reduced glucose concentrations at the start of the meal.  Coffee 1hr before increased post-prandial glucose by 28%.  Coffee + 10g of carbohydrates 1hr before a meal reduced post-prandial glucose concentrations by 20%.

 

Experimenting with no pre-breakfast exercise and instead drinking coffee (20g black, no sweetener), then starting with a small amount of fat+carbs (pistachios + berries), followed by a bunch of vegetables+fat (a heaping bowl of salad & a heaping plate of veg), then finally dipping into cooked & cooled white rice + plantains (100g+ net carbs) (two medium sized bowls full), my +35m post-prandial glucose measured 71 mg/dL (this is the lowest value I've measured), and +60m post-prandial glucose measured 98 mg/dL.  I did take a handful of supplements which might have contributed to this effect, and I had some stevia + sugar alcohols this morning which might have increased insulin relative to the amount of glucose my body thought I was eating.

 

Perhaps coffee might work well before breakfast rather than (or in addition to) after breakfast.