glucose versus cholesterol optimization

[mccoy]

At last I overcame my legendary lazyness and went to the pharmacy to have my finger pricked for a glucose+lipids panel.

Fasting glucose was 90. I'm happy about that since I started again to eat some simple carbs, I couldn't resist Sicilian oranges, plus I'll have green bananas sometimes, beans, or very black bread often with buckwheat flour.

HbA1c is 5.2%, which is satisfactory. It's not metformin time for me, yet.

Lipid panel is also pretty good, considering that I'm an avid consumer of healthy fats. I indulge with liberal amounts of EVOO, large amounts of walnuts + other nuts, also some saturated fats, I try to moderate myself but they are unavoidable in dairy products and low-carb pastries.

Total Chol = 154 mg/dL

Trigs = 93 mg/dL

HDLc = 66 mg/dL

LDLc = 69 mg/dL

Non-HDLc = 88 mg/dL

My BMI has lowered from 25.5 when I noticed an elevating trend of FG (up to 106 mg/dL) to the present 23.6, with less adiposity but also less muscle mass.

All in all, presently I can say I reached a certain degree of optimization, mainly by checking the amounts of carbs and eating ad libitum vegetable fats, moderating saturated fats.

Interesting thing is that the abundance of fats does not seem to impinge unfavourably on the lipids panel, at the same time avoiding too high values of blood glucose.

[Sibiriak]

Congratulations, McCoy!    Very impressive results from your efforts!

[Ron Put]

9 hours ago, mccoy said:

Fasting glucose was 90. I'm happy about that since I started again to eat some simple carbs, I couldn't resist Sicilian oranges, plus I'll have green bananas sometimes, beans, or very black bread often with buckwheat flour.

There are hardly bad carbs (well, depending on how refined is the flour, being black may or may not tell you much).

Overall, congrats, mccoy! Your numbers are good, although I'd strive for lower TG, as well as lower VLDL at al.

One important omission is insulin. Without it, glucose doesn't mean all that much.

Just curious, were you eating processed carbs before, like pasta, or pastries?

[mccoy]

Ron , no, I didn't eat pasta, rice, potatoes, only some home-made bread with whole grain flours, sometimes oat flakes. But I did eat some cookies, honey and sometimes lots of fruit. Occasionally a home-made cake, sometimes very small pastries.

Insulin: once I measured fasting insulin together with glucose, and it was a very small value, close to zero. HOMA-IR suggesting high insulin-sensitivity. I only did that once though.

It's not easy to understand the reason of the improvement, since there may be many confounding factors. 

My next strategy is to keep like this, not avoiding totally carbs but keeping the consumption of them moderate.

If FG AND HbA1C rise again, then I know that I may have become glucose-intolerant.

 

[Ron Put]

On 3/17/2023 at 5:52 AM, mccoy said:

Insulin: once I measured fasting insulin together with glucose, and it was a very small value, close to zero. HOMA-IR suggesting high insulin-sensitivity. I only did that once though.

IMO fasting glucose without insulin is not all that telling, as it can be affected by many factors, such as what you ate during the last day or exercise, among others.

My own latest numbers are sadly not great, with FG at 100 and insulin at 7.2. A1C is 5.3. I attribute this to an increase in fructose intake that I see in Cronometer, mainly because I have fallen in love with ripe papaya had it virtually every day in Asia) and carob powder. I din't realize carob has so much sugar, and I've been eating about 30-60g of the stuff a day...

[mccoy]

Ron, I sure understand your addiction to ripe papaya. Presently I am hugely moderating myself with fruit but I must say I got accustomed to it, better than I believed.

[mccoy]

On 6/18/2021 at 11:52 PM, mccoy said:

And I was impressed by his record from the GCM: almost totally flat, no peaks, low average glucose, very little variability (7:00 minutes).

 

How does he do it? And, above all, how does he control cholesterol? My thoughts as follows:

1. All right, he eats usually once a day and fasts regularly
2. But he no more follows a keto diet
3. He eats a huge salad with salmon
4. What else does he eat, since he's active and needs about 3500 kCals a day or more?
5. If he really keeps carbs pretty low, then how he reaches his caloric input, likely with lots of fats.
6. Since he reiterates in his podcasts that the lower the LDL-c, LDL-P, APOE-B, the better, how does he control his cholesterol? Eating no animal fats at all?
7. He probably takes statins or other cholesterol-lowering drugs such as PCKS-9 inhibitors (?)
8. He maybe takes some of the newest glucose-lowering drugs like Liraglutide or similar (?)
9. HAs anyone a subscription to his AMAs and knows the end of this episode?
10. Has anyone more clues than I have?

My hunch is that he uses a mix of carbs controls and pharmaceutical drugs to succeed in lowering both glucose and cholesterol at the same time. I assume his cholesterol is low, if he adheres to his optimization strategies.

Maybe in his book he will disclose clearly these aspects (but he continuously delays the publication)

In a post above I was speculating about the almost flat glucose AUC Peter Attia's Dexcom displayed.

Lately, I heard in one of his podcasts that he takes SGLT-2 inhibitors. They work, and my hunch was right, since he also takes PCSK-9 inhibitors.

[mccoy]

Today my fasting glucose today was 83 mg/dL, diet the preceding days was as usual, the night's sleep was crappy as usual.

If the trend goes on like this, the strategy of restricting carbs worked. The problem arose when I measured 106 mg/d fasting glucose. I did not practice a keto diet but just a moderate low-carb one, with main sources of carbs being dairy products and non-starchy vegetables plus seeds and nuts plus occasional cereals or fruit. No more honey, abundant fruits, fruit juices and so on.

I still have no idea what happened about 3 years ago, since I trained regularly but ate honey and lots of fruits. Maybe my body chose an anabolic path, triggering insulin resistance, since I reached my max bodyweight in 30 years.

Now I weigh 6 kg less and exercise less but my FG went back down to good values.

Edited July 3, 2023 by mccoy

[Ron Put]

On 7/3/2023 at 5:38 AM, mccoy said:

Today my fasting glucose today was 83 mg/dL, diet the preceding days was as usual, the night's sleep was crappy as usual.

If the trend goes on like this, the strategy of restricting carbs worked. The problem arose when I measured 106 mg/d fasting glucose. I did not practice a keto diet but just a moderate low-carb one, with main sources of carbs being dairy products and non-starchy vegetables plus seeds and nuts plus occasional cereals or fruit. No more honey, abundant fruits, fruit juices and so on.

Attia is not a healthy specimen, and neither is Dayspring. But they sell comfort through pharmaceuticals to those who refuse to change their (unhealthy) lifestyle.

Glucose without insulin is largely meaningless, unless you are diabetic. CGMs for healthy people are becoming part of an industry, and yes, carb restriction will flatline glucose, but it may often mask insulin resistance. Misleading and far worse than normal spikes in metabolically healthy people, IMO.

[IgorF]

49 minutes ago, Ron Put said:

Glucose without insulin is largely meaningless, unless you are diabetic. CGMs for healthy people are becoming part of an industry, and yes, carb restriction will flatline glucose, but it may often mask insulin resistance.

I would add my speculations based on what happen with me during slight negative balance.

My calories distribution is biased towards morning and on the evening (4pm to 5pm) I eat 1000-1200kcals, with relatively few protein. Because of this I could go to sleep with slight a shade of hunger. Sometimes I am lucky to sleep with it, but on the long run I will first start to get 95-110 morning glucose (relatively inacurate palm/finger prick but consistent) every second or third day and then my sleep will lose depth and I will either get up earlier or I will have ~1h "windows" and then sleep more. Lab measurements are usually better a bit. I also have an SNP that is associated with several points higher (2 or something alike) morning glucose, hard to say to what degree if any it is in effect.

What actually happens? First of all due to glucose deficiency body starts to fill the gap, so the brain will not suffer. So glucose release from glycogen (or neogenesys?) fires up. Also to channel the glucose to the most important area less important but hungry cells are suppressed, this is exactly insulin resistance but it is in effect for good, not for bad (I hope). This coordinated resistance is described many times, it is studied a lot.

A side-effect from my way of doing things (I was not able yet to narrow it down to see if I can improve something somehow) is a bit blunted homeostasys and delayed glucose levels decrease.

If I will eat more, or later the chances to get the things mentioned are much lower. I can not assess this practice from a longterm perspective, maybe it is not ok, but without context "I have prediabetes and some IR confirms it", knowing the context I don't. This night I had bad sleep, with an hour of unwanted awake window 2-3am and morning glucose of 97 paired with 77 for triglies (both measurements with pricks), this is even formally (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2551650/) not a risk group, no need to know my dietary context.

In addition to these things I have higher hba1c (5.6 %or 5.7% probably) and without context it is also "not good" but from my observation on rbc and several reticulocites tests I concluded that idea of a bit prolonged rbc life in CR regimen is plausible (also an opposite effect of higher rbc retention in obese people makes sense - even as an additional way to dissipate some unwanted energy).

So, hoping my speculations are not far from how the things works I am a bit less scared with the figures I observe sometimes. On the other hand - I still wish to do it somehow better, to lower the AUC but this requires CGMs to be cheap, I don't want to pay 11usd/day for their usage in a several months run.

Br,

Igor

Edited July 6, 2023 by IgorF

[mccoy]

3 hours ago, IgorF said:

I eat 1000-1200kcals, with relatively few protein.

Do you mean per day or per meal? In the former case, it would sound excessively low...

[IgorF]

Per evening meal. I have 2900-3000kcal daily now, with 200+k steps per week.

[Dean Pomerleau]

4 hours ago, IgorF said:

Per evening meal. I have 2900-3000kcal daily now, with 200+k steps per week.

A man after my own heart! 

[IgorF]

8 hours ago, Dean Pomerleau said:

A man after my own heart! 

To be honest, it is only summer time that allows to walk that much, when it is cold or rainy it requires unhuman will to do so))

Hadza had a climate bonus, otherwise they would probably also invent civilization as others did))

[Dean Pomerleau]

3 minutes ago, IgorF said:

when it is cold or rainy it requires unhuman will to do so

Or a treadmill!