My friend Annie has been struggling with elevated blood glucose (blood sugar) and a multiple serious health conditions. She’s been pre-diabetic for years, then had a dangerous spike recently after sugar-bingeing on vacation. She was on the brink of diabetes, so I asked (pleaded with) her to completely abstain from sugar and processed grains for one week.
The sweet deprivation was nearly torture at first and made her realize just how much sugar she consumes on a daily basis. There were a lot of socially awkward moments when she had to say “no” to disappointed hosts, especially because it was Christmastime. But she persevered. By day 5 she was not craving sugar as much. After one week she woke up not really needing that sugar fix.
I was pleased with her progress and asked her to go a full month, to fully release her body from the clutches of sugar addiction. Excess sugar consumption leads to excess insulin in the blood and it makes you crave more carbs; this vicious cycle is hard to break. Annie said “No, I want my sugar back.” She reluctantly agreed to one more sugarless week, just till her upcoming doctor appointment. I anticipated a 10 point drop but was in for a bigger surprise:
The doctor was amazed, Annie was proud, and I danced a jig.
Other health markers in her blood also improved. This is not a surprise because:
- Fructose, sucrose, and glucose all inhibit the proper functioning of white blood cells called phagocytes. These cells protect the body from disease by ingesting harmful bacteria. The impact of sugars on these cells is almost immediate and can last up to 5 hours. That means that sugar compromises your immune system each time you consume it. Read more about the link to diabetes.
- high glucose levels inhibit vitamin C from entering our cells, decreasing absorption and leading to reduced immune function.
- high intakes of fructose activate enzymes that degrade stores of vitamin D, cause the kidneys to break it down, and interfere with its synthesis in the body. Vitamin D deficiency can lead to susceptibility to infection, lower immune function, and certain cancers.
- high glucose and insulin cause kidneys to excrete magnesium which reduces its absorption. Magnesium helps the body make protein, build bone, and regulate blood sugar. It is vital for every organ in our body.
- calcium is best absorbed when Vitamin D is adequate, so the lack of one will impact the other. Sugar also causes calcium to be excreted. Calcium is necessary for the health of bones and teeth and for the proper functioning of nerves and muscles.
- Sugar causes chromium to be excreted. Deficiency can lead to decreased glucose tolerance and eventually diabetes.
- the risk for diabetes and cardiovascular disease correlates with a range of chronic inflammatory disorders including Crohn’s disease, ulcerative colitis, arthritis, autoimmune diseases, psoriases, and many other disorders. This suggests that high blood sugar causes inflammation and can lead to multiple additional conditions.
I entreated Annie to stay the course. She went on vacation again. I urged her to eat mindfully and she actually did, returning with a FPV (fasting plasma glucose) level of 90.
Then, she decided that it really wasn’t so bad if her glucose went up a bit, so she allowed herself more sugar. Next doctor appointment it was 90; the following month it crept up to 94, then 97, and last week, 99. In 6 months’ time much of her hard work was lost.
With each increase I warned her that she should scale back her sugar consumption and pay close attention to the glycemic index of foods. But she was convinced that she was still in a “safe zone”. Why would she think that?
Because she was looking at the American Diabetes’ Association‘s (ADA) recommendations for “normal blood sugar”. According to them, you’re scot-free all the way till 99. She thought she had a wide berth. Now that she’s hit 99 she’ll dial it back so she doesn’t go over “the threshold” of 100.
What’s wrong with this picture?
Is there really a threshold? Is 99 a magic number? According to the ADA, normal fasting plasma glucose (FPG) is anything under 100 mg/dL. By setting this standard and using the term “normal”, the ADA is telling you that your blood sugar level is fine until it reaches 100. So 99 is fine, and all of a sudden at 100 you’re pre-diabetic. That’s only a 1 point difference. Can health plummet in 1 point?
Actually, health exists on a continuum, and so does the health of your blood. The research shows that the lower your fasting plasma glucose (FPG), the less likely that you will develop diabetes. Conversely, if your FPG levels are in the upper end of the range that the ADA considers “normal”, you are at increased risk for developing diabetes. It turns out that the increase risk starts at 86.
This study followed 46,578 Kaiser Permanente patients in Oregon for 10 years and evaluated four ranges of fasting blood glucose (FPG):
- less than 85 mg/dL (milligrams per deciliter)
- 85 to 89 mg/dL
- 90 to 94 mg/dL
- 95 to 99 mg/dL
- The risk of developing diabetes increased as FPG levels increased, even if the FPG was in the ADA’s “normal” range.
- There was a statistically significant difference in the progression to diabetes among the 4 ranges.
- Each milligram per deciliter increase in FPG (fasting plasma glucose) increased diabetes risk by 6%.
- Subjects in the 95-99 group were 2.33x more likely to develop diabetes than those in the below 85 group.
A study in Israel with 13,163 subjects in the military also demonstrated an increased risk of developing diabetes in those with a FPG between 90-99 combined with triglycerides over 150 as compared to subjects with an FPG below 86 and triglycerides under 150.
A study in Milan, Italy with 13,845 subjects between 40-69 confirmed the same results.
Another study conducted on the island of Mauritius showed that the risk of diabetes started to increase at a fasting plasma glucose level higher than 94 mg/dL.
Hemoglobin A1c or HbA(1c) is another way to test the amount of sugar in blood. It is a measure of how much hemoglobin in red blood cells is bonded to glucose. The ADA claims that 5.7 and below is normal, but this study shows that results higher than 4.6 correlated with higher risk for coronary heart disease.
According to the research, the “normal” fasting blood glucose and A1c numbers recommended by the ADA do not help prevent diabetes or coronary heart disease.
Now back to Annie. Is a 99 fasting plasma glucose okay? Well, that depends on whether you want to lay the groundwork for diabetes, or whether you want to steer clear of it. Doctors typically do not advise you to make changes in your diet and lifestyle to avoid disease. They just tell you what to do once you get the disease. The Good Food Fighter wants to help you not get there, to go in the other direction. And to help Annie by supporting, encouraging, and educating her. Stay tuned for updates in this article.
Stop the sugar!
(and scale back the bread, pasta, rice….)
Harvard has a great chart of the glycemic index (GI) of a range of foods. The GI shows how fast blood glucose levels will rise in an average person after consuming 50g of specific foods. The index compares each food with glucose. Glycemic load (GL) is a more practical measure because it calculates the amount of carbs in a real serving size (50g). While the glycemic index of carrots is moderately high, the load is extremely low—you would need to eat about 14 carrots to get to 50g of carbs because carrots are so low in carbs. So unless you’re juicing carrots bigtime, you’re never going to get close to that quantity. And consider this: the GL of 14 carrots is nearly equivalent to one cup of white rice. Hopefully that puts rice in a new light. Maybe quinoa sounds better? Check out The ADA website for more information.
What can I use instead of sugar?
- Cinnamon. If you are able to wean yourself off sugar, cinnamon will taste truly sweet to you. It’s a great way to sweeten oatmeal and pancakes and even some vegetable dishes like squash. Read about it here.
- Blackstrap molasses. Ever heard of it? It’s got a great taste and is packed with nutrients. Find out here!
- Stevia. Of all the artificial zero-calorie sugars, this is the only one I will eat.
I hope that the ADA will shift its recommendations downward on “normal” fasting plasma glucose, as they have done once before, to align with the research. The American College of Cardiology and American Heart Association recently revised their blood pressure recommendations to reflect a growing body of research that links previously “normal” blood pressure to coronary events like strokes. This is the slow and steady march of science: new data periodically becomes available that renders previous data irrelevant. In the meantime, you can examine the studies yourself and draw your own conclusions.
Here’s a quick dessert to satiate your craving for sugar and fat!Print
Rich, creamy, luscious fruity dessert to satisfy both your sugar and fat cravings!
Brought to you by the esteemed Chef Brittany, a paleo nutritionist.
Browse our tasty low-glycemic Good Food Fighter recipes! Stay safe, eat less sugar, and keep your blood sugar moving in the right direction.
More GFF articles on sugar, processed carbs, and glycemic index:
- Does sugar cause cancer?
- What is the best sugar substitute?
- What you should really be scared of this Halloween.
- Against the grain: GFF battles the Gluten Monster
Other good reads on sugar:
- The Sweet Danger of Sugar, Harvard Health
- How long does it take to reverse diabetes?, Pritikin Longevity Center
- Five Nutrients You’re Deficient in if you Eat Too Much Sugar, Dr. Sarah Ballantyne
- Sugar Weakens your Bones, Health and Science