Idiot farm

The notion of genetic modification of foods and livestock is a contentious issue. The purposeful insertion or deletion of a gene into a plant or animal's genome to yield specific traits, such as herbicide resistance, nutritional composition, or size, prompted the Codex Alimentarius Commission, an international effort to regulate the safety of foods, to issue guidelines concerning genetically-modified foods.

The committee is aware of the concept of unintended effects, i.e., effects that were not part of the original gene insertion or deletion design. In their report, last updated in 2009, they state that:

Unintended effects can result from the random insertion of DNA sequences into the plant genome, which may cause disruption or silencing of existing genes, activation of silent genes, or modifications in the expression of existing genes. Unintended effects may also result in the formation of new or changed patterns of metabolites. For example, the expression of enzymes at high levels may give rise to secondary biochemical effects or changes in the regulation of metabolic pathways and/or altered levels of metabolites.

They make the point that food crops generated using techniques without genetic modification are released into the food supply without safety testing:

New varieties of corn, soybean, potatoes and other common food plants are evaluated by breeders for agronomic and phenotypic characteristics, but generally, foods derived from such new plant varieties are not subjected to the rigorous and extensive food safety testing procedures, including studies in animals, that are typical of chemicals, such as food additives or pesticide residues, that may be present in food.

In other words, conventional plant breeding techniques, such as hybridization, backcrossing, and introgression, practices that include crossing parental plants with their progeny over and over again or crossing a plant with an unrelated plant, yield unique plants that are not subject to any regulation. This means that unintended effects that arise are often not identified or tested. Plant geneticists know that, when one plant is crossed with another, approximately 5% of the genes in the offspring are unique to that plant and not present in either parent. It means that offspring may express new characteristics, such as unique gliadin or gluten proteins in wheat, not expressed in either parent and with new immunological potential in consuming humans.

Dr. James Maryanski, the FDA's Biotechnology Coordinator, stated during Congressional testimony in 1999 that:

The new gene splicing techniques are being used to achieve many of the same goals and improvements that plant breeders have sought through conventional methods. Today's techniques are different from their predecessors in two significant ways. First, they can be used with greater precision and allow for more complete characterization and, therefore, greater predictability about the qualities of the new variety. These techniques give scientists the ability to isolate genes and to introduce new traits into foods without simultaneously introducing many other undesirable traits, as may occur with traditional breeding. [Emphasis mine.]

Efforts by the Codex Alimentarius and FDA are meant to control the introduction and specify safety testing procedures for genetically modified foods. But both organizations have publicly stated that there is another larger problem that has not been addressed that predates genetic modification. In other words, conventional methods like hybridization techniques, the crossing of different strains of a crop or crossing two dissimilar plants (e.g., wheat with a wild grass) have been practiced for decades before genetic modification became possible. And it is still going on.

In other words, the potential hazards of hybridization, often taken to extremes, have essentially been ignored. Hybridized plants are introduced into the food supply with no question of human safety. While hybridization can yield what appear to be benign foods, such as the tangelo, a hybrid of tangerines and grapefruit, it can also yield plants containing extensive unintended effects. It means that unique immunological sequences can be generated. It might be a unique gliadin sequence in wheat or a unique lectin sequence in beans. None are tested prior to selling to humans. So the world frets over the potential dangers of genetic modification while, all along, the much larger hazard of hybridization techniques have been--and still are--going on.

Imagine we applied the hybridization techniques applied by plant geneticists to humans, mating an uncle with his niece, then having the uncle mate again with the offspring, repeating it over and over until some trait was fully expressed. Such extensive inbreeding was practiced in the 19th century German village of Dilsberg, what Mark Twain described as "a thriving and diligent idiot factory."

Comments (10) -

  • Jayzee

    6/12/2011 2:26:37 AM |

    Google Hinze Hogendoorn http://tinyurl.com/3t48zhf
    17-year-old Dutch undergraduate student Hinze Hogendoorn  has created scientific history with his simple experiments.

    is there ever any good news from the food science arena?

  • Might-o'chondri-AL

    6/12/2011 5:20:15 AM |

    Metabolite screening should be done to compare with old standard and apparently is being done to some extent; there will always be someone who reacts adversely to what is innocuous to most people.  Since field agriculture is not free of  problems there will always be need for adaptations.

    Japanese daikon root pickle made today has a different degree of physiological benefit  than when made with a traditional old cultivar of smaller sized daikon.  Hinze's rats might have found old fashioned fare more appetizing but they don't have to struggle to produce it like hungry people worldwide must try to do.

    *  2006 article "Transgenes has less impact on the transcriptome of wheat grain than conventional breeding"
    Plant Biotechnology Journal 4, 369 - 380

    * 2006 article "Effect of transgenes on global gene expression in soybean is within the natural range of variation of conventional cultivars"
    Journal Agricultural Food Chemistry 56, 3057 - 3067

    * 2008 article " Microarray analyses reveal that plant mutagenesis may induce more transcriptomic changes than transgene insertion"
    Proceedings National Academy Science USA 105, 3640 - 3645

  • Jim Anderson

    6/13/2011 7:31:13 PM |

    It's astounding that tests are not done -- are not mandated by law and international treaty -- on hybridized plants prior to the plants being sold for human consumption! One doesn't need to be a bio-chemist to see the danger there.  Of course, I have to wonder what kind of tests should be required.  Some dangers may not be readily apparent.  It could take a human generation or two for the problems to be recognized.  We are lab rats!

  • MK Davis

    6/14/2011 2:59:29 AM |

    Our number one forage crop is in danger of infecting the nation's livestock with an organism that is causing infertility in a large percentage of food animals.

    Don Huber Interview - Roundup Ready GMOs - PATHOGEN NEW TO SCIENCE.flv
    swirly78777@mypacks.net

  • MK Davis

    6/14/2011 3:09:49 AM |

    The URL to the Don Huber video is:  http://bit.ly/k25NpH

  • Dr. William Davis

    6/14/2011 1:01:36 PM |

    Thanks, MK.

    Anyone with even a passing interest in food and food safety absolutely need to view the video link posted by MK Davis (no relationship).

    Dr. Huber brings an incredible depth of insight into the glyphosate GMO crop question.

  • jpatti

    6/14/2011 1:40:02 PM |

    I'm surprised to see stuff about hybrid and GMO plants here.  

    I was an avid gardener before I became disabled and very gung-ho about using open-pollinated seeds, mostly heirlooms.   Even though I didn't save seed, I only bought open-pollinated seeds and plants in order to encourage their preservation by seed companies.  No F1 seeds for me, and DEFINITELY no GMO.  

    When you look into the history even a little bit, you realize even the so-called heirlooms are all pretty new plants.  

    It's been a very short period of time that sweet corn has even existed - corn was always a grain, not a vegetable.  

    Similarly, tomatoes used to be much more acidic than modern varieties are.  It used to be safe to can tomatoes in a hot-water bath.  But new tomatoes need to be canned in a pressure canner... or you have to add acid to the recipe to safely do the water-bath thing and avoid botulism.

    Also, most people have no idea how much yummier heirlooms are.  Vegetables for factory farming have been bred for things like uniform harvest by machinery, ability to keep in storage, not bruising when shipped across country, etc.  Not for TASTE.  

    A Brandywine tomato (my favorite heirloom) tastes NOTHING like what you can buy in a grocery store - because when individuals were doing the breeding, taste was a factor as opposed to  ease of machine harvest and transport and long-term storage.

    You can get good seeds from companies that have taken the No-GMO pledge... such as Baker's Creek Heirloom Seeds, Bountiful Gardens, Southern Exposure Seed Exchange, Pinetree Garden Seeds and Seed Savers Exchange.

    The largest problem is with corn.  Monsanto corn has a gene that makes the plant resistant to Round-up, their primary pesticide.  Even farmers who intend to raise heirlooms have found their fields pollinated by neighbor's Monsanto corn - and been sued since the gene is patented.  

    Farmers that raise heirloom seeds have to raise corn in very isolated spots, and good seed companies test each batch of seed to make sure it's not been infected by the GMO gene.

    Almost ALL corn available today is not only not open-pollinated, but not even normal hybrid corn; rather most of it is GMO.  There's a very few sources of things like non-GMO cornmeal and almost no sweet corn.  

    Same with soybeans - it's all pretty much GMO.  

    IMO, very good reasons to avoid these products in the diet.  I keep a small batch of non-GMO  cornstarch and non-GMO tamari for cooking purposes, but we eat very little corn or soy - and absolutely none of their oils.  Even the non-GMO stuff, corn is very carby, soy causes thyroid issues, and their oils are full of PUFAs. But the small amounts we use in our diet are absolutely non-GMO.

    I forget if it's been released yet or not, but there's a GMO alfalfa coming down the pike.  If the gene is as invasive as the corn gene is, soon it'll be hard to find pasture-raised meat and dairy that hasn't been raised on GMO feed.  

    The largest problem worldwide is in poor countries, where farmers traditionally saved seed to plant again the next year.  These folks literally cannot afford to buy seeds every year.  When all that is available is patented seed or hybrid seed, they are screwed in terms of being able to raise their own food.  People literally starve due to the geopolitics of GMO seed.

    Read up on Monsanto.  They're pretty damned evil.  Probably responsible for more infant deaths than even Nestle.  I personally won't buy products from any company that sells Monsanto products; it's really THAT bad.

    Well, I shall stop my rant now.  I've been ranting about this since back when I was in grad school doing recombinant DNA work myself... I'm getting bored with myself.  ;)

    I actually stopped by to drop off this link for you, Dr. D: http://www.diabetesincontrol.com/articles/diabetes-news/10953-common-test-predicts-early-death-in-diabetes-

  • Dr. William Davis

    6/15/2011 12:11:28 PM |

    Thanks for the detailed commentary, jpatti. Exceptionally well said.

    A return to the simplest forms of farming and plant selection are, I agree, are about the only ways to dodge all the genetic shenanigans provided by agribusiness. Scary stuff.

  • Lois

    7/11/2011 3:23:15 PM |

    Now we know who the snesible one is here. Great post!

  • Peter Defty

    7/21/2011 3:05:27 PM |

    Thank you! for stating a musing I have expressed for years! Plant breeding starting with Mendel has probably done a whole lot more than soem obscure snippet of gene insertion....not being a proponet here but I agree that a much larger point is missed......but this theme seems to run in a lot of directions in the health world like worrying about "SmartMeters" and their radiation when that cell phone, cordless phone and wireless signals are right there in their face......or how African-American kids in urban environments are asthmatic and all the potential causes make the news  EXCEPT that the notion that that high carb diet they most likely are eating is the main trigger......ditto for all the suffering this population group has later in life.....

    thanks for reviving this Mark Twain quote... to book end it  perhaps reviving Parkinson's Law would be appropriate.

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Total cholesterol and heart scans

Total cholesterol and heart scans

Andy was fearful of heart disease in his life. At age 52, he'd already had four CT heart scans--one each year on or near his birthday.

Yet, when I looked at Andy's scans, his scores had been increasing 20-24% per year. Each and every score was greater by 20% or more over the previous.

So I asked Andy what steps he had taken to stop this relentless progression. "Well, I've always been real health conscious. But ever since my first scan, I really started sticking to a healthy diet, exercising nearly every day, and I take a bunch of supplements."

"What did your doctor advise?" I asked.

"Well, Dr. ---- said that nothing needed to be done, since my total cholesterol was always below 200."



Men's Health magazine's fabulous story about the folly of using total cholesterol to gauge heart disease risk.




Aaaauuuggghhh!! Wrong!

This man was, in fact, at rapidly escalating risk for heart attack. This rate of growth simply can't continue forever without igniting this bomb.

A total cholesterol below 200 is meaningless, as Andy's increasing coronary plaque proved. For instance, you can have a total cholesterol of 165 mg but with an HDL cholesterol of 27 mg. This would constitute very high risk for heart disease despite the low total cholesterol. The low HDL pattern is among the most common reasons for a misleading total cholesterol. Small LDL, high triglycerides, and lipoprotein (a) are other frequent reasons.

Andy, run the other way! Do not heed this doctor's advice! You need a solid answer to the question: Why exactly do I have coronary plaque in the first place?

Then, agree on a treatment program that corrects your specific causes.
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The best artificial sweeteners

The best artificial sweeteners

Our new recipes, such as New York Style Cheesecake and Chocolate Coconut Bread, are wheat-free and low- or no-carbohydrate. They fit perfectly into the New Track Your Plaque Diet for gaining control over coronary atherosclerotic plaque, not to mention diabetes, pre-diabetes, hypertension, small LDL particles, high triglycerides, high inflammation (c-reactive protein) and other distortions of metabolism.

However, there's one compromise: We include use of non-nutritive sweeteners. It's therefore important to know that artificial sweeteners are not all created equal.

One common tripping point: maltodextrin.

Maltodextrin is composed of polymers (repeating subunits) of glucose, as few as 3 or as many as 20 or more glucose subunits. So maltodextrin is glucose sugar. While it lacks the especially destructive pentose sugar, fructose, maltodextrin is metabolized to glucose and thereby increases blood sugar substantially.

Many artificial sweeteners are bulked up with maltodextrin. For instance, granulated Splenda and Stevia in the Raw, two sweeteners billed as low-calorie and sugar-free that is used on a cup-for-cup basis like sugar, are primarily maltodextrin--with only a teensy bit of Splenda or stevia.

The best artificial sweeteners, i.e., the most benign without a load of maltodextrin, are:

Liquid stevia--Just the extract from stevia leaves and water. It can be a bit pricey, e.g., $10 for a 2 oz bottle, but a little goes a long way.

Truvia--While I'm not too fond of the manufacturer (Cargill), I believe that Truvia is among the better sweeteners around. It is a mixture of the natural sugar, erythritol, that generates little to no blood sugar effects and rebiana (rebaudioside), an isolate of stevia. Some people aren't too fond of the mild menthol-like cooling effect of the erythritol nor the slight aftertaste. I find it works pretty well in most recipes.

Be aware that, no matter which artificial sweetener you use, it has the potential to stimulate appetite. I therefore like to not eat foods sweetened with liquid stevia or Truvia in isolation but as part of a meal. That way, any appetite stimulation that results is substantially quelled by the proteins and fats ingested.

Comments (23) -

  • Princess Dieter

    8/12/2011 11:53:20 PM |

    Thank you for the link. I was just talking with hubby last night about finding a recipe for cheesecake that had no wheat/gluten and would be good for us for special treats/occasions (like an upcoming family birthday). Yay.

  • pjnoir

    8/13/2011 2:52:19 AM |

    I never use Truvia. The best stavia hands down is SweetLeaf, either the liquid or the powder. BUT Stevia acts like insulin, in fact, Asia has been using it as an insulin substitute and comes with a warning to diabetics about using it with one’s daily  insulin shots.   I stopped using it as I don’t need to rev up by insulin production.  I’m diabetic. I still go with local honey and get the benefits of having local pollen in my body.

  • Shreela

    8/13/2011 3:27:35 AM |

    Both DH and I noticed the aftertaste. I figured out how to use half stevia/half sugar for a few days, then 1/4 each, then all stevia, which solved the aftertaste problem for me. I then tried one teaspoon of sugar to a quart of stevia-sweetened tea with DH - he didn't notice any weird taste. So hopefully just adding a tiny bit of sugar for 1-2 weeks will get your taste buds used to stevia.

  • Gabriella Kadar

    8/13/2011 3:29:15 AM |

    Why do people feel the need to eat desserts?  Doesn't adherence to a consistent low carb diet eventually curb most of the craving for sweets?  One teaspoon of fruit jam should be able to quell any overweening desire.  Or is the socio-cultural programming for eating confections so deeply ingrained that people just can't live without?

  • Michia

    8/13/2011 9:06:53 AM |

    I agree.  In our house (LC for years), the same logic applies to low carb "treats" that applies to low carb Frankenfoods.  Don't eat foods that are trying to be foods that you know you can no longer have.  

    There is a real danger in continuing to eat really sweet foods, even artificially sweetened.  "Low carb" needs to be "low sweet".  If you hang in there, you do eventually lose your taste for it.  

    As for Splenda, you can find the liquid if  you try.  And the mini tablets are minimally carby.

  • cancerclasses

    8/13/2011 6:13:31 PM |

    Both cancer & systemic fungi make energy by means of glycolysis and create demands for large amounts of sugars.  People with continuing carb cravings that won't resolve may have one or the other condition.  Otherwise I'm with you, people hanging onto sweets are still living to eat rather than eating to live.

  • Might-o'chondri-AL

    8/13/2011 7:27:21 PM |

    Hi Dr. Davis,
    Server blocked me elsewhere, so writing this here.
    Amazake data when made from white rice (brown, short & long may each differ) =
    30 - 70 % complex carbohydrate saccharides
    20 - 45 % maltose (not amylose)
    3 - 5 % glucose
    5 - 9 % protein
    3 - 5% fat
    1 - 7 % fiber
    0.3 - 0.4 % mineral ash
    iron, niacin & thiamine

    Sample 1 liter (1 quart) sauce pan Amazake home kitchen batch:
    200 ml ( 7 ounce volume, +/- 200 grams) short grain brown rice rinsed and drained
    bring to boil  in 2.5 times the volume water
    reduce heat to low and, covered,  cook 50 - 60 minutes (until not wet)
    transfer cooked rice to an incubation vessel & let cool
    when cooled to  60* Celcius (140 * F) mix with 400 ml (14 ounce volume) of Koji innoculant
    cover with aluminum foil (or somehow) and put where can keep warm
    incubation ideal temperature is 57 - 60 * C  (with leeway)
    ferment for  desired time , 12 hours sweeter and I use 22 hours
    when time up pan boil the Amazake (stir) 3- 5 minutes to inactivate Koji fungi
    refrigerated covered keeps weeks

    Dosages mentioned previously (for 165 pound adult, and Amazake was eaten with protein and fat):
    (a) " low" dose with 2 hour blood glucose ending up being same as pre-prandial blood glucose was 1/8th (by volume) of the above Amazake (rough calculation would thus be ingesting 1/8th  of  +/- 600 grams  total of original dry rice and Koji rice)
    (b) "high" dose with 2 hour blood glucose rebound (suggested for athletes carbs) was 1/4 (by volume) of the above Amazake recipe (rough calculation  would in this case be ingesting 1/4 of +/- 600 grams total of original dry rice and Koji rice)

    Koji innoculant ( steamed white glutinous rice infused with Aspergillus oryzae and then dessicated) used was wholesale direct from L.A. producer Miyako Oriental Foods 626-962-9633; call for your local retailer of their Koji under the "Cold Mountain" brand. They recommend double their Koji for any volume of rice substrate. Other makers of Koji proportions may be less if the Koji is less dehydrated; family business G.E.M. Cultures in Wash. mail orders their Koji and it may (?) be suitable for using less (GEM also sells spores with instructions to make your own Koji).

  • Might-o'chondri-AL

    8/13/2011 7:43:26 PM |

    Dr. Davis,
    Orientation for those athletes interested in experimenting with Amazake:
    Innoculant of rice is Aspergillus oryzae fungal infused rice grains, called Koji; Koji has alpha-amylase, glyco-amylase, acid protease, lipase, amylo-glucosidase , acid carboxy-peptidase , chitosinase and citric acid.
    Incubation lets fungal penetrate new rice substrate and fungal hyphal tip performs hydrolytic enzyme secretion.

    Cooking the rice first gelatinizes the starch held in granules inside of organelles with lipoprotein membranes (amyloplasts) into 16 - 30% amylose and 65 - 85 % amylopectin which are ammenable to hyphal hydrolytic action. Koji's amylo-glucosidase enzyme digests the gel &  Koji's alpha amylase enzyme reduces molecular size of amylose, which makes it less viscous and more fluidly mobile. It is glyco-amylase enzyme that turns amylose and some of the amylo-pectin chains  into glucose.
    Incubation lets the fungi grow and their mycellial cell wall builds up with the amino mono-saccharide glucosamine (a.k.a. chitosan); fungi generally have 67 - 126 mg mycelial glucosamine per 1 gram dry weight mycellium. Amazake is well tolerated by most since glucosamine is useful in colitis. Glucosamine (chitosan) is a poly-cationic bio-polymer formed when chitosanase I enzyme de-acetylates chitin (in fiber); with optimal enzymatic pH being 5.5 - 6.5. Chitosan is more acid pH soluble than chitin and under chitosanase II enzyme (working from pH 3.8 -8.5) some chitin is de-acetylated to form more oligo-saccharides.

    Amazake may have biologically active high molecular weight immunological poly-anionic polysaccharide
    derivatives like the poly-acetyl carboxylic acid  COAM (chlorite oxidase oxy-amylose). COAM comes about when a saccharide chain is oxidatively cleaved between 2 carbon atoms resulting in oxy-amylose, a polymer of 2 aldehyde functions;  when these aldehydes gets further oxidized they produce functional carboxyls.  Rice has aldehydes like the volatile aldehyde hexanal we smell as stored rice &/or from rice bran.

    Rice, like most bean & grain carbohydrate polysaccharides, include the following in both the soluble and insoluble form: arabinoxylan, beta-glucan, cellulose, mannose, galactose, xylose and uronic acid. For us these non-starch  polysaccharides are not digestible;  as neither is fiber (made up of cellulose, hemicellulose, pectin and lignan ) since 90% of our dietary fiber is linked together by beta-glycosides that our digestive enzymes can't cleave. Arabinoxylan, mannan, galacto-mannan and xylan are considered anti-nutritional since can lower intestinal uptake of nutrients; while mannose reacts with amino groups in dietary protein to reduce the amount of certain aminos properly digested.

    Koji's fungal hyphal hydrolytic enzymes include mannosidase enzymes; beta mannanase catalyses the mannosidic links in insoluble mannan polysacharides where there are galactosyl residual features.  The  so-called endo-mannanase (a manno -hydrolase) cleaves mannan and galactomannan to free up molecules like manno-triose, manno-biose and manno-tetraose that human gut Bifidobacteria can then feed on. This may be part of why a substantial dose of Amazake seems to yield more delivery of  sustained energy beyond what one would get from the usual amount of short chain fatty acids put out by gut bacteria.

    Amazake incubation is a solid state fermentation, since want the minimal free fluid when culturing;  too much water and the substrate porosity is diminished and resultant depressed oxygen transport in substrate  causes fungal cell numbers to decline. A  submerged fungal ferment, when cooked rice with koji substrate is set out  too soupy can result in 3.5 times less enzymatic activity. Using  too much rice substrate mixed with too sparse koji innoculant and the fermentation won't proceed promptly due to low oxygen. Also do not stir the blend while incubating to avoid damaging mature fungal hyphae or breaking new growth.

    Mannanase enzyme development in 1st day is less than 50 units/gram and this goes to a maximum of 100 units/gram after 2 days; a peak mannanase content seems to be +/- 250 units/gram on days 3-5. I incubate short grain brown rice Amazake for 22 hours; while most commercial Amazake products and home producers probably do not incubate more than 12 hours. The longer incubation is allowed to go on for the more llikely bitter flavors develop from oxidation of the bran's oil content;  yet the bran is desired for it affords better beta- mannanase and beta-mannosidase enzymatic formation.

    Amazake has exceptional anti-oxidant properties; with longer incubation time this activity increases. Amazake also raises the bodies ability to inhibit lipid peroxidation; so concern over any of rice bran's oil oxidation is probably moot.
    END

  • Elenor

    8/14/2011 5:13:52 PM |

    You don't mention liquid surcralose (Splenda)  -- which has all the 'benefits' of sucralose without the maltodextrin.  I use it and nothing else.

  • Dr. William Davis

    8/15/2011 12:51:28 PM |

    Wow, Might. You are a walking Wikipedia!

    Thanks for the incredible insights.

  • Marlene

    8/15/2011 5:44:10 PM |

    I have never been able to find liquid Splenda in stores in the U.S.  If it's there, what brand name is it sold under?

  • ibh

    8/15/2011 8:36:23 PM |

    I use Sweet Leaf as well. It is in the powder from. the box states no chemicals,no alcohols, no erythritol, no ethanol or menthol,, no aspartame, no sucralose, no maltodextrin, no dextrose or additivees. Seems clean to me. Any thoughts as to problems with this product.

  • Anonymous

    8/15/2011 8:36:54 PM |

    Doc, also notice the removal of all of Might's comments from Guyenet's site. This speaks for itself, as to where the truth lies. Might is truly a wonder and knows what he's talking about.

  • Jack Kronk

    8/15/2011 9:57:54 PM |

    What does that mean, that the comments from Guyenet's site are removed? Stephan removed them, or Might removed them? I've traded comments with Might over there dozens of times.

  • Jack Kronk

    8/15/2011 10:00:22 PM |

    I just use pure Stevia powder, which is gauranteed to be at least 95% pure stevia crystals (like the liquid stevia, on in teh form of powder. The brand I use is Stevita. A tiny little 0.7 ounce conainer lasts FOREVER! You only need a tiny pinhc of it for coffee. It doesn't exchange well versus sugar as a substitute, but adding a little to whatever you might be baking or making can help with using less of whatever other sweetener you may need to use.

  • Janmar Delicana

    8/16/2011 12:13:10 AM |

    Dear Dr. Davis,
    It’s a great pleasure to read your blog. I find your post very informative. Thank you for sharing.
    As a reader, I consider your writing to be a great example of a quality and globally competitive output.
    As a moderator for Physician Nexus (a community for physicians) I would like to share your genuine ideas and knowledge. With this you can gain 1000 physician readers on Nexus.
    We would love for you to visit our community. It's free, takes seconds, and is designed for physicians only - completely free of industry bias and commercial interests.
    Best,
    Janmar Delicana
    On behalf of the Physician Nexus Team
    www.PhysicianNexus.com

  • Might-o'chondri-AL

    8/17/2011 12:33:07 AM |

    Stephan who hosts the WholeHealth blog is smarter than me &  the removal of my comments there came from someone using my computer. These days I do not have the time to follow Stephan's blog, which has nothing to do with validity of his approach.

  • Stefan

    8/31/2011 1:46:14 AM |

    Marlene,
    I buy it at SuperSupplements or at Whole Foods. Any nutritional supplements &vitamins stores should carry it. If you live in a place whch doesn't havenay -> use Amazon. It's simple Smile.

  • Stefan

    8/31/2011 1:50:21 AM |

    Whoops - I thought you meant Stevia. Liquid Splenda is at amazon as well

  • Serge

    9/2/2011 11:27:16 PM |

    Dr. Davis--

    I'd like to recommend ZSweet.  It's a stevia/erythritol blend but isn't a Big Ag product like Cargill/Coca-Cola's Truvia or Pepsico/Monsanto-er-Merisant's PureVia.

    It's funny how Stevia was banned by the FDA in the 80s, only to be given the GRAS label in 2008, which just happened to be the same year that Truvia was launched.  Coincidence?

  • Dr. William Davis

    9/2/2011 11:40:52 PM |

    Hi, Serge-

    I have no doubt that the clout of Cargill pushed Truvia through. I wasn't aware of ZSweet--thanks!

  • Susan

    12/18/2011 6:10:37 AM |

    I am absolutely thrilled to have found this blog.  I've been extremely cautious of sugar and sweets since my mother was diagnosed with diabetes when I was a child.  Unfortunately I did fall into the "healthy whole grains" trap for a while, but have kept my daily carbs between 50-100 for many years now.  I like Stevia products, but unfortunately they leave me with a slight headache.  I've been (sparingly) using Volcanic Agave Nectar for years, mostly in tea and for the occasional baked good.  I understand that due to the rich soil in which it's grown, and minimal processing, volcanic blue agave has a lower glycemic index-load than other traditional agave nectars, at 27.  

    Am I doing myself harm by using it?  I'd like to try the liquid Splenda, that contains no maltodextrin.  Thank you Elenor and Stefan for mentioning it, but should I be concerned about its processing?

  • jpatti

    5/27/2012 6:58:29 PM |

    I'm not big on Truvia.  

    From what I've heard from other diabetics erthyritol doesn't have the GI side effects of most sugar alcohols and has a lesser effect on bg, but even so... I prefer a plain stevia powder.

    I don't think erthyritol has been around long enough to know what it's side effects may be, that it doesn't raise bg much and doesn't cause GI distress isn't good enough. There's any number of other bad side effects that exist in the world besides those two.

    Stevia is food.  Granted, the plain white stuff is relatively refined, but I still feel better about it than erthryitol.  

    Susan, agave nectar has almost no GI effect because it is fructose, not glucose.  It has MUCH more fructose than HFCS.  Search this blog for a long list of the bad stuff that fructose causes.  I'm a diabetic, and I'd seriously rather eat sugar than agave.

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Fish oil: What's the difference?

Fish oil: What's the difference?

Ultra-purified, pharmaceutical grade, molecularly distilled. Over-the-counter vs. prescription. Gelcap, liquid, emulsion.

There's a mind-boggling variety of choices in fish oil today. A visit to any health food store, or any "big box" store for that matter, will yield at least several, if not dozens, of choices, all with varying and often extravagant claims of purity and potency.

So what's the real story?

Given the analyses conducted over the years, along with my experience with dozens of different preparations, I believe that several conclusions can be reached about fish oil:

Fish oil is free of contamination with mercury, dioxin, PCBs, or furans. To my knowledge, only one fish oil preparation has been found to have a slight excess of PCBs. (This is different from cod liver oil that has been found by one source to have a slight excess of PCBs.)

Oxidative breakdown products differ among the various brands. Consumer Lab (http://www.consumerlab.org/), for instance, has found that several widely available brands of fish oil contained excessive oxidative breakdown products (TOTOX). You can perform you own simple test of oxidative breakdown products: Sniff it. Your fish oil should pass the "sniff test." High quality fish oil should smell non-fishy to lightly fishy. Rancid fish oil with excessive quantities of oxidative breakdown products will smell nasty fishy.

FDA approval does not necessarily mean greater potency, purity, or effectiveness. It just means that somebody assembled the hundreds of millions of dollars to obtain FDA approval, followed by lots of marketing savvy to squash the competition.

This means that there are a number of excellent fish oil products available. My favorites are the liquid fish oils from Pharmax, Nordic Naturals, and Barleans. Capsules from Carlson, PharmaNutrients, and Fisol have also performed consistently. The "big box" capsules from Sam's Club and Costco have also performed well and are wonderfully affordable.

Comments (27) -

  • Bill Millan

    12/10/2010 3:01:47 PM |

    I have engaged in more discussion about fish oil than any other supplement. Just remember we could care less about the fish oil, what we are after is the EPA+DHA Omega 3 in the oil. The rule of thumb is, "the higher the price, the more Omega 3." You can save money and get the 30% in the Kirkland or Sam's Club brand or spend a lot more money and get the 50% to 70% brands.

  • Bill Millan

    12/10/2010 3:01:47 PM |

    I have engaged in more discussion about fish oil than any other supplement. Just remember we could care less about the fish oil, what we are after is the EPA+DHA Omega 3 in the oil. The rule of thumb is, "the higher the price, the more Omega 3." You can save money and get the 30% in the Kirkland or Sam's Club brand or spend a lot more money and get the 50% to 70% brands.

  • arnoud

    12/10/2010 3:11:11 PM |

    Often I have wondered about the benefits, if any, of krill oil versus regular fish oil.    
    It seems that the Phospholipids in the Krill oil play a role in HDL quality.

    I have not yet found a good paper explaining this, but Neptune Technologies is doing some research on this.  I prefer whole foods, rather than drugs, but the research on this topic looks interesting.

    From their website on a research on concentrated phospholipids form krill oil:
    Neptune Technologies & Bioressources Inc. Reports Completion of Acasti Pharma Comparative Benchmarking Program versus Lovaza®



    Laval, Québec, CANADA – November 25, 2010 – Neptune Technologies & Bioressources Inc. (“Neptune”) (NASDAQ: NEPT - TSX.V: NTB) subsidiary, Acasti Pharma Inc. (“Acasti”), reports the completion of its  preclinical program designed to compare the lipid management effects of Acasti’s drug candidate CaPreâ„¢ versus prescription drug Lovaza®.  Blood lipids were monitored in two animal models in order to assess and compare the efficacy of CaPreâ„¢ and Lovaza® over a 12-week treatment period.

        * A low daily human equivalent dose of 1g CaPreâ„¢ reduced LDL-C (bad cholesterol) levels by 40% and increased HDL-C (good cholesterol) by 180% in a normal rat model (“SD”) while 4gr of Lovaza® did not show any significant effect.
        * An even lower daily human equivalent dose of 0.5g CaPreâ„¢ was shown to be as efficient as 4g of Lovaza® in reducing triglycerides levels by 40-50% in obese rats with severe diabetes and high triglycerides (“ZDF”)


    “These results suggest that a low (0.5g to 1g) daily dosing of CaPreâ„¢ is more effective than 4g Lovaza® in elevating HDL-C and lowering LDL-C and triglycerides.  These effects become even more striking considering that a 1g daily dose of CaPreâ„¢ contains 8.9 times less EPA and 11.1 times less DHA than the recommended 4g daily dose of Lovaza®. It is also important to note that the triglycerides reduction was observed only after 4 weeks and was maintained throughout the study suggesting a significant metabolic impact of CaPreâ„¢,” said Dr. Bruno Battistini, Senior Director, Pharmaceutical R&D of Acasti.

  • Geoffrey Levens

    12/10/2010 4:38:02 PM |

    If one brand showed slight excess of PCB's, does that mean all the rest also contained PCB's only just the right amount?

    What are the benefits to cardiovascular health of taking plant/algae sourced DHA vs fish sourced EPA/DHA?

  • Anonymous

    12/10/2010 4:54:31 PM |

    What do you think of the conclusions in this blog post?
    http://thehealthyskeptic.org/when-it-comes-to-fish-oil-more-is-not-better

    For a "healthy" person are your recommendations the same- as in make sure to get a high quality fish oil?

    I really appreciate you taking the time to write on this blog.  Thank you!
    Char

  • Jack

    12/10/2010 5:00:58 PM |

    or you could just eat natural food sources of omega-3, like wild salmon, tuna, sardines, grass fed butter, eggs from pastured chickens, fermented cod liver oil. then you wont need supplements.

    cheers
    jack k

  • Eric

    12/10/2010 5:20:40 PM |

    What if you can't stand the taste of fish like salmon and sardines or fermented cod liver oil?

    I'm hoping Carlsson's is good, that's what I've been taking for the past few months and I love how it tastes like lemon oil, not fishy at all.

  • Dr. William Davis

    12/10/2010 7:48:29 PM |

    While there is debate on the reduction in cardiovascular events with omega-3 fatty acids, I use them to achieve correction of a number of physiologic parameters:

    1) Reduction of triglycerides
    2) Acceleration of clearance of postprandial lipoproteins, such as chylomicrons, chylomicron remnants, and VLDL
    3) Reduction of lipoprotein(a)

    The data on the likelihood of cardiovascular mortality correlates inversely with RBC omega-3 EPA + DHA; the relationship is quite strong. While we lack prospective trials outside of GISSI Prevenzione on the reduction of cardiovascular death with higher levels, given the overall improved surrogate measures of risk, I believe that the data overall are sufficiently compelling.

  • Anonymous

    12/10/2010 8:49:01 PM |

    Funny, I've been reading up about this lately. I like the fact that if we can - there is the possibility of actualy getting the appropriate amount of EPA+DHA Omega 3's by eating fish. I recently started buying sardines just for this purpose and I'm going to try real hard to incorporate oily fishes. I like it when people help others minimize the amounts of supplements they use.

  • Anonymous

    12/10/2010 10:03:22 PM |

    dr. davis

    i can't smell anything rancid in my distilled fish oil with orange flavour but its so weird its too heavy barely digests and stays as if stuck in the chest. feels horrible.

    not sure what to make of it.

  • Pater_Fortunatos

    12/10/2010 10:07:40 PM |

    There are a few benefits of a plant based diet: avoiding acid load, toxin accumulation in the food chain, and another one, high lipid peroxidation level of the longer chain EFA.
    So I just heard that "Reduction of triglycerides" using fish oil, is an effect of liver damage.

    Just search for this book:
    "Fatty acids in foods and their health implications" - Ching Kuang Chow
    I just quote from the chapter V. MEMBRANE UNSATURATION AND LONGEVITY
    _______________________________
    In summary, the above mentioned studies provide a correlation between the maximum longevity of animals and the degree of unsaturation of membrane fatty acids. That correlation joins the previously stated one between the rate of mitochondrial oxygen radical generation and the maximum
    longevity of animals. In long-lived homeothermic vertebrates, both free-radical production and the
    membrane fatty acid unsaturation are lower, offering an explanation for some of the main causes of
    the low aging rate peculiar to these animals. No studies have been carried out on these aspects in
    relation to dietary fat and, as it will be stated below, this is another notable aspect of fatty acids and
    aging.
    _______________________________

  • John

    12/11/2010 2:35:55 AM |

    Is there an over-the-counter brand of fish oil that closely matches prescription Lovaza?

  • Jack M.

    12/11/2010 3:37:59 AM |

    westonaprice.org has very informative articles on this. Type "cod liver oil" in the search box to find their articles.  There is great info on how the better brands are manufactured.

  • William Trumbower

    12/11/2010 3:24:04 PM |

    A product similar in principal to krill oil is Vectomega.  It is a phospholipid bound salmon oil made from salmon heads.  The heads used to be discarded and this is a resource that doesn't deplete the food of whales etc.  According to the companies data, one tablet is the equivalent of eight standard capsules (probably 2.4gm of EPA+DHA).  It is a little pricey, but you will never burp it and it is very portable when you travel.  I suggest to my patients that if they regularly take much more than 2.5gm, that they get AA/EPA ratio available thru many labs.  yourfuturehealth.com,    LEF.org

  • Geoffrey Levens

    12/11/2010 4:57:33 PM |

    Supposedly DHA converts in the body to EPA pretty easily.  Anyone know any data about taking DHA alone vs with EPA?

  • Vlado

    12/11/2010 5:36:56 PM |

    to come from other side, I have started to read Ray Peat's articles and he is big on the dangers and overhype of non saturated fatty acids , in particular omega 3. It makes sense that humans having developed in hot climate require primarily saturated fat to protect from heat, light and oxygen. There is a reason why fish oils smell and why vegetable oils must be deodorized, it's basically our body telling us that non saturated oils are bad for us. Ray Peat says these oils make our membranes "floppy" and our skin prone to photo dammage by the sun. Basically we need all the saturated fat we can get primarily from coconut oil and butter but polyunsaturated fats should be minimum and certainly no supplement. Read up here
    http://raypeat.com/articles/articles/fishoil.shtml
    http://raypeat.com/articles/articles/membranes.shtml
    http://raypeat.com/articles/articles/unsaturatedfats.shtml

  • Anonymous

    12/11/2010 6:57:14 PM |

    I take at least 900 EPA + 600 DHA fish oil daily. I usually take 1-2 softgels with each meal. I continue to experiment with higher doses, but so far, I can't tell the difference between 5 softgels daily vs 10 softgels daily except 10 softgels means 50 extra calories. Sometimes I actually need extra calories, so I've taken as much as 40 softgels in one day.

  • rhc

    12/12/2010 2:30:31 AM |

    I guess I'm the only one who actually LIKES chewing my fishoil capsules. To me they are like a treat! This has the added advantage of knowing for sure if they are rancid. I've been getting Sundown Naturals for over a year - never had a bad one yet. The taste is very mild and I they never make me burp.

  • Anonymous

    12/12/2010 2:53:27 PM |

    dr. davis i d like to know your take on this

    http://raypeat.com/articles/articles/fishoil.shtml

  • Travis Culp

    12/12/2010 7:27:04 PM |

    I've found that Barlean's cod liver oil is least offensive taste-wise, followed by Spectrum. Both are molecularly distilled. I have trouble finding Barlean's, however.

  • Anonymous

    12/12/2010 9:45:55 PM |

    In declaring EPA and DHA to be safe, the FDA neglected to evaluate their antithyroid, immunosuppressive, lipid peroxidative (Song et al., 2000), light sensitizing, and antimitochondrial effects, their depression of glucose oxidation (Delarue et al., 2003), and their contribution to metastatic cancer (Klieveri, et al., 2000), lipofuscinosis and liver damage, among other problems.

  • Anonymous

    12/13/2010 4:56:56 PM |

    Dr. Davis,

    Should Vitamin D gelcaps have an odor? I've been taking a generic drugstore brand and they always have an unpleasant smell, but I assumed they were supposed to.

    Thanks!

  • Vin

    12/13/2010 7:29:14 PM |

    @arnoud - phospholipid-bound Omega-3 appear to get incorporated into membranes 1.5 to 2X more than triglyceride or ethyl ester Omega-3. But Neptune researchers have not explained why krill oil reduces LDL more than Lovaza.

    @Geoffrey Levens - just about every food product has small amounts of PCBs. Yes, fish oil too. Cod and Shark liver oils typically have much higher levels. More on fish oil and PCBs here.

    Retroconversion of DHA to EPA is not very efficient. Roughly 10% of DHA gets converted to EPA. EPA to DHA far less efficient. Several metabolic factors affect these conversions. Bruce Holub at Univ Guelph has done great work on this. Check out PMID: 9507234 and 9076673.

    @John - Several brands have 700 - 900 mg Omega-3 per pill, like Lovaza.

    A few have 20-30% more Omega-3 than Lovaza:
    Minami Nutrition CardiO3
    OmegaVia
    Ocean Blue Professional
    RenewLife come to mind.

    These all have over 1000 mg Omega-3 per pill.

    Next-gen fish oil (pipeline) drugs like Epanova and AMR101 are mostly EPA - so worth looking into high EPA OTC formulas for a fraction of the price.

  • Kevin

    12/14/2010 12:05:36 AM |

    $2000 per month doesn't seem so bad.  For the three of us, two adults and one 18yr old, we pay $2600 per month.  But my wife had cancer twice:  Hodgkins Lymphoma 24 years ago and breast cancer six years ago.  Before doing anything that might be dangerous, I remind myself of the $1500 deductable.  

    kevin

  • Anonymous

    12/15/2010 8:27:27 AM |

    dr. davis

    i did some research and to answer my own question on fish oil...
    for those without heart disease (like me) 1 gram of fish oil is sufficient and should be taken with 4 grams of saturated fat otherwise fish oil slips through the intestines undigested. 4 grams of saturated fat is used for making the liver start bile production.


    -----------------------------------
    original question

    dr. davis

    i can't smell anything rancid in my distilled fish oil with orange flavour but its so weird its too heavy barely digests and stays as if stuck in the chest. feels horrible.

    not sure what to make of it.

  • Buy Resveratrol

    1/13/2011 9:41:21 AM |

    It is good; however the oil came from the liver. It can contain too much Vitamin A and it could be dangerous if u overdose. I suggest sticking with eating a variety of fish.

  • Anonymous

    2/12/2011 10:33:52 PM |

    ah great info.......i live in the UK and I usually take different supplements, plz cud u tell me what should i look for while buying the fish oil....tnx in advance Smile

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Normal fasting glucose with high HbA1c

Normal fasting glucose with high HbA1c

Jonathan's fasting glucose: 85 mg/dl
His HbA1c: 6.7%

Jonathan's high HbA1c reflects blood glucose fluctuations over the preceding 60-90 days and can be used to calculate an estimated average glucose (eAG) with the following equation:

eAG = 28.7 X A1c – 46.7

(For glucose in mmol/L, the equation is eAG = 1.59 × A1C - 2.59)

Jonathan's HbA1c therefore equates to an eAG of 145.59 mg/dl--yet his fasting glucose value is 85 mg/dl. 

This is a common situation: Normal fasting glucose, high HbA1c. It comes from high postprandial glucose values, high values after meals. 

It suggests that, despite having normal glucose while fasting, Jonathan experiences high postprandial glucose values after many or most of his meals. After a breakfast of oatmeal, for instance, he likely has a blood glucose of 150 mg/dl or greater. After breakfast cereal, blood glucose likely exceeds 180 mg/dl. With two slices of whole wheat bread, glucose likewise likely runs 150-180 mg/dl. 

The best measure of all is a postprandial glucose one hour after the completion of a meal, a measure you can easily obtain yourself with a home glucose meter. Second best: fasting glucose with HbA1c.

Gain control over this phenomenon and you 1) reduce fasting blood sugar, 2) reduce expression of small LDL particles, and 3) lose weight.  

Comments (24) -

  • Mark

    3/23/2010 5:56:04 PM |

    So what is the basic recommendation here?
    Eat meat, nuts, vegetables, no starch, no fruit? A ketogenic diet?

    It looks like the recommendation is to avoid blood sugar spikes primarily. I would think that insulin is less of a worry because insulin doesn't necessarily mean that sugar is in the system (dairy for example).

    Some clarification would be greatly appreciated. Thanks

  • Anonymous

    3/23/2010 6:44:31 PM |

    Dr. Davis, my husband has the opposite problem, can you (or anyone else) explain it?  His 1-hour postprandial glucose never exceeds 90 and yet he has an HBA1C of 5.9.  We have checked his glucose at different times and it never goes over 100.  He is on a very low carb diet.  

    His HBA1C indicates an average blood glucose of 123, but we never see readings this high.  Is there something else that can glycating hemoglobin and thus show an elevated HBA1C reading?

  • Anonymous

    3/23/2010 7:03:19 PM |

    What would be considered an optimal (or at least good) HbA1c level? And same for fasting glucose?

    I have noticed my fasting glucose tends to vary, between 80-95, with my HbA1c at 4.6.

    Curious also if there is any data on HbA1c correlating directly with triglyceride levels.

    My own trig values are higher than I like, around 125-150, yet I limit carbs, use fish oil, and think my HbA1c number is relatively decent.  So wondering if carbs/glucose isn't my problem, what else raises triglycerides?

  • Jake P.

    3/23/2010 10:30:18 PM |

    Dr Davis, do you have any recommendations on blood glucose test meters, as far as brand/model? Also, I'd prefer something that doesn't require a prescription, if possible.

  • Dr. William Davis

    3/24/2010 1:41:43 AM |

    Anon--

    The only two causes I am aware of are 1) iron deficiency anemia, and 2) hemoglobin variants.

    Also, are you confident of the accuracy of your blood glucose meter? You can check it by running side-by-side glucoses with a blood draw.

  • Dr. William Davis

    3/24/2010 1:42:31 AM |

    I've had good experiences with One Touch Ultramini, Aviva, Relion, and Accuchek meters. All are available without prescription.

  • Anonymous

    3/24/2010 5:26:17 AM |

    This is exactly why everybody should have a blood glucose meter, and know their numbers.

    While I have not been diagnosed as having type 2 diabetes, I was darned close.  My meter, and the information found here and in the blogs that link to and from it, have helped me to lose about 3 pounds per week for the past 6 months, and not be hungry or feel deprived.

    I was like Jonathan.  Until 6 months ago my fasting glucose was always under 100.  Now that I am managing to keep my average BG reading, including post prandial readings, under 95, I have stopped suffering from the inflammatory symptoms I've had for a decade.

    My meter and initial 100 test strips was the best under $50 purchase I've ever made.

    Thanks for the USEFUL information I get at The Heart Scan Blog.

  • Alfredo E.

    3/24/2010 2:52:07 PM |

    Hi All. I eat a low carbs diet and I have the a high fasting glucose, 95-105, but a low postprandial, 85-100.

    I also exercise everyday and do Intermittent Fasting.

    What could be the mechanism working here?

    Thanks for your ideas.

    Alfredo E.

  • Anonymous

    3/24/2010 3:20:00 PM |

    David Mendosa has a good blog/site/comments... on diabeties for many things A1C, food, low carb, etc. Check him out at www.mendosa.com
    Look under "health central" or

    http://www.healthcentral.com/diabetes/c/17/75106/david-guide-a1c-6-0

    For A1C guidance.

    He seems to lean away from strict AHA, ADA, and government things that do not work for him.

    His meter data is getting a little dated, and he does not specify exact things like he states vitamin D, as opposed to stating: D3. And he seems to be a little soft about major statements, possible law suit shy.

  • Anonymous

    3/24/2010 4:01:15 PM |

    I'm curious why you believe that gaining control over postprandial glucose will result in lower *fasting* glucose.  Is there a mechanism for this?  I've found that my fasting glucose hasn't fallen since I started the TYP diet 3 months ago; it's still in the mid to high 90s -- even though my one hour glucose is rarely much higher than that.

  • Anonymous

    3/24/2010 6:40:34 PM |

    Responding to Dr. Davis' comment:
    "The only two causes I am aware of are 1) iron deficiency anemia, and 2) hemoglobin variants.

    Also, are you confident of the accuracy of your blood glucose meter? You can check it by running side-by-side glucoses with a blood draw."

    I don't think he has iron deficiency anemia unless high ferritin level indicates that?  His ferritin level was 320 at the time he got the HBA1C of 5.9.  What are hemoglobin variants?

    We have the Accuchek meter and have also had fasting and post-prandial lab tests done and the meter seems to be in the ballpark.

    Thank you very much for your reply.

  • Anne

    3/24/2010 9:28:20 PM |

    My fasting was below 100. My A1C was 6.5. A OGTT spiked at 202. My doctors told me as long as my fasting BG was good, I did not have to worry as I only had insulin resistance not diabetes. That was 10 yrs ago.

    A year ago I bought a glucometer and started eliminating foods that spike my BG. My last A1C was 5.5.

    I wish I could get a hold of the results of my OGTT from 40 yrs ago. I was told it was slightly abnormal but I did not have diabetes. How much damage has been done from elevated postprandial blood sugars?

  • Anonymous

    3/25/2010 12:20:28 AM |

    Dr. Davis,

    Would you anticipate that a healthy 25 year old would obtains similarly high postprandial sugars to those meals?  Or do young, healthly, slim people have high glucose tolerance, and hence low postprandial responses to sugar?  I've seen many articles featuring sports stars who subsist on high carb, low fat diets, such as rafael nadal, roger federer, tiger woods... I find it hard to believe they exceed 120 mg/dl postprandially...

    David

  • mikyy748

    3/27/2010 5:31:11 AM |

    Please help with an explanation ! My last meal of the day (with NO carbs) is around 4PM. At 9-10PM, my glucose test shows about 100-105. But... in the morning the test shows 125-130. How is it possible?!

  • Anonymous

    4/10/2010 4:37:12 AM |

    Veeerrrrry interesting!

    I have been on an extremely resrricted carb diet for several months.  My One Touch (and my wife's, she's T1 on a pump) my glucose levels never vary from 100-120 with the vast majority right around 110-113. Tests are run about once a day at various times including 1-2 hours post prandial.

    At my PCP's office (she's also an endocrinologist) today, her office machine complained of an HbA1C of 20+ and wouldn't give a reading, while it did report my other lipid levels, most moderately elevated as usual.

    Tubes were drawn for processing by a lab.  Of course it's the weekend and I'm obsessing about it... sigh.
    I worry that my low carb lifestyle might be masking what would be high glucose readings which is not very logical, or if something is wrong with my blood such as anemia.  A quick google and here I am.

    I wonder if this is common for extremely low-carber diabetics?

    Am on low doses of Diovan, HCTZ and colchicine...

    Thanks to all for any thoughts.
    -Ron

  • Anonymous

    4/13/2010 2:26:58 PM |

    Thanks to all who commented ;)

    Lab work came back with an HbA1C of 5.9, so the office machine was just being stupid as hoped/mostly expected.

    Good luck to everyone else.

  • mongander

    4/27/2010 11:22:25 PM |

    This MedScape article doesn't make sense.  It claims that <6 may be too low...That >7 has a better all cause mortality.
    http://www.medscape.com/viewarticle/720391

  • William A. Ryan

    7/15/2010 1:32:59 PM |

    FYI, another possible cause of abnormally high HbA1c is Vitamin B12 and/or folate deficiency.  This causes anemia with low red blood cell turnover, so any given Hb molecule is floating around longer, and thus has a higher probability of glycation.

  • Helena

    9/29/2010 11:01:56 PM |

    So.. I just started testing my blood sugar again today... first reading was 90
    Then I had lunch. Rice and curry with coconut milk (probably loaded with sugar) and it went from 156 to 258 to 124 in 2.5 hours after that meal... I am a little concerned.

    Think I will go back on my low carb diet ASAP!

  • Helena

    9/30/2010 3:22:01 PM |

    Let me correct my numbers... I didn't have them in front of me when I wrote the previous post so here they are:

    Lunch was Rice, shrimp, coconut milk based curry pot

    Blood levels:
    60 min after - 193
    90 min after - 217
    130 min after - 258
    2.5 hrs after - 140

    This morning I had a reading of 89 and after having my protein shake with cream and water it was 106...

    Def going to go back to my low carb diet asap!
    Thanks for a great blog full of valuable information and help to get back on track.

  • Anonymous

    10/15/2010 2:05:41 PM |

    This is a recent day of testing. 90 minutes after eating 50 grams of processed brown flax, my BG was about 117, but it also depends on what I eat the night before. 2 hrs after eating 8 oz hummus with tahini, my BG was 101. 1 hr after eating a 143 gram (quick rolled) oat cake with 95 grams chocolate syrup with a lot of sugar and water, my BG was 120. Next day fasting BG was 120. Carbs do a good job of BG stabilization, although I'm trying to decrease some carbs and lower my fasting BG. I will try soymilk, and less carbs.

  • H Saleem

    11/22/2010 9:04:14 PM |

    Hi, Let me add my 2Cs. The objectives for diabetics and pre-diabetics are poles apart and confusing the two can  lead to irreparable loss for the pre-diabetics and those with insulin resistance.  

    For diabetics, when the disease is well established, the focus is on minimizing the harm i.e. to minimize the blood sugar level. Elevated blood sugar does so much harm in the long run that it should be kept under control through any means possible: diet, exercise, medicine, weight loss etc. When one plan and/or drug regimen fails to control the blood glucose level, it is replaced by another, all the time focusing on maintaining optimum blood glucose levels resulting in normal (for diabetics) readings on fasting glucose, HbA1C etc. I am not fully aware but possibly there is no mainstream healthcare regimen or drug that focuses on  reversing the disease or trying to minimize diabetes damages (other than those caused by high blood glucose) like destruction of pancreatic cells.

    For pre-diabetics and those with insulin resistance, the focus should NOT be on lowering blood glucose level DIRECTLY. For pre-diabetes, it is possible to keep on "travelling" towards diabetes in reality but assuming otherwise just because some "local" interference does not let the blood sugar rise. So if you start taking any alpha-glucidase, your postprandial reading will not rise much. But this does not mean that you have controlled pre-diabetes. The causes are all there like being over-weight, lack of exercise bla bla. And your body's normal ability to regulate blood sugar keeps on deteriorating ultimately leading to a point when the alpha-glucidase alone will not be sufficient. So when pre-diabetes is treated like diabetes, it can lead to actual diabetes. This is because here the focus should not be on lowering blood glucose levels or "treating" the condition but REVERSING it. In other words the goal should be to transform the body back to the point where it can naturally process the foods while keeping the blood glucose levels and HbA1C levels in normal range. All this without the help of any drugs or special diet or aids. And for this the usual solutions are already well known: weight-loss, exercise etc.

    The moral of the story is that if you are pre-diabetic, you can keep yourself happy by eating almonds, vinegar or psyllium with meals to "show" you that your post-prandial glucose levels are in range. This can be done by eating a low-carn diet or taking diabetes drugs. But if keep the same weight, continue the same eating habbits, and do no exercise then you are possibly doing nothing to prevent a preventable disease.

  • H Saleem

    11/22/2010 9:04:58 PM |

    Hi, Let me add my 2Cs. The objectives for diabetics and pre-diabetics are poles apart and confusing the two can  lead to irreparable loss for the pre-diabetics and those with insulin resistance.  

    For diabetics, when the disease is well established, the focus is on minimizing the harm i.e. to minimize the blood sugar level. Elevated blood sugar does so much harm in the long run that it should be kept under control through any means possible: diet, exercise, medicine, weight loss etc. When one plan and/or drug regimen fails to control the blood glucose level, it is replaced by another, all the time focusing on maintaining optimum blood glucose levels resulting in normal (for diabetics) readings on fasting glucose, HbA1C etc. I am not fully aware but possibly there is no mainstream healthcare regimen or drug that focuses on  reversing the disease or trying to minimize diabetes damages (other than those caused by high blood glucose) like destruction of pancreatic cells.

    For pre-diabetics and those with insulin resistance, the focus should NOT be on lowering blood glucose level DIRECTLY. For pre-diabetes, it is possible to keep on "travelling" towards diabetes in reality but assuming otherwise just because some "local" interference does not let the blood sugar rise. So if you start taking any alpha-glucidase, your postprandial reading will not rise much. But this does not mean that you have controlled pre-diabetes. The causes are all there like being over-weight, lack of exercise bla bla. And your body's normal ability to regulate blood sugar keeps on deteriorating ultimately leading to a point when the alpha-glucidase alone will not be sufficient. So when pre-diabetes is treated like diabetes, it can lead to actual diabetes. This is because here the focus should not be on lowering blood glucose levels or "treating" the condition but REVERSING it. In other words the goal should be to transform the body back to the point where it can naturally process the foods while keeping the blood glucose levels and HbA1C levels in normal range. All this without the help of any drugs or special diet or aids. And for this the usual solutions are already well known: weight-loss, exercise etc.

    The moral of the story is that if you are pre-diabetic, you can keep yourself happy by eating almonds, vinegar or psyllium with meals to "show" you that your post-prandial glucose levels are in range. This can be done by eating a low-carn diet or taking diabetes drugs. But if keep the same weight, continue the same eating habbits, and do no exercise then you are possibly doing nothing to prevent a preventable disease.

  • KDL

    12/12/2010 9:50:40 PM |

    I have a 16 year old daughter who HBA1c is 11.7 (yes very high).  I have been working with her especialist to bring it down.  The problem is her daily readings are normal for a type 1 diabetic. I know the monitors can be cheated however I am pretty confident that most of the time she does the right thing.  I also know that sometimes she does not.  However I am wondering if there are any other things that can cause this annomoly?

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Blood sugar: Fasting vs. postprandial

Blood sugar: Fasting vs. postprandial

Peter's fasting blood glucose: 89 mg/dl--perfect.

After one whole wheat bagel, apple, black coffee: 157 mg/dl--diabetic-range.

How common is this: Normal fasting blood sugar with diabetic range postprandial (after-eating) blood sugar?

It is shockingly common.

The endocrinologists have known this for some years, since a number of studies using oral glucose tolerance testing (OGTT) have demonstrated that fasting glucose is not a good method of screening people for diabetes or pre-diabetes, nor does it predict the magnitude of postprandial glucose. (In an OGTT, you usually drink 75 grams of glucose as a cola drink, followed by blood sugar checks. The conventional cut off for "impaired glucose tolerance" is 140-200 mg/dl; diabetes is 200 mg/dl or greater.) People with glucose levels during OGTT as high as 200 mg/dl may have normal fasting values below 100 mg/dl.

High postprandial glucose values are a coronary risk factor. While conventional guidelines say that a postprandial glucose (i.e., during OGTT) of 140 mg/dl or greater is a concern, coronary risk starts well below this. Risk is increased approximately 50% at 126 mg/dl. Risk may begin with postprandial glucoses as low as 100 mg/dl.

For this reason, postprandial (not OGTT) glucose checks are becoming an integral part of the Track Your Plaque program. We encourage postprandial blood glucose checks, followed by efforts to reduce postprandial glucose if they are high. More on this in future.

Comments (23) -

  • Jenny

    2/5/2010 2:26:07 PM |

    Dr. Davis,

    157 one hour after eating is NOT the diabetic range by any standard.

    To be considered diabetic a person must go over 200 mg/dl.

    The data collected by Dr. Christensen's CGMS studies suggest that 160 at one hour is the top of the normal range if the blood sugar drops back in the next hour.

    That 157 is "prediabetic" though the term is a misnomer because most people with "prediabetic" blood sugars will NEVER become diabetic since they lack the necessary genetic flaws that produce true diabetes.

    I mention this not to discourage people from lowering their carb intake and blood sugar--that's a very good tack to take, but because I hear from hundreds of people who obsess about being diabetic when they are not some of whom end up spending a lot of unnecessary money on doctor appointments that produce nothing useful.

    The latest research suggests that keeping blood sugar under 155 mg/dl at all times will control the blood sugar related component of heart disease. But to diagnose even "pre-diabetes" you have to look at the 2 hour reading. It is the inability to reduce a spike within 2 hours that appears to be associated with most diabetic complications.

  • Anonymous

    2/5/2010 2:57:04 PM |

    When do you recommend taking postprandial glucose measurements?  45 mintues, 1 hour, 2 hours?  And are they timed from the start of the meal, or the end of the meal?

  • Onschedule

    2/5/2010 3:57:11 PM |

    For those of us who do not eat wheat, avoid grains, and restrict sugar intake, it is important to know that the pancreas gets used to dispensing a certain (lower) amount of insulin. Therefore, if you decide to test postprandial glucose after eating a meal with significantly more carbohydrate/sugar, be aware that you will likely get scary-high readings. When preparing for an oral glucose tolerance test, a patient is normally told "do not restrict carbs" or "eat a normal diet" during the week preceding the test in order to allow the pancreas to adjust its phase 1 insulin response. (when they say "normal diet" they are sadly not referring to *our* normal).

    Following Dr. Davis's life-saving advice, I have been wheat-free since last August and avoid grains, and restrict sugar intake. The first time I tested my postprandial glucose after an uncharacteristic meal, I was convinced I had become diabetic. (meal was corn chips, rice, beans, chicken fajitas, and a large margarita). After several consecutive days of eating higher-carb, the same meal generated significantly lower postprandial glucose. (Of course I knew before testing that this meal was a *bad* choice for me).

    Using postprandial glucose levels as Dr. Davis recommends to discover which foods cause your blood glucose to spike (and hence trigger small-dense LDL) is wonderful advice. I have learned that I do not tolerate oat bran! Just be careful not to self-diagnose diabetes based on high readings resulting from uncharacteristic meals. I know Dr. Davis has never recommended this - I only mention it because I really scared myself the first time I measured postprandial sugar, and have since discovered that at least two of my "low-carb" friends had the same experience...

  • zach

    2/5/2010 5:43:05 PM |

    Do you measure one hour after eating?

  • Anonymous

    2/5/2010 5:57:42 PM |

    When you say your patient was at 157 mg/dl postpranial, do you mean right after eating?  Or are you talking about a 2 hour test?  What's the time frame for measuring?  And if you don't do OGTT, how do you control how many grams of carbohydrate you're giving the patient?  Does the load matter?

  • Derek S.

    2/5/2010 7:36:27 PM |

    If coronary risk is increased by 50% at a glucose level of only 126 postprandial, then there is no hope of a heart-healthy diet that takes any form other than Low-Carb or Paleo.  I challenge anyone out there to show me someone who can eat an entire bagel, an apple and coffee (likely sweetened for most people) and maintain postprandial glucose of 100.  Totally impossible.

    Postprandial glucose is not the problem...it's the food that's the problem.  The glucose is only the symptom.  Cut out the bagels (and all grains for that matter), fruit (except in small amounts), sugar, processed starch, omega-6 oils while keeping carb intake (via whole foods only) to 20% of calories or less and the postprandial glucose will take care of itself given enough time.

  • davide

    2/6/2010 1:49:01 AM |

    Dr. Davis,

    I'm curious as to whether genetic predisposition plays a factor in how one's body naturally reacts to sugar.

    I happen to have very high LDL cholesterol(220), the vast majority (i think 98%) being very large particles. Yet, I happen to eat a good amount of wheat, juice and fruit, and it doesn't seem to affect my blood sugar or particle size.

    Is this typical with some of your patients?

  • Helen

    2/6/2010 3:28:41 PM |

    Eating low-carb can give you a bigger glucose spike when you do eat more carbs.  (As onschedule noted.)  There may be more than one dietary pattern that keeps blood glucose in a good range for the non-diabetic among us (though I don't think low-fat is it).

    It is possible, as Derek suggested, that the type of carb eaten may be causing some bad change in CVD risk factors (such as grains, sugar, and fruit vs. root vegetables, for instance).  An interesting hypothesis.

  • Jedi

    2/6/2010 5:47:37 PM |

    Derek S I have been checking my fasting and post prandial glucose for a month and i frequently have 100 or less after a carb heavy meal. It is not impossible!

  • ET

    3/16/2010 10:46:23 AM |

    On a low-carb diet, my post-prandial blood glucose level is always 90 or less.

    Several weeks ago, when I donated blood, my blood sugar measured 63 after losing a pint of blood.  Wierd thing is that I felt fine, no shakiness, hunger, or any other symptom of low blood sugar.

    There is a down side to eating low-carb though.  Even a moderate amount of sugar sends my blood sugar through the roof.  My blood pressure increases significantly and I turn beet red and feel awful.  

    I tell my wife that the secret of not eating sugar is to not eat sugar.

  • handsewn

    4/1/2010 1:28:10 PM |

    Thank goodness I found you guys and gals. My daughter has been following a low carb diet to control her type 1 diabetes and she ate a handful of chocolate chips and spiked to 375 almost immediately. I didn't realize that eating low carb can make you super sensitive to carbs. Thank-you for providing this important piece of the puzzle for me!

  • Electronic Medical Records

    5/12/2010 5:26:51 AM |

    Thanks for discussing this...there are so many going through the same situation of ill health and shocking medical reports and not knowing it is common in the world.

  • jignesh

    10/11/2010 7:34:11 AM |

    how to measure after eating...
    Jignesh.

  • karan

    10/22/2010 6:20:17 PM |

    same question by my how to measure it please reply to it i want to inform this thing to my friend

  • buy jeans

    11/3/2010 7:36:08 PM |

    For this reason, postprandial (not OGTT) glucose checks are becoming an integral part of the Track Your Plaque program. We encourage postprandial blood glucose checks, followed by efforts to reduce postprandial glucose if they are high. More on this in future.

  • Anonymous

    11/17/2010 6:59:41 PM |

    I recently saw an article on veg oil and hexane which eventually led to this blog and others of the same bent, Whole Health Source, www.cholesterol-and-health.com, as a result I completely changed my diet. I now eat only meat, whole milk, heavy cream, fresh vegatables, broccoli, spinach, asparagus, salads with balsamic and olive oil, with yams, carrots, or beets once a day for carbs. I eliminated wheat, breads, cerials, sugars, and coffe. Prior to this diet never abused sugar no sodas, occasional ice cream. About a month into this diet I decided to buy a glucose meter and scared myself to serious anxiety as my fasting numbers range from 129-160. The strange thing is that my postprandial numbers if I walk a little after eating range any where from 87-120 usually. and almost never get past 135. Any thoughts?

  • Anonymous

    1/17/2011 4:00:45 PM |

    No one has yet answered the key question - *when* do you measure your one hour and two hour readings? from the start of a meal? End? Mid-way?

    Bloodsugar101 says from the start of a meal, but If you eat and chew slowly - which is sensible - the timing presumably makes BG readings vary quite a lot.

    When I sit down to a meal, it is probably 45minutes from first bite of main course to last bite of fruit/cheese afterward.

  • Anonymous

    1/29/2011 6:38:43 PM |

    Second part of my comment above:

    Also, my resting heart rate came down to 48 bpm. And I plan to get a new lipid profile done soon. My bP was already 120/80, but maybe it has decreased now.


    Pre-diabetes can be reversed with lifestyle modifications. I am not really following a low-carb diet, just a low-calorie, no-junk-food diet. And with only about 45 minutes of exercise on weekdays, it is possible to turn things around.

  • Anonymous

    1/29/2011 6:41:05 PM |

    On Nov 10, 2010, I went for a routine physical checkup while visiting my family in India. I am a lacto-ovo vegatarian. My mother was diagnosed recently with diabetes at 62. I am 40, so I decided to start checking my vitals. My lipids turned out to be (in mg/dL) TC: 170, HDL: 46, LDL: 106; TriGL: 88 and my BMI was 26.2 and resting heart rate 72 beats/minute.

    But my Glucose numbers were not so good:

    Fasting: 98 mg/dL
    2-hr post-prandial OGTT (75g glucose solution): 119 mg/dL

    Since they seemed high, I asked the doctor about this, and he brushed it off saying it was in the normal range of 60-100 for fasting, and less than 145 for the 2-hr test. He also said since the lipid profile was good I should not worry about it.

    An interesting article caught my eye:

    "Extremely short duration high intensity interval training substantially improves insulin action in young healthy males"

    http://www.biomedcentral.com/1472-6823/9/3

    as did the following study by Dr. Christensen:

    http://www.phlaunt.com/diabetes/16422495.php

    I did a lot, and I mean a lot, of online research about nutrition, exercise, types of exercise, caloric restriction, glucose toxicity etc. I must have read at least 200-300 papers and/or articles and 10 different books.

    I used to eat a lot of refined carbs like chips, bagels etc and lots of diet colas (1 can a day). Being a vegetarian, I decided to do things my own way, since none of the existing diets really suited me.  I adopted the following diet and exercise schedule:

    Breakfast: Nutritious Living Hi-lo cereal (low GI low-carb 7g + high protein 12g per serving) along with Soymilk and a sprinkling of walnuts, almonds, pecans, peanuts and chestnuts.

    Lunch: 1 Granola bar (140 cals, 19g carbs) + salad (greens including baby spinach leaves, and vegetables like tomatoes, onions, beans, asparagus, peas, artichokes, beets, brussels, cucumbers, lentils etc) with olive oil dressing + one fruit (orange, pear or apple).

    Snack: 1 fruit and sugar-less black tea.

    Dinner: Two slices of sprouted rye or whole wheat bread, with hummus and some salsa + a few nuts, or mixed vegetable Indian foods (many choices there).

    Water: 2-2.5 liters/day

    Exercise: mornings after getting up and on empty stomach before breakfast, only on weekdays.

    * 15 minute 6.5 mph run on the treadmill to exhaust glycogen stores taking about 225 kCal.

    * 15 minutes weight training with dumbbells (lower-body/upper body on alternate days). Only two sets of 10 reps with medium weights (a pair of 20 or 30 pound dumbbells) in a circuit, making for a vigorous workout.

    * 10 minutes high-intensity interval training on an exercise bicycle. The pattern being, 2 minute warm-up, 6 10-second, extremely intense, all-out sprints at the beginning of each minute, and then a 3 minute cool-down at moderate intensity. At the end of each sprint, my heart-rate would be around 190 bpm, slightly beyond my theoretical max level (220-40 = 180 bpm).

    The result? On Jan 1, 2011, after just 7 weeks of the above routine, my numbers were:

    BMI: 22.6
    Fasting blood glucose: 77 mg/dL
    2-hr post-breakfast (Kellog's raisin bran cereal + nuts + soymilk): 94 mg/dL

    I intend to keep going until I get to:

    BMI: 21.0
    Fasting/2hr-PP: 75/85 mg/dL

  • Anonymous

    1/29/2011 6:42:15 PM |

    Not sure why my two comments above ended up in the reverse order.

  • Anonymous

    2/12/2011 10:56:05 PM |

    To: Anonymous, posting Jan. 29, 2011...
    Very good job w/ changing your #'s via diet / exercise. I've made similar changes, & my numbers are also good. I think the challenge will be ongoing consistency & maintenance.
    Exercise & diet are both huge.

  • vanessa taylor

    8/24/2011 4:29:37 PM |

    Hi, my name is vanessa.  What is normal for blood glucose readings?.  I was told that two hour postprandial was okay as long as it wasn't over 180.  Is this correct?.

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