This is very good - just mixed up a large glass full (minus the flaxseed).  And, that's my question, do you use finely ground flax seed?  I also tossed in a fist-full of blueberries - should be able to tolerate them well; I just had a very intense resistance training session

I'd love to see more recipes for some ideas.  I disagree with those who wrote in on the earlier post, characterizing smoothies as "not real food."  I'm a big fan for time-challenged mornings and post-workout nourishment.

Bill

I can't believe you passed up a perfectly good opportunity to embed a cheesy 80's Reese's commercial in this post.

http://www.youtube.com/watch?v=DJLDF6qZUX0

Anon--

Yes, I used a finely-ground flaxseed.

The berries are a great idea, provided quantity is small.

Just a cautionary note -

Sucralose/Splenda can have severe reactions.

I seem to respond/react to things severely.  Sucralose has caused both allergic reaction (swollen mucus membranes) and severe migraine for me.  In fact, as a frequent migraine sufferer (tho much less now that i've removed gluten and sulfites), the migraine i got from sucralose was by far the worst i've ever had.  

Personally, i am of the belief that if it effects me so strongly, it is probably not good for anyone, but the damage it does is much less pronounced in other people.

I stick to stevia for a no-calorie sweetener.

http://jstevens.wordpress.com/2008/02/20/how-sucralose-aka-splenda-is-made-and-why-you-want-to-avoid-it/

"How Sucralose (aka Splenda) Is Made And Why You Want To Avoid It

...I wanted to comment on Splenda.  Splenda, also known as sucralose, was created accidentally when some chemists were trying to produce an insecticide.  Here is the process by which they produce the formula sold in stores:

“1.  Sucrose is tritylated with trityl chloride in the presence of dimethylformamide and 4-methylmorpholine, and the tritylated sucrose is then acetylated with acetic anhydride.

2.  The resulting sucrose molecule TRISPA is chlorinated with hydrogen chlorine in the presence of tolulene.

3.  The resulting 4-PAS is heated in the presence of methyl isobutyl ketone and acetic acid.

4.  The resulting 6-PAS is chlorinated with thionyl chloride in the presence of toluene and benzyltriethylammonium chloride.

5.  The resulting TOSPA is treated with methanol in the presence of sodium methoxide to produce sucralose.”  (Note that methanol, wood alcohol aka paint remover,  is one of the questionable ingredients in aspartame.)

In addition, the bags and packets of Splenda commercially available are not pure sucralose.  They also contain bulking agents.  All artificial sweeteners use bulking agents.  Do you know what they use?  Sugar.  Dextrose, sucrose, and maltodextrin.  (Maltodextrin is corn syrup solids composed primarily from fructose and glucose in a starch form.)   All sweetener packets are at least 96 percent sugar.  Splenda is 99% sugar.

The packets are labelled calorie free as a result of manipulating a loophole in the food labeling laws.  The product can be described as sugar free if a serving contains less than 5 grams of sugar, and calorie free if a serving is less than 5 calories.  So they set the serving size on bags at .5 grams  and the packets contain a serving of 1 gram.  A one gram packet contains 4 calories.   This can be confirmed on the manufacturer’s website in the FAQ section:  â€œLike many no and low calorie sweeteners, each serving of SPLENDA® No Calorie Sweetener contains a very small amount of common food ingredients, e.g., dextrose and/or maltodextrin, for volume. Because the amount of these ingredients is so small, SPLENDA® No Calorie Sweetener still has an insignificant calorie value per serving and meets FDA’s standards for “no calorie” sweeteners. “

To make matters worse, when sucralose was shown to not raise blood sugars, it was the pure substance that was tested, not the mixture that is sold to the public.  Dextrose, sucrose, and/or maltodextrin are definitely going to raise a diabetic’s blood sugar.  There is also a great deal of evidence that artificial sweeteners actually cause an increase in appetite, causing people who consume them to take in more calories than they would otherwise.

Stevia, on the other hand, lowers blood sugar, making it a much better choice.  If you have tried stevia in the past and did not like the flavor, you might want to try another brand. ..."

If your looking for a more nutritious "sweetner" you should try adding half a cup of coconut water. Delicious!

Ps. I love your blog. Keep up the great work!

Tapioca starch in the almond milk, but not enough to hurt you.

I enjoy your blog. You have a good thread about the hazards of hyperglycemia.
However, this recipe is not one I would recommend to patients attempting to reverse metabolic syndrome, T2D, or IR.
Their main concern is the inflammation caused by the above listed disorders. The omega 6 content of the peanut butter, sunflower seed, and to an extent, almond butter would exacerbate the inflammation mitigated by the hyperglycemia.
In addition, sugar alcohols (xylitol, erythritol) tend to cause GI upset (gas, diarrhea). Also the hazards of Sucralose are intuitively obvious....it contains chlorine molecules....commonly found in many household cleaners, and of course used in WWI as a pulmonary choking agent.
I would only use macadamia nuts/nut butter, and Stevia to sweeten.
Dr. John

Thanks, Dr. John.

I hear you on the sucralose issue. I've actually been having positive experiences with stevia, xylitol, and erythritol. The important thing is that people have some good choices nowadays, unlike 20 years ago when we had saccharine . . . period.

There is no question that mannitol and sorbitol have greater potential for both GI distress (diarrhea) as well as increases in blood glucose, so these are clearly on the no-no list (unless you need a quick laxative).

Sucralose is not metabolized.  Most of it is excreted unchanged in the feces.  A small percentage is absorbed and excreted unchanged in urine.  

Sodium in food is more of a concern for a person who experiences migraine headaches.  Over-activity of muscles activated by the Trigeminal nerve due to airway resistance secondary to water retention is a greater concern.  Various factors are present both anatomically and physiologically in people who experience migraine.  The only way to determine if sucralose is actually the cause of a migraine is to consume sucralose on its own.

What concerns me is what happens to the sucralose in the environment.  The addition of a chlorine atom, (not a molecule, Dr. John) results in a molecule which cannot be metabolized by bacteria.  If environmental degradation is possible, then sucralose excreted by human beings is not an issue.  But if it persists in the environment, then it is a pollutant.

I am practically a fruitarian, so much of what I like would be off limits.
Is there an article here on what IS recommended?

Yes, atoms, not molecules...ie. precisely 3 atoms of chlorine/molecule of sucrose...

An interesting thing about this selective halogenation of sucrose, is the fact that sucralose (being 600 times as sweet as sucrose), increases the HbA1c numbers in my patients. This demonstrates a lessening of diabetic control. Thus, hemoglobin gets glycated and fasting blood sugar increases....with the attendant hyperglycemia issues as mentioned, and this excellent blog site.

For this reason I do not recommend sucralose for diabetics nor anyone wanting to keep blood sugar levels within normal limits. The current cost and future costs for diabetes will cripple our healthcare structure. Here are ADA numbers:

$174 billion: Total costs of diagnosed diabetes in the United States in 2007
$116 billion for direct medical costs
$58 billion for indirect costs (disability, work loss, premature mortality)

Dr. John

Dr. John, is it possible that other factors contribute to higher H1ac levels in your type 2 diabetic patients?  

Since sucrolose is not metabolically active and does not act as a laxative, then there could be other endocrinological and neurological reasons for higher glucose levels.

Here's an abstract on sucralose and Type 2 diabetes:

Grotz VL, Henry RR, McGill JB, Prince MJ, Shamoon H, Trout JR, Pi-Sunyer FX. Lack of effect of sucralose on glucose homeostasis in subjects with type 2 diabetes. J Am Diet Assoc. 2003 Dec;103(12):1607-12.

OBJECTIVE: To investigate the effect of 3-months' daily administration of high doses of sucralose, a non-nutritive sweetener, on glycemic control in subjects with type 2 diabetes. DESIGN: A multicenter, double-blind, placebo-controlled, randomized study, consisting of a 6-week screening phase, a 13-week test phase, and a 4-week follow-up phase. SUBJECTS/SETTING: Subjects with type 2 diabetes (age range 31 to 70 years) entered the test phase of this study; 128 subjects completed the study. The subjects were recruited from 5 medical centers across the United States and were, on average, obese. INTERVENTION: Subjects were randomly assigned to receive either placebo (cellulose) capsules (n=69) or 667 mg encapsulated sucralose (n=67) daily for the 13-week test phase. All subjects blindly received placebo capsules during the last 4 weeks of the screening phase and for the entire 4-week follow-up phase. MAIN OUTCOME MEASURES: Glycated hemoglobin (HbA1c), fasting plasma glucose, and fasting serum C-peptide were measured approximately every 2 weeks to evaluate blood glucose homeostasis. Data were analyzed by analysis of variance using repeated measures. RESULTS: There were no significant differences between the sucralose and placebo groups in HbA1c, fasting plasma glucose, or fasting serum C-peptide changes from baseline. There were no clinically meaningful differences between the groups in any safety measure. CONCLUSIONS: This study demonstrated that, similar to cellulose, sucralose consumption for 3 months at doses of 7.5 mg/kg/day, which is approximately three times the estimated maximum intake, had no effect on glucose homeostasis in individuals with type 2 diabetes. Additionally, this study showed that sucralose was as well-tolerated by the study subjects as was the placebo.

PMID: 14647086 [PubMed - indexed for MEDLINE]

Now, I can understand how sugar alcohols taken in large quantities might have some effect on blood sugar because they are laxative and increase gut motility and cause discofort or pain, both of which will spike blood sugar values. the liver dumps glucose into the bloodstream when the body is under stress like this.  And of course, the pancreas reacts very sluggishly to endogenous glucose.

I think type 2 diabetics should have routine sleep study screening to determine whether breathing issues during sleep may be upramping the sympathetic nervous system and causing high sugar levels during sleep. We can't just help these people improve their life quality by looking at only one parameter.

They need otolaryngological evaluation for anything from deviated nasal septa to chronic allergies, enlarged adenoids and tonsils.  The size of their jaws, how they function and tongue posture also factors in.

Not to mention, anyone with pulmonary issues would have increased effort on breathing...asthma, pulmonary hypertension etc.  The existance of chronic pain and anxiety conditions also influence how the body produces its own glucose.  

Patient's require a multi-disciplinary workup to determine the multiple factors that result in the development of type 2 diabetes.  It's not merely diet because these people have an awfully hard time changing their diets without having other problems addressed.

Excellent! Dr. Davis, you have had many posts of what not to eat but very few on what we should eat. Taking something out of our diet means we have to replace it with something. This post seems to be in the right spirit. I am going to try this soon. Now if only you can post a similar substitute for Keva Juice's Oreo Speedwagon smoothie! Yes, I know they are hazardous to your health but they are wickedly good!

-- Boris

I'm not totally convinced why sucralose, a chloro-carbon, similar to DDT and PCBs, would elevate the HgA1c levels. My guess would be a neurological response to an ingested poison. Sucralose does kill intestinal beneficial bacteria...lactobacillus, bifidobacteria, and bacteroides...of varying amounts of 37-67%...and the enteric nervous system would react by elevating cortisol/adrenaline/glucagon: while at the same time not delaying gastric emptying.
Body perception is stress....glycation of RBCs result, with CVD and sudden cardiac death.

Studies that use diabetic, and obese subjects in the assessment of A1c elevation are biased from the start. These individuals have already lost glycemic control and as a result would not have normal A1c levels to begin with...let alone studying their response 13 weeks later.

McNeil Nutritionals, maker of SPLENDA® Brand products, stated it has provided the American Diabetes Association (ADA) with a sponsorship to support the Association's efforts to fund research, information and advocacy programs on behalf of people with diabetes.
And McNeil Nuts. are owned by Johnson and Johnson, who are large contributors to the ADA...the journal of the previously listed biased study showing the sucralose doesn't affect A1c levels...in spite of the fact in clinical results showing the opposite.

Anything, sucrose or sucralose, that elevates A1c levels is cardio-lethal...and is best avoided.

Dr. D,
Do you use regular coconut milk or the lite? Does it make a difference, except calorically?

Thanks!

Jeanne

I am allergic to the artificial sweeteners. Thought I could tolerate sucralose but it just took a little time for a reaction. My mouth and throat became inflamed and I had sore bumps all over the inside of my throat and back of my mouth after about a week.

I don't like stevia or the other natural no calorie sweeteners either...they just don't taste sweet to me or have odd flavors.

But I found something.  It is not calorie free, but it has low glycemic index and tastes just like sugar.  It is "Organic Blue Agave". What are a few calories in exchange for some actual taste.

I bought it at Costco.

""Organic Blue Agave". What are a few calories in exchange for some actual taste."

High fructose corn syrup (HFCS) is about 55% fructose and cause inflammation, insulin resistance, and elevates triglycerides.  Agave syrup is often 70% or higher (possibly as high as 90%) fructose!  Marketing scam...

It's about time SOMEBODY started telling the truth about the heart disease "plumbing" racket!

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?

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

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!

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

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

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.

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-

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.

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

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.