Very awesome study...I love when people get so worked up over how natural foods must be better.
The way I like to think about blood sugar is not necessarily how fast it "spikes sugar" but how does it change your overall resistance to insulin (For a type 2 diabetic)? Did they use hemoglobin A1c as the testing measure? The way to measure actual insulin resistance most accurately would have been to get a c-peptide as well.
The microbiology part is also fascinating and one I had not considered. Maybe probiotics in general can help with type 2....
As a Type 1 diabetic I have noticed personal trends in blood sugar from years of having it and science backs this up. If you eat candy it's a simple sugar so it hits the systemic blood stream in less than 10 minutes. Fruit will do the same thing ( always annoying when Type 2 diabetics think it's healthy for them to eat LOTS of fruit...I see no scientific data in that because fruit often can be high calorie and spike blood sugar). Bread and rice tend to raise sugar in about 30 minutes because it takes time for the complex carbs to be broken down into simple sugars.
I always like to prove to people that bread is sugar by having them suck on a thin cracker. That cracker in your mouth will break down into simple sugars and you can start to taste the sweetness of it.
Thanks for providing more clarity on this topic. Carbs in general should try to be very limited from a Type 2s diet bottom line.
Did they use hemoglobin A1c as the testing measure? No they used an oral glucose test, which is not nearly as accurate. However as far as I know A1c is a good measure of average blood glucose over a long period of time and is great for identifying diabetics, however it is less useful for monitoring rapidly changing blood glucose, as the attachment of glucose to hemoglobin is not a real time process.
Yep, our spit contains amylase which does the breaking down of the long chain polysaccharides into single sugars.
Good ol' amylase. I understand why they were measuring oral glucose but there is not great data necessarily showing that spikes in sugar lead to more health complications than a bad average blood sugar over 3 months.
Lets say that a food like candy spikes the sugar to 300 mg/dl and bread raises if to 230 mg/dl over a longer period of time. The A1c, in my opinion, would be a better predictor on what is better to eat haha. So, the study would need to carry on for at least 3 months.
Again, thanks for writing this!
This is a very good point
Going to have to #BTFO on that anti-fruit conspiracy.
http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices/fruits.html
Or better yet as that's a industry funded pile of garbage;
https://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines/news/2017-04-12-daily-diet-of-fresh-fruit-linked-to-lower-diabetes-risk/
Or if you don't mind a real life example;
http://mindfuldiabetic.com/
He has a youtube channel too, all he eats is sugary fruits and he's a type 1 diabetic and has helped thousands of other diabetics over the years.
Fruit raises blood sugar slower as it has way more fiber than most rices do, as well as lower fat than what you would likely typically eat with your rice or bread.
You're right that they turn into sugar, yes, all carbohydrates must be broken down to simple sugars to be used by the body, but fruit is hardly the devil here.
I don't disagree with the conclusion of the pubmed article. People who eat fresh fruit may have had better outcomes. However, are there other confounding variables?
For instance, maybe those who ate fruit chose to eat healthier overall, lost weight, and hence had less insulin resistance due to weight loss, leading to better glucose levels. There is for sure a correlation here, but a correlation does not necessarily mean it's a causation.
Eating fruits especially lower sugar fruits like cantaloupe are fine. Drinking the juice of fruit does not have the "fiber" and will lead to faster sugar spikes. When I think of diabetic complications, I think less about blood sugar spikes and more about average blood sugar over three months because there is much more data we can relate to that in relation to complications.
As far as the Type I diabetic....I am Type I myself. We make no insulin so we have to take insulin. Theoretically we can eat anything we want as long as we know how to count the exact carbohydrates in relation to the amount of insulin we need. So a Type I diabetic can eat sugar and still be in perfect control.
When I say limit fruit, I mean a Type II diabetic who does not take insulin. If I have a patient come in who is eating lots of sugary fuits...AND is losing weight, then I will not tell them to stop. Weight loss is the most important; if fruit makes them eat less calories, then great!
Again, I am not looking at spikes in sugar; I am looking at the overall average blood sugar, which we can relate directly to complications.
If you're not talking about blood sugar spikes I'd say there's even more of a reason for people to eat fruit as fruit is extremely low in fat (aside from avocados, etc) because lower fat means better insulin levels (type 2) in general as insulin resistance is almost entirely determined by fat in the bloodstream blocking glucose from entering cells.
Juice, yeah, that's horrible for diabetics, even if you're doing lots of exercise it's just a disaster.
https://www.ncbi.nlm.nih.gov/pubmed/15650564
If not fruit what could a diabetic possibly eat in it's place? There's no better carb in general other than potentially sweet potatoes, and it's unadvisible to have any more fat than absolutely necessary, and lean protein is rare to find unless it's in plant-sources as well is generally not beneficial to ones overall health in excess. Furthermore protein also requires insulin to metabolize, thus increasing insulin needed and thus insulin resistance.
I would disagree with some of your discussion on protein. While insulin is involved in protein metabolism, it does not elevate blood sugar. If you give a Type I diabetic a steak with no short-acting insulin, you will not see much increase in their blood sugar.
Furthermore, you talk about resistance. Resistance has everything to do with fat...as in excess weight in an individual...however, if a skinny individual eats fat it is not like that specific fat is floating around the bloodstream causing insulin resistance.
High fat foods should be discouraged because of its potential for weight gain. Sugar will eventually lead to more fat storage as well.
https://www.ncbi.nlm.nih.gov/pubmed/9416027
My recommendations: Eat the meals that are lower in carbs and eat protein that is lower in fat. If you do this, you will decrease your overall calories, lose weight, and have less insulin resistance.
you know most crackers also have white sugar in them?