Friday, December 13, 2019

Retrospective #300: ‘Sugar’ in Food and Blood: a primer on carbohydrates

I saw an ad on TV a while ago for a diabetes drug. The ad explains that, “It (the drug) removes some sugar from your body.” I talked back to the TV and asked, “But how did the sugar (that the drug removes) get into your body in the first place?!!!” And that suggested the corollary question, “If you didn’t eat so many carbohydrates, wouldn’t you have less “sugar” to “remove from your body”? Which begs the question: What foods become “sugar” (glucose) in your blood in the first place? What foods convert to glucose? The answer is: ALL CARBOHYDRATES.
I put sugar in quotes because I am not referring to table sugar. The copywriter and I are referring to “blood sugar” (glucose), the compound that carbohydrates break down into by digestion or conversion by the liver. Table sugar (sucrose), for example, breaks down into fructose and glucose, and dairy carbohydrates break down into galactose and glucose, but starches, which are also ALL carbohydrates, are long-chain glucose molecules that break down to just simple glucose. This monosaccharide glucose, commonly called “blood sugar” or just “sugar,” is what the ad refers to.
If you have been diagnosed with Prediabetes or Type 2 diabetes, it is because you have a high blood “sugar” level. You first developed a precursor condition, Impaired Glucose Tolerance, which progressed to Impaired Fasting Glucose. These conditions collectively are called Insulin Resistance (IR). Insulin secreted by your pancreas is required to move the glucose in the bloodstream and “open the door” to your cells to “take up” the glucose for energy. Insulin Resistance means the “door” is partially blocked; glucose isn’t being taken up by your cells as quickly as it should, so the pancreas sends more insulin. Meanwhile, as the glucose builds up to high levels, it damages your organs and small blood vessels. And you are at high risk for a multitude of diseases. This unifying condition is called Metabolic Syndrome.
Most people who are newly diagnosed Prediabetics or Type 2 diabetics are surprised to learn the “sugar” (glucose) content of common foods. But how much “sugar” do carbohydrates make? To understand the answer in context you need to know how much “blood sugar” is “normal,” that is, normally circulating in the blood of a person (before a meal) who has a normal glucose metabolism. The answer is surprisingly low; it’s 1 teaspoon (5 grams). See Retrospective #232, “A spoonful of sugar.” For an explanation of the math, search the blog of Michael Eades, MD.
As Dr. Eades points out, a diagnosis of Type 2 diabetes is having a “sugar” (glucose) level in your blood equivalent to just 1¼ tsp. Yet, a McDonald’s “small” Coke (16oz) has 8 tsp of sugar, a Big Mac 9 tsp of “sugar,” a large fries 13 tsp of “sugar,” a large chocolate McCafé shake (22oz) 28 tsp of “sugar,” a bagel 10 tsp of “sugar,” a low-fat chocolate milk 5 tsp of “sugar,” a baked potato 7 tsp and an 8 oz container of low-fat fruit yogurt 9 tsp of “sugar.”  For these and more examples, search
If the door to your cells is partially closed by Insulin Resistance, can you really afford to eat 30, 40, 50 times more “sugar” in one meal than your body can handle? Do you really want to become more and more dependent on drugs to take the “sugar” out of your blood that you put into it? You do have a choice, you know. Self management works.
 You don’t have to go crazy. You just need to be aware of what your body can handle (by testing your blood sugar), and be guided accordingly in your food choices. If you don’t, the disease you have acquired (on the government’s advice!) by eating “low fat” and too many foods too high in processed carbohydrates and added sugars for too long will damage your body, and shorten your life…
That’s the choice you have to make. I’m not trying to scare you. I’m trying to educate and inform you about how you can make better choices. You probably know this. I hope you now feel empowered to take the steps you need to take. 

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