Heart Scan Blog by Dr William Davis
To get low-carb right, you need to check blood sugars
http://tinyurl.com/yhyslev
Posted: 19 Jan 2010 05:42 AM PST
Reducing your carbohydrate exposure, particularly to wheat, cornstarch,
and sucrose (table sugar), helps with weight loss; reduction of
triglycerides, small LDL, and c-reactive protein; increases HDL;
reduces blood pressure. There should be no remaining doubt on these
effects.
However, I am going to propose that you cannot truly get your low-carb
diet right without checking blood sugars. Let me explain.
Carbohydrates are the dominant driver of blood sugar (glucose) after
eating. But it's clear that we also obtain some wonderfully healthy
nutrients from carbohydrate sources: Think anthocyanins from
blueberries and pomegranates, vitamin C from citrus, and soluble fiber
from beans. There are many good things in carbohydrate foods.
How do we weigh the need to reduce carbohydrates with their benefits?
Blood sugar after eating ("postprandial") is the best index of
carbohydrate metabolism we have (not fasting blood sugar). It also
provides an indirect gauge of small LDL. Checking your blood sugar
(glucose) has become an easy and relatively inexpensive tool that just
about anybody can incorporate into health habits. More often than not,
it can also provide you with some unexpected insights about your
response to diet.
If you’re not a diabetic, why bother checking blood sugar? New studies
have documented the increased likelihood of cardiovascular events with
increased postprandial blood sugars well below the ranges regarded as
diabetic. A blood sugar level of 140 mg/dl after a meal carries 30-60%
increased (relative) risk for heart attack and other events. The
increase in risk begins at even lower levels, perhaps 110 mg/dl or
lower after-eating.
We use a one-hour after eating blood sugar to gauge the effects of a
meal. If, for instance, your dinner of baked chicken, asparagus brushed
with olive oil, sauteed mushrooms, mashed potatoes, and a piece of
Italian bread yields a one-hour blood sugar of 155 mg/dl, you know that
something is wrong. (This is far more common than most people think.)
Doing this myself, I have been shocked at the times I've had an
unexpectedly high blood sugar from seemingly "safe' foods, or when a
store- or restaurant-bought meal had some concealed source of sugar or
carbohydrate. (I recently had a restaurant meal of a turkey burger with
cheese, mixed salad with balsamic vinegar dressing, along with a few
bites of my wife's veggie omelet. Blood sugar one hour later: 127
mg/dl. I believe sugar added to the salad dressing was the culprit.)
You can now purchase our own blood glucose monitor at stores like
Walmart and Walgreens for $10-20. You will also need to purchase the
fingerstick lancets and test strips; the test strips are the most
costly part of the picture, usually running $0.50 to $1.00 per test
strip. But since people without diabetes check their blood sugar only
occasionally, the cost of the test strips is, over time, modest. I've
had several devices over the years, but my current favorite for
ease-of-use is the LifeScan OneTouch UltraMini that cost me $18.99 at
Walgreens.
Checking after-meal blood sugars is, in my view, a powerful means of
managing diet when reducing carbohydrate exposure is your goal. It
provides immediate feedback on the carbohydrate aspect of your diet,
allowing you to adjust and tweak carbohydrate intake to your individual
metabolism.