PDF Summary:Glucose Revolution, by Jessie Inchauspé
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Do you often get hungry soon after eating? Do you feel tired and out of sorts throughout the day? If so, you may be experiencing glucose spikes. In Glucose Revolution, biochemist Jessie Inchauspé explores glucose’s role as our body’s primary energy source while also examining the adverse consequences of too much glucose. She argues that glucose spikes are at the center of most common health issues and offers a collection of strategies for taking control of your health by stabilizing your glucose levels.
In this guide, you’ll learn the basics of where glucose comes from and how it works in the body. We’ll also explore various diseases and conditions that can result from repeated glucose spikes over time and Inchauspé’s strategies for preventing these negative effects by stabilizing your glucose levels. Finally, we’ll examine alternative methods for managing glucose levels and take a closer look at some of the medical advancements Inchauspé references.
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(Shortform note: The term oxidative stress derives from the fact that most free radicals contain oxygen. The chemical reactions that free radicals cause in the body with their odd number of electrons are called oxidation. Antioxidants—molecules that can offer an electron to a free radical and remain stable—are the body’s solution for this. Damage to our cells and organs happens when there are more free radicals than the antioxidants in our body can handle. Antioxidants in your diet come from foods like berries, dark leafy greens, nuts, and fish.)
Glycation
Glycation is another process that frequent glucose spikes exacerbate. It happens when glucose molecules touch other molecules in the body. Glucose damages the other molecules and literally cooks and browns our insides. Once a molecule is glycated, it’s damaged forever. This process is the main reason why we age and our organs decline, eventually leading to death. It’s unavoidable, but the speed of the process can be increased or decreased. Glucose spikes speed glycation up since more free glucose molecules are administered to the body at once.
Advanced Glycation End Products
Glycation damages the body when it forms advanced glycation end products (AGEs), which form when fat or protein combines with sugar in the bloodstream. AGEs are dangerous compounds: When they accumulate too quickly, the body can’t get rid of them, and they eventually lead to oxidative stress, inflammation, and various diseases. However, a healthy body can eliminate them with antioxidants and enzymes before they cause too much damage.
Eating too much glucose can speed up glycation and lead to the build-up of AGEs, as Inchauspé states, but that’s not the only way this happens—we also consume secondary AGEs in the cooked food we eat. Foods cooked with dry heat using methods like grilling, barbecuing, roasting, baking, toasting, and frying contain AGEs. When we consume too many, they accumulate faster than our bodies can eliminate them. Foods that are high in protein and fat and come from animals are more likely to contain high levels of AGEs from cooking.
Glucose Spikes and Health Problems
In the last section, we covered the basics of where glucose comes from, how it works in the body, and how too much of it causes stress in the body on a molecular level.
In this section, we’ll examine how frequent glucose spikes—and the corresponding effects of increased free radicals, oxidative stress, and glycation—contribute to many acute and chronic health conditions, including the following:
Type 2 Diabetes
According to the author, type 2 diabetes is the condition that’s most commonly associated with increased glucose levels. It results from the relationship between glucose and insulin: First, as previously noted, when we experience glucose spikes, the pancreas releases insulin to store away the excess glucose as glycogen in the liver, muscles, and fat. The more glucose there is, the more insulin is released, and the more glucose has to be stored as fat.
Second, as the pancreas releases more and more insulin, our cells become resistant to the hormone. Because of this resistance, larger quantities of insulin are needed to store the same amount of glucose as glycogen.
Eventually, the storage system fails—the body can’t store glucose as glycogen anymore. With nowhere and no way to store glucose molecules, their concentration in our bodies increases permanently.
Screening for and Preventing Type 2 Diabetes
Type 2 diabetes is a well-known disease because it’s extremely prevalent—the CDC states that nearly half of US adults have type 2 diabetes or prediabetes. Still, it’s estimated that over 80% of people with prediabetes and a quarter of people with diabetes aren’t diagnosed.
This is a serious problem, as unchecked type 2 diabetes can have heavy consequences on the body. For example, persistently elevated glucose levels that arise when the body can’t store glucose anymore—the condition known as hyperglycemia—can cause numerous other health issues such as vision loss, nerve damage, kidney disease, and slow wound healing.
Many clinicians recommend being screened for diabetes if you’re between 35 and 70 years old, especially if you’re overweight—the earlier both prediabetes and type 2 diabetes are diagnosed, the easier they are to treat.
You can also make changes to your lifestyle that help prevent type 2 diabetes and even reverse the effects of prediabetes. For example, some research indicates that coffee may help prevent type 2 diabetes by lessening the effects of insulin resistance. One study found that having an extra cup of coffee a day reduced the risk of diabetes in participants by 4% to 6%.
Increased coffee consumption led to lower levels of markers that indicate inflammation and higher levels of anti-inflammatory markers. Specifically, coffee consumption increased levels of one anti-inflammatory marker called adiponectin, which helps make the body more sensitive to insulin and lower glucose levels. (However, if your glucose levels are particularly sensitive to caffeine, as we explored earlier, excessive coffee consumption may exacerbate your glucose-related health issues.)
Heart Disease
Inchauspé states that elevated glucose levels and frequent glucose spikes can also lead to heart disease in the long term. This is because glucose spikes contribute to cholesterol accumulation beneath the lining of our blood vessels, which sets off heart disease.
(Shortform note: In addition to damaging blood vessels by causing cholesterol accumulation, persistently high glucose levels damage the nerves that control the heart and blood vessels. This nerve damage further contributes to heart disease and increases your chance of having a stroke. People with high glucose levels from diabetes are almost twice as likely to experience heart disease or stroke.)
How do glucose spikes lead to cholesterol accumulation? The cells lining our blood vessels are highly susceptible to mitochondrial stress, which glucose spikes directly contribute to. When experiencing mitochondrial stress, the blood vessel lining’s cells go from even to irregular in shape, making it easy for cholesterol to get caught in the grooves of the lining.
(Shortform note: Research has increasingly focused on the role of mitochondrial dysfunction in the development and progression of vascular diseases (diseases relating to the body’s vessels, especially blood vessels), particularly atherosclerosis, or the buildup of fat on the inner walls of arteries. High glucose levels exacerbate oxidative stress and inflammation, two conditions linked to atherosclerosis. There’s ongoing research into potential therapeutic interventions targeting mitochondrial damage and dysfunction for the treatment of vascular diseases, including treatments that suppress mitochondrial production of free radicals called reactive oxygen species.)
Additionally, when our glucose levels make our insulin levels too high, our liver begins producing a small type of cholesterol called LDL pattern B that gets stuck more easily on the edges of blood vessels than other types of cholesterol. High levels of glucose, fructose, and insulin contribute to the oxidization of LDL pattern B, making it even more likely to stick under the lining of our blood vessels. Finally, we experience heart disease when enough cholesterol accumulates to start hindering our blood flow.
(Shortform note: Cholesterol is a type of fat, and it must be connected to a protein to travel through the body. LDL cholesterol is a type of lipoprotein—a particle made of fat and protein. Specifically, it’s a low-density lipoprotein, meaning it contains more fat than protein. LDL cholesterol delivers fat to the cells as needed. In contrast, HDL cholesterol (or high-density lipoproteins) brings cholesterol to the liver, which eliminates the cholesterol from the body. Though research supports Inchauspé’s idea that the prevalence of small, sticky LDL pattern B cholesterol is connected to external factors such as glucose levels, there’s also a genetic component to the size of our LDL cholesterol.)
Cancer
According to the author, glucose spikes can increase our risk of cancer in three ways:
First, the increased number of free radicals that result from glucose spikes can increase our risk of dangerous DNA mutations. Studies suggest that this may be how cancer begins.
(Shortform note: Other factors beyond glucose spikes can lead to the proliferation of cancer-causing, DNA-altering free radicals, including tobacco smoke, UV radiation, environmental and occupational chemicals, air pollution, medical radiation, and certain viruses. Free radicals are most likely to cause cancer when they alter tumor suppressor genes that direct repairs of damaged DNA. Mutations in these genes are the primary reason cancer cells form.)
Additionally, high glucose levels lead to chronic inflammation, which encourages the rapid increase of cancer cells. Generally, inflammation is one way for the body to defend against harmful intruders, such as viruses and bacteria. However, the body attacks itself when it’s chronically inflamed, leading to tissue and organ damage.
(Shortform note: Inflammation happens when the body responds to pathogens by producing chemicals in immune cells that kill the intruders. However, these chemicals can also alter DNA in healthy cells, which increases the likelihood of cancer-causing mutations. Symptoms of chronic inflammation may not be obvious at first, making it harder to prevent it from developing into more serious conditions. Typical indicators of chronic inflammation include muscle and joint discomfort, weight gain and unexplained weight loss, sleep disorders, skin problems, frequent infections, digestive problems, fever with an unknown cause, and mood disorders.)
Finally, high levels of insulin that result from elevated glucose levels make cancer spread faster, increasing the likelihood that we’ll die from it. (Shortform note: Increased insulin levels offer more opportunities for cancer cells to develop because insulin encourages cell production and decreases cell death. The more cells your body grows and the fewer that die, the more likely it is that some will develop into abnormal cancer cells. Specifically, research has linked high insulin levels with increased risk of colorectal, breast, and prostate cancers.)
Mental Health Issues and Cognitive Decline
Inchauspé also describes how glucose spikes can contribute to mental health struggles and cognitive decline. First, research suggests that people who eat diets that lead to frequent glucose spikes experience more mood disturbances and instances of depression than people whose diets result in more stable glucose levels.
(Shortform note: MRI data suggest that elevated glucose levels can lead to depression because they hinder connections in a part of the brain that regulates emotions and self-perception, which seriously affects people’s moods. Additionally, consistently high glucose levels contribute to the dysregulation of glutamate, a neurotransmitter that’s associated with bipolar disorder and major depressive disorder.)
Second, glucose spikes can contribute to the development of cognitive diseases such as Alzheimer’s. When the mitochondria in brain cells get overloaded with glucose after repeated glucose spikes, they go into oxidative stress. This then causes neuroinflammation, which can turn into cognitive decline as brain cells get damaged.
(Shortform note: The damaging effects of high glucose levels on the brain come from more than just mitochondrial stress—they also stem from the insulin resistance caused by consistently elevated glucose levels. Too much glucose means the body produces too much insulin, and over time, this can make it more difficult for insulin to enter the brain. Without enough insulin, the brain can’t process enough glucose to power its numerous cognitive processes. Cells in the hippocampus—the memory center of the brain—are especially vulnerable to insulin deficits, which explains why glucose-related brain diseases like Alzheimer’s involve loss of memory.)
Cravings and Hunger
Finally, according to the author, glucose spikes can cause various issues related to our relationship with food, including food cravings and too-frequent hunger.
Food cravings typically happen during the crash following a glucose spike. Studies indicate that when our glucose levels drop, we crave high-calorie foods. For example, during a glucose crash, we’re more likely to choose a slice of pizza over a salad.
(Shortform note: In addition to craving high-calorie foods, we also often crave high-carb foods when our blood sugar is low, such as during a glucose crash. We do so partly because they increase feel-good neurochemicals in our body like serotonin (which evens out our mood) and endorphins (which help us feel calm).)
Additionally, we may experience too-frequent hunger when we have glucose spikes. This is because frequent glucose spikes lead to high insulin levels, and too much insulin can block the hormone leptin, which tells us when we’re full. Then, ghrelin—the hormone that indicates hunger—becomes more active, pushing us to eat more. Thus, when our glucose levels are dysregulated, we get hungry as soon as two hours after eating.
(Shortform note: Leptin is made in the fat cells, and it regulates long-term weight control. Ghrelin is synthesized in the stomach, and it has more to do with short-term appetite control. In addition to its role in regulating hunger, ghrelin increases fat storage, prompts the movement of food from the stomach to the intestines, and stimulates the release of growth hormones from the pituitary gland. Finally, ghrelin helps direct the release of insulin. Thus, when glucose spikes lead to overactive ghrelin, the way we store fat, gain weight, and digest food can all be disrupted and changed.)
Strategies for Stabilizing Your Glucose Levels
Now that we’ve discussed some of the most dangerous and unpleasant effects of glucose spikes, we’ll touch on some of Inchauspé’s strategies for preventing them. In this final section, you’ll learn methods for stabilizing your glucose levels, including how to eat and what to eat.
How to Eat to Prevent Glucose Spikes
According to Inchauspé, the key to preventing glucose spikes isn’t just in what you eat—it also matters how you eat your food. The following strategies can help you stabilize your glucose levels without requiring you to give up anything you like to eat:
Strategy #1: Eat Fiber First
Inchauspé argues that you can dramatically reduce glucose spikes by simply changing the order in which you eat your food. Start your meal with fiber, then eat proteins and fats, and finish with starchy and sweet carbohydrates.
(Shortform note: Regulating glucose levels by changing the order in which you eat may help people who aren’t able to change their diet by altering what they eat. There are many factors that influence our food choices, including socioeconomic class, religion, and family. If money is a barrier, for example, someone may be unable to afford to change their food choices, so being able to simply change the order of their meal makes this strategy accessible.)
Studies indicate that this eating order is as successful at preventing glucose spikes as diabetes medications targeted toward the same issue.
(Shortform note: Research supports the idea that eating in the order Inchauspé recommends can significantly reduce glucose spikes in diabetes patients. In one study, when patients with type 2 diabetes ate fiber and protein before carbohydrates, they showed a 29%, 37%, and 17% decrease in glucose levels at 30 minutes, 60 minutes, and 120 minutes after their meal, respectively.)
According to Inchauspé, you should eat fiber first because it prevents glucose from being absorbed into your bloodstream too quickly, thus preventing harmful spikes. Fiber accomplishes this in three ways. First, it slows the activity of the enzyme alpha-amylase. As a result, your body breaks down starch into glucose more slowly.
(Shortform note: Researchers are trying to isolate the plant compounds and fibers that inhibit alpha-amylase as a potential treatment for type 2 diabetes. Synthetic options for drugs that have the same effect have a lot of unwanted side effects, so natural compounds and fibers could be a better alternative. For example, one study examined grape pomace, a waste product of the wine industry, for its enzyme-inhibiting potential.)
Second, fiber reduces the speed at which your stomach contents empty into your intestines. Glucose is absorbed into the bloodstream through your intestines, so this slowing effect ensures that you won’t get too much too quickly.
(Shortform note: The slowing effect of fiber on digestion specifically comes from soluble fiber, or fiber that can dissolve in water. Soluble fiber draws water into the digestive tract and forms a gel, allowing for slower, more successful nutrient absorption. In contrast, insoluble fiber—fiber that doesn’t dissolve in water—speeds up the digestive process and adds bulk to your stool. Both types are integral to a healthy diet.)
Finally, fiber creates a permeable barrier in your small intestine that makes it harder for glucose to pass through it into the bloodstream, preventing too many molecules from entering at once. (Shortform note: Studies suggest that a lack of dietary fiber leads to the thinning of the intestinal lining, which makes your intestines more permeable. This has implications beyond quick glucose absorption—a too-permeable gut lining can have negative effects on your immune health and leave your gut vulnerable to pathogens.)
Inchauspé suggests making a vegetable dish the first course of every meal, so you never forget to start with fiber. (Shortform note: If creating vegetable dishes for every meal sounds intimidating, consider looking online for high-fiber recipes that can serve as starters. For example, NYT Cooking has a whole page devoted to high-fiber dishes, and the Mayo Clinic has a list of high-fiber recipes organized by category.)
Strategy #2: Eat Fats and Proteins Second
Inchauspé expands on her advice, stating that eating fats and proteins second further amplifies the beneficial effects of lowered glucose spikes—fats and proteins also prevent the stomach from emptying too quickly, thus blocking rapid glucose absorption. You can still eat sweet foods and starches during your meal if you want, but they won’t have such a negative effect if you eat them last.
(Shortform note: In addition to slowing digestion, fats and proteins make us feel full for longer. Fats are the last macronutrient to leave our digestive tract, so they play an important role in making us feel satiated. Just like it’s better to eat unprocessed carbs, it’s best to eat whole, unprocessed fats like avocados, nut butter, and olive oil. Further, studies suggest that peptides, the digested versions of dietary proteins, block certain chemicals in nerve cells that make us want to eat more. By curbing our appetites, this prevents us from eating too much. If we’ve eaten proteins and fats before carbs, these feelings of fullness will make us less likely to overindulge in glucose-heavy foods.)
Alternatively, if you eat your starchy and sugary carbs first, they move swiftly to your small intestine, and there’s nothing to slow their breakdown into glucose molecules. The glucose enters your bloodstream in a large, quick influx, causing a spike. (Shortform note: Not all carbs enter your bloodstream at the same rate. The speed at which you digest and absorb a carb is called its glycemic response. Foods with high glycemic responses break down quickly, while foods with low glycemic responses enter the bloodstream slowly and steadily.)
Strategy #3: Avoid Eating Carbs by Themselves
Inchauspé acknowledges that it isn’t always possible to eat the food types separately and in the right order—sometimes, you’re in a rush and can’t plan a balanced meal. Other times, you might be eating a dish that contains all the food types at once, like soup. (Shortform note: If you want to create healthy, balanced meals that require low effort, you could try one-pot recipes that combine all your macronutrients (proteins, fats, fiber, and carbohydrates). Nutritionally well-rounded meals usually include a mix of protein, healthy fats, and complex carbohydrates.)
In these cases, Inchauspé suggests always accompanying carbs with one of the other food types to still prevent the quick absorption of glucose. For example, if you’re having an apple, eat it with unsweetened peanut butter so the fat and protein help prevent a glucose spike from the sweet fruit.
(Shortform note: Some people practice food combining diets, meaning they believe certain types of food shouldn’t be eaten together. This contrasts with Inchauspé’s advice to always combine carbs with another food type. Proponents of food combining diets think eating the wrong combinations of food can lead to disease, poor digestion, and increased toxins in the body. For example, some believe that proteins and carbs should never be eaten together, and dairy products should only be consumed on an empty stomach. There’s very little science to support these food combining beliefs, however, and most of them derive from ideas that are over 100 years old. In contrast, there’s ample evidence to support Inchauspé’s opposite claims.)
Strategy #4: Exercise After Eating
According to Inchauspé, you can also prevent glucose spikes by changing what you do after you eat—specifically, by exercising. When you move your muscles during exercise, they use an energy-providing molecule called ATP to contract. ATP is made from glucose in the mitochondria, so you burn glucose every time you exercise. Instead of letting glucose collect throughout your body and cause a spike, your muscles use it up.
The rate at which your body burns glucose depends on the type of activity you’re doing. The more your muscles contract, the more glucose and energy they require. That being said, you don’t have to do intense exercise to achieve these benefits. Even just taking a short walk after a meal can help.
Different Kinds of ATP
Some types of exercise are better for burning glucose because different kinds of ATP are made for physical activity of varying duration and intensity. Your body uses four different sources of ATP:
A small amount of immediately available ATP is stored in your muscles, but this only lasts about three seconds.
Once you’ve used up your ATP reserves, your muscles use a high-energy compound called creatine phosphate to rapidly synthesize ATP. This lasts for about eight to 10 seconds, and it’s good for short bursts of intense activity, like weight-lifting.
Your muscles can also use their reserves of glycogen (the stored form of glucose) to make ATP quickly. This form of ATP is made more slowly than the kind that comes from creatine phosphate, but it’s still rapidly available, and it lasts for around 90 seconds. This kind of energy is good for exercise like longer sprints. By using up your glucose stores, this also makes room for more reserved glucose from the food you eat, reducing your risk of spikes.
Finally, after about two minutes of exercise, your body provides your muscles with oxygen, which means that aerobic respiration can happen. Aerobic respiration is the process by which glucose is turned directly into ATP with the help of oxygen. The glucose used may come from remaining glucose in the muscle cells, the liver’s glycogen stores, glucose from food in the intestine, and fat reserves. This kind of ATP takes the longest to create, but it also lasts the longest—as long as there’s a supply of glucose to fuel it, your body can make more ATP. It’s good for longer forms of exercise, like long-distance running, rowing, and so on.
ATP made through aerobic respiration helps control glucose spikes after eating by burning glucose from many sources throughout your body. Walking, which Inchauspé suggests doing after eating, is a great example of aerobic exercise that can trigger this process.
What You Should Eat to Prevent Glucose Spikes
Here, we’ll highlight two of Inchauspé’s strategies for patterning your food choices in a way that prevents glucose spikes:
Strategy #1: Eat Savory Foods for Breakfast
The author argues that we shouldn’t eat sweet, carbohydrate-rich foods at breakfast because we’re especially vulnerable to glucose spikes first thing in the morning. After sleeping and not eating for hours, the first thing we eat gets digested very quickly, so glucose from carbohydrate-rich foods is absorbed too rapidly. Then, this causes glucose spikes that throw our glucose out of balance for the rest of the day.
The easiest way to prevent glucose spikes at breakfast is to eat savory foods. Inchauspé suggests focusing on protein like eggs, then adding in some fiber and fat, such as kale and cheese.
(Shortform note: Some argue that eggs aren’t a very healthy option for a savory, protein-rich breakfast because they contain too much cholesterol, which contributes to heart disease. However, studies suggest that eggs have a minimal negative effect on the body compared to other high-cholesterol foods. Additionally, they provide essential nutrients such as vitamins B12, D, and A. Just watch that you don’t eat eggs with too many other foods high in saturated fats, salt, and cholesterol, like cheese, bacon, and butter. For a healthier option, try eating just egg whites with fibrous greens, or try cooking eggs in olive oil instead of butter.)
The Benefits of Breakfast for Diabetics (and Non-Diabetics)
According to recent studies, eating nothing for breakfast can be just as problematic for people with type 2 diabetes as breaking their fast with carbohydrate-rich foods. Researchers found that diabetics who ate nothing until lunchtime experienced large glucose spikes after all of their meals. Additionally, eating nothing for breakfast suppressed their body’s response to insulin.
Eating breakfast arguably has health benefits for everyone, not just diabetics: In addition to lessening the likelihood of glucose spikes throughout the day, breakfast foods that provoke a lower glycemic response make us feel more full. Therefore, they lessen the likelihood that we’ll overeat at our other meals. One study specifically found that people who ate whole almonds with their breakfast—a food with a low glycemic response—felt sated longer and had smaller glucose fluctuations at breakfast and lunch.
Strategy #2: Drink Diluted Vinegar
Finally, Inchauspé states that drinking one tablespoon of vinegar diluted in a glass of water before eating something sweet can reduce a glucose spike significantly. Additionally, consuming one tablespoon daily can decrease your overall glucose levels.
(Shortform note: You can use any kind of vinegar to experience the effects Inchauspé describes, but apple cider vinegar in particular has been studied for its glucose-stabilizing properties. Research suggests that apple cider vinegar can improve insulin sensitivity, which is one way it lowers glucose levels. Recommendations for a pre-meal dose range anywhere from a tablespoon (like Inchauspé suggests) to two tablespoons diluted in water. Apple cider vinegar is also thought to improve digestion, help fight infections, and reduce the risk of heart disease and cancer, but little research has been done to support these claims.)
These glucose-lowering effects come from the acetic acid in vinegar, which briefly inactivates alpha-amylase. Without the enzyme doing its work, starch and sugars can’t change into glucose as quickly, and we absorb glucose more slowly, preventing spikes.
(Shortform note: One study found that lemon juice also had an inhibiting effect on alpha-amylase, reducing participants’ glycemic response to bread (which is primarily starch). Lemon juice doesn’t contain acetic acid, but it does contain a high concentration of citric acid. This suggests that generally, acidic foods that lower the pH of a meal may help slow the digestion of starch.)
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