HbA1c – What is it? Why is it Important? What should it be?

I don’t want to bore non-diabetics with details. Simply put, HbA1c is a blood test that measures one’s blood glucose over three months. The average is determined by looking at the amount of sugar that binds to the the haemoglobin in red blood cells. For the science nerds out there, you can go to Wikipedia.

Now my HbA1c has been between 6% and 7% for years. I thought that was pretty damn good until I came across one of Dr Ken Berry’s videos a while back. He insisted that the highest acceptable level for anyone is 5.7%. Anything over that and you are doing major damage to yourself.

Dr. Ken Berry, MD - Diet Doctor
Dr Ken Berry

Well that tends to focus the mind a bit, and it’s one of the reasons I started this site. I believed sharing my story would help focus me enough and discipline me enough to get to 5.7%…or better. Dr Berry, unfortunately, doesn’t explain why numbers above 5.7 are bad given that most endocrinologists will say numbers in the sixes are good. We can use a little logic here and conclude he’s right. High blood sugar leads to all kinds of problems. Why wouldn’t slightly elevated blood sugar lead to problems too especially in the long term. It makes sense. Yet the way Dr Berry talks about it, you would think a reading of 6.0% would lead to an amputated limb tomorrow. So I did more digging.

I came across a short clip of Dr Richard Bernstein, the diabetes expert, who gave his views of what will happen to someone who maintains a 6.5% reading over an extended period:

  • blindness
  • amputations
  • neuropathy
  • erectile disfunction
  • dying young

So the question is why? Why do trained doctors tell diabetics that HbA1c above 5.7% is fine. Dr Bernstein provides the answer. Doctors have told him over the years, time and again, the above results are the natural consequences of diabetes, but if one patient out of my 3000 dies of hypoglycaemia, I get sued.”

So that’s why I’m driving for 5.7 or better.

Here’s the clip.

Pork Experiment – Marinated Pork Chop

Long-time readers may remember my suspicion that pork has negative effects on my blood glucose and general health. I wrote about this in my post “Pork – The Other White Meat or Tasty Poison?”

Based on the study I found from the Weston A. Price Foundation, I decided to carry out the same experiment, as best I could, under non-laboratory conditions. My first step was eating a fresh pork chop for dinner and seeing what would happen to my blood glucose the next morning. The results were surprising:

Well this wasn’t what I was expecting. My blood was a respectable 7.6 mmol/L this morning. Since my water/black coffee fast, 7.6 is the highest blood glucose level that I will accept.

Now I had meant to do the next leg of the experiment, a pork chop marinated in apple cider vinegar, the next week, but life got in the way. I carried it out two nights ago and kept broadly to the same diet and exercise in the morning and afternoon as I did for the first experiment. Dinner consisted of a barbecued pork chop and my Sautéed Courgettes in Garlic Butter. It was a very low carbohydrate meal with moderate protein and moderate fat.

What was the result? I checked my blood glucose before dinner and it was 7.6 mmol/L, so it was a little high for that time of the day. Nevertheless, I did not expect my blood glucose to shoot up to 11 mmol/L when I checked it in the morning. Fortunately my blood came down reasonably quickly yesterday morning after a great 5K run. I followed that up with a most beautiful and gruelling 8K hike along the English coast. My blood glucose this morning was 7.5 mmol/L.

Conclusion

The Weston A. Price Foundation study demonstrated that pork chops marinated in apple cider vinegar did not have a major coagulating effect on the participants’ blood. This would suggest that inflammation was not significant either when you look at the rest of their study. It didn’t seem to have that effect on me. My blood glucose certainly did not react well to marinated pork chops. Given that I’m a strong believer in inflammation being the root of many health evils, I think I’ll just have to give up on fresh pork, marinated or otherwise. Once again, I think it’s worth quoting the conclusion of the Weston A. Price experiment:

The early blood coagulation and clotting observed after consuming cooked unmarinated pork are adverse changes in the blood. A shorter blood coagulation time is associated with increased systemic biochemical inflammation as well as the possible formation of blood clots in the body, as in heart attack or stroke. This condition in the blood, if chronic, is associated with increased risk of chronic degenerative disease, including cardiovascular disease, cancer, autoimmune disorders and others.

It’s not the worst thing in the world giving up fresh pork. I can always have steak!

Cutting Back on Coffee – Sitrep Two

This is my second situation report on the coffee cutback. I remember trying to go cold turkey about twelve years ago, and it was not good. I couldn’t take it: the headaches, the lethargy, the grumpiness. Now I’m not planning to give up coffee completely, but I must say this gradual approach is much easier. I’m now down to one, twenty ounce coffee as of this morning.

I had two coffees yesterday: one in the morning and one at noon. My energy levels were great for the rest of the day; I started getting sleepy around nine o’clock; and I slept very well last night. The only negative was I had a mild headache for about a half-hour around 7:00pm.

My plan now is to scale back on the size of my morning coffee. For the next few days I’ll go with sixteen ounce mugs, then smaller and smaller. In a couple of weeks I’ll be down to one normal sized coffee in the morning.

Conclusion

So my peak consumption was something like five, twenty-ouncers per day. I’m now down to one.

I feel good with no ill effects really. It’s pretty much all positives.

I’ll write up another report next week regarding coffee and sleep. Once I’m down to my one, small coffee, I’ll see if it has any effect on my blood glucose.

Paleo Friendly Product – Mae Jum Thai Curry Pastes

I love curries. Yet, making my own takes time, and I don’t have a lot of it during the week. Thai curries are particularly delicious with their hot spice combined with cooling and soothing coconut cream.

There’s a problem though. I have never been able to find a Thai Green Curry Paste at the supermarket which wasn’t full of things I don’t want in my body: sugar, rapeseed oil, cornflour, sunflower oil, potato starch, fish powder and yeast extract (a flavour enhancer similar to MSG).

I’ve explained my aversion to rapeseed oil elsewhere. I think it’s terrible for my body. But these pastes contain a lot of sugar, carbs and preservatives. What is a diabetic supposed to do?

Enter Amazon and a quick search for Thai curry pastes. The first product that came up was the Mae Jum Classic Bundle. I had never seen this product before, but the lovely packaging caught my eye.

Classic Bundle: Great Product

Things got better as a scrolled down the page. This was the company’s product claim:

  • 100% Natural Ingredients
  • No artificial colours, flavourings or preservatives
  • Registered with the Vegan Society
  • Fresh herbs and spices – Gluten Free
  • Traditional family recipe – Authentic flavour

The ingredients support the claim above. This is what’s in the Thai Green Curry:

  • Green Chilli
  • Lemongrass
  • Shallots
  • Garlic
  • Rock Salt
  • Galangal
  • White Pepper
  • Turmeric
  • Coriander Root
  • Coriander Seeds
  • Kaffir Lime Rind
  • Cumin Seeds

Total carbs from one serving of the paste? Something like 3g maximum.

How does it Taste?

This sauce has an amazing flavour. I whipped up a great dinner last night using the Thai Green Curry Paste and a recipe I found using chicken breast, fresh veg and coconut cream. It had a really lovely heat as well. That tends to be another problem with the bog standard supermarket versions: no fire.Not so with Mae Jum!

Blood Glucose?

I was a little worried this morning given some of the blood spikes I’ve had in the past with curry sauces. Not so today. My glucose was a good 7.8 mmol/L.

Conclusion

If you like Thai curries and can get your hands on this wonderful product, I recommend getting it now. I’ll be trying the red and yellow pastes in coming weeks and will write a brief review for each.

Bitter Melon (aka Karela): Blood Glucose Control

Look ugly, taste worse

I take a lot of supplements, some for general health and others to improve me blood glucose levels. One supplement I’ve had some success with is bitter melon which is also known as karela or bitter gourd.

There are a lot of lists out there touting all kinds of benefits that come with eating bitter melon. I’m going to stick with blood glucose management in this post.

Now I say this is a supplement because it is rather difficult to get the fruit here in the UK. I’ve had limited success getting it delivered online. Unless you live in a reasonably large city with a Chinese, Indian or Pakistani community, you’re going to have trouble finding this as a fresh fruit. I can’t speak for North America, but I’m guessing the same rule applies.

Bitter melon has been used in the Far East for ages to treat diabetes. Scientific research demonstrates that the fruit has some properties that help control blood glucose levels. In particular, polypeptide-p, charantin, and vicine all have positive effects on blood glucose levels.

Polypeptide-p seems to function as an insulin mimetic (mimic). Charantin and vicine also act as hypoglycaemic agents but it is not wholly clear how or why this occurs. One study argues that bitter melon is acting on several levels within the body to lower blood glucose:

Different mechanisms contribute to the antidiabetic activities of M. charantia [bitter melon], these include increasing pancreatic insulin secretion, decreasing insulin resistance and increasing peripheral and skeletal muscle cell glucose utilization, inhibition of intestinal glucose absorption and suppressing of key enzymes in the gluconeogenic pathways.

The studies linked above also suggest that bitter melon may repair beta-cells or help the pancreas create more. Now that’s exciting.

It’s near impossible to get bitter melon fresh where I live. This is a shame because when I have had it fresh, I’ve enjoyed a considerable drop in blood glucose levels. I tried taking it as a juice, but I did not experience the same hypoglycaemic effects, and I was not impressed with the quality of the long-last juices coming from India. They are also exorbitantly expensive. I’ve had to settle with tablets. There is still a slight hypoglycaemic effect.

Conclusion

Bitter melon does appear to have proven hypoglycaemic effects when eaten fresh or juiced. Long-last juice which has been pasteurised did not have a significant effect on my blood glucose. I have settled on supplements on tablet form which, when combined with my metformin and other supplements, has a marginal but not inconsequential effect on my blood glucose. Since I’m now growing more and more of my own vegetables, I’m going to buy some karela seeds and try growing them in my sun room. I hope to have something to report in the next couple of months on the effects of fresh bitter melon.

Getting Enough Sleep

When Napoleon Bonaparte was asked how many hours sleep people need, he is said to have replied: “Six for a man, seven for a woman, eight for a fool.”

It would seem I fit somewhere in the woman to fool range according to the Little Corsican.

For as long as I remember, I have needed at least seven hours sleep to function well during the day, eight is ideal. Anything less than and I’m groggy, moody and headachy. Most people are the same. Sure, there are some supermen out there who famously got by with four hours sleep or less: Napoleon, Thatcher, Churchill to name a few. Bully for them!

For the rest of us mortals a good night’s sleep is mandatory. What I find fascinating is the research arguing just how important sleep is for our overall health. Sleep is something so mundane that I never gave it much thought until relatively recently.

Studies suggest that deep sleep lowers the body’s glucose levels, increases human growth hormone (HGH) and lowers cortisol production. Thus, sleep is essential in glucose regulation.

In contrast, poor sleep patterns can lead to increased blood glucose levels. The linked study focuses on black Americans, but it cites previous studies that had similar findings for Europeans and Asians.

Here’s a key takeaway from the study:

In addition to studying sleep apnea, the researchers found that participants who experienced other types of disturbed sleep—including sleep fragmentation and sleep duration variability—were also more likely to have increased measures of blood glucose.  The associations between disturbed sleep and high blood glucose levels were stronger in participants with diabetes compared to those without diabetes, the researchers said. In those without diabetes, disturbed sleep was also associated with increased insulin resistance.

I’ve typically been a good sleeper, and I’ve improved in this respect since giving up booze. I think all readers know the sleep one gets after three glasses of wine or four pints of ale. You’re not exactly drunk, but you’re not sober either. For me, the sleep that comes with that kind of drinking was horrible: restless and never deep.

Conclusion

I work a lot harder now to sleep well especially during the work week. I have my last coffee at around five, and it’s lights out at 11:00pm if not earlier. That way, I always have my guaranteed seven hours.

By the way, what got me really interested in sleep was a conversation Joe Rogan had with sleep expert Professor Matthew Walker. It’s really worth a watch:

Sitrep – Six Weeks after Fasting

So it’s been six weeks since my four-day water/coffee fast. I also worked in a three-day fat fast a couple of weeks ago which had very good results.

How has my blood glucose been? Overall, good. But I had a little bit of a hiccup last week. Unfortunately, I had a three-day run where my morning blood glucose went from 8.4 mmol/L to 9.6 to 10.8. What happened?

It was a combination of things. I had a week off from work and binge watched two seasons of the Sopranos. The result? I wasn’t exercising as much, and I was nibbling too many nuts.

Also, I had three meals in a row where I ate too much protein. In particular, two were chicken breast based meals. I’ve written about gluconeogenesis before. Once again too much dense protein led to higher than acceptable blood glucose levels in the morning.

I’ve managed to get my blood glucose back to some normalcy through increased exercise, some intermittent fasting and more fatty meats. Yesterday, my morning reading was 7.2 mmol/L. This morning it was 8.0. The higher reading today was, again, due to too many nuts while watching TV.

Conclusions

I can’t have nuts in front of me on the coffee table. One handful becomes two then three then four. Also, when I do have chicken breast, I must exercise more restraint. I should be eating less than a chicken breast to be honest.

Over the next three weeks I’ll be playing around with meal skipping. I’ll also do a time restricted experiment to see how that affects my blood.

I’ve also found a new exercise routine that looks exciting. More on that shortly.

At the beginning of August, I’ll be going on another fat fast.

Until then. Less nuts!

Stevia Experiment Results

AVOID! The Toxic Truth About Stevia – Jane's Healthy Kitchen
Stevia?

Always read the label right? Well, I’ve been duped again through sheer carelessness! I’ll return to that in a moment.

So I came home from work and with my blood glucose at 5.2 mmol/L. I had a quarter teaspoon of Truvia and waited to see what would happen to my blood sugar. Fifteen minutes later it was at 5.6. After a six kilometre jog, it was up to 7.2. So clearly stevia is not for me. But wait there’s more.

I was wrong yesterday in my post. What I have in my cupboard is an artificial sweetener. True stevia is green and has a bitter, liquorice-like after taste. What was I eating? Truvia. This is, in fact, a blend of highly processed stevia and erythritol. What’s erythritol you ask? It is an artificial sweetener extracted from GMO corn by the good people at Coca-Cola. It makes up the bulk of Truvia. It supposedly has no effect on blood sugar either. That’s not true for me it seems. So I hadn’t read the label carefully. Shame on me again.

Now how bad is this processed sweetener for your average bear whose pancreas actually works properly? Don’t know. It depends on who you read.

My go to man, Mark Sisson, argues that as sweeteners go erythritol isn’t too bad. He doesn’t think that Truvia is the devil’s brew, but he doesn’t think it’s good either. At the other end of the spectrum, there are some health food advocates who think that Truvia and other semi-stevia products are just terrible.

Now this little factoid doesn’t prove anything, but it is nevertheless interesting. It seems that fruit flies die very quickly when they eat Truvia:

https://www.cbsnews.com/news/truvia-sweetener-is-toxic-to-fruit-flies-study-finds/

I’ll let you decide for yourself. Mine’s going in the bin.

I really need to remember what Mrs Featherbottom said, “You should always read the label, you should always read it well!”

Mrs. Featherbottom - Arrested Development Wiki
https://arresteddevelopment.fandom.com/wiki/Mrs._Featherbottom

Three Day Fat Fast – Day 3

Americans are missing out on Red Leicester

So I’m breaking my fast right now with some coffee and Red Leicester. Another fast out of the way!

Blood glucose? It was 5.7 mmol/L this morning. I was expecting it to be lower, but I didn’t do much exercise yesterday, and I may have forgotten to take my metformin before bed. Oopsy! Still, it was down to 5.2 when I got home from work.

I have to say it again. Fat fasts are a complete doddle. There’s very little craving for food during the day. If I’m feeling a bit of a pang, I’ll just have a little organic butter. Sorted.

I just got back from a six kilometre run. When I ran the same route during the water fast, I was in a bad way. Especially going up hills. This time round? No problems. I felt really good.

Energy was great today and only a very mild headache this morning. That went away a few minutes after having a big pinch of sea salt.

Conclusions

I don’t see myself going back to three or four day water fasts to be honest. Why? Fat fasts are so much easier, and the benefits are pretty similar. I’m in ketosis, autophagy still happens, but I don’t have headaches as much, and I’m not that hungry.

I’ll keep with the three-day fat fasts once a month and cycle in the odd one-day water fast here and there.

My next experiment is going to be time restricted eating. More on that later.

Stevia Experiment

The science behind the sweetness of the stevia plant ...

Stevia has become the darling sweetener in the paleo/keto community; I can see why. Because the body does not metabolise the active compounds of stevia (mainly stevioside and rebaudioside), it has virtually no calories.

A little internet digging reveals some interesting things. First, some websites call it an artificial sweetener. Well that’s pure bunk. How can it be artificial if it is derived from the leaves of a plant. Sugar is derived from sugar cane or sugar beets. Does that make sugar artificial. God what nonsense. Second, I came across this site that claims stevia is used in South America as a cheap way to combat…hyperglycaemia (i.e., high blood sugar). It supposedly “stimulates the release of insulin and normalizes the response to glucose, especially in type 2 diabetes.” I have to confess that this article, written by an unknown staff writer, looks rushed and slipshod. There were no links to actual studies.

More digging revealed an actual study on stevia. I won’t bore you with all the details, but it goes some way in explaining why stevia may help with blood glucose levels. The study showed that the “active components of stevia extract, stevioside and steviol, stimulate the ion channel TRPM5…TRPM5 also ensures that the pancreas releases enough insulin, for instance after a meal. Therefore, it helps prevent abnormally high blood sugar levels and the development of type 2 diabetes.”

Now this is interesting, but the study argues multiple things. One, it prevents the development of diabetes. Well, that doesn’t help me. Second, if it stimulates the pancreas into releasing more insulin what does that mean for Type 2 diabetics who are more insulin deficient than insulin resistant. Put another way, what would stimulating the release of more insulin do to my already damaged pancreas? Will it burn out what’s left of my beta cells? Will it just make it easier for my pancreas to release what insulin it has with no ill effects? I need to research more here.

In the meantime, I’m not convinced that stevia works for all diabetics in that sense that it does not raise blood glucose. I have some in the cupboard and use it in small amounts when my gravies are too bitter. My plan tonight is to break my fast with a half teaspoon of stevia and see what that does to my blood sugar. I’ll do a before and half-hour after tonight.

Watch this space.