The Ultimate Guide To Biohacking Your Blood Sugar Levels (And Why Sugar Sometimes Isn’t Bad).

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In one of my Quick & Dirty Tips articles, I mentioned that one “hack” I use to avoid experiencing big spikes in blood sugar from a big meal is to do some basic strength training with a dumbbell prior to eating that meal, which, as I explain in that article, activates specific sugar transporters responsible for taking up carbohydrate into muscle tissue, rather than partitioning those sugars into storage fat.

Since my own personal genetic testing has revealed that I have a higher than normal risk for Type 2 diabetes, hacking blood sugar levels to get them lower is a topic near and dear to my heart. (These are the specific genetic variations associated with diabetes.) Type 2 diabetes rates are rising, both in the United States and globally (even among athletes and so-called “healthy” people), and so are a host of other chronic disease, neural degradation and weight issues directly related to high blood sugar. Characterized by insulin resistance and chronic high blood sugar levels (hyperglycemia), type 2 diabetes can lead to both brain and metabolic dysfunction, and is also a significant risk factor for cardiovascular disease (especially if you're experimenting with something like a high-fat diet, since sugars can easily adhere to cholesterol particles from that cup of fatty coffee you're drinking and make a high-fat, low-carb diet highly atherosclerotic).

When blood sugar is chronically elevated, the insulin released by the pancreas becomes progressively less effective in bringing those blood sugar levels down, and ultimately, pancreatic tissues begin to suffer damage (although some evidence shows this pancreatic damage can be reversed with specific lifestyle and food strategies). Although blood sugar can slightly rise in response to factors such as stress, hard exercise, or long periods of sedentary time, blood sugar typically rises most significantly after a meal, and studies show that these post-meal or “post-prandial” hyperglycemic spikes are the most likely to lead to vascular complications, even when compared to elevated fasting glucose levels.

When it comes to controlling high blood sugar, your body has two choices: get rid of the blood sugar as potential energy via uptake into muscles, or store the blood sugar in fat tissue. So in this article, you’re going to get four ways to control your blood sugar without it simply getting partitioned into fat tissue, you’re going to learn how to get rid of stubborn carbohydrate related body fat (and even reduce your risk of diabetes based on the latest medical research on exercise and blood sugar), and you're also going to learn why sugar in your food isn't as big a deal as you've probably been led to believe that it is.

Two other quick things before we dive in:

1) I am not a physician and this is not to be interpreted as medical advice. Please talk to a licensed medical professional about any chronic disease or health conditions related to high blood sugar!

2) This article isn't really going to focus much at all on supplements or medications, but I do have a daily practice of maintaining insulin sensitivity by drinking a cup of homemade kombucha each day, consuming at least two teaspoons of cinnamon each day, and before every meal that contains a significant amount of carbohydrates, swalloing two bitter melon extract capsules, which are as powerful as the diabetic drug metformin in lowering post-prandial blood sugar.

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How Sugar Gets Into Muscles

Before discovering how certain movements and exercise strategies can lower or stabilize your blood sugar, it’s important to understand how sugar gets transported into muscle in the first place (you can dig into the science of everything you’re about to read in this research article).

The entry of glucose into muscle cells is achieved primarily via what is called a “carrier-mediated system” which consists of small protein transport molecules. One of these transport molecules is “GLUT-1”, is normally found in the sarcolemmal membrane (a sheath that surrounds your muscle fibers) and is thought to be involved in glucose transport under basic resting, non-active conditions.

gluttransporters

When the hormone insulin gets released by your pancreas, which is something that can happen after a large meal of protein (yep, whey protein can spike blood sugar and insulin higher than a candy bar) or carbohydrates, glucose transport can be accelerated even more because insulin upregulates the activity and the number of yet another sugar transporter called “GLUT-4”, which, just like GLUT-1, is found in skeletal muscle, but is also found in cardiac muscle and in adipose tissue, and helps GLUT-1 transporters get even more sugar and storage carbohydrate into these areas.

So think of it this way: insulin causes fat cells and muscle cells to soak up energy, and if your muscle cells are already “full”, which is often the case if you're not incorporating the strategies you’re about to discover in this article, then most of the sugar winds up getting driven into fat cells.

glut4

But here’s the amazing thing: just like insulin can upregulate sugar transporters, exercise can also upregulate GLUT-4 sugar transporters, but without an actual release of insulin from the pancreas. This means fewer chronic disease risks related to constant surges of insulin, less pancreatic strain, and a higher likelihood that carbohydrate and protein energy from food gets partitioned into skeletal muscle and cardiac muscle rather than into adipose tissue. Exercise can even increase not just the activity, but also the number of GLUT-4 transporters you have available.

Of course, as you probably already know, physical activity can do much more than just play around with your sugar transporters, and can also mobilize fatty acids from your adipose tissue to be used as energy, increase your sensitivity to insulin when it does get released, and cause a host of other extremely helpful metabolic adaptations that make it one of the most powerful “drugs” on the face of the planet.

So, let’s look at for highly effective ways to maximize these blood-sugar controlling benefits of exercise, shall we?

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Blood Sugar Control Strategy #1: Strength Train 

Before diving into strength training, it’s important to understand the concept of “glucose threshold”. The glucose threshold is the point at which sugar output into the bloodstream (e.g. from sugars in your diet, sugars that get broken down and released by your liver, etc,) and uptake (e.g. sugar getting driven into muscle) are in balance: if you are above the threshold, then glucose levels rise and you have high blood sugar, and if you are below the threshold, your blood sugar levels fall or stay the same. You can read more about glucose threshold and blood sugar levels in this study.

Research has found that when you strength train, your ability to drive glucose into muscle tissue from strength training occurs, and thus your ability to cause a decrease in your glucose threshold can occur when you lift weights that are at least 30% of your single repetition maximum weight (1RM). This is (surprisingly) not that heavy or difficult and means you can control blood sugar and upregulate sugar transporters with even relatively light body weight exercise.

Let’s take a closer look at this study. In it, test subjects (both diabetic and non-diabetic overweight middle-aged men with previous resistance exercise experience) were assigned to either a low or a moderate intensity protocol. Both protocols consisted of a weight training circuit of 3 sets of 30 repetitions of six basic weight training exercises that you're probably familiar with or can easily find at a gym: leg extension, bench press, leg press, lat pull down, leg curl, and seated row. Subjects recovered for 15-20 seconds between exercises, and then for a full two minutes between circuits. Weights were set at 23% of one repetition maximum (1RM) for the low intensity group, and 43% of 1 RM for the moderate intensity group. Blood sugar and rating of perceived exertion (RPE) were measured both between sets and at 15-minute intervals during a two-hour post-exercise resting period. Subjects also ate a 285-calorie breakfast two hours before the test.

Blood sugar levels in the non-diabetic subjects fell initially during exercise, then rose after exercise as the body released some sugar into the bloodstream to support the exercise (a process known as glycogenolysis), then leveled off again.

No surprises there.

In subjects with type 2 diabetes, both the low and moderate intensity circuits lowered blood glucose, but surprisingly, the low intensity circuit produced lower glucose levels, along with a lower rating of perceived exertion accompanied by less metabolic stress. This finding should be particularly relevant to overweight or untrained individuals who are just beginning a blood sugar management program, or for people who just feel too “tired” to exercise before or after a meal, because it means that even a single session of low intensity resistance exercise at a relatively easy weight can offer significant benefits for blood sugar control.

Now, before leaving the topic of strength training for blood sugar control, it is important to understand that if you're already a relatively fit personthe heavier and more intense your strength training, the more rapidly you will deplete muscle and liver glycogen levels, the higher your post-exercise metabolic rate will be, and the greater your amount of blood sugar control will be, so you eventually should progress to workouts such as a heavy 5×5 protocol or any of the other strength training strategies I describe here. But it’s also important to realize that even light weight training will suffice for basic blood sugar control.

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Blood Sugar Control Strategy #2: Pre-Breakfast Fasted Cardio

A study published in The Journal of Physiology suggests a second, potent strategy for controlling blood sugar, especially in response to a meal: exercise before breakfast, particularly in a fasted state.

In this study, researchers in Belgium recruited 28 healthy, active young men and began stuffing them what would be considered a pretty poor diet – a diet comprised of 50 percent processed, unhealthy fat (we’re not talking extra virgin olive oil and avocadoes, but more like soy and lard and the other nasties fed to subjects in laboratory studies) and 30 percent more calories than the men had been consuming prior to the study. A portion of the men (the control group) did not exercise during the experiment, and rest of the subjects were assigned to one of two exercise groups, working out four times a week in the mornings by running and cycling at a hard intensity for 60-90 minutes.

Now, here’s the kicker: two of the groups – the control group and just one of the exercising groups – were fed a huge, carbohydrate-rich breakfast. In the case of the fed exercising group, this meal occurred before exercising and then they continued to ingest carbohydrates (in the form a sports drink) during their workouts. But the second group exercised without eating, and drank only water during the training. The researchers did, however, made up for the abstinence of calories in this second group by matching their energy intake of the first group with a big breakfast later that morning after training, a meal exactly comparable in calories to the fed group’s big pre-exercise and during-exercise portions.

The experiment lasted for a total of six weeks. At the end, the nonexercising group had, not surprisingly, packed on an average of more than six pounds of fat. Furthermore, they also developed insulin resistance, meaning their muscles were no longer responding to insulin and weren’t pulling sugar out of the bloodstream efficiently, resulting in the storage of extra fat in both adipose tissue and within intramuscular fat stores.

And the men who ate breakfast before exercising gained weight, too, although only about half as much as the control group. But somewhat surprisingly, just like the sedentary eating group, they also become more insulin-resistant and were storing away a greater amount of fat.

You’re probably anticipating what comes next. Only the group that exercised before breakfast gained nearly no weight and showed zero signs of insulin resistance. In addition, their metabolic rate changed in such a way that they also burned the fat they were taking in far more efficiently (a higher rate of fat oxidation). The study’s authors concluced that “that exercise training in the fasted state is more effective than exercise in the carbohydrate-fed state to stimulate glucose tolerance despite a hypercaloric high-fat diet.”

And what was one significant characteristic of that pre-breakfast exercise group? You guessed it: increased levels of the muscle protein GLUT-4, which, as you may recall, is responsible for insulin-stimulated glucose transport in muscle and plays a pivotal role in regulation of insulin sensitivity.

So…exercise before breakfast? Yep. Here's my morning routine and how I do it.

One last note here: should a 60-90 minute pre-breakfast exercise session seem daunting to you, you should be aware of another study review entitled “The impact of brief high-intensity exercise on blood glucose levels”. In this study, researchers investigated the effect on insulin sensitivity and blood glucose from a relatively small amount of high intensity exercise – just 7.5 to 20 minutes per week. They found that two weeks of sprint interval training increased insulin sensitivity for up to three days after the exercise session! Furthermore, they found that twelve weeks of near maximal intensity interval running (for a total exercise time of 40 minutes per week) improved blood glucose to a similar extent as running at a lower, aerobic intensity for 150 minutes per week. In type 2 diabetics, they found that a single high intensity exercise session improved postprandial blood glucose for 24 hours, while a 2-week high intensity exercise program reduced average blood glucose by 13% at 48 to 72 hours after exercise and also increased GLUT4 transport protein expression by 369%! The researchers concluded that:

 “…very brief high intensity exercise (HIE) improves blood glucose (BG) 1 to 3 days postexercise in both diabetics and non-diabetics. HIE is unlikely to cause hypoglycemia during and immediately after exercise.”

So there you have it. When it comes to blood sugar control, there’s no need to hop on the treadmill for a full, epic hour and half. You can simply do brief, high intensity exercise, and here’s a full article I wrote that reviews some of the best, most up-to-date research on what kind of exercise counts as high intensity. Finally, not from peer-reviewed research but from my own testing with a blood sugar monitor, I've even found something as simple as a 30-minute easy walk in the sunshine, yoga session or relatively short, easy, aerobic effort can significantly lower post-prandial blood sugar levels after breakfast.

So now you've got zero excuses, eh?

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Blood Sugar Control Strategy #3: Post-Prandial Walks

A few years ago, I was inspired to begin setting a rule to move or walk for at least a few minutes after each meal, even a late dinner, when I read an interesting Japanese study entitled “Postprandial lipaemia: effects of sitting, standing and walking in healthy normolipidaemic humans.”

This study compared the effects of sitting, standing and walking on postprandial fat storage in healthy Japanese men. The fifteen participants in the study completed three two-day postprandial trials (you may remember from last week’s article that “post-prandial” means “after a meal”) in a random order: 1) sitting; 2) standing, and 3) walking. On day one of the sitting trial, participants rested. On day one of the standing trial, participants stood for six, 45-min periods. On day one of the walking trial, participants walked briskly for 30 min at approximately 60% of maximum heart rate. On day two of each trial, participants rested and consumed test meals for breakfast and lunch. The researchers then collected blood samples in the morning and afternoon on day one, and in the fasted state and at 2, 4 and 6 hours postprandially on day two. On day two, they found serum fat concentrations were 18% lower in the walking trial compared to the sitting and standing trials, proving that postprandial lipaemia was not reduced when standing (or, of course, sitting) after a meal but was reduced after low-volume, easy walking for 30 minutes.

 The study “Postprandial Walking is Better for Lowering the Glycemic Effect of Dinner than Pre-Dinner Exercise in Type 2 Diabetic Individuals” takes this science even one step further and looks at the effect of walking before a meal vs. walking after a meal.

In this study, twenty minutes of self-paced, easy walking done shortly after meal consumption resulted in lower blood glucose levels at the end of exercise compared to values at the same time point when subjects had walked pre-dinner. In addition, the investigators in this study found that one hour of aerobic exercise performed in fasted state prior to dinner had a minimal impact on post-dinner glucose levels, but when performed two hours after the meal, induced a significant decrease in plasma glucose levels.

So, from what we know thus far, it looks like if you’re going to go on a walk at some point in the evening around dinner, you’re better off doing it after dinner rather than before dinner, and that you get benefits when it’s as short as 20 minutes (although I’d highly suspect you get benefits from any movement at all!).

The same study also makes another interesting observation about the timing of moderate aerobic exercise around a meal and the effect on blood sugar of this exercise: specifically that postprandial, morning moderate intensity exercise decreases blood sugar levels after a morning meal, but this effect does not persist during and after the following lunch meal. This means that if you exercise in the morning, you’re probably going to still want to maintain at least low-level physical activity (e.g. a standing or walking workstation) between breakfast and lunch if you want to continue to reap the benefits of that exercise.

The study also reports that moderate bicycling exercise after any meal (breakfast, lunch, or dinner) results in a significant decrease in blood glucose levels and that both postprandial high-intensity exercise and longer bouts of walking (e.g. two hours versus one hour) reduce blood glucose levels and insulin secretion, suggesting that the effect of exercise is related more to total energy expenditure rather than to peak exercise intensity, leading the researchers to conclude that it is possible that the short duration of the exercise bout in this study (20 minutes) could have had a greater impact blood sugar if either the intensity or its duration had been increased. This is backed up by the study entitled “Effect of Post-Prandial Exercise Duration on Glucose and Insulin Responses to Feeding”, which found that longer bouts of exercise after a meal produce a greater decrease in glucose and insulin.

Once again, sugar transporters play a big role here, and researchers reported that “the binding of insulin to its cellular receptors in muscle and adipose tissues recruits GLUT4 transport proteins to the cell surface that facilitates glucose transport. Muscular contractions themselves are known to stimulate glucose transport into muscle cells without the need for insulin through an independent mechanism, but in an additive manner, thereby potentiating the effects of post-meal exercise.”

So let's stop for a moment.

What do we know so far from all these studies? We know that one excellent strategy to control blood sugar would be to set a habit of exercising before breakfast in a fasted state, preferably using either longer aerobic exercise, brief high-intensity exercise or (if you're like me) even just a bit of yoga or a simple walk, and then, if time permits, to go on an easy 20-60 minute walk after dinner.

OK, there’s one more strategy, so let’s keep on rolling!

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Blood Sugar Control Strategy #4: Standing

Using a standing desk can lower blood sugar levels, and there’s research to back it up!

In one study of office workers, standing for 180 minutes after lunch reduced the post-lunch blood sugar spike by 43% compared to sitting for the same amount of time. Interestingly, researchers noted that both groups took the same amount of steps after lunch, indicating that the smaller spike in blood sugar was due to standing rather than additional physical movements around the office.

Another office worker study discovered that alternating between standing and sitting every 30 minutes throughout the workday reduced blood sugar spikes by 11.1% on average. And yet another study showed that the harmful effects of sitting after meals, with excessive sedentary time post-meal at the office being linked to a whopping 112% greater risk of type 2 diabetes.

And that is why I not only recommend a standing or walking workstation, but also the incorporation of a concept called “greasing the groove”. This is a concept I originally discovered in a book called The Naked Warrior. The idea is basically this: Instead of (or in addition to) doing a long or hard workout at the gym, you simply spread your exercises throughout the day.

This not only allows you to become proficient at certain movements such as pull-ups or squas, but also elevates your metabolism throughout the day and gets you fit or maintains fitness without you needing to always set aside time for structured workouts. For example, I have a pull-up bar installed above the door of my office. Every time I walk under that bar, I have a rule that I have to do five pull-ups.

Other examples of “Greasing the Groove” that I include in my own life to become fit and control blood sugar even when I’m not exercising are:

 -Beginning every day with a few minutes of yoga and calisthenics with deep nasal breathing…

-Doing 25 body weight squats or 100 squats every time I take a bathroom break…(caution: click here to see a hilarious video in which this practice got me into some serious trouble at an airport)

-Doing 30 burpees at least once per day…

 -Doing 100 jumping jacks for every hour that I actually am sitting…

-Taking a cold shower 2-3 times each day…

You get the idea. Even during a day at the office, you don’t actually have to “workout” to be working out or to be controlling blood sugar.

Whew! This has been quite a post thus far. You’ve learned why you need to control blood sugar, how sugar can wind up in either fat or muscle, why you should strength train (even at low intensities), the benefits of pre-breakfast fasted cardio, the benefits of post-evening meal walking, and the concept of staying active at the office with activities like standing and greasing the groove.

But I'm not done yet. At the risk of getting completely villified in the comments section of this post, I should mention that sugar in your food isn't always bad…and doesn't always mean bad-news-bears for your blood sugar levels.

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News Flash: Sugar In Your Food Isn’t Always Bad

Prepare to be shocked. Ready? Okay, here we go…sugar is probably not as bad as you can like to believe. Yes, you heard me right.

These days, it seems that sugar is one of the demonized substances on the face of the planet, and I been flabbergasted at the number of people who will look at the label of, say, an extremely healthy protein powder or adaptogenic herb complex or kombucha bottle and completely flip out over the 5 to 10 g of sugar or fructose or dextrose or maltodextrin that they see on the label of the package. This practice becomes even more shocking when you look at the level of physical activity in these folks: Ironman triathletes, Spartan athletes, CrossFitters, and people for whom this amount of sugar is truly a speedbump when it comes to any amount of metabolic damage.

This would fall into the category of what I have, on a previous podcast, deemed as “orthorexia“, an unhealthy obsession with analyzing every tiny ingredient on a food label and flipping out if there's even a semblance of something that might make you fat or bump up your blood sugar or be a “toxin”.

And yet you hear the same things over and over again, often from extremely active, insulin-sensitive people:

“Sugar is toxic!”

“Any sugar gets turned into fat in the liver!”

“Sugar oxidizes cholesterol, no matter what!”

“Sugar causes massive insulin spikes that make you fat!”

“Sugar rips you out of ketosis and fat-burning mode!”

Whenever I hear such extreme statements made about sugar, I get just a little bit annoyed, and you're about to discover why.

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What Is Sugar?

Let's first look at what sugar really is.

fig-1-mcabe

In nutrition science are three forms of sugar: monosaccharides, oligosaccharides and polysaccharides.

Monosaccharides are often called simple sugars because they have a very simple structure (mono means one and saccharide means sugar). Monosaccharides include glucose, fructose, and galactose.

Glucose is a type of sugar that is most commonly known as blood sugar, and is found in your blood and produced from the food you eat. Most food-based carbohydrates contain glucose, either as the only form of sugar or combined with fructose and galactose. So when you hear people talk about blood sugar levels, they’re referring to the amount of the monosaccharide glucose in the blood.

Then there's fructose. Fructose is a sugar naturally found in fruit, and also in processed products such as sucrose (table sugar) and high-fructose corn syrup (HFCS), both of which are about 50% fructose and 50% glucose. Fructose is basically converted into glucose by your liver and then released into the blood as blood sugar. Finally, galactose is a type of sugar found in dairy products and it’s metabolized similarly to fructose.

Okay, let's move on to all oligosaccharides. Oligosaccharides are molecules that contain several monosaccharides linked together in a chain.These sugars are one of the components of fiber found in plants, and your body is able to partially break down some of these oligosaccharides into glucose. Vegetables (shocker!) even have sugar in the form of fructo-oligosaccharides, which are short chains of fructose molecules. These chains are broken and the individual fructose molecules are then converted into glucose. Raffinose, for example, is  a common form of oligosaccharide and is comprised of a chain of galactose, glucose, and fructose, and is found in healthy foods like beans, cabbage, Brussels sprouts, broccoli, asparagus, and natural, whole grains.

Then there are polysaccharides, which are long chains of monosaccharides, with ten or more monosaccharide units. Starch from plants and cellulose, a natural fiber found in many plants, are two examples of polysaccharide “sugars” (so toxic, eh?). Your body is able to break starches down into glucose, but not cellulose, because it passes through your digestive system intact…

… But every single sugar you just discovered, whether it's from vegetables, whole grains, or can of soda, mostly winds up his glucose. As a matter of fact, every drop of carbohydrate you eat is either metabolized into glucose is left indigested as dietary fiber, and your body truly can’t tell the difference between the sugar found in fruit, honey or milk, or a candy bar. They’re all broken down into monosaccharides, which are then turned into glucose, which are then transported to your brain, muscles, and organs.

Now don't get me wrong: I'm not saying that you should forgo the salad for a cup of ice cream or the bowl of broccoli for a Snickers bar because it all winds up with the same metabolic fate, but I do want you to understand that you're probably eating “sugar” no matter whether you realize it or not.

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When Sugar Is Bad

So, when is the intake of sugar actually a problem? To answer that question let's turn to this whole “sugar is toxic” argument.

On May 26, 2009, Robert Lustig gave a lecture called “Sugar: The Bitter Truth,” which was posted on YouTube. The video been viewed over 800,000 times, gets new viewers at a rate of about 50,000 per month, and is basically a 90-minute discussion of the subtle nuances of fructose biochemistry and human physiology.

In the video, Lustig presents the argument that sugar is a “toxin” or a “poison,” referring not only the white granulated sugar that we put in coffee and sprinkle on cereal (sucrose) but also high-fructose corn syrup (HFCS), which Lustig calls “the most demonized additive known to man.”

He claims that sugar is not just an empty calorie, and that “It’s not about the calories…it has nothing to do with the calories. It’s a poison by itself.”

But in a 2010 review of the science of sugar, entitled “Misconceptions about fructose-containing sugars and their role in the obesity epidemic”,  Luc Tappy, a researcher at the University of Lausanne in Switzerland who is considered by biochemists who study fructose to be the world’s foremost authority on the subject, said there is “not the single hint” that HFCS was more deleterious than other sources of sugar. Here’s what Tappy has to say:

“A causal role of fructose intake in the aetiology of the global obesity epidemic has been proposed in recent years. This proposition, however, rests on controversial interpretations of two distinct lines of research. On one hand, in mechanistic intervention studies, detrimental metabolic effects have been observed after excessive isolated fructose intakes in animals and human subjects. On the other hand, food disappearance data indicate that fructose consumption from added sugars has increased over the past decades and paralleled the increase in obesity. Both lines of research are presently insufficient to demonstrate a causal role of fructose in metabolic diseases, however. Most mechanistic intervention studies were performed on subjects fed large amounts of pure fructose, while fructose is ordinarily ingested together with glucose. The use of food disappearance data does not accurately reflect food consumption, and hence cannot be used as evidence of a causal link between fructose intake and obesity. Based on a thorough review of the literature, we demonstrate that fructose, as commonly consumed in mixed carbohydrate sources, does not exert specific metabolic effects that can account for an increase in body weight. Consequently, public health recommendations and policies aiming at reducing fructose consumption only, without additional diet and lifestyle targets, would be disputable and impractical. Although the available evidence indicates that the consumption of sugar-sweetened beverages is associated with body-weight gain, and it may be that fructose is among the main constituents of these beverages, energy overconsumption is much more important to consider in terms of the obesity epidemic.”

In a nutshell, what research actually shows is that sugar-sweetened compounds are bad for us not because there’s anything particularly toxic about the sugar they contain but just because people consume…

…too much sugar.

The list of research backing up this idea that sugar is not the issue but that overeating sugar is the issue goes on and on.

One extensive review of HFCS literature that says:

“Sucrose, HFCS, invert sugar, honey an many fruits and juices deliver the same sugars in the same ratios to the same tissues within the same time frame to the same metabolic pathways.  Thus…it makes essentially no metabolic difference which one is used.”

Here’s one from an Another HFCS literature review says:

“Based on the currently available evidence, the expert panel concluded that HFCS does not appear to contribute to overweight and obesity any differently than do other energy sources.”

And another literature review says:

“The data presented indicated that HFCS is very similar to sucrose, being about 55% fructose and 45% glucose, and thus, not surprisingly, few metabolic differences were found comparing HFCS and sucrose. That said, HFCS does contribute to added sugars and calories, and those concerned with managing their weight should be concerned about calories from beverages and other foods, regardless of HFCS content.”

The bottom line is that fructose is just another simple sugar can only harm you when you over-consume it. And, as you learned earlier, sucrose occurs in completely natural foods like pineapples, sweet potatoes, beets, sugar cane, walnuts, pecans, and cashews.

Here’s another shocker. In this study, researchers from The Sugar Bureau in the UK found that increased sugar intake was associated with leanness, not obesity, and concluded that there simply wasn’t enough evidence to warrant a quantitative guideline for sugar consumption. Another study, at the University of Hawaii, which is an extensive review of sugar-related literature, quoted:

“It is important to state at the outset that there is no direct connection between added sugars intake and obesity unless excessive consumption of sugar-containing beverages and foods leads to energy imbalance and the resultant weight gain.”

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Summary 

So what's the take away message here?

When you're looking at the label of some fancy health tonic, or a bottle of kombucha, or protein powder and you see that it contains 5 to 10g of something like sucrose fructose or maltodextrin or glucose, that is a veritable drop in the bucket that has never been proven by any form of nutritional science to causing any form of metabolic disease, especially if you are a physically active person. You are literally burning that much sugar within the first 15 minutes after you get out of bed.

That amount of sugar is, as I have described before, a veritable speedbump for an active person, and yes, that even includes active people who are maintaining a state of ketosis.

Case in point – below are the labels of two compounds that I've been known to sip while (shocker!) sitting sedentary on an airplane, or in the complete absence of exercise: TianChi adaptogenic herb complex and LifeShotz wild plant food extract.

TianChi label…

TianChi_SupplementFacts

LifeShotz label…

life-shotz-lifeshotz-ingredient-list-sugar-free-regular-capsules-httpwwwmaryblucacom-1-638

I can't tell you how many freakin' e-mails and comments I get from active, healthy people who flip out about the level of “sugar” shown on labels just like this (almost 40 calories…gasp!) – the same people who will go on to consume hundreds more calories of “sugar” in their breakfast of eggs, bacon and avocado or their evening meal of grass-fed steak, sweet potatoes and a glass of red wine (that's via a process called “gluconeogenesis” in which protein can spike your blood sugar, and here's a great article in the Journal of Diabetes that explains how).

I'm just sayin…

So when is sugar a problem?

It is the overconsumption of sugar, and the 1000+ calories of soda, hamburger buns, ice cream, pizza and the like that causes the issues related to chronic disease, metabolic issues, obesity, insulin resistance, a loss of “fat adaptation” and all the other issues that sugar enemies are screaming about.

Another issue is sucking down a cup of coffee stuffed with so much butter and coconut oil that it tops the 500+ calorie mark (you'd be surprised at how fast cream, butter and coconut oil, etc. can add up calorically), then moving on an hour or two later to a glucose and insulin spiking meal of eggs and bacon.

Another issue is the bar of dark chocolate that accidentally snuck into your diet five nights a week after the glass of red wine, resulting in an extra 3000 calories of sugar each week, or 168,000 extra calories of sugar a year.

That's the sugar you need to worry about. Not the sugar in a pack of healing herbs or a bottle of kombucha.

OK, I'm off my soapbox. Let's summarize.

1) Lift heavy weights so that you can drive glucose into muscle tissue;

2) Exercise in a fasted state before breakfast;

3) Stand at work;

4) Take a short walk after dinner;

5) Don't be orthorexic. In small amounts, and especially from natural sources, sugar isn't even remotely toxic.

Geez.

Now that I look at it, these aren't really “biohacks” as much as basic healthy living concepts, eh?

What do you think? Do you agree? Disagree? Do you have questions, comments, or feedback about these four biohacks for controlling your blood sugar level, why sugar in food sometimes isn't that bad or anything else? Leave your thoughts below! And be sure to check out the free Diabetes Summit from April 18-25, 2016…

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  7. Jeff fodi says:

    Ben – thanks for detailed analysis and pulling this together. There is a great podcast from Peter attia and Richard Johnson that speaks to the different metabolic pathways for fructose versus glucose that would be really interesting to include – https://peterattiamd.com/rickjohnson/

    Keep building those hypotheses, testing and pushing us to grow our understanding.

  8. Clint Grove says:

    Ben, great article, thank so much, really. I did find a mistake in your text, it’s here “mostly winds up his glucose’ I suppose it should read “mostly winds up as glucose”

  9. Molina Morgan says:

    I purchased Nightrider BluCon last year to track my blood sugar level. The device works perfectly well and alerts me whenever my readings hit the unsafe numbers. Great product to rely on.

  10. Lisa Hardy says:

    Hi Ben,
    Thank you for your work!
    I have been wondering why my FBG is always high–above 95 and usually around 101—but my post-prandials are not too high–usually also above 100, but never above 140!
    Looking for any articles that might explain this.
    Please help, as, of course, my doctor can’t! ha!

  11. maria says:

    Hi Ben, where can I find the japanese study that talks about the benfits of doing 30sec of exercise before a meal?

    Thanks!

  12. Rita Maguire says:

    Can you recommend a 24 hour or continuous blood sugar monitor please

    1. Hans Keesom says:

      Abbott freestyle libre. You need to scan manually but version 2 is coming up that does alarm when going high or low.
      It makes it easy to follow blood sugar and keeping it stable and at or below 5.4 moll/l which is where you will burn fat

  13. gareth says:

    I find diet a real bore – dont like to meal plan, count calories etc

    But I do try to eat healthy – mediteranen not keto

    I take from this one should test with a blood sugar monitor at certain tmes throughout the day & make adjustments if required?

  14. George says:

    The links to the paragraph about The Sugar Bureau wont work. Could you point me in the right direction.
    Was there any chance for bias with their recommendations or have I misunderstood their role?

  15. Peter says:

    Just one other point: Pineapples, sweet potatoes, beets, sugar cane (and most popular fruits) are not “completely natural” but bred for increased sugar content to the extent that they barely resemble their wild cousins. Also on the natural theme – they would only be availabe naturally in occasional gluts, and not on a daily basis.

    Not wanting to detract from the article overall, thank you for the detailed and careful thought.

    1. Not disagreeing but would love to see well done studies to prove this

    2. Michael says:

      One other factor that in my opinion needs to be considered: Natural sugars are usually contained within foods with a generous amount of fiber which slows the rate at which the sugars are absorbed.

  16. Peter says:

    IMO Excellent well thought out evaluation.

    The only point I where It think you are significantly wrong is fructose metabolism, where there is evidence that it is not as simple and easy as “fructose is converted into glucose”, with evidence for many knock-on effects of fructose metabolism, and proposed onward secondary effects. In a simplistic view, glucose metabolism is regulated, but fructose emzymes are not sensitive to feedback control, and there is a “runaway metabolism” of fructose. Again oversimplifying, but thre is evidence that the consequence of the rapid metabolism is increased local conversion to fat, primarily in the liver but also in the viscera, which as Im sure you are aware are risk factors for T2 diabetes. Also a separate but related impact on purine metabolism and gout, and also linked to a similar problem with alcohol metabolism.

    Point being that I suggest we should be very cautious about saying Fructose is “just another sugar”!

    1. Jeff fodi says:

      Great feedback. A reference to Richard Johnson’s work may be helpful.

  17. Dan says:

    Do you have a recommendation for a device that continuously monitors blood glucose levels? For example, Medtronic has their Guardian Connect which is expensive and requires a prescription. Thanks.

  18. Nishu S says:

    Thanks for the article on confusing sugar topic. Now i can finally stop yelling at my husband for drinking 16oz of Vita Coco everyday which contains 22g of sugar. Lol.. Guess it cant be that bad since the sugar comes from a natural source? He consumes it daily due to his activity level amd ofcourse high potassium !! Thanks

  19. Konsmo says:

    Ben,

    Great article and content!

    Any concerns regarding Bitter Melon and how it induces oxidative damage in testes? Or with limited use its not to big of a deal?

    Thanks and great work!!!

    1. It does not cause that at all. Super safe.

  20. LGBT says:

    “…Perhaps 50–60% of protein goes through the process of gluconeogenesis in the liver, but virtually none of this glucose enters into the general circulation….”

    Why the fuck should anyone be worried about this? In any way?

    Jesus, get a freaking glucose meter, eat eggs and protein, and carry on.

    .

  21. Tony says:

    Ben,

    Thoughts on sugar post workout out for hypertrophy body comp? I’ve seen reccomendations on 2:1 carb to protein ratio (dextrose & whey). Were you playing with post workout sugar when doing your body building competition?

  22. M says:

    Yet another site that presumptuously assumes lower blood sugar is always better. People with hypoglycemia are ignored, yet again. I won’t be following this misinformation, thanks, as it is only applicable to those with high blood sugar problems, NOT to those with low blood sugar problems.

    And no, hypoglycemia is not “just a rebound to a blood sugar spike from too many simple carbs”, and no I’m not talking about reactions to prescription insulin medications, which we have never used nor needed. Not everyone has the HIGH sugar problem, there also exists a LOW sugar problem.

    This articl is a complete pass.

  23. Adam says:

    Hey Ben,

    Quick question regarding blood sugar and intermittent fasting. I’ve been training fasted for years now and love it, except for one thing. I often find that if I perform any type of activity following my first meal of the day, which is post-workout, I get that feeling one associates with low blood sugar – sort of weak and shaky and feeling like I need to eat something. For example, say I’ve fasted for 14 hours, go out and do a strength workout, and then have a big salad, sweet potato and chicken breast. I feel great during the workout, but if I were to go for a walk 20 minutes after the meal, I would feel like crap. Doesn’t really seem to matter what the post-workout meal consists of, but it’s usually protein and fat and just a few carbs (My evening meal is more carb-heavy).

    Was wondering if you could shed any light on this? Appreciate it!

    1. Possibly a hypoglycemic rebound response in response to the meal…I'd try eating more slowly and chewing your food 20-25x and see if that helps…

      1. Adam says:

        Interesting. I’ll give that a shot. Thanks for the advice.

  24. AWF says:

    Hey Ben,

    Great article, especially the section on how, where, and why sugar gets stored. I think an interesting follow-up to this article would be one that focuses on fats; specifically, how fat is stored in the body and what determines if it is stored in muscle (i.e., intramuscular triglycerides) or in adipose tissue. Thanks.

    1. Great idea! I'll work on that…

    2. AWF says:

      Awesome, looking forward to it!

  25. Todd says:

    I have a quick question about the advice to exercise in a fasted state before breakfast. I do my weight training workouts in the morning; does this advice pertain to weight training as well? I’m programed to think that I need to eat some protein and simple carbs to give me the fuel I need to lift weights, so just wanted to ask. Thanks!

    1. As long as it is not longer than an hour you should be fine. But if you're trying to gain muscle I would do some amino acids, like 10g of this <a href="http:// :https://getkion.com/shop/body/kion-aminos//” target=”_blank”> <a href="http://:https://getkion.com/shop/body/kion-aminos//” target=”_blank”>:https://getkion.com/shop/body/kion-aminos//

  26. Louis says:

    Good post….Frequently people with diabetes also have problems with high blood fats or cholesterol levels,..I want to say its better the patients should control diabetes here we can get anti-diabetic products

  27. Cathy Cooke says:

    Ben, how am I confused? You keep referring to the article in the diabetes journal about gluconeogenesis, but I’m not following since this is their argument: Perhaps 50–60% of protein goes through the process of gluconeogenesis in the liver, but virtually none of this glucose enters into the general circulation.

    How am I misunderstanding this?

    1. Part of it comes down to your insulin sensitivity, as you can read here: http://www.ncbi.nlm.nih.gov/pubmed/9416027 – I recommend you consume a protein rich meal then TEST your blood glucose levels with a blood monitor to see what happens.

  28. Yvette Castro says:

    Thank you Ben for writing this article. It has helped clarify things about glucose. Now I can relax and not be so orthorexic about consuming more naturally occurring sugars. I appreciate your soap box.

  29. Chris says:

    So basically, dont eat or drink and you’ll be fine.

  30. Linda says:

    Hi Ben,

    Like your summary at the end, our whole family can do this, maybe the kids can’t lift heavy weights though they can do some pull ups and push ups, and agree yes it is just about living a healthy lifestyle.

  31. jaimee says:

    Interesting read- thanks Ben. Just wondering if exercising in a fasted state before breakfast is a good idea for a female with adrenal fatigue? Interested in your thoughts on this.

    1. As long as it's in moderation, not a big deal…I wouldn't exceed 60 minutes!

  32. Michelle Silbernagel says:

    Bump :-)

    Gluconeogenesis. Protein spikes your blood sugar, and here’s a great article in the Journal of Diabetes that explains how: http://journal.diabetes.org/diabetesspectrum/00v1…

    Read more https://bengreenfieldfitness.com/2016/04/best-…

  33. magnus says:

    What about the effects of sugar/sugar products on hormones, esp those related related to satiety and hunger e.g. leptin and ghrelin?

    1. Yep, that can be another issue. But again, in moderation not a big deal…check out this study: http://www.ncbi.nlm.nih.gov/pubmed/17234503

  34. Mike says:

    Great work Ben,just great!

  35. Mohammad says:

    Another issue is sucking down a cup of coffee stuffed with so much butter and coconut oil that it tops the 500+ calorie mark, then moving on an hour or two later to a glucose and insulin spiking meal of eggs and bacon.

    How are eggs and bacon insulin spiking?

    In my opinion a better example would be following your bullet proof coffee with fruits, rice or sweet potatoes. Now that would be a disaster.

    However the whole point of having BP coffee for breakfast is not eating “insulin spiking” carbs till night.

    1. Gluconeogenesis. Protein spikes your blood sugar, and here's a great article in the Journal of Diabetes that explains how: http://journal.diabetes.org/diabetesspectrum/00v1…

  36. Jackie says:

    “why do you call eggs and bacon a glucose/insulin spiking meal”

    I’m curious about this question from Daniel also.

    and this too….I thought eggs, bacon, avocado, and steak didn’t have sugar?

    “the same people who will go on to consume hundreds more calories of “sugar” in their breakfast of eggs, bacon and avocado or their evening meal of grass-fed steak, sweet potatoes and a glass of red wine.”

    I know that sweet potatoes and wine have sugar, but eggs, bacon, avocado, and steak? Do tell!! :-)

    1. Gluconeogenesis. Protein spikes your blood sugar, and here's a great article in the Journal of Diabetes that explains how: http://journal.diabetes.org/diabetesspectrum/00v1…

      1. Jackie says:

        Ahhhhh…thank you. I don’t think many people realize this. How much protein would you recommend for a moderately active person? Dr. Mercola always warns against eating too much protein, not that he’s the ultimate guru. But here is one of his articles about that. Would you tend to agree? http://articles.mercola.com/sites/articles/archiv…

        1. 0.5-08 grams per pound of body weight, with the higher end for muscle gain only.

      2. Hi Ben — read the article, the whole thing. While I found the conclusions about protein interesting, I’m not so sure about the rest of the ‘status quo’ thinking that dominates the rest of it. It basically argues for the ‘magic pill’ for obesity, and doesn’t look at the larger comorbid costs of arguing against diets that create weight loss, like ketogenic diets. As with most of the metabolic scientific literature, there are things that are hard to run real experiments on. But the reality is that obesity is a plague in our country, it’s not getting better, and folks have to try something in order to find pathways for change.

  37. Lisa Jordan says:

    Great article! I’m 34 female, Type 2 Diabetic and pretty lean through exercise. I’m 5’8 and 60kg. I was curious about what this statement means ,” is also a significant risk factor for cardiovascular disease (especially if you’re experimenting with something like a high-fat diet, since sugars can easily adhere to cholesterol particles from that cup of fatty coffee you’re drinking and make a high-fat, low-carb diet highly atherosclerotic).” I’m trying to adhere to a low-carb, high-fat whole foods diet and now feel concerned about my heart health after reading this. Are you referring to the sugars in nuts and low-carb veggies that would stick to the fat in my diet? Thanks!

    1. Don't worry about sugars in nuts and low carb veggies. Those are not a significant source of gluconeogenesis. But do be concerned about things like big portions of red meat, bacon, eggs, and other foods that people don't realize can actually spike insulin and also affect blood sugar.

  38. Anup says:

    A Big LOL on bacon and eggs spiking sugar levels :)

    Keep going on these Joslin Style comments

    1. Gluconeogenesis. Protein spikes your blood sugar, and here's a great article in the Journal of Diabetes that explains how: http://journal.diabetes.org/diabetesspectrum/00v1…

  39. Marcellus S says:

    Good morning Ben,
    Awesome article. But I’m confused. If I drink Bulletproof Coffee fasted until late in the day and then eat a salad is that still bad?
    So when consuming BPC what foods should follow my 18 hour fast?

    Thanks

    1. It depends on whether or not you add a bunch of, croutons, etc. to the salad. If you keep the cello low-carb and only low to moderate protein and don't going crazy on either the carbohydrates or the protein, and won't be a big deal.

  40. Phillip says:

    *GASP!* So, are you telling me I can eat a butter soaked potato once and again and not get fat!?!?!?

    Please! Oh please say YES!!!!

  41. Wolfgang says:

    I liked this article. It’s balanced and covers the angles well. I’ve wondered about the high fat diet related to low carbs/sugar. Does eating a high fat diet make it more important to keep carbs/sugar down? Is it just a matter of too much calorie if I aleady have energy from fat and eat carbs/sugar so I might be just basically overeating?

  42. Melinda Greenfield says:

    Ben,
    I’m guessing you discovered your predisposition to diabetes from your 23andme data? Can you share which specific aspect showed you this? Or did you find it from another source? Just curious

    1. There are specific genetic snips associated with diabetes. Check this out: https://www.snpedia.com/index.php/Type-2_diabetes

  43. David says:

    Thanks Ben. There is definitely a lot of misinformation on sugars. I had always heard that fructose was converted to fat by the liver.

  44. James Baker says:

    Bacon and eggs (and avacado?) spike glucose and insulin? How? What am I missing? Do I need to change course? I eat eggs & avacado daily, uncured bacon a few times a week with it. Love the info, thanks!

    1. Gluconeogenesis. Protein spikes your blood sugar, and here's a great article in the Journal of Diabetes that explains how: http://journal.diabetes.org/diabetesspectrum/00v1…

  45. Juck says:

    I totally see your point here. Just three things

    – why the 500+cal mark? Is that where something important regarding blood sugar happens?

    – I know protein can spike blood insulin&glucose, but this effect is significantly lessen when protein is consumed with fat, is this correct?

    – I once read your article saying consuming too much fat/meal can spike insulin, does this spike glucose as well? also, any idea how much are we talking about here?

    1. Gluconeogenesis. Protein spikes your blood sugar, and here's a great article in the Journal of Diabetes that explains how: http://journal.diabetes.org/diabetesspectrum/00v1… – the 500 cal mark is not something magical, but I was just throwing that out there because that's actually calories you'll find in the average cup of fat filled coffee.

  46. Wendy says:

    Actually, sugar is toxic to people who are allergic to it. Yes, they exist. Also, from the latest reports I have read, fructose is not the same as other sugars. It is metabolized in the liver, causing the liver to work harder than normal. Also, if I remember correctly, after that the liver shoots the sugar directly into the fat cells completely bypassing the muscles. So if you want to stress out your liver and get fat, eat fructose. I personally cannot eat too much sugar without suffering ill effects including fatigue, headache, muscle weakness and hunger within a couple of hours since my blood sugar drops rapidly after it spikes giving me low blood sugar. I also note it appears to decrease immune system function making it easier to get sick from colds (recently had a killer cold when I hadn’t had one for about 10 years! Had eaten lots of sugar for some days prior. Also, suffered extreme stress which all resulted in getting horribly sick. Not fun!)

  47. daniel says:

    You say:

    “So when is sugar a problem?

    Another issue is sucking down a cup of coffee stuffed with so much butter and coconut oil that it tops the 500+ calorie mark, then moving on an hour or two later to a glucose and insulin spiking meal of eggs and bacon”

    …this example sounds a bit very abstract to me. first of all a bulletproof coffee version at 500+ i’ve never seen anyways….if if this would be realistic i can guarantee you that there is no way that you feel like having eggs and bacon after an 1 or 2. and again even if this would be the case (for maybe a farmer…) why do you call eggs and bacon a glucose/insulin spiking meal….all a bit extreme.

    Read more https://bengreenfieldfitness.com/2016/04/best-…

    1. Do the math. You'd be surprised at how quickly things like butter and coconut oil add up. Regarding eggs and bacon: Gluconeogenesis. Protein spikes your blood sugar, and here's a great article in the Journal of Diabetes that explains how: http://journal.diabetes.org/diabetesspectrum/00v1…

      1. Bob says:

        Hi Wendy, The only time I eat fruit (mostly a frozen berry medley thawed and about 50 grams of black grape raisins) is right after my resistance workout. I add a moderate 15 minute treadmill walk to top off after the fruit. They don’t bypass the muscles at that point because I’d be gaining fat but I continue to lose fat. Also there is study involving Trehalose and it’s ability to stop the livers of mice from gaining fat in their livers despite eating a high fructose diet. I use that also about 5 grams or so with my berries. https://source.wustl.edu/2014/06/fatty-liver-dise…

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