Carnivore diet

Sugar Pilled: Sugar Is Not Bad For You...Here's Why

Sugar Pilled: Sugar Is Not Bad For You...Here's Why

Sugar...the only thing demonized today more than my beloved red meat.

Well, just when you thought my views couldn’t get any more controversial, I’m here to prove you wrong….

And before you ask, no I am not locked in a basement being tortured by the big orange juice lobby, forced to write this.

Sugar supposedly can cause cancer, obesity and diabetes. Sometimes it will even jump out of the bag and punch you in the face.

I used to think this too. It took a while for me to open my eyes, but it’s nice being able to see again.

The goal of this post is to start to dispel some of these notions in this probably won't be totally complete by the end, however. You're likely to still shy away from sugar, and probably will still be afraid of sunning your genitals too...But we can try.

Let's ease into it...Before I get into why I think sugar is actually good for you (if this is too hard for you to read, pretend I didn't say this), in this article let me dispel some myths about why it’s bad for you.

“Everything popular is wrong” -- Oscar Wilde

What is Health?

An overly reductionist view has permeated mainstream medicine. Ancient medicine viewed our bodies as self healing, energetic organisms. Whereas the modern, technolgoical, allopathic approach looks at us like a car...disease to ancients was a product of imbalance energy flow throughout the entire body, whereas to moderns its due to a faulty part.

Despite what I thought was a more holistic approach to health with the carnivore diet, I now realize that it too was quite redunctionist, distilling health down to the absense of “inflammation” or blood sugar spikes.

But now I realize that I missed the forest for the trees

Health is not simply avoiding carbs, or vegetables. Nor is it necessarily “eating ancestrally”. Real health is resilience. It is about maximizing the energy flowing through your mitochondria. Which in turn means maximizing your vitality, beauty, and intelligence. This ensures that your mitochondria do not degrade into more primitive energy production mechanisms like yeast do (the same fermentative process that happens when you get cancer).

See what separates us as humans is turning oxidative + nutrients into ATP and using that vital life energy to reach higher forms of consciousness. But when oxidative phosphorylation malfunctions, our cells revert into a primitive fermentation process, called the warburg effect. I will get into this in another article, but just because this fermentation process uses a lot of glucose, doesn’t mean that glucose causes it.

Back to health…

Health, in my opinion, is what the ancients called chi. It is:

  • Great, stable energy
  • Restorative, deep sleep
  • Clear skin
  • Sex drive
  • Non painful periods
  • Thick, luscious hair
  • Good libido
  • Optimized hormonal balance
  • Peaceful mood
  • Not peeing 20x a day
  • Low stress
  • Lean muscle mass
  • Well-functioning gut

It is SO much more than having a 6-pack, and this is part of where we have gone wrong

Chi, or energy, is based on your metabolism. And metabolism is a result of hormone optimization, oxygen delivery, thyroid health, glucose metabolism, and mineral / vitamin balance.

Pretty much all signs regarding my health were pointing towards me needing more sugar. And finally I took the signs and had to give in.

Sugar and Disease

A hindu fable describes six blind men who approach an elephant trying to guess what it is. The first approaches, bumps up against the side and declares “it’s a wall!”. The second feels the tusk and mistakes it for a spear. The third grabs its trunk and thinks it’s a snake. So on and so forth, until all the men end up arguing passionately for their position. While each is partially right, none is fully right. This illustrates the issue with seeing one part of a complex subject and assuming it to be the whole.

It is a perfect analogy for nutrition and something I’ve fallen into myself.

The history of nutrition is littered with examples of groups of people villifying one nutrient at the expense of others based on a myopic focus on a biomarker. Everyone sees part of the puzzle, develops tunnel vision with respect to their expertise, mistaking their limited view for a complete picture.

Rarely are things as black and white as people want to paint them. There are pros and cons to everything...even to steak and ball sunning.

Many, if not all of you, now agree that red meat has been mistakenly vilified due to poor, misinterpreted evidence. Distilling heart disease down to a single food that we’ve been eating forever is backwards and foolish.

Well, when saturated fat was vindicated, health experts turned to sugar next as the villain.


And I fell for the trap too. Sugar was synonymous with sickness for me, forever...However, over time, I started to see more and more evidence that chiseled away at this dogma.

If sugar is so poisonous, why do we always have sugar coursing through our bloodstream at all times? Why does our body go out of its way to convert protein and fat into sugar so that the brain has an adequate glucose supply? Doesn’t our body know it is so toxic? And how has our health still continued to decline, with obesity and diabetes rates increasing despite sugar consumption falling across the board?

How are the kitavans, hadza and kuna, who eat a very high % of calories from sugar and carbs so healthy?

Maybe avoiding sugar isn’t the key to optimal health and maybe it is actually hurting us?

Briefly, what is sugar?

The sugar in our diets today comes in three main forms.

1: Starches, which are predominantly made up of chains of glucose. These are things like potatoes and grains.

2. Fruit: most people don’t realize that fruit is approximately 50% glucose and 50% fructose, thus is a sucrose molecule.

3. Table sugar: sucrose. Pretty much the same thing as fruit!!

4. High fructose corn syrup: frankenstein hybrid of the two above, containing up some fructose and some starch. This is not the same as table sugar.

So many people today will tie themselves in a not trying to claim “natural fruit is healthy but table sugar is not” the bandaid off and realize the two are pretty much the same thing...and BE FREE.

Similarly, other health gurus will promote complex starches, but not fruit or sugars which I think is the exact opposite of what you should do. As I show below (and more in other articles), fruit is lower glycemic index because of the fructose and much easier to digest.

Why does everyone think sugar is bad?

I’m not going to deny that there are studies showing that sugar is bad for you. What I am going to argue is that all of the studies that purport to show that are very low quality and that there are much better studies showing the opposite. This is the same exact thing that happened with red meat.

The more I learn, the more I realize how hard it is to sift through the scientific literature. Most of the things that health gurus speak about are tied to a handful of studies that have been promoted by bigger agendas. The villifcation of red meat and the promotion of intermittent fasting are two such things.

The saying is somewhat true that you can find a study to prove just about anything. But where people go wrong is that it is not true that you can find a very high quality study to prove anything. Most people just do not decipher between the two.

So the first reason why people think sugar is bad for them is because sugar intake does tend to be correlated with disease.

In epidemiological studies, consumption of added sugars is associated with obesity <23,24,25> and risk factors for cvd <26>, diabetes and cancer <36,37>.

However, for those that skipped high school science, we all know that correlation is not equal to causation. As I will discuss below, when examining studies with isocaloric substitution of sugar / fruit, the evidence does not hold up.

The second big reason why it’s easy to blame sugar for disease is because blood sugar dysregulation tends to go hand in hand with disease. But this is the same exact clown and pony show which happened with cholesterol. Dietary cholesterol was attacked early on because high cholesterol was associated with heart attacks, but now even the FDA and USDA admit that is not the case. Similar to cholesterol, what matters more when it comes to blood sugar is endogenous production. Just beecause you eat sugar, doesn’t mean that your fasting blood sugar will be high. I will get into that more below.

The third reason why sugar is easy to blame is because for people with super low nutritional status, high pufa intake and metabolic dysfunction, it is indeed possible that sugar may harm them. Thiamine status, for example, plays a big role in shuttling sugar through oxidative metabolism -- a nutrient that many people are deficient in. But that doesn’t mean you can’t paint it with a broad brush and say it is bad for everyone and the cause of that disease.

The fourth reason is because refined sugar isn’t very satiating, so when people eat sugar they tend to eat more calories. Some studies will show sugar is harmful for this reason -- it causes people to gain weight, simply because they eat more. That doesn’t mean that sugar is inherently bad.. As I’ll get into more below, it’s the weight gain that’s causing the issues, not the sugar. And as I’ll discuss in the follow up to this post, I actually think that higher carb / higher fruit diets can help to lose weight.

And the final reason why sugar is often blamed for poor health is because of how people consume sugar. Most people eating high sugar diets aren’t getting it from fruit or natural, organic cane sugars...they are getting it from soda, candy and high fructose corn syrup. The studies blaming sugar don’t distinguish between these sources. These forms are also mixed with other chemicals and additives that contribute to issues. As you’ll recognize, this is exactly what has happened with red meat too -- most people eating a lot of meat aren’t eating high quality, grass fed steaks on their own, but are eating burgers, fries and toppings with a lot of chemicals.

Listen, I was this guy in the middle below for a while so I totally understand where you’re coming from. But when my health started to deteriorate, I had to respond. If yours is too, it’s time to question some of your closest held beliefs.

Why You Can’t Trust Most Studies & Headlines

I’ll be frank...most nutritional studies are absolute garbage. They’ve been cherry picked for food companies and big pharma’s interests.

Over the last year, I’ve seen scientific research published that shouldn’t get a passing grade in high school. But even worse, the news outlets that people rely on have incompetently misinterpreted the results.

When it comes to studies, there’s a hierarchy of the trustworthiness of evidence. It starts with personal opinion, and ends with systematic reviews and meta analyses of randomized controlled trials.

Most studies in nutrition are cohort epidemiological studies (also colloquially referred to as observational studies). Epidemiology is the branch of health that look for associations of disease in groups of people and try to infer their cause. They key words “associations” and “try”. Whereas a randomized and controlled study is used to determine causality, observational studies can only assume a correlation.

This key, unrecognized distinction is one of the biggest reasons why so many people are in poor health. Observational studies are like astrology to astronomy — they aren’t real science.

Yet they’ve been used to support all nutrition recommendations. It’s like if doctors started prescribing meds based on the moon cycle…

However, epidemiological studies do this in reverse. They first gather data and later come to a conclusion. But science is only science if you’re making falsifiable hypotheses that you can test.

This is why epidemiological studies are only useful to uncover correlations that you later rigorously stress test.

Without randomizing and controlling, there are likely confounding factors that alter the results. Just because A and B are related doesn’t mean A caused B. B could have caused A. For instance, rich people tend to live in big houses. That doesn’t mean that big houses make you rich.

Pretty much every nutrition study quoted in the media is an observational study. Keep this in mind as you read scientific news.

The Studies Vilifying Sugar Are All Garbage

When it comes to sugar, pretty much all of the studies disparaging it fall into one of four categories:

  1. Epidemiological
  2. Adding excess calories to diet in the form of high fructose corn syrup (or sometimes just sucrose)
  3. High fructose corn syrup instead of sucrose (which contains a much higher fructose content + starch content)
  4. Studies on rats who react much differently to fructose than humans do

Whereas there is a substantial amount of higher quality evidence on the opposite side: controlled, isocaloric studies on sucrose in human beings showing no detriment to adding sugar. But similar to red meat, these aren’t what generate interest these days and aren’t what’s cited.

Don’t believe me. Let’s get into the actual studies they use to claim sugar is bad for you since we’re all so pro science here.

Let’s google it first

Here are some examples of the quality of evidence people use to support their claims…

A quick google search on why sugar is bad for you. Follow along… The first article is from healthline. They’re good right?

Let’s look at the studies healthline quotes for instance.

Every single study in the first section on sugar causing weight gain is looking at sugar sweetened beverage and soda consumption. A little misleading, no? As I’ll get into below, if you restrict the studies to sucrose consumption in humans, it doesn’t paint such a clear negative picture. But instead, this article cherry picks sugar sweetened beverage studies on humans and / or in animals.

What about diabetes? Sugar causes diabetes of course right?

Well they make this claim without any citations: “What’s more, prolonged high-sugar consumption drives resistance to insulin, a hormone produced by the pancreas that regulates blood sugar levels.” I’ll show below is false.

Then they cite an associational study of sugar sweetened beverages and diabetes here. Sure, i will grant that drinking a lot of soda may cause diabetes. That is not what I am trying to refute in this article.

Once again, no controlled study on sugar. Frankly, this article has proved nothing and I am shocked at how low the quality of evidence is.

Let’s go to the twitter sphere for some more evidence...

Now here’s another that the “celebrity doctor” doctor tro used as evidence.

Oooooh scary headline about “fructose causing de novo lipogenesis”.

Listen, I respect dr tro, but it’s clear that he put no time into analyzing the actual study. These types of claims are quite dangerous (and something I’ve fallen into the trap of in the past).

This was a study on mice where they fed them 60% fructose. If you drank soda all day long as your only food, you couldn’t even get 60% of your calories from fructose as pretty much any form of sugar you consume is at most 55% fructose. Nor am I recommending you consume all of your calories from sugar / fructose...

So if you’re a mouse consuming an unnatural amount of fructose as all you eat, then you probably should be worried.

These are just some examples of how the evidence on sugar has been bastardized to push an agenda.

Confirmation bias is a hell of a drug.

Sugar Pilled: It’s not actually bad for you

So is there any good evidence on sugar consumption? Turns out, like with red meat, there are isocaloric studies on sugar consumption...they’re just being ignored by most people. In fact, there are some meta analysis that have aggregated all of the good evidence on sugar and reviewed the results.

This paper here reviewed the whole shabang of evidence. They isolated studies down to ones reviewing isocaloric differences in sugar consumption in natural forms, and found zero health benefits to restricting it.

“We conclude based on high quality evidence from randomized controlled trials (RCT), systematic reviews and meta-analyses of cohort studies that singling out added sugars as unique culprits for metabolically based diseases such as obesity, diabetes and cardiovascular disease appears inconsistent with modern, high quality evidence and is very unlikely to yield health benefits”

And another one here:

“Prospective cohort studies, which provide the strongest observational evidence, have shown an association between fructose-containing sugars and cardiometabolic risk including weight gain, cardiovascular disease outcomes and diabetes only when restricted to sugar-sweetened beverages and not for sugars from other sources.”

Based on the totality of evidence, nothing suggests that isocalorically sucrose in its natural form in normal doses is bad in any way for humans. Meaning if you take someone eating 1000 calories from protein and fat and swap out the fat calories for table sugar, there is no evidence this is harmful (and in my next article I’ll show why it may actually be beneficial).

Sugar is getting blamed for what soda, high fructose corn syrup and an unhealthy lifestyle did.

Let’s dispel some of the myths 1 by 1.

Myth#1: Sugar Breaks “Keto” (and this is bad)

A myopic focus on ketone levels has dissuade a lot of people from eating any carbohydrates at all. This reductionist view of health has missed the forest for the trees, replacing good health with one metric like ketone levels. In reality, as I mentioned above, health is a complex equation between hormonal health, nutritional status, energy levels and tanness of genitals (lol). What people miss about nutrients and sugar in particular is that it is much more than something that provides nutrients -- sugar is powerful signal to your body that it is in a food rich environment and thus can relax. That doesn’t show up in your keto levels.

Nonetheless, the keto diet has benefited a tremendous amount of people. But I think that the benefits aren’t actually from the ketosis part of the keto diet. And despite being a tremendous boon for people that have been struggling with their weight, it’s far from optimal for your overall long-term health.

Instead, I believe that many of the benefits from going keto stem from these changes:

  • Eating more protein
  • Cutting out gut stressors
  • More nutritious red meat
  • Removing seed oils and lowering PUFA consumption
  • Increasing consumption of saturated animal fats
  • Eliminating junk food

In fact, even when it comes to weight loss, this meta analysis here says it’s not necessarily the low carb-intake that’s doing it on keto, but it’s the higher protein. Additionally, recent metabolic studies have shown no difference in weight gain between keto and higher carb diets when calories and protein is controlled. As I’ll also show below, you can lose weight even when you have glucose and insulin in your blood (in fact, protein is also insulinogenic, so if it were the case that insulin completely shut off fat loss, you’d want to eat almost no protein too).

As I discuss in this article, eating sugar definitely does reduce keto levels, but that’s not a bad thing. In exchange, eating more sugar can help to increase co2 levels, thyroid function, libido, mood and metabolism.

Myth #2 Sugar Makes You Fat

It makes sense why people would think this...if you’re obese, you probably consume a lot of sugar (along with a lot of other junk). But that doesn’t mean that sugar caused the obesity. In fact, there are now a number of studies that disprove this.

There have been four recent meta analyses that aggregated these RCTs. The key, as I mentioned, is isocaloric exchange.

This meta analysis looked at an isocaloric exchange of fructose for other carbohydrates and found no differences in weight gain. You may argue it was because they were still consuming carbs and if they had some magical ketones they’d be okay (but as I’ll show below that may not be true). At the very least, this helps to dispel the notion that fructose is particular problematic.

One of the largest trials on high sugar diet vs high fat diets was the carmen study comparing ad libitum diets in 398 obese individuals. Both groups lost weight and there was no significant difference between the two diets.

This study found that in two energy restricted diets, the group with higher fructose intake lost almost double the weight in 6 weeks. According to the researchers a high protein high fructose breakfast induced more thermogenesis than a high protein, high glucose breakfast….which uncoincidentally is the diet I’m promoting these days.

One reason why is because fructose is particularly unique in that it doesn’t require insulin to get into the cell and can actually boost metabolism and energy expenditure.

What about the evil glycemic index and blood sugar spikes? In this study on over 200 people, the only difference in weight loss was due to protein intake, not the glycemic index effect.

I can go all day….

Another study in which one group ate 70% of their calories from carbs and 40% of their total calories from sucrose (table sugar) and another ate only 4%. The researchers found: “Both groups showed decreases in depression, hunger, and negative mood, and increases in vigilance and positive mood with time (P < 0.01). Results showed that a high sucrose content in a hypoenergetic, low-fat diet did not adversely affect weight loss, metabolism, plasma lipids, or emotional affect”

As I’ll discuss next article (I know a lot of teases in this), sugar can be incredible for your mood as this study revealed.

In this 8 week trial, the group of participants that got 10% of their calories from sugar lost more weight than those that got 5% of their calories from sugar.

This study on rats that were fed coca cola (sweetened with sucrose) ad libitum showed that they ate 50% more calories, but didn’t gain any weight...(And by the way, this is exactly what happened with me. I didn’t consume my extra calories from coca cola, but I consume almost 1000 more calories now when eating fructose and I have gained no weight).

And finally, for the people who look at orange juice like it’s crack because they’ve heard it will “increase liver fat”: This study showed that a 50% surplus diet with 800g of carbs daily (none of you are doing this), absolute DNL in the liver is < 5g of fatty acids. Nobody is getting fat from eating excess fruit.

CHO overfeeding DNL

To summarize, with one more study pictured below, “sugars do not make a unique contribution to obesity”. Obesity is an energetic problem regarding the entirety of your lifestyle.

But what about diabetes? Won’t it raise your blood sugar, cause insulin resistance and make you implode?

Myth #3: Eating Sugar causes Insulin resistance and diabetes

The next biggest reason why people avoid sugar is because they think it will cause “insulin resistance and diabetes”.

Insulin resistance is very important to treat and consider, but many are going about it all wrong. There’s this huge misconception, especially in the keto world, that the cause of insulin resistance is excessive insulin spikes, reducing the responsiveness to its action over time. It’s almost like insulin is a nagging child...and after a while your body ignores it. Given one of insulin’s predominant roles is to push sugar into cells, the response from low carb folks is to limit sugar intake.

Unfortunately, however, the science does not back that up. Sugar doesn’t cause insulin resistance or diabetes, and may actually help.

There are a number of studies showing that high carb and sugar intakes are not associated with insulin resistance and diabetes <* * * *>. And as I’ll cite below, there are others that show sugar and high carb diets may even be therapeutic in diabetes.

The main point I want to get across in this section is that just beacuse diabetes is represented by high blood sugar, doesn’t mean sugar consumption is causing it. Nor does it even mean that you should restrict carbohydrate intake when you have high blood sugar. Let me explain:

It turns out that the high blood sugar in diabetes is mainly from the liver converting fuel into sugar and not from dietary sugar.

What is really happening I now realize is the unifying principle of most, if not all diseases. Your cell is perceiving an energy shortage because it can’t properly metabolize glucose. Thus it is sending out stress signals, causing your body to break down tissues and turn it into fuel (and store fat in other areas for perceived future shortages).

What is actually causing the diabetes in these situations? I think it’s a combination of stress, excessive fatty acid / PUFA oxidation. The most common cause, in my opinion, is excess stress (this isn’t just psychological stress, but biochemical and physiological stress due to perceived energy shortages).

Cortisol causes “enhance muscle protein breakdown, adipose tissue lipolysis, and hepatic gluconeogenesis, and reduce glucose utilization, effects which elevate circulating glucose concentrations”. Essentially it increases blood sugar and decreases its utilization: pretty much the exact profile of diabetes.

If the fatty acids released are due to pufas, it can interfere with insulins action. And, by the way, it’s not just omega 6 linoleic acid that may be an issue. Omega 3’s too can oxidize and produce insulin resistance. This study suggests that chronic stimulation of the HPA axis via stress can also contribute to insulin resistance. Over time, chronically burning fatty acids will slow metabolism because it’s a signal to your body that you’re stressed and need to preserve fuel. This is adaptive in the short term, but can lead to long term complications.

Ultimately, diabetes is a disease of mitochondrial dysfunction where it cannot oxidize glucose and has to instead push it through glycolysis.

It’s for this reason why keto and low carb diets actually end up slowing down your thyroid production and metabolism over time instead of ramping it up like the real cure should do. Keto

Keto can help to put a bandaid on the issue almost like skipping leg day at the gym because you have weak legs...but it doesn’t actually solve the problem.

Just to drive home the point. sugar can even be beneficial for it. In this study, high carb diets (65%-85%) were highly therapeutic for diabetes. According to the researchers:

“virtually all sucrose contained in the high-sucrose diet was added to fruits, milk, beverages, and coffee” (9). That sugars are innocuous and even beneficial only in the form of diluted solutions is also suggested by the improved glucose tolerance with a liquid-formula diet containing 85% of energy as dextrose or a mixture of dextrins and maltose “.

The more sugar they ate, the better they processed sugar.

According to the others, studies in which weight gain is controlled (one of the major issues with studies on sugar), showed “that fasting blood glucose levels decreased <5,6>, glucose tolerance improved <5>, and insulin requirements were either unchanged or decreased <5-9>, when patients with insulin-dependent diabetes were fed carbohydrate-rich diets.”

Mind, blown. What seems to be happening is that sugar is highly therapeutic for diabetes because the body is overproducing it in response to a perceived shortage. The shortage can be for a number of reasons -- like the ones described above -- but sugar with a nutrient and mineral rich diet (especially coupled with things like NAD, B1, aspirin and magnesium) may be highly beneficial for diabetes (I’ll break this down more later). Back to the stress point above, some studies have shown that sugar is highly anti stress. So via blunting the cortisol spikes, eating sugar can lower blood sugar.

Fructose also may have some anti diabetes superpowers. Fructose can by pass the excessive fatty acid suppression of glucose oxidation, providing pyruvic acid to ramp back up the oxidative metabolism. This may be why honey, in this study, protected against metabolic disease.

Once again, I’m not saying just to eat sugar...but I am saying that it can be beneficial on top of a meat diet. Especially given the insulinogenic nature of protein, which on its own will lead to low blood sugar and cortisol spikes.

A few other causes of diabetes to be aware of that aren’t sugar. This study here found that endotoxins stimulate inflammatory cytokines that induce insulin resistance. Gut irritation is a huge cause of disease and I think explains a large part of the association between junk food diets and diabetes / other disorder.

Lack of sleep is associated with diabetes, most likely via the stress pathways.he study demonstrated that men who slept less were at 2.8 times greater risk of developing diabetes, those who had difficulty falling asleep has almost 5 times higher risk of diabetes, and those with difficulty in maintaining sleep had 4.8 times greater risk”

Diabetes is so much more than a “sugar intolerance”.

Myth #4: Sugar Causes Inflammation

Ooooh, the scary boogeyman of inflammation. There’s a widespread misconception that sugar will cause inflammation, ultimately leading to a whole host of diseases. Either because sugar is inherently toxic...a poison...or because blood sugar spikes are.

Both are partially true...but taken out of context.

Sugar can cause inflammation...when you consume way too much of it. Fructose is our liver’s go to fuel, which is why people often have the misconception that it’s bad for the liver...Unlike alcohol, it doesn’t go to the liver for detoxification purposes, it actually goes there for fuel.

Human livers have a remarkable ability to take up fructose and use it to burn more for fuel (2). However, when you consume more than this amount, that is when you may cause some inflammation as a signal to stop eating so much damn food. However, according to this meta analysis, once again the research is only supported by lower quality studies which use: “animal models of overfeeding and select human intervention studies with supraphysiological doses or lack of control for energy”

The big problem with the inflammation research, especially on fructose, is that most of it is done on rats.

Jay feldman sums up the reasons why these studies don’t apply to humans well here. Essentially, most are done on rats which convert many times more fructose into fat than our livers do. Additionally, if you block the metabolites of PUFAS, the fructose no longer activates the inflammatory pathway. Given they’re fed a high PUFA diet in a lot of these studies, it would make sense that there is inflammation.

This study here sums it up well: it’s the obesity, not the sugar or carbs causing inflammation. .

Myth #5: Blood Sugar Spikes are Bad

What about blood glucose spikes, the cult around continuous glucose monitors and fake sugar replacements?

Blood sugar is tightly regulated, but the problem with the myopic focus on postprandial blood glucose levels is it tends to ignore other factors that are at least or more important: glucagon cortisol, adrenaline, thyroid and growth hormone all play a major role in regulating blood sugar levels.

Meaning myopically focusing on a food’s impact on blood sugar is kind of like choosing a car based on how loud it is….It may be a decent selling point, especially if you’re trying to distract from something else (like the fact that you’re buying a 2003 mazda with no muffler), but it also detracts from the actual driving experience. Same goes for blood sugar -- it’s sexy to monitor with a continuous glucose monitor and high blood sugar tends to be associated with disease...but that doesn’t mean you should choose a food based on its glycemic index.

Additionally, another problem with this approach is it ends up pushing people into foods / products that may end up making your health even worse. Stevia, for instance, has been linked to infertility in rats. It also is the fuel behind the entire whole wheat movement, which I believe is even worse for your health due to the indigestibility & endotoxin load.

This meta analysis reviewed higher quality studies on GI and found that glycemic index has no relevance for health in good interventional studies. “The strongest intervention studies typically find little relationship among GI/GR and physiological measures of disease risk. Even for observational studies, the relationship between GI/GR and disease outcomes is limited. Thus, it is unlikely that the GI of a food or diet is linked to disease risk or health outcomes. “

If you’re really worried about blood sugar spikes (which I don’t think you should be), you should reduce your starch consumption, not sugar.

Lastly, as I will discuss more below, I think there may be some reason to be concerned at least as much about postprandial triglyceride spikes.

Kevin Hall’s recent metabolic ward study showed that swapping glucose for fat pretty much just directly trades off between which nutrient you’re spiking in your blood after each meal.

Myth #6: Sugar Causes Cancer

Last but not least: according to some people, sugar is like rocket fuel for cancer. However, this is another reductionist misconception people have based on a superficial read of the evidence.

Something called the warburb effect describes the pathologic changes in metabolism of a cancer cell, where it reverts to anaerobic glycolysis even in the presence of oxygen. In this state, the cell tends to consume a lot of sugar, and many have interpreted this to mean that sugar is particularly harmful in cancer.

But new research suggests that this hypothesis is backwards.

In fact, it looks like the cell is actually turning a lot of the sugar it’s consuming into fat to use.

According to Ray Peat who cites a pair of studies: “Cancer cells use glucose and the amino acid glutamine primarily for synthetic purposes, and use fats as their energy source;the growth stimulating effect of the "essential fatty acids" (Sueyoshi and Nagao, 1962a; Holley, et al., 1974) shows that depriving a tumor of those fats retards its growth. The great energetic inefficiency of the cancer because it synthesizes fat from glucose and amino acids, and then oxidizes the fat as if it were diabetic.”

Cancer, in many ways, is similar to the diabetic phenotype where the cell can no longer use oxidative glucose metabolism so it shifts to more stressful and primitive energy production mechanisms -- the anaerobic metabolism. In fact, if you restrict glucose in the diet, cancer cells will still get it by increasing cortisol and consuming muscle tissue. This is what drives the usual cachexia and wasting away of cancer.

Regarding fuel, some studies suggest that it’s really fatty acids that cancer cells are hungry for. This one on leukemia even goes as far to say they are “fat addicted”

.."The leukemia cells' appetite for fat seems to be formidable," Taegtmeyer said. "More importantly, fat oxidation seems to promote leukemia cell survival. Conversely, shutting off fat oxidation makes the cells vulnerable to self-destruction. If these initial results hold up, inhibitors of fat oxidation may become a new way to treat leukemia patients."

Another study on melanoma from a major cancer research center recognizes that sugar has little role in fueling growth. When it was restricted, the cancer switched to oxidizing glutamine and became much more aggressive. Cancer cells are hungry and they will consume energy even if you try to restrict it.

Ultimately, I think cancer comes down to energy metabolism. When cells are injured, they induce hypoxia inducible factor, which blocks mitochondrial respiration. This is what triggers the shift towards glycolysis and fatty acid oxidation. Over time, the cell will actually break down and consume its glucose oxidation apparatus, ensuring it switches to less energetically intensive pathways, which ultimately perpetuate the cancer further. The lactate that glycolysis produces ends up being another signal for the cancer to spread.

As you can see in the photo below, in a normal cell metabolism, it’s oxidizing glucose to provide a substantial amount of co2 and atp. But in a cancer cell, its only able to produce a fraction of the amount with the rest going into lactic acid, further perpetuating the cancerous tumor. The key is flipping the cell back to efficient oxidative phosphorylation.

As the cell dies it emits growth signals to cells around it, encouraging them to spread to survive.

This recent study found that the loss of oxidative phosphorylation is enough to cause the cells to de differentiate into the cancerous state.

without mitochondrial complex III and cellular respiration, certain metabolic byproducts were missing from the cells, which acted as a signal that enough lymphatic endothelial progenitor cells have left the vein and the Prox1-VEGFR3 feedback loop can shut down. “This is probably a general sensor of the metabolic status of the cell, somehow capable of sensing the micro-environment and detecting what the cells need to do,”

If this all comes back to energy, it’s likely that cortisol plays a major role in cancer metabolism. Studies are now addressing this pathway. Georgi Dinkov shared a study on pancreatic cancer being reversed by blocking cortisol, for instance.

And if cancer is really addicted to fatty acid oxidation like the studies above suggest, then the last thing you’d want to do is increase fat consumption. In fact, you’d probably want to block fatty acid oxidation...and some studies suggest that may be effective. Both aspirin and niacinamide are fatty acid oxidation blockers and have both suppressed tumor growth and caused cancer cells to die in a number of studies. In this study, aspirin was effective at slowing breast cancer tumor growth.

And in this study, niacinamide reversed breast cancer metastasis by increasing the NAD / NADH ratio.

Despite the war on cancer, rates are going the opposite direction. Maybe it is because we are looking at diet and health all wrong?

Take the Sugar Pill

It’s not so scary. Stay tuned for an article on all the benefits of sugar coming soon.

Further reading:

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