More blood sugar, more dementia!

Want to avoid dementia as you get older? Then perhaps you should use caution with foods that raise blood sugar.

A recent study published in the prestigious scientific journal New England Journal of Medicine shows that the risk for dementia is higher in people with higher blood sugar levels. This also applies to so called “normal” blood sugar levels, not just diabetics.


Above is a graph from the study showing average blood glucose levels in non-diabetics and the relative risk for developing dementia.

Low blood sugar, low risk

As you can see it’s statistically beneficial to maintain an average blood sugar level around 90 mg/dl (5 mmol/l) – and less beneficial if the average is above 108 mg/dl (6 mmol/l).

As usual, statistical correlations don’t prove that the risk for dementia decreases with avoiding blood sugar-raising food (like sugar and grains). This is just another clue. We know from before that dementia is far more common in people with abdominal obesity, type 2 diabetes and other metabolic disorders. These are problems you also run the risk of getting from excessive amounts of bad carbohydrates.

To determine the cause we have to perform expensive studies that test advice on a low-carb diet and compare against a control group in order to see whether the risk of dementia is actually decreasing. Such studies take a long time, once they’ve been started. We may have to wait 10-20 years for results.

While we’re waiting I checked my blood sugar, one hour after a rich LCHF breakfast. My blood sugar was 92 mg/dl (5.1 mmol/l). Feels good.

Measuring Blood Sugar

Previously on measuring blood sugar

Order a blood glucose monitor from


Better Blood Sugar, Better Memory

The ketogenic diet for Alzheimer’s prevention and treatment: can it help?


  1. eddy

    Excerpted with permissions from Penguin Books India from the book ‘The Diet Doctor: The Scientifically Proven Way to Lose Weight’ authored by Ishi Khosla.

    Replies: #4, #15
  2. Andy
    Great, I'm fu#ked! T2D and even on a (pretty strict) LCHF diet with lots of exercise, I can't keep my glucose levels close enough to normal. Very rarely do I get a reading below 100. Goddamned diabetes sucks. :-(
    Replies: #3, #5, #6
  3. FrankG
    I don't see it that way Andy.. I am in the same boat and it is hard to get my BGs down to truly normal levels but consider that the graph above shows a curve... the closer to normal you get, the better. And the LCHF approach keeps my BGs very stable instead of the roller-coaster I was on when following the standard advice.
  4. FrankG
    Interesting eddy.. the 8 Indian diet habits thay are bad for you are listed as:

    High-carbohydrate and high-glycaemic diets
    The myth of the Indian vegetarian diet
    Sugar and sweetened products
    Poor quality and nature of fats
    Late dinners
    Indian hospitality
    Staying still

  5. Paul the rat
    Andy don't panic, please measure your glucose by proper enzymatic tests. Most of those over-the-counter glucose meters overestimate readings by up to 25 points. (probably so that you have to inject insulin more often - more $$ for insulin makers. (I never was politically correct and never will be)
  6. Paul the rat
    keep exercising, build your muscles/mitochondria and add +- 1.0 gram of cinnamon to your diet/day
  7. eddy
    Keep in mind I am not a vegetarian, the authors comments on vegetarians are this
    "Vegetarians worldwide are far fitter, with normal lipid profiles and low rates of heart disease, than Indians."/
    Replies: #9, #17
  8. Jan
    I am not a diabetic but my husband is a type 2 diabetic. We both follow a low carb high fat lifestyle. I feel great, my numbers are normal BUT more importantly his blood sugar numbers are great.

    As FrankG says "the closer to normal you get, the better."

    Whether you are a diabetic or non diabetic the closer to normal you can get your blood sugar numbers the better.

    All the best Jan

  9. FrankG
    "far fitter than" is a relative term eddy :-P and why the heck should I listen to this author anyway?

    Any chance we could get back to the study in this blog post? Do you think?!?

  10. Wade Henderson
    Diet Doc "While we’re waiting I checked my blood sugar, one hour after a rich LCHF breakfast. My blood sugar was 92 mg/dl (5.1 mmol/l). Feels good."

    Nice, but I'm not doing LCHF and yet my last 5 blood sugar readings were as follows
    Three random, 81, 83, and 85
    Two fasting, 86 and 90

    So the issue for me is, why would I try to cut out carbs to lessen my chance of developing dementia, Alzheimer's, etc.

    Some here keep suggesting that everyone needs to go the low carb route because we probably have some hidden internal fat even though we can't see it.
    Or that our blood sugars are doing us in, even though we are slender.

    Its these kinds of blanket statements that trouble me.
    I question their validity.

    BTW, in several previous threads I gave out the precise information that the chart now shows. Namely that there is no data suggesting benefits for those below that 90 mg/dl level.

    If anyone has such data, please supply it.

    Replies: #12, #14, #19
  11. greensleeves
    My standard BG measure by the Abbott meter is 68-72. An hour after a strict LCHF meal, I've never been above 86, I'm usually 83-86. I recently ate a small square of 80% chocolate (usually eat 100%) and I could really feel it - nasty rush feeling. My BG was 86. I just feel much better and "normal" at 70 (3.9 mmol/L). :D
  12. FrankG

    ...I'm not doing LCHF and yet my last 5 blood sugar readings were as follows Three random, 81, 83, and 85
    Two fasting, 86 and 90

    So the issue for me is, why would I try to cut out carbs to lessen my chance of developing dementia, Alzheimer's, etc.

    Some here keep suggesting that everyone needs to go the low carb route because we probably have some hidden internal fat even though we can't see it. Or that our blood sugars are doing us in, even though we are slender.

    Its these kinds of blanket statements that trouble me. I question their validity.

    What point are you trying to make? That not everyone needs to eat an LCHF diet? Is anyone forcing you so to do? Are you so easily influenced by what an anonymous commenter says on a blog post? Is Dr Andreas stating that everyone should eat LCHF?

    Are you making a point here, or just arguing for its own sake?

    You "not doing LCHF"... does that mean you eat the Standard American Diet (SAD), a Western Industrial Diet high in processed, packaged foods, high in sugars and refined starches? Or are you (as I suspect) already eating a diet of real whole foods, that by comparison to the SAD is actually much lower in carbs than many eat. Sure you may not be at ketogenic levels but who says you have to be?

    What is your point? You seem to have found what works for you... why do you seem so set against the idea that others may still need some direction to get there?

    You claim to be after balanced neutral science but clearly show a bias against LCHF.

    Once again this site is devoted to learning about LCHF.. I see no need for it to cater to every nutritional need out there... why do you?

    Perhaps you should start your own blog?

  13. Wade Henderson
    "What point are you trying to make? Is Dr Andreas stating that everyone should eat LCHF?"

    Actually yes, I think he is suggesting that everyone should eat LCHF.

    As to the " point I am trying to make".... actually I am just probing the science, the ideas, and such, by asking questions and pointing out where the idea that most people should eat this way may be lacking.

    I think there are some brilliant people who are not physically screwed up and yet have chosen to eat LC. Cynthia Kenyon at UCSF comes to mind. When a really brilliant researcher puts herself on such a diet, it makes me want to look into it.
    What you perceive as a attack is more a investigation wherein one questions what is put forth.

    After, if ever lower blood sugar is valuable in preventing dementia and alzheimers, then even skinny people without issues may want to pursue it. As Ms Kenyon does.

    As to my diet already avoiding processed carbs, sugars and soft drinks, that is true.
    However in my pursuit of a diet of real whole foods, I do eat a boat load of carbs.
    Easily over 100 grams at many individual meals.
    Thus my interest in any possible value in avoiding such to keep a low blood sugar even lower than it currently is. By way of history, my father had Alzheimers. Thus the interest in all diets that may influence ones chances of the same fate.

    Just reading, and questioning, as we all should do.
    One shouldn't feel threatened or disturbed because certain comments raise doubts.
    How else are you gonna learn unless you have questions and don't blindly accept whatever is written.

    Replies: #16, #21
  14. Lori Miller
    You're surely aware that thin people can have type 2 diabetes, yes?

    Time was, I could eat a boatload of carbs and stay thin, too. But on such a diet, I got a boatload of cavities, had to work out daily, and developed a constant upset stomach, acid reflux and an esophageal ulcer. And I eventually gained 20 pounds. The acid reflux was what got me to try a LC diet. A pain-free stomach, no more tooth decay, niggling joint pain gone, less time spent working out, and a 20-pound weight loss were pleasant side effects. Oh, and I didn't feel the need to eat every few hours and spent a lot less time cooking.

    However, if you're happy eating a boatload of carbs, by all means continue.

  15. Galina L.
    I suspected that Indian's diet sucks (too much rice, sweets, too spicy), but now I have an inside opinion to validate my suspicion. "Real food" has many opportunities to be unhealthy. O, there are stick-thin people everywhere! Does it mean that sugar is healthy or it means that part of population is starving?
  16. Alan

    Was your father overweight or did he have high blood sugar (or other metabolic syndrome markers besides Alzheimer's)?

    Have you ever measured your HbA1c?

    Why would reducing carbs not be interesting to you (in terms of science)?

    Reply: #18
  17. Lori Miller
    The rest of the paragraph on vegetarian Indian diets:

    "In a large-scale scientific study, nearly half the participants were lifelong vegetarians and yet the rates of obesity and heart disease were similar to those found among non-vegetarians. In fact, the rates of diabetes were actually higher among the vegetarians.4 This is because the concept of vegetarianism is different among Indians, who eat large amounts of high-glycaemic carbohydrates, potatoes, fry food frequently and reuse the oil, and do not include enough raw foods, salads and fruits, which must be central to a good vegetarian diet."

  18. Wade Henderson
    Alan, father not overweight. Did not have high blood sugar.

    I've never measured my HbA1c. Why do so?

    "Why would reducing carbs not be interesting to you (in terms of science)?"

    Oh, it is interesting. That is why I keep reading about it.
    Thus far I haven't seen anything to suggest it might be of benefit to me.

    As indicated before, I seldom eat the typical refined carbs, or the sugary things, drinks, desserts, etc.

    As for other carbs, I eat lots of them. After all, I have to eat something to maintain my weight.
    I am about a BMI of just under 20.0
    I eat a ton of veggies but have to find more calories to maintain weight.

    Thus one investigates the appropriate choice of carbs or fats.
    For one without any of the physical problems most here seem to have come with, its hard to just go for less carbs and more fat.

    Aside from the dementia/alzheimers angle, I can't seem to find any reason to cut down on carbs.
    And since my blood sugar is already below 90, I was exploring any potential reason for attempting to take it lower.

    So far, I'm finding the data lacking in any direct evidence for those of us with readings below 90 gaining additional benefit.

    But I'll keep reading and throwing in a skeptical question when appropriate.

    While my situation isn't similar to many here, it is hardly unique in the general population.

    Replies: #20, #22, #23, #26
  19. Gunnar Lkpg
    The reason your blood sugar is fine is because you are healthy!

    If you are healthy you can eat a lot of junk and still have a fine blood sugar. Your body is producing sufficient amount of insulin. If the insulin levels are high it might get you problem later, or not.

    Another alternative is that you are eating a healthy diet!

    Doc advocates that all should eat good, healthy whole unprocessed food and stay away as much as possible from fast and junk food.

  20. BR

    Have you read Art an Science of Low Carb Performance? If you haven't you should. In it Drs Phinney and Volek lay out a pretty compelling case for going keto.

    However, even they, ardent believers in all kinds of benefits of the keto diet AND keto dieters themselves for decades, state that the current official uniformal dietary advice is suitable for 1/3 of the population and wrong for the other 2/3rd. You very well may be in the lucky 1/3, I mean some carbs taste pretty good and you're lucky to enjoy them without repercussions - good for you. There are people out there that do very well on a diet high in carbs their entire life. The point is we badly need individualized approach to nutrition but we're not there yet, not even close. So we're left wondering around looking for what works for us as individuals.

  21. FrankG

    ... actually I am just probing the science, the ideas, and such, by asking questions and pointing out where the idea that most people should eat this way may be lacking.

    What you perceive as a attack is more a investigation wherein one questions what is put forth.

    One shouldn't feel threatened or disturbed because certain comments raise doubts.

    How else are you gonna learn unless you have questions and don't blindly accept whatever is written.

    Yes yes... so you keep saying when you are challenged as to why you keep coming here.

    But the rest of the time why do you resort to hyperbole such as "I don't buy butter (although I happily eat it when out or over at friends homes). I don't see any medicinal value in slathering it on." in a recent discussion here?

    If you want a reasoned, adult discussion then when not offer one, instead of constantly picking away at strawmen of your own construction? Or maybe you think Dr Andreas is really suggesting that butter has a medicinal value if applied liberally?

    Maybe your own bias is creeping into the way you interpret what others are writing here?

    I do not believe that Dr Andreas IS "suggesting that everyone should eat LCHF", at the very least without several caveats, including that clearly the level of carbs different people can healthily tolerate differs. Someone who undertakes high intensity physical activity for example can evidently tolerate far higher levels.

    Does that mean that: in general terms a great many people could NOT benefit from a diet which limits sugars and refined starches?

    I don't take your posts as "attacks". I am not so easily influenced by the words of an anonymous commenter on a blog. But perhaps you need to address your choice of words unless you wish to be misunderstood.

    Many of us are quite capable of critical thinking and learning without you playing devil's advocate thanks.

  22. FrankG

    I think there are some brilliant people who are not physically screwed up and yet have chosen to eat LC.

    Yet another example...

    Do you really not see how your poor choice of words displays a bias against LCHF?

  23. Paul the rat

    I am fortunate to never have weight problem or suffer from serious malady. No one in my family had Alzheimer's, however I am in full ketosis for number of years now because 1) I just feel great, 2) I am convinced that fatty acids and ketones are the fuel for our body 3) I am convinced that glucose is toxic.

    If you feel great eating bananas - ENJOY them, don't look for science to back it up. Listen to your body. If you are still hesitant about adverse effects of dietary carbohydrates on health by reading the pages of this blog and links - well, you always be. Enjoy your glucose !!.

    Neuroscience. 2013 Dec 3;253:110-22. doi: 10.1016/j.neuroscience.2013.08.044. Epub 2013 Aug 30.

    Inter-relationships among diet, obesity and hippocampal-dependent cognitive function.

    Davidson TL, Hargrave SL, Swithers SE, Sample CH, Fu X, Kinzig KP, Zheng W.
    Center for Behavioral Neuroscience, American University, Washington, DC, United States. Electronic address:
    Intake of a Western diet (WD), which is high in saturated fat and sugar, is associated with deficits in hippocampal-dependent learning and memory processes as well as with markers of hippocampal pathology. In the present study, rats were trained to asymptote on hippocampal-dependent serial feature negative (FN) and hippocampal-independent simple discrimination problems. Performance was then assessed following 7days on ad libitum chow and after 10, 24, 40, 60, and 90days of maintenance on WD, on ketogenic (KETO) diet, which is high in saturated fat and low in sugar and other carbohydrates, or continued maintenance on chow (CHOW). Confirming and extending previous findings, diet-induced obese (DIO) rats fed WD showed impaired FN performance, increased blood-brain barrier (BBB) permeability, and increased fasting blood glucose levels compared to CHOW controls and to diet-resistant (DR) rats that did not become obese when maintained on WD. For rats fed the KETO diet, FN performance and BBB integrity were more closely associated with level of circulating ketone bodies than with obesity phenotype (DR or DIO), with higher levels of ketones appearing to provide a protective effect. The evidence also indicated that FN deficits preceded and predicted increased body weight and adiposity.

    This research (a) further substantiates previous findings of WD-induced deficits in hippocampal-dependent FN discriminations, (b) suggests that ketones may be protective against diet-induced cognitive impairment, and (c) provides evidence that diet-induced cognitive impairment precedes weight gain and obesity.

  24. Paul the rat
    Am J Clin Nutr. 2013 Sep;98(3):641-7. doi: 10.3945/ajcn.113.064113. Epub 2013 Jun 26.

    Effects of dietary glycemic index on brain regions related to reward and craving in men.

    Lennerz BS, Alsop DC, Holsen LM, Stern E, Rojas R, Ebbeling CB, Goldstein JM, Ludwig DS.
    New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, and Harvard Medical School, Boston, MA.
    Qualitative aspects of diet influence eating behavior, but the physiologic mechanisms for these calorie-independent effects remain speculative.
    We examined effects of the glycemic index (GI) on brain activity in the late postprandial period after a typical intermeal interval.
    With the use of a randomized, blinded, crossover design, 12 overweight or obese men aged 18-35 y consumed high- and low-GI meals controlled for calories, macronutrients, and palatability on 2 occasions. The primary outcome was cerebral blood flow as a measure of resting brain activity, which was assessed by using arterial spin-labeling functional magnetic resonance imaging 4 h after test meals. We hypothesized that brain activity would be greater after the high-GI meal in prespecified regions involved in eating behavior, reward, and craving.
    Incremental venous plasma glucose (2-h area under the curve) was 2.4-fold greater after the high- than the low-GI meal (P = 0.0001). Plasma glucose was lower (mean ± SE: 4.7 ± 0.14 compared with 5.3 ± 0.16 mmol/L; P = 0.005) and reported hunger was greater (P = 0.04) 4 h after the high- than the low-GI meal. At this time, the high-GI meal elicited greater brain activity centered in the right nucleus accumbens (a prespecified area; P = 0.0006 with adjustment for multiple comparisons) that spread to other areas of the right striatum and to the olfactory area.

    Compared with an isocaloric low-GI meal, a high-GI meal decreased plasma glucose, increased hunger, and selectively stimulated brain regions associated with reward and craving in the late postprandial period, which is a time with special significance to eating behavior at the next meal. This trial was registered at as NCT01064778.

  25. Paul the rat
    Nutr Res. 2013 Nov;33(11):905-12. doi: 10.1016/j.nutres.2013.07.022. Epub 2013 Sep 18.

    Dietary carbohydrate restriction improves insulin sensitivity, blood pressure, microvascular function, and cellular adhesion markers in individuals taking statins.

    Ballard KD, Quann EE, Kupchak BR, Volk BM, Kawiecki DM, Fernandez ML, Seip RL, Maresh CM, Kraemer WJ, Volek JS.
    Departments of Kinesiology, University of Connecticut, Storrs, CT 06269, USA.
    Statins positively impact plasma low-density lipoprotein cholesterol, inflammation and vascular endothelial function (VEF). Carbohydrate restricted diets (CRD) improve atherogenic dyslipidemia, and similar to statins, have been shown to favorably affect markers of inflammation and VEF. No studies have examined whether a CRD provides additional benefit beyond that achieved by habitual statin use. We hypothesized that a CRD (<50 g carbohydrate/d) for 6 weeks would improve lipid profiles and insulin sensitivity, reduce blood pressure, decrease cellular adhesion and inflammatory biomarkers, and augment VEF (flow-mediated dilation and forearm blood flow) in statin users. Participants (n = 21; 59.3 ± 9.3 y, 29.5 ± 3.0 kg/m(2)) decreased total caloric intake by approximately 415 kcal at 6 weeks (P < .001). Daily nutrient intakes at baseline (46/36/17% carb/fat/pro) and averaged across the intervention (11/58/28% carb/fat/pro) demonstrated dietary compliance, with carbohydrate intake at baseline nearly 5-fold greater than during the intervention (P < .001). Compared to baseline, both systolic and diastolic blood pressure decreased after 3 and 6 weeks (P < .01). Peak forearm blood flow, but not flow-mediated dilation, increased at week 6 compared to baseline and week 3 (P ≤ .03). Serum triglyceride, insulin, soluble E-Selectin and intracellular adhesion molecule-1 decreased (P < .01) from baseline at week 3, and this effect was maintained at week 6.

    In conclusion, these findings demonstrate that individuals undergoing statin therapy experience additional improvements in metabolic and vascular health from a 6 weeks CRD as evidenced by increased insulin sensitivity and resistance vessel endothelial function, and decreased blood pressure, triglycerides, and adhesion molecules.

  26. Galina L.
    Like many people who discuss benefits of LC here , I have relatives, friends and family members who do not have the same need as me to eat a very low carbohydrate diet . I think that another marker of health which is important to watch is the susceptibility to infections, allergies and dental health. Everybody seems to pay too much attention on a person being fat or thin, while the picture is more complicated. From observing other people and myself, I got an impression that eating more animal products and fat could be important for the people who get sick more easy or have trouble to recover after illness or a surgery, amount of carbohydrates could make the difference for the people with mental issues. In my family history we have a record of a person who managed to recover from tuberculosis at the time when antibiotics were not available by eating a lot of eggs, butter, pork fat. My thin and athletic son who has no problems with blood sugar , eats a LC diet only when he feels like he may be getting a flu, during busy test time at university he lives on two stakes a day to save time from cooking. He limits sugar and avoids gluten during regular time , but not carbohydrates in general. I have a friend who is absolutely do not let herself to gain a pound, goes to a gym, but she is a magnet for seasonal flues, and her recovery is usually a long one.
    I am not implying you are sick and miserable, I just want to re-direct your attention from BMI to other things which are important. I also remember reading about benefits of exercise for a mental health.
    Reply: #27
  27. Paul the rat
    "...I also remember reading about benefits of exercise for a mental health."

    I say because exercise markedly increases ketones. Plus I second everything you just said Galina backed by personal and people I know experience.

    Reply: #31
  28. Marcy
    I hope this is on topic, but it has been killing me since I read it in an insert in our local paper, The Denver Post, yesterday. Under a section called '10 Tips for a healthier you', the first section, 'Eat Better', says, "Avoid fried foods, burgers and other fatty meats, such as pork, bacon, ham, salami, ribs and sausage. Dairy products such as cheese, cottage cheese, milk and cream should be eaten in low-fat versions. Nuts and sandwich meats, mayonnaise, margarine, butter and sauces should be eaten in limited amounts." I don't know why but this just makes me mad. The no fat and low fat way of eating never seems to change around here.
    Replies: #29, #33
  29. FrankG
    It amazes, frustrates, angers (and saddens) me too Marcy, to see that the low-fat message is still so widespread in popular media (TV ads, cooking shows etc...) and even health advice.

    I sometimes wondered if it was just me was being particularly sensitive to it; as one or two of the folks who comment here (usually knocking LCHF) seem to suggest that such advice is no longer mainstream!

  30. eddy
    The Denver Post tips of avoid fried food and fatty meats this I agree with, avoid all fast foods, there are healthier ways to get fat through nuts and avocados. even a higher fat yogurt.

    Also Deli meats and bacon, I agree , they are full of nitrates. A better choice would be fish however they have mercury issues.

    I don't agree it is necessary to eat lo fat dairy. It would wiser to give up on sugar products and limit the amount of bread and pasta.
    Also I would remove all processed goods such cookies, processed cereals, ketchup, ready made salad dressings. All are high in sugar and vegetable oils. I would remove all vegetable oils. .

    Things I will not give up on are my 20 minute to cook steel cut oats.

  31. Galina L.
    Thank you,Paul,

    While I do not have an opinion that everyone should eat a LC diet, sometimes I wonder, how I would advise to someone to add more animal fats and meat in a diet high in carbohydrates? Foods high in cholesterol are very important for one's health. For example, lets say somebody eats an oatmeal for a breakfast. I have read too many comments of the people who reported that adding more fat to their carbs just resulted for them in a weight gain (more likely fat gain). It looks like just adding butter to your carbohydrates-based breakfast may be not a good idea. So, at the end of the day people have to choose more or less between eating a lot of carbohydrates or eating more fat. I guess, eating in the pattern of IF (two meals 6-8 hours apart, without snacks, 16 hours minimum fasting window) one could get more relaxed about mixing carbs and fats, and it will sure result in a lower average blood sugar level.

    Wade, if you avoid butter as Frank said, re-think it. Grass-fed butters contain important nutrients. You can Google the subject, I am sure. Weston Price discovered health benefits of it during his research, but didn't know how to call such phenomenon, and used "factor X" instead It doesn't look like a person needs much of it. Weston Price managed to stop caries among the people prone to a dental decay with a one teaspoon 3 times a day of the mix of a grass-fed butter and a cod liver oil.

  32. Marcy
    I agree with you, eddy, the lunch meats and bacon with nitrates/nitrites is bad for you as is margarine. But pork? I don't get that. The paper made me annoyed today as well, FrankG, Denver International Airport has just been ranked the number one airport in the USA for healthy food. Guess what the healthy food is? at least one high fiber, cholesterol free menu item. I don't get it, they are still going on about cholesterol, and now they want to change the guidelines so more adults are put on cholesterol lowering meds. I am becoming a conspiracy theory person here thinking all the interest groups have more influence than common sense and science when it comes to eating and drugs. Sorry it this is still a bit off topic.
  33. Lori Miller
    Denver metro resident here. When I look around grocery stores like Sprouts and Vitamin Cottage, talk friends, neighbors and coworkers about food, and go to restaurants around here, it seems to me the low-fat, high-carb craze is over. Someone needs to alert the Denver Post.

    As for pork, isn't that one of the staples of those healthy, skinny Asians?

  34. murray
    Paul, I am with you on the ketones. Lots of benefits after going keto, from loss of tinnitus, to loss of forehead wrinkles and softer, tighter skin generally, to reversal of greying, to greater endurance, to hardening of teeth (grass-fed butter with plenty of K2-retinol-D3), to requiring less sleep. Now I am finding lots of research coming out on how ketones activate Foxo genes that ramp up glutathione production and have other anti-oxidant, anti-aging effects. I am also seeing more research on ketones and low glucose for brain health. The more I read, the more butter, egg yolks and coconut oil I add, and the lower goes my HbA1c.

    Wade, the study in question did not measure below 90 mg/dL (5.0 mmol/L), which seems ludicrous, as mine is rarely 5.0 or above. But significantly, the curve did not turn up again or even flatten as blood sugar decreased. In every study I have seen reported on cognitive decline or loss of brain mass, the lower the glucose the lower the decline or loss of brain mass, as far down as was measured. I have found fasting blood glucose to be highly variable (I measure every day) so I expect studies that rely on that are less reliable. For this reason, most studies I have seen reported rely on HbA1c, which measures the extent of glycation damage to blood protein from sugar and is indicative of time-weighted average blood sugar levels over the previous 90 days or so.

    However, newer research shows that even fasting blood glucose and average blood glucose fail to tell the whole story. This study shows how transient hyperglycemia induces long-lasting activating epigenetic changes in the promoter of the nuclear factor κB (NF-κB), resulting in elevated oxidation and inflammation. "Transient high glucose causes persistent epigenetic changes and altered gene expression during subsequent normoglycemia," JEM vol. 205 no. 10 2409-2417. Here is the kicker---the epigenetic effect lasts six days after blood sugar returns to normal. Friends don't let friends do that to their brains. (Countervailing epithet: No one can be a prophet in their own land.)

    My mother used to say she would never give up her oats. She got a blood glucose monitor. She gave up oats.

    There is no food I would not abandon if my inquiry indicated it had a significant net cost and it wasn't a culinary item "to die for" literally and figuratively. I was avoiding saturated fat seven years ago and was in excellent health. A long investigation into science, anthropology and food chemistry ("soft matter physics") has lead me to keto by choice. what I have found remarkable is the emotional resistance to the possibility keto could be a diet of choice.

    Nonetheless, I certainly appreciate the wait-for-more-certainty approach, especially when one is in excellent health by the first level of standard metrics and not experiencing any difficulties.

    Reply: #36
  35. Alan

    random BG testing is not a very sensitive measure. HbA1c is better (it estimates your average BG over the past few months or so). Even better would be a oral glucose tolerance test (OGTT). But you could do this at home with a glucometer. Gorge on your carbs (or jelly-beans for a tougher test) and see how your body responds to the stress. Test every 30 minutes for ~2-4 hours. If your BG goes over ~125 then you might want to think about not eating that (if you choose to reduce the probability of health troubles later...).

    BG is an important factor but not the only one. What else was going on with your father? Why are you so interested in vitamin D and nutrition? What is going on with you?

    If the" only reason" for you to eat low carb is to reduce your probability of getting Alzheimer's then why isn't this a pretty damn good reason? The brain is Control Central.


  36. Wade Henderson
    Murray, thank you.

    ""Transient high glucose causes persistent epigenetic changes and altered gene expression during subsequent normoglycemia," JEM vol. 205 no. 10 2409-2417. Here is the kicker---the epigenetic effect lasts six days after blood sugar returns to normal. "

    The question would be whether those effects would be adverse in individuals who don't have diabetes or other risk factors.
    Whether a huge meal of carbs, IF it raised ones blood sugar for X period of time, would do damage either in the short or long term (six days).
    Interesting concept regarding endothelial or vascular cells (to include the brain)

    On the other point where the curve does not begin to flatten or bend, we really need more data.
    The above data doesn't show anything below 90 mg/dl.

    It would be foolish to think that if I am at 85, that going to 80 or 75 (if that was even possible), would provide some measure of safety from dementia or Alzheimers.

    If you have anything showing a beneficial effect below 90 mg/dl, please pass it along.

    However, as I said, and I don't know her actual numbers, Cynthia Kenyon of UCSF is eating to lower her blood sugar.
    I'd be more impressed by that view if I knew her "normal" readings on a standard diet were already at 85 or 90. For all I know, her normal is 100 and she eats that way to get to 90.

    I'll keep looking.

    I am curious where my blood sugar reading is after some of my huge meals.
    And if high for a hour, whether that one hour would cause damage over those 6 days mentioned. Might be fun to get one of those cheap meters that come with 15 starter strips.

    I only know after a huge dinner, piled high with whole wheat pasta, a beer, and wine + veggies etc,, about 40 minutes later I feel like putting my head on the table...... though I tend to eat very late, like in Europe.

    Would like to see my readings during that phase. Or it may just be the beer and wine.

    Reply: #41
  37. Marcy
    Lori, I hope you are right. Did you read the Post today and the 'healthy foods' that made DIA the healthiest airport in the country are, well, here is the quote, "Dieticians from the physicians committee reviewed 18 of the busiest airports in the U.S. between April and August, classifying something as healthful only if it includes at least two of the four food groups on the committee's "power plate", which are fruits, vegetables, whole grains and legumes.' Really!? I hope there is an Elway's at the airport, there is, isn't there, I will go and have a steak.
    Reply: #40
  38. murray
    Wade, Dr. Kenyon eats low carb to reduce insulin and IGF-1, not blood sugar. Insulin and IGF-1 are the prime culprits for aging and activating genes (such as daf-2) and metabolism that promotes degradation with aging. What is more relevant is the levels of insulin, as this is a signal to activate genes. (The presence of insulin signals that the organism is in a time of dietary over-abundance so go into grow-reproduce-die mode, versus conserve-and-repair mode.) So even if blood sugar normalizes well (due to insulin being released and the cells being insulin sensitive), one forgoes the anti-aging benefit because the cells respond to insulin. This is why I watch ketones, as insulin stops ketosis, so this is my proxy measurement to confirm low levels of insulin. Plainly, blood sugar spikes are going to stimulate insulin, so I avoid those like the plague.
  39. Galina L.
    Actually, the desire to lay down in one hour after a meal or feeling tired is often caused by the spike in a blood sugar, people who experience it even developed the therm a "carb coma". It could be a normal response on a big meal, but I really think it is worth checking. Some people experience reactive hypoglycemia after the sugar spike, when body releases too much insulin to correct the rise in a blood sugar, the symptoms of that are similar to panic attack (racing heart bit, sweating.)
  40. Lori Miller
    Didn't see the airport article. Did you see the article where the AHA is recommending statins for 33 million Americans? Buried in the article is a gem of a quote--that it's impossible to find a large group of experts that don't have any pharmaceutical industry ties.

    Newspapers have become nothing but a bunch of press releases. No wonder they're dying.

  41. Lori Miller
    Here are two articles on normal blood sugars:

    Sleepiness 40 minutes after a big, carby meal sounds like carb coma; it would definitely be interesting to see BG numbers. (Pasta is said to wallop your blood sugar some five hours after you eat it.)

    A high carb meal will drive up triglycerides and small LDL particles. See this:

  42. Marcy
    Yes, Lori, I did hear and read about the AHA recommending statins for about a third of people over the age of 60. One of the side effects of statins they don't like to talk about is diabetes. I will take my chances with the cholesterol.
  43. Galina L.
    Alzheimer is the decease of a civilization (together with high blood pressure, caries, gall bladder inflammation,appendix inflammation, diverticulitis, heart attack, stroke, cancer,diabetes, IBS...). I guess, in order to be on a safe side of the issue, ditching sugar, most grains, especially refined ones, and seed oils could be the logical thing to do even for a person who thinks that LCarbing is an over-kill. What is the point of reading every post on a LC blog, then turning around and have some pasta? Unfortunately, BMI=20 gives no reassurance that everything is right with your metabolism.

    No one can see in a future. My father died at 51 from a heart arrest(normal weight), after being diagnosed for 10 years with ischemia, my grandma is still alive at almost 95 (has been plump all her life,but now thin), diagnosed with Alzheimer at 89. I don't know what is worse.

    Reply: #44
  44. Wade Henderson
    " What is the point of reading every post on a LC blog, then turning around and have some pasta? Unfortunately, BMI=20 gives no reassurance that everything is right with your metabolism."

    Some of us read blogs on various ends of the spectrum to see what the science is.
    Just because we read things doesn't mean we suddenly change our lifestyle overnight or perhaps ever. You do know that there are other blogs that give out exactly the opposite message with the same number of 100% convinced contributors and mountains of studies to back up their opinion.

    I find seeing what both sides say to be valuable.
    Right now, as I investigate, I see no immediate need or even benefit to eliminating all pasta for someone in my health category. Perhaps in the future I may.
    One size probably doesn't fit all people.

    A 20 BMI with low cholesterol and top cardiovascular fitness doesn't guarantee anything.
    But the probabilities suggest I am not at substantial risk for heart attacks, diabetes, and such dangers. Nothing is 100 percent assured. Why assume the worst and base everything on a fractional probability.

    I am however interested in the angle that relates to dementia, and Alzheimers.
    Thus my interest in exploring the available data.

  45. Galina L.
    I didn't imply I expected you to turn into a LCarber after reading a LC diet blog (and choose a side in a dispute), indeed, the way I put it in writing allowed to think so. Most opponents who disagree about red meat, saturated fats, eggs, starches being staples in one's diet and many other things, are in an agreement about refined flour , sugar and HFCS. It is where Taubes agrees with Dr.Ornish. I don't think you are in an immediate danger, just pay attention on small things like immunity, wound healing, and it is better to check glycated hemoglobin and post-meal sugar levels.
    I turned my diet complitely around only after my health was going downhill for a year, so I understand how hard life should push a person in order for start considering major changes. I always followed general health recommendations, cooked my food from scratch and exercised, but in my case it was not enough.
  46. murray
    Wade, I suggest you have to do the research and not wait for definitive studies, which will not be coming along for years. You also have to decide if your goal is merely to postpone or avoid dementia, or to maximize brain performance.

    As to brain and sugar studies, the Mayo study showed the highest carb group had 3.6 times the rate of signs of cognitive decline as normal and the highest fat in diet group had 0.42 times the rate of normal. Another study found the rate of annual decline in brain mass varying directly with level of HbA1c. The least brain loss was in HbA1C in the 4.2 to 4.8 range, which was the lowest range measured. Again, every study I have seen has the least loss of brain mass or performance with the lowest measured indicator of blood sugar--no U-curve in any study.

    Until more definitive studies with better designed controls come along, I suggest you research mitochondrial health and performance, eicosanoid metabolism and gut-mind interaction. A paradigm-shifting research result for me was the glymphatic system in the brain. When you go into deep sleep, the neurons shrink to facilitate the system removing toxins--like glycated proteins from high blood sugar or free radicals from sugar oxidation. Using ketones as fuel in the brain does several things. It enhances mitochondria, for more neural energy and more energy for the glymphatic system. It raises levels of glutathione, which is the most potent anti-oxidant and free radical scavenger. I aim for the most efficient sleep, not the longest sleep. Long sleep indicates inefficiency in the glymphatic process. So I do things like measure how many seconds in the morning I can stand on one leg with eyes closed while whisking (grain-free) crepe batter for my son's breakfast. One has to measure oneself to maximize performance. These are all pieces of the puzzle and help make sense of studies such as the Mayo one showing the huge benefit to the highest fat diet.

    I suggest starting with the Ottoboni's book The Modern Nutritional Diseases for a good primer on eicosanoid metabolism, which will help you interpret studies on the effects of vegetable oil, insulin-raising foods and omega-3 fats on systemic inflammation.

    Similarly, there is much to be learned from research and clinical experience on gut flora and gut lining health from diet and other factors, such as anti-biotics and lesser stresses. There are lots of neuro-toxic connections. One interesting recent report found that an increase in staphylococcal bacteria produces toxins that override the liver's ability to handle toxins from normal ambient e. coli (most e. coli strains are benign and even helpful in general), which results in adopise tissues producing and releasing cytokines, causing systemic inflammation. (Not good for the brain, likely a co-factor leading to diabetes and its sibling, Alzheimer's). It comes as no surprise that slowly digested starches (such as, pasta, for example) are perfect food for fostering staphylococcal bacteria. The GAPS protocol for restoring gut health, for example, calls first for elimination of grains and starches, to help get rid of bad bacteria, yeasts and fungi, and promote restoration of beneficial strains.

    Finding guidance for real-time decisions in the absence of definitive science is like learning to view impressionist paintings. One could wait for cartoon renditions, with nice bright clear lines for tyros and the interpretively challenged, but to home in on solutions ahead of the curve requires more work and refinement of interpretive skills. One has to perform Nietzschean reversals and Husserlian/Heideggerian variations with every outcome. An experiement is a narrative (setting, event, outcome). Skills in interpreting narratives is directly applicable to science. I find most scientific researchers are thick-fingered interpreters. Reading what someone has to say about Shakespearean dramas or Nietzsche, etc., says a lot about how reliable they are at interpretation of science results. These are touchstones for more insight interpreters of data--the ones who see patterns in impressionist paintings, before the Disney animated version is released.

  47. Eric Anderson
    Here is an innovative way to measure and keep track of blood sugar and insulin from
    SWEDEN> Eric

    Reading the pancreas through the eye
    Swedish researchers describe innovative way to study body glucose regulation

    IMAGE: Dr Per-Olof Berggren at Karolinska Institutet in Sweden suggests an innovative method to study body glucose regulation through the eyes. The findings are published in the November 18-22, 2013...

    Click here for more information.

    Researchers at Karolinska Institutet in Sweden have found an innovative way to study glucose regulation in the body: by transferring the vital insulin-producing cells from the pancreas to the eye, the latter can serve as a kind of window through which health reports can be obtained from the former. The results, which are expected to have a significant impact on diabetes research, are published in scientific journal PNAS.

    The endocrine part of the pancreas, the Islets of Langerhans, produces and secretes insulin, the hormone that regulates blood sugar levels. After a meal, the hormone is released into the blood at an amount that is in direct proportion to the amount of food ingested; blood insulin levels therefore vary from one meal to the next and between individuals. In the case of conditions such as obesity, large amounts of insulin are needed to compensate for the high consumption of food and insensitivity to the hormone.

    The Islets of Langerhans try to adapt themselves to this condition by increasing the number of insulin-producing beta-cells and/or modulating their individual secretion of insulin in response to the intake of sugar. This plasticity is essential to the maintenance of normal blood sugar levels, and its dysfunction leads to diabetes, a serious disease that has reached pandemic proportions.

    The greatest obstacle to studying the exact workings of the Islets of Langerhans and how they adapt to individual conditions is their relative inaccessibility, in that they lie deeply embedded in and are distributed throughout the tissue. Now, however, researchers have found a new way to study the insulin-producing beta-cells: by transferring the Islets of Langerhans to the eye.

    "What we've done is made the cells optically accessible by grafting a small number of 'reporter islets' into the eyes of mice, which allows us to monitor the activity of the pancreas just by looking into the eye," says Per-Olof Berggren, professor of experimental endocrinology at Karolinska Institutet's Department of Molecular Medicine and Surgery, and director of the Rolf Luft Research Centre for Diabetes and Endocrinology. "We're now able to really study the insulin-producing beta-cells in detail in a way that wasn't possible before."

    The eye may be used, as a kind of reporter reproducing the activity of the pancreas and allowing readings of the status of the pancreas under different conditions in health and disease.

    "The Islets of Langerhans can be visualised repeatedly over a period of several months, and our work shows that during this time, functional and morphological changes occur in them that are identical to those occurring in the pancreas," says first author Dr Erwin Ilegems, researcher at the Rolf Luft Centre.

    Using the new monitoring system and pharmacological treatment, the researchers have reduced food consumption in obese mice models and thus stopped the enormous growth in beta-cell population. This means that they are now able to individually tweak drug doses.

    "We'll also be using the system to identify new drug substances that regulate beta-cell plasticity and function," says Professor Berggren. "In the future we may also conceive a similar use of reporter islets in humans in order to find unique, tailored treatment principles, to measure the effects of personal medication, or to diagnose problems with the pancreatic islets."

    This work was mainly supported the Wenner-Gren Foundation, the Swedish Research Council; the Swedish Diabetes Association; the Swedish Society for Medical Research; the Novo Nordisk Foundation; the Strategic Research Program in Diabetes at Karolinska Institutet, the Knut and Alice Wallenberg Foundation, the Family Erling-Persson Foundation and the Stichting af Jochnick Foundation.

    Publication: 'Reporter islets in the eye reveal plasticity of the endocrine pancreas', Erwin Ilegems, Andrea Dicker, Stephan Speier, Aarti Sharma, Alan Bahow, Patrick Karlsson Edlund, Ingo B. Leibiger, and Per-Olof Berggren, PNAS, online 18-22 November 2013.

  48. Leaf Eating Carnivore
    @Paul the Rat - what do you mean by a "proper enzymatic (BG) test"? And where would I get the wherewithall (US)?

    Accuracy and precision are big deals, indeed.

    Reply: #49
  49. Paul the rat
    Leaf Eating Carnivore
    You need to organize it with your family practitioner. You drink a solution containing 75g of glucose after 8 h of fasting (so you have to stop eating your leaf for 8 hours-must be big leaf!) and your blood is taken at time 0, 1h, 2h. Blood glucose is analyzed enzymatically in a laboratory. Don't be scared it does not hurt (much).
  50. Mark
    Interesting piece in New Scientist about links between diabetes and Alzheimer's:

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