How to Prevent Blood Sugar & Triglyceride Spikes after Meals

How to Prevent Blood Sugar & Triglyceride Spikes after Meals
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Within hours of eating an unhealthy meal, we can get a spike in inflammation, crippling our artery function, thickening our blood, and causing a fight-or-flight nerve response. But there are foods we can eat at every meal to counter this reaction.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Standard American meals, rich in processed junk and meat and dairy, lead to exaggerated spikes in sugar and fat in the blood. This generates free radicals, and the oxidative stress triggers a biochemical cascade throughout our circulation, damaging proteins in our body, inducing inflammation, crippling our artery function, thickening our blood, and causing a fight-or-flight nerve response. This all happens within just one, two, three, four hours after eating a meal. Worried about inflammation within your body? Well, one lousy breakfast could double your C-reactive protein levels before it’s even lunchtime.

Repeat that three times a day, and you can set yourself up for heart disease—though you may not even be aware how bad off you are, because your doctor is measuring your blood sugar and fat levels in a fasting state, typically drawing your blood before you’ve eaten. But, what happens after a meal may be a stronger predictor of heart attacks and strokes—which makes sense, since this is where most of us live our lives, in a fed state.

And, not just in diabetics. If you follow nondiabetic women with heart disease, but normal fasting blood sugar, how high their blood sugar spikes after chugging some sugar water appears to determine how fast their arteries continue to clog up. Perhaps, because the higher the blood sugar spike, the more free radicals are produced.

So, what are some dietary strategies to improve the situation? Thankfully, “[i]mprovements in diet exert profound and immediate favorable changes.” What kind of improvements? Specifically, a diet high in antioxidant, anti-inflammatory whole plant foods. “[m]inimally processed, high-fiber plant-based foods such as vegetables and fruits, whole grains, [beans], and nuts, will markedly blunt the after-meal increase[s]” in sugar, fat, and inflammation.

What if you really wanted to eat some Wonder Bread, though? In less than an hour, you’d get a big spike in blood sugar. But, if you smeared it with almond butter, what would happen? Adding about a third of a cup of almonds to the same amount of Wonder Bread significantly blunts the blood sugar spike.

But, wait; wouldn’t any low-carb food help? I mean, why add almond butter when you can make a bologna sandwich? Well, first of all, plant-based foods have the antioxidants to wipe out any excess free radicals. So, not only can nuts blunt blood sugar spikes, but oxidative damage as well—and blunt insulin spikes as well. Adding nuts to a meal not only calms blood sugar levels, but also calms insulin levels. Now, you’re thinking, “Well, duh, less sugar means less insulin.” But, that’s not what happens with low-carb animal foods.

If you combine some chicken with white rice—steamed skinless chicken breast—you get a greater insulin spike than just the white rice alone. So, adding the low-carb plant food made things better, but adding the low-carb animal food made things worse. Same thing with adding chicken breast to mashed potatoes—a higher insulin spike with the added animal protein. Same thing with animal fat; add some butter to a meal, and get a dramatically higher insulin spike.

If you add butter and cheese to white bread, white potatoes, white spaghetti, or white rice, you can sometimes even double the insulin. Whereas, if you add a half an avocado to a meal, instead of worsening, the insulin response improves, as it does with the main whole plant food source of fat: nuts.

What if, instead of almond butter on your Wonder Bread, you used an all-fruit strawberry jam? We’ll find out, next.

Please consider volunteering to help out on the site.

Icons created by Persheid, mikicon, unlimicon, Pavel Melnikov, ProSymbols, Imogen Oh, hatayas, Nikita Kozin, retinaicon, and Marco Galtarossa from the Noun Project.

Image credit: Kristina DeMuth. Image has been modified.

Video credit: Avocado Video.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Standard American meals, rich in processed junk and meat and dairy, lead to exaggerated spikes in sugar and fat in the blood. This generates free radicals, and the oxidative stress triggers a biochemical cascade throughout our circulation, damaging proteins in our body, inducing inflammation, crippling our artery function, thickening our blood, and causing a fight-or-flight nerve response. This all happens within just one, two, three, four hours after eating a meal. Worried about inflammation within your body? Well, one lousy breakfast could double your C-reactive protein levels before it’s even lunchtime.

Repeat that three times a day, and you can set yourself up for heart disease—though you may not even be aware how bad off you are, because your doctor is measuring your blood sugar and fat levels in a fasting state, typically drawing your blood before you’ve eaten. But, what happens after a meal may be a stronger predictor of heart attacks and strokes—which makes sense, since this is where most of us live our lives, in a fed state.

And, not just in diabetics. If you follow nondiabetic women with heart disease, but normal fasting blood sugar, how high their blood sugar spikes after chugging some sugar water appears to determine how fast their arteries continue to clog up. Perhaps, because the higher the blood sugar spike, the more free radicals are produced.

So, what are some dietary strategies to improve the situation? Thankfully, “[i]mprovements in diet exert profound and immediate favorable changes.” What kind of improvements? Specifically, a diet high in antioxidant, anti-inflammatory whole plant foods. “[m]inimally processed, high-fiber plant-based foods such as vegetables and fruits, whole grains, [beans], and nuts, will markedly blunt the after-meal increase[s]” in sugar, fat, and inflammation.

What if you really wanted to eat some Wonder Bread, though? In less than an hour, you’d get a big spike in blood sugar. But, if you smeared it with almond butter, what would happen? Adding about a third of a cup of almonds to the same amount of Wonder Bread significantly blunts the blood sugar spike.

But, wait; wouldn’t any low-carb food help? I mean, why add almond butter when you can make a bologna sandwich? Well, first of all, plant-based foods have the antioxidants to wipe out any excess free radicals. So, not only can nuts blunt blood sugar spikes, but oxidative damage as well—and blunt insulin spikes as well. Adding nuts to a meal not only calms blood sugar levels, but also calms insulin levels. Now, you’re thinking, “Well, duh, less sugar means less insulin.” But, that’s not what happens with low-carb animal foods.

If you combine some chicken with white rice—steamed skinless chicken breast—you get a greater insulin spike than just the white rice alone. So, adding the low-carb plant food made things better, but adding the low-carb animal food made things worse. Same thing with adding chicken breast to mashed potatoes—a higher insulin spike with the added animal protein. Same thing with animal fat; add some butter to a meal, and get a dramatically higher insulin spike.

If you add butter and cheese to white bread, white potatoes, white spaghetti, or white rice, you can sometimes even double the insulin. Whereas, if you add a half an avocado to a meal, instead of worsening, the insulin response improves, as it does with the main whole plant food source of fat: nuts.

What if, instead of almond butter on your Wonder Bread, you used an all-fruit strawberry jam? We’ll find out, next.

Please consider volunteering to help out on the site.

Icons created by Persheid, mikicon, unlimicon, Pavel Melnikov, ProSymbols, Imogen Oh, hatayas, Nikita Kozin, retinaicon, and Marco Galtarossa from the Noun Project.

Image credit: Kristina DeMuth. Image has been modified.

Video credit: Avocado Video.

Doctor's Note

Previously, I’ve covered the effect adding berries to a meal has on blood sugar responses in If Fructose is Bad, What About Fruit? That raises the question: How Much Fruit is Too Much?

In addition to the all-fruit jam question, in my next video I’ll cover The Effects of Avocados and Red Wine on Postprandial Inflammation.

Vinegar may also help: Can Vinegar Help with Blood Sugar Control?

Maybe this explains part of the longevity benefit of nut consumption. See Nuts May Help Prevent Death.

I also talked about that immediate inflammatory reaction to unhealthy food choices in my recent video, Best Foods to Improve Sexual Function.

Surprised by the chicken and butter reaction? Same thing happens with tuna fish, and other meat. Check out Paleo Diets May Negate Benefits of Exercise.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

171 responses to “How to Prevent Blood Sugar & Triglyceride Spikes after Meals

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  1. Tolerable video, oh but the cliffhanger season is upon us. whoot.

    Funny how often Dr. G is going on about chicken or such and I’ve a mouthful of blueberries and other plants at that very moment. Lots and lots of bacon and eggs to make up for, but I feel so much better now-it’s easy.




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    1. The graphs are getting easier to “see” and understand…..looks like somebody is into GRAPHING! Done right…it explains things better.




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      1. I agree Fred. Everytime I find a video I really enjoy I check the acknowledgements. This year, more often than not, the videos have been done by Avocado video. I dont know these people (I’m not a relative LOL), but I am really impressed by their work. Thanks to all who contribute to the workings of NF.




        2
      1. And what about this one? This one has info about polyphenol content in various foods (with specific names of polyphenols).

        http://phenol-explorer.eu/reports/43
        http://phenol-explorer.eu/reports/40
        http://phenol-explorer.eu/reports/39

        and links to all of these:
        http://phenol-explorer.eu/reports

        Now you can mix and match your polyphenols however you want!!!
        Functionally, it’s a little bit similar to the paper describing antioxidant content of 3000 foods (which was featured in one of the videos) but here you have detailed information at hand.




        0
  2. Good video to share with meat eating friends and family. BTW, that dish of veggies at the start of the video looks like my daily lunch. Making me hungry already :-)




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  3. At 4:08, I don’t get why the version with avocado is said to improve the insuline response — it looks like it is just a bit later, but just as heavily.




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      1. Another one that I’ve tried is using hummus to grains/potatoes/sweet pats and making it into a sauce by adding almond milk or water. Greatly improves flavor and adds nutrition. I bet it also slows the insulin spike. You can always eat more legumes.
        John S
        PDX OR




        4
      2. I love the website and love the videos, and mostly love this video, but No, in fact, Rick is right…

        … the study in question added 1/2 Hass avocado to be incorporated into the lunch or eaten in addition to it. You can see the abstract starting at 4:02, and although he makes a summary statement at the end of this study that refers back to both the almond and avocado studies.

        Unless I’m really missing something, Dr. Greger should fix the audio on that section. AND it raises interesting questions about why 1/2 avocado didn’t have the same effects as almonds… more total fat?




        3
        1. Agreed with Karl Wheatley. The graph didn’t show that avocado affected insulin. Here is the study.

          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4222592/

          Blood glucose and insulin changes

          There were no significant differences between the 3 lunch test meals for AUC(0-3h) blood glucose (Figure 1). Compared to the AI test meal, the AUC(0-3h) for blood insulin was higher in the C and AA test meals (P = 0.04 and P = 0.05, respectively). Difference in blood insulin levels between treatments were observed at the 30 minute time point (P = 0.04) as follows: adjusted mean (95% CI) for C = 54μIU/ml (39, 74); AI = 34μIU/ml (25, 47); and, AA 42 μIU/ml (30, 57).




          1
    1. I follow intermittent fasting as well as being almost WFBP. I simply miss breakfast. Last meal is at 7. Then midday meal at 12-ish. So that is a daily 17 hour fast. Easy to do (and time saving every morning). I just have a cup of red bush tea (no milk).

      Reason is as a low activity paraplegiac wheelchair user, I have a low calorie requirement. If I eat breakfast as well I put on tummy fat.

      Those that claim you can eat all you want on a WFPB diet must be high activity types. I need to be selective on high calorie food choices.

      So IF (intermittent fasting) definitely works for me.

      Wish we could have more info on this site for IF. It was promised in a recent live video.




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      1. Tony! – I’m with you! I’m in my 60’s now and just not as active as I used to be so calorie requirements are lower. I, too, have experimented with various types of fasting. The easiest for me to incorporate is like you – a long overnight period of fasting before re-feeding. The body, from what I’ve been able to learn, kicks into the “left over fat” burning mode after 10 hrs. The body will also, with extended fasting of 4 days, re-boot the immune system. A fasting period has been found recently to be helpful with the administration of chemotherapy. Here’s why: when fasting, our cells go into a “hybernating state”. This means that they are not uptaking food/nutrients and are senescent, sleeping. Chemo therapy is administered while cells are in this protected state because the cancer tumor cells do not go to sleep and continues its uptake of whatever is in the system – in this case chemo therapy. The result is that the bodys cells are protected while the cancer is clobbered. One fasts 2 days before chemo, during, and then one day after. This is not appropriate for someone extremely fragile who cannot manage the lack of calories of course so you doctor needs to be involved in this. I’m just relaying the power of fasting.
        If one wants to look more into fasting check out Valter Longo, Ph.D. on youtube. He is the director of aging at U of Calif (Davis) school of Gerontology. He also has a lab in Italy (where he is from) and is basically WFPB eater (with a little fish upon occasion I believe). Also, another expert in fasting is Alan Goldhammer, D. C., in Santa Rosa, CA. He has operated at medical fasting clinic for 30 years now. He has an excellent presentation (Youtube) where he discusses the reversal of a particularly nasty cancer in a woman who came to him. Her doctors told her there was little to no treatment for her cancer – so she went to Dr. Goldhammer. They fasted her and her tumors disappeared. They wrote up this clinical research and it was published in a peer reviewed journal.
        http://gero.usc.edu/faculty/longo/
        https://www.youtube.com/watch?v=6FOBa_hfbRE
        https://www.youtube.com/watch?v=fSH4vBBSDmg

        I’ve shared the links above to get you connected – watch everything on both of these men. One of the things I learned is that Harvard U has teamed up with Goldhammer to study the effects of fasting (per one of his discussions). Harvard has the $ to do the research and Goldhammer has the expertise. They are looking for more info on the hows and whys that fasting is beneficial. And probably also to try to develop a drug to sell to the public to make money on (from Harvard’s point of view). Goldhammer is participating because the science, then, shows the benefits of fasting.
        When you think of it . .. Type II diabetes is, in actuality, over-feeding. Too many calories. Goldhammer has great success in reversing diabetes.
        Have fun!




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    2. Thanks for your question Brian.

      That is a great suggestion, but here is what we know about intermittent fasting. According to a 2015 review:

      “In conclusion, whether fasting actually causes improvements in metabolic health, cognitive performance, and cardiovascular outcomes over the long term; how much fasting is actually beneficial; and where the threshold of hormesis resides (i.e., a balance between long-term benefit from fasting compared with harm from insufficient caloric intake) remain open questions. Unfortunately, the vast majority of human studies of a fasting intervention were weight-loss studies using single-arm, non- randomized approaches or multiple intervention arms with no control. Whereas further research of CR is needed [e.g., the ongoing CALERIE Trial (52, 53)], considerable additional clinical research of fasting is required before contemplating changes to dietary guidelines or practice. Dietary research has inherent challenges; thus, well-designed fasting trials of clinically relevant outcomes and populations are needed to avoid missteps

      Future fasting research should determine whether and to what extent fasting regimens are safe. Further research is needed to determine whether fasting is effective for improving health in the general population, higher-risk people, and diseased in- dividuals. Additional knowledge is also needed regarding the mechanisms of benefit and the optimal frequency and duration of fasting in apparently healthy and high-risk individuals. Fi- nally, in deference to the current focus on lower-cost healthcare, fasting has no direct financial costs and represents a nominal savings on food expenses. In summary, intermittent fasting may improve health; however, substantial additional clinical research is needed before advocating its use for health purposes.”

      Regarding meal frequency, according to a 2017 Statement From the American Heart Association (see here):

      “The impact of meal timing, particularly related to the evening meal, deserves further study. Epidemiological findings suggest a potential detrimental effect of late meals on cardiometabolic health, but clinical interven- tion studies, which would address causality, have been limited in scope and too diverse to draw definitive con- clusions and make recommendations. Moreover, the potential benefit of increased meal frequency should be evaluated in the context of timing and duration of the daily prandial period.”

      Hope this answer helps for now, but it’s a good suggestion for a future video.




      2
      1. My problem is that I am not hungry at breakfast or really much at lunch but I am naturally too hungry at dinner. Following a wfpb diet I eat uncle sam with berries for breakfast and some veggies, salad, apple at lunch but I really do have to watch the dinner time. I haven’t always seen a problem with counting calories and following strictly a wfpb diet but I still am skeptical of those who say you don’t have to watch calories at all.




        1
        1. I am with you 100%. I never use oil, and rarely nuts, avocados or other high caloric density whole foods, and still tend to pack on the pounds, though I am never hungry until evening. Trying to eat smaller meals more often is probably a better idea, but feels like a huge chore when you have no appetite.




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    1. In other tests, they use only healthy free range chickens and it makes zero difference. You can’t claim eating healthier animals is good for you.




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    2. Thanks for your comment Melinda.

      When it comes to chicken and for example, insulin response, chicken contains amino acids which raise insulin response regardless of the quality (see here).

      It should also be noted that advanced glycation end products (AGEs), which occur naturally in meat and are formed through heat processing, may also have proinflammatory actions (see here). AGEs will be formed regardless of quality.

      Hope this answer helps.




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  4. Hello all. I have been on a whole foods plant based vegan diet for a year and a half. I only cheat with snacks like pretzels and some pizza without cheese. Some chocolate almonds (non dairy). I really eat like the way Dr Greger recommends for the most part. So, my cholesterol came bak with huge improvements. Im 45 and in pretty good shape, BMI 22.
    Overall cholesterol went from 201 to 167
    LDL went from 119 to 75. BUT…….HDL went from 44 to 35 and triglycerides went from 175 to almost 250…..Which was very disappointing. Since then, I have cut back on coffee to 2 half cups a day with a half the sugar. Trying to snack less on junk. Any suggestions???? Should I be concerned about the triglycerides at those levels and the drop in HDL?




    3
      1. Right…But still doesn’t explain the worsening of my numbers. Before I went WFPB, I used to put oil on everything and eat wings and burgers and fries…LOL




        1
    1. Post what you eat for a normal day (and be honest). Let’s see if we can get to the bottom of this. By the way: congrats on the diet change, total cholesterol, BMI, etc. – that is awesome.




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    2. Do you follow the 1/4 teaspoon of turmeric recommendation? Don’t overlook this! Also, for triglycerides, do you avoid all oil? Nuts are okay, but you should completely avoid any trace of oil.




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      1. Thank you. Any relation to Nathan? LOL. I cheat on the weekends with some oil at restaurants but all week long I am pretty clean..

        Restaurants by me are limited and it is hard enough already. I do have a few drinks 2 nights per week, which I am sure is not helping

        I started putting turmeric root in my smoothies too. I have curcumin pills but don’t take them regularly, but I will start.




        2
        1. hi Rich, a few weeks ago we had lengthy discussions about lowering triglycerides.. if I find it I will post it. You will find similar under any of the cholesterol videos. The upshot is, higher triglycerides is due to one of, or a combination of these factors: too many calories overall, alcohol, flour/simple carbohydrates/sugar or fats (oil, nuts, avocados) .
          In my own experience, I dont drink, eat moderately, no restaurant food,and had to cut out all flour products (bread, bakery , pretzels!, pizza crust, premade cereals) , nuts , avocados, oils, to get to 70 triglycerides. Beans, veg, fruit, whole grains , all good




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        2. These days I order only dry salads in restaurants. Even something innocent looking like a stir fry might be loaded with grease in a restaurant. I remember one time I visited a restaurant in my neighborhood I sat down in the front waiting area to wait for a table. As I sat there I watched the cook several yards away making five simultaneous meals behind the counter. He had five huge wok kettles sitting on top of five gas burners. He picked up each kettle and wiped it out with a rag. Then he took something from a plate that looked like a blue brick, pealed the paper off, and threw the contents into each kettle – it looked like a block of white butter the size of your fist. I have to assume that this was some kind of lard or similar oil. The important point is that he did it to ALL of the kettles. After he “seasoned” the woks, he added veggies and meats to the five. So… whether or not a patron ordered beef, shrimp, pork, chicken, or a meatless dish, he got a brick of white goo added to his kettle before the ingredients went in.

          That was the last time I ordered anything in a restaurant other than a dry salad. (Except for True Food Kitchen in Scottsdale.)




          5
          1. Chinese and Thai – steamed veggies and brown rice. Rice and bean bowl at Mexican restaurant where you can pick your own add-ons. Some soups at Panara Bread. Not easy.




            2
          2. drcobalt, I, too, love True Food in Scottsdale, but have found that even there you have to be careful. I ordered a vegan squash pizza not too long ago, and it was dripping in oil.




            1
            1. You do need to be careful about the rice and beans as they are often cooked in a meat broth. I ask multiple times to get the straight answer.




              0
            2. I’ve found True Food to be pretty good but they are oriented toward Andrew Weil’s take on fats. That is they are likely to be rather higher fat in their recipes.




              0
            3. Ok, here’s what we do: we get Scottsdale city government to require that all restaurant operators AND their cooks read How Not To Die and pass an exam, minimum score of 80%, before they can run their restaurant business.

              Either that or we ask the manager if we can borrow the kitchen and make our own lunch.




              0
    3. Hi Rich,
      My blood profile did a similar thing and I wonder if that is an expected effect or not? So I did just what you did by cutting back on the refined goods (which I was in denial about the amount) and started watching my sugar intake overall with attention to taking in more watery, higher fiber fruit. I hope this strategy will help me as well. I think I will try to really stick to the Daily Dozen plus Weight Watchers (it helps me with portion control).

      Lastly, I think I heard that Dr. C. Esselstyn looks out for his patient’s elevated triglycerides levels as an indicator of their switch to a WFPBD but I may have that all wrong, so off I go to get his book as see if comments on that.

      Anyone else heard about triglycerides on WFPBD?




      5
      1. 3-1/2 yrs on Wfpb. But my triglycerides are the problem: 300! I use fresh Turmeric about three times a week or whenever I have a food or smoothie that I can put it in. I do all the right things food-wise. now my doctor is asking me to cut down on bread and certain other carbs. I am so tired of trying to figure out this puzzle. None of the WF docs have really come up with a solution either. I do 2 hours of strength training and 10-15 miles/week on indoor bike.




        3
        1. Watercress, . . a couple of thoughts . .
          My triglycerides spiked as well, up to 200 at one point. Now down to 170 or so. I hate to admit this, but I like my glass or two of red wine in the evenings before/with dinner. I have cut back on that which seemed to help as alcohol does contribute to triglyceride levels. I also very severely reduced my bread products and evening carbs. No big bowls of rice with dinner but big salad with plates of green/yellow veggies. Perhaps a very small potato or winter squash, but not much. I eat my high calorie carbs during the day and avoid at night. Build in a 12 hr fast period at night. This seems to have helped. I’ve replaced my bread products with winter squash (more vitamins anyway) and potato.
          Also, Dr. Fuhrman states that if triglycerides are a problem to go to a “Beans and Greens” diet. He states too many high energy carbs are in the diet and fruit and/or fruit juice (simple sugars) contribute to higher triglycerides. It’s in his book “Eat to Live”. You can read his advice there.
          Lastly, someone else posted this link from Dr. McDougall re: triglycerides but I’ll repost it again here. When I saw where on the scale my “high triglycerides” are, I felt better. At 200 or 300, he sees those figures as “Slightly high”. He mentions he’s seen triglycerides at 5688! That made me feel much better :-). Read more about triglycerides from Dr. McDougall here:
          https://www.drmcdougall.com/misc/2003nl/030100putamingelevatedtriglycerides.htm
          This is my 10th year WFPB and each year I get better at it. Keep at it, . . your body will love you:-)




          3
      2. Same thing happened to my husband recently. His cholesterol went down about 40 pts and he lost 15 lbs, but his triglycerides went up from 150 to 210. He’s only wfpb no oil at home though, because I’m the one who cooks. He does go out for lunch every weekday and only occasionally orders chicken (so he says). I’m pretty sure it’s the chicken/oily restaurant food, but he’s still of the mentality of ‘everything in moderation’.

        But why would only the triglycerides go up?




        2
    4. Hi Rich,

      Did you fast for 12 hours before the lipid panel that showed high triglycerides? If you ate some fats during the fasting period then i believe that will show up as high triglycerides.

      Food does raise triglyceride levels for several hours, usually to a modest degree. After a high fat meal these increases can be striking. Therefore, a doctor may still order a fasting test of triglycerides if non-fasting values are significantly elevated.

      Quote is from here… http://www.health.harvard.edu/blog/farewell-fasting-cholesterol-test-201606169784




      1
    5. My BP before nf.org was typically 127 over 78 (when I was a chicken-eating, semi-vegetarian). Today I am an almost-vegan and get consistent BP readings of 105 over 62 on my own device. One evening last week I got 96 over 52. There’s no doubt that there’s power in plants. I’ll bet my blood work is much cleaner these days too. I eliminated all animal products to get these numbers. If I carried a PETA card and swapped out my leather belt for cloth, I’d be a pure vegan. =]

      It’s not that I want to live to be 110, but I sure don’t want to get triple bypass surgery in my 60s (like my older brother got last year) or a set of metal coronary stents installed in my arteries (like my younger brother got while in his 50s).




      7
    6. Wouldn’t worry at all about HDL. We counsel patients ahead of time that probably their HDL will drop on the Esselstyn type diet (simple analogy is that of garbage – LDL and garbage trucks – HDL; if less garbage, don’t need as many garbage trucks).

      Triglycerides a bit more complicated. Biggest risk factors: diabetes, simple sugars, alcohol, total calories. TG can fluctuate more, even day by day.
      I’d stop all simple sugars, including fruit juices, etc, especially sugar containing sodas and alcohol and recheck in a week of two.




      4
      1. I think it’s the alcohol. I usually drink 2 or 3 nights per week. 2-3 drinks each night. Think it’s time to cut back to 1 or 2 nights and only 1 or 2 drinks. Have to have a little fun!!!




        3
    7. How much fat do you consume? Very low fat high carbohydrate diets are associated with increased triglycerides. The cause of this change and the nature of these triglycerides is not fully understand. Recent evidence suggests that it due to a reduced uptake of triglycerides into fat cells. There is controversy as to whether this increase in triglycerides is actually harmful. This is because populations with low-fat high-carb diets tend to have higher triglyceride levels than those with more moderate intake of carbs and fat, however their arterial and heart health is much superior.




      3
      1. Thank you Finbun. Please provide any links you may have supporting this argument. My doctor (not a WFPB doc) wants to put me on meds for my high T’s. I do eat the diet you describe. I need some scientific evidence to back my argument with my doctor. I’d like to see Dr. Greger address this issue as well as it seems there are more than just a few of us out there in this situation. Thanks again




        4
        1. This series of posts goes over a lot of the science and studies regarding elevated triglycerides on high carb low-fat diets, where they come from and whether they’re harmful

          http://carbsanity.blogspot.com/2011/05/where-do-triglycerides-come-from-part-i.html
          http://carbsanity.blogspot.com/2011/06/where-do-triglycerides-come-from-part.html
          http://carbsanity.blogspot.com/2011/08/where-do-triglycerides-come-from-part.html

          Here is some more content related to the issue
          http://carbsanity.blogspot.com/2011/05/triglycerides-atherosclerotic-or-sad.html




          3
          1. Much obliged Finkbun for going to all that trouble. I hope the others who have commented about their high triglycerides will catch these references. I have not looked at them yet because I’m in the middle of something now but that’s my project for tomorrow. Again many thanks




            0
      2. Outside of 7-8 nuts a day and 1 tablespoon of ground flax, maybe a little chia in my cereal or smoothie, I don’t eat fats. I guess I can add avocado.
        When you say “due to a reduced uptake of triglycerides into fat cells” does that mean then that they remain in the blood stream and when measured come out high? They’re not getting into the fat cells? Thanks.




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    8. Get some really nice coffee (both roast and blend) and prepare it properly such that you can ENJOY the coffee without sugar. Find a coffee snob (I’m not-really) and they’ll be glad to help you satiate your tastes, NSA. Personally I like lightly roasted Ethiopian the best (and sugar would kill half the great fresh flavors of such), but I mostly drink a store-brand “breakfast blend”. It’s much more convenient and is pre-roasted.

      Great luck and I’m no expert on bloodwork, but methinks most of those numbers are a sign that you’re on the right path. Cheers




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    9. In latest studies and my own diet proves that its not fats that cause high triglyceride and low hdl levels but carbs such as pasta breads potatoes and rice and sugary things and my understanding with a vegan diet is that its quite high in these foods because of lack of animal products ..is that right and of course i forgot to add legumes and pulses because these all these foods require an insulin response which leads to fat storage in the liver so that causes fat levels to rise in the blood .




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    10. Hi Rich. Been thinking about your issues with cholesterol and triglycerides. First I would not worry too much about HDL C. The main thing is the LDL.
      Now years ago I began taking fish oil and my triglycerides did go down somewhat. My sister on the other hand had very high triglycerides for which the doctor prescribed a fairly large dose of fish oil. It worked. Then for a variety of reasons I went wfpb and started eating about 2 tablespoons of ground flax a day. I also cut out the fish oil. My triglycerides went down further from about 70 to 31. I can’t swear that it was the n 3 oil but it stands to reason that the more whole food source would be best and avoiding fish is always a good idea. Besides the lignan is justification for the flax by itself.

      Also, fructose can raise triglycerides. This has not been found to be the case with whole fruit but juices, honey, agave nectar et al can be an issue.




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      1. Thank you Stewart…The more I think about it, the more I realized how much I unnecessarily cheat throughout the week. I am going to cut back on the late night empty calories, less sugar in my coffee, less breads and pastas and less alcohol See if gets the numbers down…..If not, I will just blow my brains out…LOL




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      2. You already had a great level at 70. Was there a further health benefit to going down to 31 from 70? My last test I was 66.




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        1. Actually, I was not trying to reduce it further. It just happened with a healthier diet.

          When eating animal I did avoid excess saturated fat. I also avoided fructose in any refined form. Now with the saturated fat down even further and no animal at all, the figures are better. And I am even more careful about avoiding fructose. The flax is for the anti cancer benefit which is a big concern in my family.




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    11. I had the same situation, but in couple years it is lowered back to the same as was before and then normal. I was wondering about this every times, no one suggest what it is.
      If Dr. Greger can comment this situation. It will be very much appreciated.




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    12. I have to watch the Glycemic Index of the whole foods I eat to lower my TG (also TC and LDL). It is annoying to eat WFPB no oil and end up with some of the worst labs I ever had. I cut back on the fruit I was eating, (including the dates–I was eating 3-4 a day for calories) and switched out the short grain brown rice for long grain or basmati brown rice. Even with adding in some oil, my labs improved.

      If you want to read more in detail, you can check out my blog post (scroll down until you see the bolded words Lipid Levels: http://www.youseasonwithlove.com/2017/03/30/lab-update-including-lipids-and-b12/

      Good luck!




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  5. My son is in denial of the detrimental metabolic effects of his high animal protein diet because of the power of its, “get skinny effect”- ah, the supreme wisdom of youth. I have to give up my anxieties about his health to a higher power and focus on my own health because that is all that I can control.

    New pledge: eat more nuts but not too many. ;)

    I am a proud monthly supporter of Dr. Greger’s work. Please support his mission (if you are able) to provide evidence based nutritional information to you so that you and yours can be well informed- his hard working team deserves your support, don’t they?

    Bobbi RN OHNC




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    1. Thank you for supporting Dr. Greger’s work Bobbi! I love your attitude about your son. And, if you concentrate on your own health, when he sees your glow and positive results his thinking may change.




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      1. It’s sliced cake without sugar and frosting, but also there is sugar added.

        I eat tortillas or make my own quick-bread, yeast bread, or tortillas because you can’t conveniently find bread in a grocery without sugar added.

        It’s not necessary, but omnipresent in processed foods.




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    1. Peter: Wonder Bread is mistaken for food here in the US, but it’s not really food. Fruit flies won’t even eat it. Seriously, we did an experiment on that in my 8th grade science class. All the flies in the Wonder Bread container died. We also put iron nails in cola for a week. The nails disintegrated. After that, I never ate Wonder Bread or drank cola ever again. Great teacher.




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    2. Wonder Bread is the most ubiquitous standard white bread in the US and is pretty much the model for white bread formulae. It did at one time contain trans fats though oils are now used. It also contains whey which is a great source of branch chain amino acids that you might want if you are trying to elevate your insulin resistance. And they do use high fructose corn sugar which might have a little added impact on your triglycerides.




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  6. It’s amazing how ignorant people are about impact of meals consisting of junk ingredients on blood glucose & triglyceride levels.
    Most diabetics refuse to check what impact their meals have on blood glucose levels — a simple BG test 2 hours after meal shows extent of spikes.
    After 48 years as a Type 1 diabetic, I know the impact of every component in my meals. Even proteins increase blood glucose levels & meats have much greater impact than vegan based protein. One needs to account for proteins, fats & fiber in one’s bolus insulin dose.
    But nothing beats a nutrient-dense diet with low carbohydrates & medium amount of proteins.




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  7. This might seem like a dumb question but, do folks know they should do a 12 hour fast (only water) before getting their blood tested? I have been told it makes a big difference. Or does it?




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    1. Hi BJ

      Apparently, from what i’ve been able to glean from various sources…

      If you don’t fast your triglyceride levels will be abnormally high. Most labs do not measure LDL directly, they use a formula based on total C, HDL and Tri’ to work out what LDL is.

      Total C – (Tri/5 + HDL) = LDL These all measured in mg/Dl

      Ergo, if you eat then your Tri’ will be too high and therefore you get a wrong reading on your LDL.

      If a lab uses direct LDL measurements then, apparently from what i’ve read, it doesn’t matter if you eat. But most labs don’t do direct measurement of LDL – i presume because it’s quite expensive to do so.




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  8. Hi Dr. Gregor, first off let me say that I am a huge fan of your work. I eat a diet composed of 90% whole based plant foods, mostly fruits, vegetablies, grains, legumes, plenty of nuts and seeds. I have spent most of my life as a strict vegan that steered clear of vegan junk.

    HOWEVER, I am currently recovering from severe anorexia, which delivered a plethora of grave health problems, including severe osteoporosis. My dad, who follows a plant-based diet himself, recquires me to drink low fat, unsweeted kefir at least once a day. I am terrified of the damage that this animal food will do to me. I never consume it on its own.

    How significant of a negative impact does adding a moderate amount of kefir (low fat, unsweetened) to plant-based whole food diet?




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    1. Abi,
      I understand that you can get all the calcium you need from dark leafy greens. Just be sure to take a vitamin D3 supplement daily to help with absorption of the calcium. Dairy products are not a good source of calcium for humans.




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      1. But if she is a severe anorexic, she may need the calories from the kefir. Long term health is not the goal for someone suffering from anorexia, short term survival is. Whatever way she can get the calories that she needs, she should do that. That might be why her dad is giving her the kefir. Animal foods can put weight on very effectively.




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    2. Hi Abi, I had to reply when I saw your post as I suffered from acute anorexia for years, from the age of 15 , now 40. I just wanted to say good luck with your recovery! I really feel for you as putting on weight is only the start of trying to get better, the mental side takes years to recover from, I am still obsessed with my diet but would say I am now 90 percent better, take care and all the best, you can beat this.




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  9. is there any study on almond/nut butters themselves?

    whole grain pasta doesnt have the same effect that whole intact grains. so maybe there is a difference too on nut butters?

    Thanks




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    1. hi Alexandre Marques, I dont know about studies on almond butters, but I have paid attention to discussions on Advanced Glycation End products..(AGE) for information on this , see this link https://nutritionfacts.org/topics/advanced-glycation-end-products/ Ihave avoided nuts for a few reasons . The calorie density is obvious one, along with the fat content. The omega 3 to omega 6 ration is terrible form many nuts and seeds with the exception of flax, chia, hemp hearts, and walnuts… maybe others I am not familiar with. The AGE for almonds and nut butters is high, particularly roasted nuts which will increase inflammation and increase risks for heart disease and other vascular orders.




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      1. the omega ratios of nuts is a little misleading because there is usually a small amount of omega 6, so even though the ratio is bad it doesn’t actually upset your overall ratio much if you only include a handful or two of nuts per day. For instance, one tablespoon of flax and one ounce of walnuts will give you a worse ratio then will one tablespoon of flax and one ounce of cashews. But cashews have a worse ratio then walnuts, right? Yes, but they have so much less omega 6 that it does not matter.




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    1. I would get less of a blood sugar spike from fruit if I had it after exercise. I like to just drink water before exercise.




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  10. Well, according to the graph, the addition of the avocado improved the insulin response for the first hour (which I guess qualifies as post-prandial), but for several minutes thereafter, the insulin spiked slightly higher than the control before settling down to about the same level as the control for the remainder of the test. So, yes, an improvement of sorts, but not all that dramatic.

    On a very low fat diet — no avocado, nuts, seeds or oils, in other words, the Pritikin diet), my fasting glucose generally ran in the 70’s, my HgbA1C% was 5.1, which translates into a 3-month average glucose of 100 mg/dL. And my C-reactive protein (a measure of inflammation) was an astonishingly low 0.04 mg/L (Average Risk 1.0-3.0). That’s for someone in his 70’s. Most people that age have dramatically higher blood sugar and C-reactive protein.

    At Dr. Greger’s recommendation, I’ve since increased my nut consumption, which has caused me to gain some weight, and has also increased my fasting glucose from the mid 70’s to the mid-80’s. (I don’t know about the post-postprandial difference.) So not so sure about the nuts. Maybe I’m eating too many of them. I do love the raw almonds and walnuts. :-)




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  11. Hello
    Can anyone one offer advice or opinion please. I try very hard to go vegan , no oils especially when I cook. I have never been able to eat any kind of bread without stomach pains , cramps . I’ve tried oatmeal for breakfast but become more sick than bread. I tried 3 times and spend 1/2 the day you know where ,so I just eat a small bowl of any legumes with vegs.




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    1. Hi Annie! I’m one of the moderators helping to answer questions on this site. In Dr. Greger’s daily dozen foods, he suggests barley, buckwheat, quinoa, corn, millet, teff, whole-wheat pasta, brown and wild rice as grain options. Maybe you could try a few of these options to see if they are a bit easier on your digestive system. Please check back to let us know how you’re doing! Good luck!




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    2. Hi Annie. If any food, even one that Dr. G recommends, leaves you feeling sick please listen to your body. A lot of people feel healthier when omitting all grains from their diet. Plant-based dietitian Brenda Davis recommends that it is fine to substitute starchy vegetables like sweet potatoes, potatoes, winter squash and corn for grains. That’s what I do and I feel so much cleaner when eliminating grains from my diet. https://nutritionfacts.org/video/how-to-prevent-blood-sugar-and-triglyceride-spikes-after-meals/




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    3. Where’s the EDIT button!! I linked the wrong article. Oh, no actually every time I try to link Brenda Davis’ Optimal Eating Guidelines today’s nutritionfacts video gets placed by mistake. So we’ll have to go about it the long way: Please Google Brenda Davis Optimal Eating guidelines.




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        1. EDIT

          get it right the first time or never! 8-P

          (i’m being a bit silly as a “sqeaky wheel” with regard to the ability to patch things up in our comments, if ever necessary. cheers all!)




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    4. Hi Annie. I can certainly sympathize with your issue. Most people raving about the evils of wheat are full of something you occasionally step in but try never to eat. But for some there is a real issue. Wheat for me is very healthy. I have a sister with celiac for whom it is poison. She should never go near it. Oats are generally contaminated with wheat flour so it could just be the wheat that is bothering you. In any case, I would get checked for celiac and other allergies asap. Immediate pain like yours strikes me as severe and in need of a definite diagnosis. The damage to your GI tract can be really serious.

      Keep in mind, I and 40 other people here can diagnose things for you. But those opinions together with 5 dollars are worth a cup of coffee at starbucks. Please get it checked.

      Legumes and greens are favorite dishes of mine. I also eat lots of whole fruit and different grains. But other recommendations will only be appropriate when you get a real diagnosis on your gastrointestinal problems. That way you will know more about what to stay clear of including what grains if any.

      Good luck and I hope to hear your results.




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    5. Hello Annie,

      I am a volunteer moderator who helps Dr. Greger answer questions posted to Nutritionfacts. I am a whole foods plant based dietitian nutritionist located in Scottsdale, Arizona.

      Your question implies that you have always had a problem with bread, even before you moved to a vegan diet, is that correct?

      I agree with others who have suggested you see a gastroenterologist for an upper/lower GI examination, as well as a biopsy for Celiac Disease. Be aware that you must be eating gluten, the protein that is in bread, in order for the biopsy to be conclusive.

      Dr. Greger has a great number of videos on the site that address celiac disease, as well as “wheat sensitivity”. I would urge you to view them, and yes, see your Doctor. It is not normal to have severe pain and diarrhea after eating any type of food.

      Thank you for your question, and have fun poking around the site!

      Cheers,
      Lisa Schmidt
      THE Mindful Nutritionist
      Scottsdale, Arizona




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    1. The studies and causation we believe indicate that there is no quantitative nutritional advantage to consuming one “lifestyle” animal/parts/pieces/excretions over another lifestyle animal. Happy or Sad or Contaminated, the nutrition derived from animal foods is inferior to that derived from plant foods of minimal processing (which excludes sugar and oils, but not whole sugar beets or whole/pitted olives).

      No real difference. Eating animal parts is less healthy than eating plants, even when some animals live brutish and short lives and others are pampered and hugged at night. Our bodies are better equipped to process plants (previously unprocessed).




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  12. My son is Type 1 Diabetic and can’t eat pizza because he gets such a bad blood sugar spike afterwards. I’m curious what would be the blood sugar affect of eating carbs with fried plant foods like a falafel containing a white pita, deep fried chickpea balls, humous and vegetables?




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    1. Wonder Bread is the most ubiquitous standard white bread in the US and is pretty much the model for white bread formulae. It did at one time contain trans fats though oils are now used. It also contains whey which is a great source of branch chain amino acids that you might want if you are trying to elevate your insulin resistance. And they do use high fructose corn sugar which might have a little added impact on your triglycerides.




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    2. Sara, I am T1 and I do eat pizza. But it is with whole wheat crust and no cheese. There is certainly going to be an insulin spike with any carbohydrate. However the saturated fats with the branch chain amino acids in animal products will cause more insulin resistance and more of a blood sugar spike. In general even the fried plant foods should be eliminated since they do have elevated advanced glycation end products and these AGEs will also add to the insulin resistance and elevated blood sugar. While falafel is not nearly as high in AGEs as any cooked animal, diabetics need to be especially careful as we normally have more endogenous AGEs than non diabetics. So we can compensate in part by reducing the dietary AGEs, that is, no animal and no fried.




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    3. Hi Sara,
      Thanks for your question.
      As Dr Gregor mentioned in the video, minimal processing is best for improving effects on blood glucose with plant foods. Therefore, deep frying is not ideal. However, the use of plant based foods along with and carbohydrate will improve regulation. There are always alternatives, like baked falafel, or even bean burgers. A choice of wholemeal pitta bread with raw vegetables as well could help. There are even options for pizza lovers, live a cauliflower crust as recommended on this Diabetics website.
      Here’s a great video on plant-based diets for Diabetes.

      I hope your son is doing well. Thanks again.




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  13. Kudos below, Rick re the shape of the curve in the video.
    Intelligent life alive and well here as always. Nice. Thanks.

    I’m wondering, more generally, which insulin or glucose profiles exert the most or least of what kinds of damage based on their curves. When and how, for example, is a super big but very short lived sugar/insulin spike worse than a mild but longer lived one? When is “area under the curve” measurement more telling than degree of maximum spike? Where does one go to attempt any understanding of any thresholds of episodic harm? How does one recognize “healthy” hormetic processes at work? (For example, the argument — might or might not be true in all cases — that inflammation after weight lifting is necessary in order to bring on the adaptive resulting hypertrophy, so don’t take an asprin to get rid of “bad” inflammation then). So, maybe — ever? — bring on that huge and brief insulin/sugar spike no problem if compensatory responses — both simultaneous and resultant — are in good order, doing what are supposed to do in such situations?

    I also often wind up wondering about specific sub-components. As a part-time educator myself, I have a lot of respect for super-simple explanations that might leave out 5% of 10% of the whole story. So, if the construct of anything-animal-all-bad-in-all-cases-all-the-time winds up matching truckload after truckload of data then that _exceeds_ useful-rule-of-thumb criteria in my mind. So I wonder what processes upstream of beta cells think of amino acids from almond protein vs amino acids from chicken. I understand that most chicken meat tends to be a bit low on fiber, so maybe it’s the fiber in the almond.

    Trying to decompose the animal vs non-animal paradigm perhaps…..
    1. All sugars and all carbs will inherently spike sugar/insulin, though unequally.
    2. All proteins will inherently spike insulin, though some (branched chained?) more (less?) than others.
    3. All fiber of all types of plans/fruit will…
    a. always decrease insulin/sugar spikes somewhat by simple mechanical binding in ingested sugars, carbs, proteins, and
    b. will decrease insulin/sugar spikes even more so if one has healthy gut bacteria: the butyrate they produce from ingesting fiber will impact liposome/hepatic/mitochondrial energy metabolism.

    So perhaps the almond blunted the spike because of its fiber — in spite of the protein it contained.
    Perhaps, out of experimental curiosity, a chicken+fiber creation with similar % fiber to almond might yield an interesting graph.

    Confession: I’ve been a bad dad.
    :(
    For years I prided myself on outings with my kids. “Why YES you can have that ice cream”, I told them. Merely (a) in moderation {i.e. dad get’s to eat half}, plus, eat it with some protein — as I whip out my processed protein bar share with them. Years on that routine? Sad: 10. {{sigh}}. Those outings aren’t as frequent any more, but today instead of protein bars I carry half mashed flax seeds in plastic coin tubes. I’ve grown to not be able to tolerate sweet things without downing tubes of the stuff.

    PRESUMPTUOUS SPOILER ALERT RE STRAWBERRIES
    The likes of this are numerous and well-aging: https://www.ncbi.nlm.nih.gov/pubmed/21736853. Neat how strawberries — like pretty much all fruit — contain polyphenols. About half a dozen subcategories of these. More or less all of these seem — eventually, depending on what the literature seems to find fashionable to study in any given year — to regulate intracellular energy and inflammation pathways. In fact, perhaps most of the healthy compounds hailed as “anti-oxidants” are healthy not because of their anti-oxidant functioning in vivo — by the time they reach the blood their concentration may be too low to impact much here — but, rather, because they function as cellular signaling. And, on that note, nature seems to have made things really really simple. The strawberry polyphenols not only regulate fat cell differentiation, fat storage and release, mitochondrial and other mechanisms of fat metabolism vs glucose metabolism, but while the’re at it they also upgregulate apoptosis. With any luck someone here will remind me what the name is — similar to “finestin”? — very high in strawberries that takes a big bite out of the senescent cell reserve, cutting back on the backlog en route to oncological mutation.

    So to my primitive list above I would add:
    4. The more polyphenol-laden a meal is, the more “improved” lipid/sugar/insulin functioning will be.

    …. and also, meanwhile, strawberries also have more fiber than chicken or butter.

    [And, meanwhile, I wonder what all these graphs would look like with people fiber-adapted guts vs non. If butyrate is a ketone then I figure I might be massively keto-adapted those weeks that I managed to down 10 lbs of spinach (candy food for me). Meanwhile I seriously doubt a single vegan overheard Mr. Bulletproof lots-of-animal-butter-in-his-coffee Dave Asprey at a recent conference describe how foolish any of his followers were not be eating “s@!tloads” of fiber every day without fail. His complete failure, in my opinion, to actively emphasize that seemed to result almost from him finding it so obvious as to be something he expected everyone to take for granted.]

    Also, Kudos to the video for calling attention how advanced drug reps (i.e MD’s — but shhh, some of them don’t like to be called that) only look at fasting levels of things. (Consistency is on their side, at least, in typically expressing no interest in blood pressure beyond sitting office visits, nor caring specifically about sdLDL vs near useless “LDL” or Cholesterol, etc, etc.)

    Thanks for tolerating the high(ish) word count.
    Any educational feedback greatly appreciated.




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  14. If meats cheese fats butter are all so bad why has my daughter who was way overweight eating these things plus low carb veggies and losing a lot of weight? How can this be bad??




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    1. Hi Diane! I’m one of the moderators on this site helping to answer questions for Dr. Greger. Diets like the one you describe seem great and can produce significant weight loss in a reasonable period of time. They generally do this by tricking the body into thinking it’s starving by significantly reducing calories while adding just enough carbohydrates to force the body to use its fat stores and at the same time tricking the brain into feeling full from the high fat in meats, cheese, etc. Unfortunately, the body and brain can be tricked forever and these diets tend to be unsustainable. In addition. the main point of eating is to fuel the body’s cells so they can perform their jobs. A diet like this just can’t do that in the long run because it lacks enough of the key nutrients like vitamins, minerals, and fiber our bodies need to perform optimally.

      I wish I could be more optimistic about the type of diet you describe but the research strongly indicates that the results are likely only short-term ones that will be difficult to maintain.

      Fortunately, NutritionFacts.org is a great place for you to find information on nutrition recommendations for optimal health. Please check out some more of Dr. Greger’s videos to learn more. Here’s one place you may want to start: https://nutritionfacts.org/topics/weight-loss/

      Good luck and good health to you and your daughter!




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    2. Hi Diane. Your question is an obvious one given that there are tremendous economic and social forces determined to tell us she is doing the right thing. Unfortunately the science says otherwise.

      First the low carb diet she is on is designed to promote ketogenesis which will, in concert with a large number of other factors, have a wide range of negative consequences. It is not the ketogenesis per se that is causing the weight loss but the effective calorie restriction from cutting out a major source of macro nutrients. The greater acidity from the ketones will in itself aggravate a wide range of maladies and work in tandem with other factors to promote numerous inter related consequences.

      The saturated fatty acid along with the branch chain amino acids she is consuming will promote insulin resistance. So if she has developed T2 diabetes or pre-diabetes, she certainly will not be doing herself any favors. The fact that she is loosing weight and limiting the carbohydrates may hide this insulin resistance but it is still a move toward T2 diabetes.

      With the meats she is eating she is raising the levels of arachidonic acid which is pro inflammatory and which in turn can lead to a host of other issues ranging from atherogenesis, depression, auto immune aggravation, and yes cancer promotion. She is also consuming heterocyclic amines which can be very carcinogenic. Then there are the carcinogens IGF-1 and mammalian target of Rapamycin.

      Of particular importance in my opinion is that though she might see a temporary improvement in her lipid profile, the nature of the fats, animal protein and consequent high levels of dietary advanced glycation end products (AGEs). These AGEs she is consuming is promoting inflammation of everything from her endothelium (heart disease), to her kidneys and beta cells (diabetes). Add to that the ketones mentioned previously and her prospects for a long and healthy life are diminished.

      The point is, there is a host of factors in the animal products she is consuming that promote ill health now and in the long run. The list I focus on because I have direct experience with it is: heart disease, cancer, diabetes (T1 and T2), chronic kidney disease and auto immune disease ranging from Lupus to arthritis, to fibromyalgia. The diet she is on does not dictate that she will get any of these. But,, it raises her odds tremendously. Furthermore, such a diet is not conducive to long term success and she will likely see a rebound effect that will create additional problems.




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  15. Another excellent video in a very good format , by the way is there a video camera involved ? Most likely a computer program that makes what I would call a slide presentation , but still very good. When you do the transcript why couldn’t you include the pages from the researchers in a PDF format? Some people would enjoy taking their time reading the research papers you present .
    When the butter was used , was it equal weight to the bread ? You said the almond butter was equal weight to the bread so I assume the butter was too?




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    1. Are you taking any drugs Rx or OTC or Supplements that may affect your blood sugar numbers? How to you define WFPB? What is your activity level? And no matter what your answers to these things are, there may indeed may be genetic issues clouding your picture. With these answers others here may know better what you should address next in order to improve your “numbers”. If, indeed, it is a problem.

      How’s’at for uncomplicated? cheers!




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  16. I’ve been eating low fat whole food plant based diet for almost 2 months now, and I’ve lost almost 20lbs. It’s been great! I have noticed over the past week that my blood sugar levels have been above 120mg/dl even 12 hours after my last meal. I am not diabetic, although my fasting BGL has usually above 100mgl but under 120mg/dl. Also 2-4 hours after meals my BGL have been 120mg/dl-140mg/dl, compared to less than 100mg/dl when I was eating a standard diet. Any thoughts?




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    1. Perhaps looking at your daily intake and seeing if your spikes coincide with larger intakes of fruit esp. juices? Could you substitute more complex grains or beans and check if those blgs go down? Joan-NurseEducator




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  17. I really liked the discussion on restaurants. Any more advice on which restaurants work best on a wfpb diet and what you have had luck ordering would be so helpful!




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    1. My husband and I eat out frequently and have most success at Mongolian BBQ restaurants (choose your own protein source, lots of veggies, and the cooks grill your food without oil if you ask them. We also find Thai and Chinese cuisine with some qualifications and questions work well. However, we go to traditional places too and just are specific about what we want-a plain baked potato with mixed veggies, no butter, oil, etc. It’s not as delicious as a nice vegan prepared meal, but it works. Just my thoughts. Joan-Nurse-Educator




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  18. Reading a book called “Wired to Eat”. One of the main points in it is that people tend to react differently to foods…some foods causing high glycemic reactions in some people, but not others.

    You can buy a cheap, but hopefully accurate glucose meter and measure your own reactions to various foods.




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  19. Hey Dr. Greger,

    I tried to find an answer of my question, but I couldn’t find any, so what are your thoughts on fortified foods (except with B12)? Are the calcium fortified milks like supplements? If anyone knows the opinion of Dr. G, please feel free to share it!




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    1. Hi Slavi,

      Here’s a video stating that calcium in fortified soy milk is absorbed in to the blood the same amount as naturally present calcium in cow’s milk. And in this other video on calcium supplements, Dr Gregor mentioned that calcium from food sources does not present the risks that calcium supplements do due to the more moderate amounts present. Therefore, we could assume that calcium foritification in milk is not like supplements.
      In fact, this study shows that those who drink fortified milk have the same bone health as those who drink cow’s milk.




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    1. Shar, you asked about recommended non-dieting cholesterol levels. The current guidelines are for total cholesterol -Less than 200mg/dL; LDL-Less than 100 mg/dL and HDL -60 mg/dL is considered protective. You should realize that these are established by National Heart, Blood and Lung Institute and that should you have specific risk factors, these guidlines might be more stringent. Also some consider these too reflective of what is normal now- not what is actually ideal, which would be lower.
      Hope that helps. Joan-NurseEducator




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    1. Anthony,

      Did you realize that this huge study has generated 180 papers….. and I started down the post you reference and found it to be another of the “read the rest of the study” before coming to a conclusion.

      You might find the paper that evaluated fruit and vegetable intake of interest and reassuring. Here is another study that reaffirms that eating a higher intake has a positive effect. Interesting other outcome associated with weight can be found at:https://www.ncbi.nlm.nih.gov/pubmed/24941447, also outcomes from this study.

      For the paper you read they mix baged the vegetarians and vegans and fail to really dive into the diets. I suspect we all know someone who is a vegetarian consuming basically non-animal proteins, but making poor choices of prepared and/or low nutrient density foods. Extrapolating generalizations from this group is fraught with error.

      The site at the Sax Institute has a large variety of info….just make certain to catch the whole story and how the study was done, before accepting the conclusions.

      Trust this sheds some light on the subject. Another suggestion ….if you doubt your diet results see a physician and get tested making sure to include your biological age criteria as part of the exam.

      Dr. Alan Kadish moderator for Dr. Greger




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    2. I saw that article too–splashed on the pages of our Montreal newspaper. The important part was buried deep in the article. ” The researchers didn’t tease out vegans,” the author wrote.

      Not only do they need to tease out vegans, but they need to tease out vegans who eat truly healthy whole food pbds.




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  20. I’m not sure where your research is coming from, but my blood sugar rises about 80 points in an hour if I eat a tablespoon of rice, or a handful of French fries. If I eat an egg or three strips of bacon, my blood sugar goes down. Everyone is different but starchy carbs do not work for most diabetics. I can’t eat fruit either. Cooked green things work. Fat, animal, olive oil, and coconut oil keep me sated and do not raise sugar levels. Eating less also helps. Not so much to lose weight, but to keep sugar in check. Diabetes takes a number of years to develop. And one sign, you are becoming insulin resistant is gaining weight. It’s a sympton, not you got fat so you get diabetes. Your system starts to fail. And the weight gain alerts you that is happening. Use a meter, and figure out what works. Move, just walk, to lower your levels. Telling diabetics to eat rice and potatoes is dangerous. And not backed up by the glucose meter.




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    1. Jane,

      My clinical experience mimics your responses. And a big “nice job” on keeping track of your blood sugars and recognizing that diabetic conditions need specific diet changes and not general advise.

      What I found clinically was that using the higher glycemic foods such as potatoes/rice/fruit etc. does indeed have a negative effect on T2D/Insulin resistant folks. My suggestion is to focus on the high fiber veggies, nuts and seeds and experiment with your body’s responses to different beans and legumes. It may be necessary to do a mixed WFPB/ animal based diet for some time, while increasing your plant-based products to maintain good blood sugars.

      You should be able to find a “sweet spot” (pun intended) where the response is much more even and lower blood sugars are present. As you point out diabetes does not happen overnight. Some notes: avoid the baked goods regardless of whole grains or otherwise use very limited amounts of grains all the while checking your tolerance. Another consideration …. if you can put the product into your mouth and it slowly will breakdown…. leave it alone. Bread, rice and other similar products are obviously in that category. Avoidance of the bacon and fried foods is very high on my list especially if your insulin resistance. No sense in putting your body thorough the ringer, chemically speaking.

      When your resistance level decreases you can continue to experiment and find what works for your body. On the fruit issue you might consider adding berries and possibly melons….. in moderation and not in juice form. The berries ability to inhibit a number of oxidative blood sugar issues, coupled with their overall positive impact on other chemistries should be considered.

      I’d also like to suggest that you might look into some additional supplementation and comprehensive testing. Many times once both exercise, adequate supplementation of vitamins/minerals, such as chromium, b vitamins and zinc, to name a few are replace, at higher than food intake levels you will find less insulin resistance and be able to expand on your diet of WFPB, with better blood sugars.

      Dr. Alan Kadish moderator for Dr. Greger




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  21. Okay, so I like the idea of adding nuts or an avocado to my vegan meals to avoid blood sugar spikes. But what other items can I add? Is it just the healthy plant fats or do any plants work?




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      1. Hi, Harriet Sugar Miller. One of the wonderful things about whole plant foods is that they are made up of thousands of compounds that act synergistically with each other to affect body systems when they are consumed. It is difficult to separate them, and to say with certainty that one specific constituent of a plant food is solely responsible for a particular effect. It may be that the particular combination of antioxidants, fiber, fat, and other phytochemicals in a whole plant food act together to blunt insulin response. For more in the topic of food synergy, you might want to see this:
        https://nutritionfacts.org/video/food-synergy/#comment-290536
        I hope that helps!




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  22. Can someone confirm or clarify my understanding please?
    If chicken inceases the insulin response, doesn’t it also decrease the glycemic index? So, on the one hand we get the AGEs from the ribose in the meat, we also get increased insulin levels by eating meat, but on the other hand, blood sugar is lowered by the increased insuling, leading to fewer AGEs? Is this accurate?




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    1. Hi, Jonathan. I will try to answer your question in a way that is not too technical. The glycemic index measures how fast blood sugar rises after eating. The video above points out that adding animal protein or animal fat to certain carbohydrate foods increases the glycemic index, because it makes blood sugar levels rise faster and higher. These spikes, requiring corresponding spikes in insulin release, lead to insulin resistance. In a way, the body gets used to large amounts of glucose in the blood, followed by large amounts of insulin, and after awhile, is unable to respond as well to them as it used to do. The short answer is no, it is not accurate that chicken decreases the glycemic index. You may want to see this, if it is not already familiar to you.
      https://nutritionfacts.org/video/why-is-meat-a-risk-factor-for-diabetes/
      I hope that helps!




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  23. Perhaps a moderator here could talk about mechanisms– including the confusion over branch chained amino acids (leucine, isoleucine, valine) and their metabolic effects.

    Sugars/carbs evoke an insulin response by spiking your blood sugar–that is, increase in glucose in blood (measured by glycemic impact–glycemic index GI or glycemic load GL) signals pancreas to produce insulin, a hormone that ushers glucose into cells for energy.

    Foods rich in branch chained amino acids (leucine, isoleucine, valine) evoke an insulin response by another mechanism. They activate mTOR signaling, telling cells to send grow messages internally. And this is where I get lost. “High levels of BCAAs persistently activate mTORC1 (mTOR complex 1), resulting in insulin resistance through the phosphorylation of insulin receptor substrate 1 (IRS-1).” Could someone please explain phosphorylation? Darryl, where are you?




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    1. Phosphorylation = adding a phosphate group and dephosphorylation = removing a phosphate group.
      This is part of the activation pathway used at insulin receptors as well as for certain other processes in the body (such as ATP and energy production).




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  24. Would choosing whole grain carbs in combination with animal protein affect differently the postprandial results?




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  25. Hi, Ximena Rossello. First of all, popular use of the term “carbs” is misleading. Carbs are not a food group. They are essential macronutrients found in all plant-based foods. We know that whole grains tend to have a lower glycemic load than refined ones, due to fiber content and slower digestion. While that might somewhat reduce the postprandial results, the studies cited in this video demonstrate that adding animal protein increases the insulin spike from high-carbohydrate foods, and I would expect that to occur with whole grains as well, just to a slightly lesser degree. You might want to check out the video linked below for more on this topic:
    https://nutritionfacts.org/video/if-white-rice-is-linked-to-diabetes-what-about-china/
    I hope that helps!




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  26. Initially the video discussed blood sugar response to certain foods, but as animal products are introduced, we are shown charts of the insulin response.

    Why the focus on insulin response and not blood sugar? The glucose charts are strangely omitted. Does adding animal protein and fat have the same effect on blood glucose as it does on insulin?




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    1. Hi Nate- I’m Dr Anderson, a volunteer with Dr Greger. This is a great question. What we’re really trying to measure is “insulin resistance,” a condition that generally precedes diagnosis of type 2 diabetes, in which the body can’t effectively use insulin to take glucose into the cells for use as energy. There are many different measures of insulin resistance, two of which are glycemic index (how much does the glucose level rise after certain foods in certain people) and insulin index (how much dose the insulin level rise). Foods of carbohydrate can have their glycemic index studied, bc carbohydrates raise the glycemic index. When you add fats and animal proteins to carbohydrates, the glycemic response is often blunted, BUT the insulin response is raised (worsened). It’s ideal to have blunted glycemic and insulin indices rather than both or one spiking after foods or food combinations. The less the spikes in glycemic index, insulin index, or other measures like inflammatory cell response, the less likely a person is to develop insulin resistance and diabetes. These are indirect measures, though. Directly measuring insulin resistance is through use of a tool called an “insulin clamp” that isn’t practical for use in actual individuals.




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  27. I’ve noticed an increasing number of people, especially on Facebook, who are concerned that their blood sugar seems to be spiking after meals. This was covered in a recent Q&A where Dr Greger explained that our blood sugar is indeed supposed to rise after we eat because that’s how our body converts carbohydrates to energy and ferries it to our organs. (My words not his.) I can see that this makes sense, but I’ve just come across a YouTube video which I found really interesting. It’s implying that our personal gut microbiome can dictate which foods are best for us to eat. This also seems to make sense. But humans are adaptable creatures. Can we assume that even if certain plant-based foods initially cause an unhealthy spike in blood sugar levels, that just by continuing to eat those foods as part of a high fibre diet containing plenty of inulin and other prebiotics, we could build up the number of healthy bacteria capable of preventing the blood sugar spike? My concern is that people who have read and been inspired by Dr Greger’s book are being persuaded (often by their health care providers) to switch to a low carb diet. Should we be encouraging them to stick with the Daily Dozen for much longer, to give their gut microbiome time to adapt? Here is the YouTube video. https://www.youtube.com/watch?v=0z03xkwFbw4




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  28. Jess,

    Good points…… I would modulate the blood sugar issues with a focus on higher fiber, lower sugar PBWF foods and limitations of fruit. I appreciate that this is controversial, however it works after seeing 1000’s of patients I’ll stick with my clinical observation. One of the telling approaches to blood sugar rises, post meals is the amount of change and the return rate to the 80’s or lower for blood sugar. Our clinic uses a top level of ~140, one hour post prandial for the cut off between a meal that works and one that does not….. I’m certain others have their own approach however this seems to work for my patients.

    You’re on the mark with the need to take some time to go forward with a PBWF diet and the pre and probiotic nature of the changes over a few weeks of time. As you’re aware the microbiome will make a difference and needs to be, think of an analogy with gardening, slowly fed, nourished and watered to blossom. Your question encourages the answer…. everyone is different and with the constantly changing input to our microbiome we need to check the speedometer for how well our fuel is working…..

    Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com




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  29. Nut butters have very high AGEs so I am reluctant to use them despite
    because of the poor cost/benefit ratio. Please comment.




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  30. Hi Garret,

    I am a volunteer for Dr. Greger. Thank you so much for your comment.

    Yes, most nut butters are relatively high in AGEs (although not as high as most meats). However, if you can find unroasted nut butters, the AGE content will be significantly lower.




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