Hi Lex,
I have read the forum rules, and, as I understand them, I am free to post here. I mention this because I am a zero-carber but not a raw foodist. I am posting to your journal to get some clarification from you.
First, some personal background. I have been ZC for more than 6 months. In that time, I was eating almost only cooked meat and water. I had eggs a few times when traveling. More recently, I added coconut oil, to test whether its purported antimicrobial properties would improve my digestion. The 6 months before that I was VLC with no grain, dairy, or legumes, with the tiny exception of a few tastes of 100% cacao mixed with coconut. Before that, I've been low-carb for about 20 years.
My whole life I was underweight, so that puts me in a separate category from the start. Also, from my teenage years on I had digestive issues, which would now be termed Irritable Bowel Syndrom (IBS) with the primary symptoms being diarrhea and burping. Until a couple of decades ago, I rarely ate any meat, maybe a serving once a month. About 20 years ago I found that eating meat helped control my diarrhea, enabled me to gain weight, mostly in the form of muscle, and gave me more energy overall.
The reason I am posting to your forum is that I recently got a blood test that gave me my HBA1c measurement. To my knowledge, I've never had that measured before. I am 54 years old. At first, I didn't even look at the A1c result, since, unlike my cholesterol and Friedewald-calculated LDL, it was not outside the reference range. But a few days later I did examine my A1c measurement and noticed that it was 5.9% with a reference range of 4-6.
I wondered how I could be so close to the upper limit of the range when I had been on what is basically an all-meat diet for the prior 6 months. I started Googling and your posts here had the most relevance to my situation.
I have not yet made it through your entire corpus here, I have only gone backwards from today to 8/11/09. But I seem to detect 2 points of view in your writings with regard to A1c, and I wonder if you are interested in taking the time to clarify them. Note, I am not accusing you of being self-contradictory (not that that would be a capital crime), but you do seem to have different emphases at different times and I am wondering if your views have evolved or if you were merely putting the emphasis on different things at different times.
In one of your earlier posts, you write
Did you every stop to think that maybe the lower values of A1c are caused by very low BG levels driven by huge infusions of insulin after eating a carb heavy meal? Here’s my reasoning:
When eating carbs, glucose spikes quickly and the pancreas responds with a large shot of insulin to control it. The refined sugars we eat creates a rapid and massive BG spike that causes the body to overestimate the actual sugar content so it over shoots with more insulin than needed. This forces BG to rapidly fall to an artificially low level for extended periods of time. Of course, if it gets to low then fat and muscle will be sacrificed (and/or you'll crave a snack) to bring the level back up. Our modern solution is to eat a candy bar or drink a soft drink which zooms BG back up and the process starts over. This creates a yo-yo effect, and, I expect, a very skewed ‘average’ which could quite easily lead to a skewed A1c level (whatever that is).
When eating fat and protein, glucose climbs in a gentle curve over several hours. The pancreas still releases some insulin but not in the panic mode as there is no large spike to make it think the body is in trouble. This gentle rise in BG with the associated slow release of insulin to control it, would keep BG in a very stable and narrow range at the high end of the 'normal' scale - right at the edge of where insulin release is triggered.
I'll call this the Lab Value Fetishization position. This critique is similar to Taubes's critique of cholesterol readings. It's something we can measure, so let's measure it and investigate how these measurements correlate with other things we can measure. But, it's not telling us anything of fundamental worth about our true health. Thus, people can have low A1c values and sub-200 cholesterol readings and drop dead tomorrow from cardiovascular disease.
The other viewpoint that you seem to be advocating more recently is that A1c values are important signs of our underlying well-being, and should be examined, and, if possible, responded to when too high. Accordingly, you have been upping your fat-protein ratio in order to lessen the amount of protein available for conversion to glucose.
Let's call this the A1c Essentialism position, because it affirms that A1c tells us something essential about our health. Recently, I read you citing studies that show that people with higher A1c and lower Vitamin D have much higher probabilities of dying in the next 12 months.
It seems as if you have abandoned the Lab Value Fetishization position for the Essentialist position. Do you agree? If you do, suppose there were a carb-eater with healthy Vitamin D levels and 4.8% A1c measurements. Do you think she's better off than a zero-carber with 6% A1c and healthy Vitamin D?
Please note, I am not asking you for advice. I end up following my gut, both literally and figuratively. My biggest concern is digestive health. So far, ZC has not brought me digestive health, but I am not ready to abandon it quite yet. But the ultimate arbiter, as far as I am concerned, of any diet or lifestyle, is how it affects my digestion. But, although I am not asking for you to advise me, I respect the care and thought you put into your postings. So I am genuinely curious how your approach the issues I raise. Thanks.
