The diabesity epidemic is a growing challenge, not just to our metabolic health and waistlines, but our global economy, threatening to bankrupt countries with growing health care costs.
To help manage this, the Nutrient Optimiser has been designed to empower users to actively manage their blood glucose with their food choices.
The Nutrient Optimiser Smart Macros algorithm helps users manage elevated blood glucose by reducing their target carbohydrate intake until the blood sugars reach normal healthy levels (note: once your blood sugars reach healthy levels users can turn their focus on nutrient density and body composition).
The recent Nutrient Optimiser Challenge provided an opportunity to see how people in the real world responded in terms of blood glucose, ketones and insulin. The major findings were as follows:
- Blood glucose decreased significantly in line with body fat levels.
- Insulin levels dropped significantly.
- Blood ketone levels increased as users started to lose weight, but later returned to baseline levels as weight loss continued.
- Focusing on satiety and nutrient density are effective in producing long term fat loss and blood sugar normalisation.
Blood glucose results
Seventy-six participants recorded daily waking blood glucose levels. Users were encouraged to record their weight and blood sugars on a daily basis, but only look at the longer-term trends.
The chart below shows their average blood glucose values divided into three groups.
Participants with the highest starting glucose saw their blood glucose trend down, dropping by more than 20 mg/dL over six weeks (i.e. from diabetic to close to normal healthy levels).
Generally, fasting blood glucose levels trended with body fat levels as predicted by the Personal Fat Threshold theory of diabetes and obesity.
Most participants found their blood sugars decreased quickly as they transitioned to a high satiety diet. A number of the participants with elevated blood glucose found that they started to lose weight rapidly after a long term stall on a higher fat “keto diet”.
Blood sugar control vs weight loss
Blood glucose can be more volatile during weight loss as the liver increases gluconeogenesis to utilise stored energy.
The challenge highlighted that people hoping to reverse their diabetes need to find a balance between:
- Controlling blood glucose with a high fat (but low satiety) diet, and
- Weight loss driven by nutrient-dense high satiety foods and meals should lead to lower body fat and better blood glucose control in the longer term.
The chart below shows how Paul’s weight and blood glucose fell together, a clear demonstration of how blood glucose levels and body fat levels are related.
A number of participants logged their blood ketones during the challenge. Average blood ketone levels increased to around 0.8 mmol/L over the first three weeks of the challenge but then dropped to around 0.4 mmol/L as participants continued to lose fat.
Blood ketones took a little longer to rise for people who identified as insulin resistant and stayed higher for longer.
While chasing elevated ketones may be relevant for people targeting therapeutic ketosis (i.e. for the management of Alzheimer’s, Parkinson’s or Dementia), it seems that focusing on satiety and nutrient density tend to promote ketosis from body fat (endogenous ketones).
Weight loss continued throughout the challenge, regardless of whether users identified as insulin resistant or insulin sensitive. Users’ fat loss was not correlated with:
- blood ketones,
- insulin sensitivity, or
- insulin resistance.
The ketone data over six weeks aligns with the observations over the longer term from the two-year data from the Virta study. While blood ketones can rise in the short term as someone starts to mobilise body fat, they are a poor marker of dietary compliance or fat loss in the longer term.
The chart below shows the total insulin dose for Monica Kendall (who manages her Type 1 diabetes on an insulin pump) during the challenge (the red line is a 14 day moving average through the individual daily insulin doses).
Monica’s insulin demand dropped by up to 50% once she started on the high satiety meal plans on 26 December 2018.
Towards the right-hand side of the chart, we see that her insulin demand began to drift back up as her energy intake stabilised at a lower level, even though she continued to lose weight.
The chart below shows Monica’s weight (blue line) and daily insulin requirement (orange line) plotted together. Weight loss tends to occur the day after a reduced daily insulin demand.
Insulin appears to decreases in response to an abrupt change in energy intake but may return to baseline levels once energy intake stabilises.
To provide some context, the chart below shows Monica’s daily insulin dose over the last ten years. Switching from a standard western diet to a low carbohydrate diet around eight years ago enabled her to decrease her daily insulin from 50 to 30 units per day. However, during the challenge, her insulin requirements decreased to the lowest levels in her 30 years of having Type 1 diabetes.
Monica’s primary focus during the challenge was on prioritising nutrient-dense, high satiety foods. The key difference from her previous approach during the challenge was a significant reduction in her intake of nuts, cheese and cream.
While high-fat foods cause a slower insulin response, they still affect insulin requirements over the long term. While low carb foods like nuts, cheese and cream can be a good way for people managing diabetes to obtain adequate energy, they do seem to trigger a long term insulin response. Focusing on higher satiety foods tends to reduce overall demand.
Overall, Monica was able to lose 7.5 kg or 10.7% of her body weight during the challenge as shown in the before and after photos below.
The results of the six-week challenge demonstrate that:
- The Nutrient Optimiser is effective in significantly improving blood glucose levels,
- Blood ketones increase in the short term in response to an energy deficit. However, over the long term, blood ketones tend to normalise as weight loss continues. Blood ketones do not seem to be correlated with long term weight loss.
- Insulin demand tends to correlate with overall energy balance and body fat levels.