Diabetic's blood-sugar levels affected by false ingredient labels

Originally published at: https://boingboing.net/2020/09/30/diabetics-blood-sugar-levels-affected-by-false-ingredient-labels.html

And the moral is … don’t read the ingredients labels?

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That’s amazing. It means that the brain processes that control the pancreas are somehow connected to the brain processes that have a cognitive awareness of sugar content at a semantic “reading” level. I would have thought they had nearly nothing to do with each other as blood sugar maintenance seems to be completely involuntary.

You can imagine all sorts of applications for this. Could some kinds of diabetics learn to get more control over their blood sugar through visualization techniques, for example?

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Glycemic index and blood glucose levels are so screwy. I’ve seen other research that also indicates that the brain partially determines the body’s response to ingesting sugar, and I was recently reading about research that showed that individual differences in metabolism (and gut flora, etc.) mean that the body’s response to sugars varied wildly between people. The glycemic index is pretty much meaningless on an individual level, only accurate as a group average. The “bad” foods for some people are “good” for others - and vice versa.

This also makes me think of the recent ruling in Ireland that the “Subway” sandwich chain’s bread contains so much sugar that it does not meet the legal definition of bread. At 10% sugar by dry weight, it’s presumably cake.

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If you are on a long term keto/atikins diet - you can show high blood glucose levels and still have a healthy a1c - to ‘diagnose’ diabetes they must take an a1c measurement.

The B/G levels are just an indicator - and in general is a good indicator of if you are eating correctly and following your medicine - however I think rather than visualization techniques this would further lead to evidence that perhaps B/G is not the best means to measure a diabetics response or health, and we could do with a better measurement system.

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Reminds me of Dr. Hegsted, his research, career, and the legacy of horrible nutrition left in its wake.

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A study that is even odder is that endurance athletes that simply rinse their mouth with a carbohydrate drink and spit it out get roughly the same benefit of energy as those that did not spit it out. Merely the taste of the carbohydrates satiates the crave for it during the long run.

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There’s been an interesting discussion lately about ultra-endurance athletes, who are evidently “suffering” from an “epidemic” of pre-diabetes, meaning that their normal blood-glucose is elevated above normal in a resting non-eating state. The medical literature on this immediately jumped on the fact that such athletes consume a lot of sugar in sports drinks and gels and blamed their diet. It never seemed to occur to most of the published researchers that the elevated glucose could either be an adaptation or a predictor of who would be successful as an ultra-endurance athlete.

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There is so much half-assed science in the world. No where in the report do they give the actual data or run the simple tests needed to really back up the claim.
Their main finding was supported by a nonlinear model which they chose because it gave them the answer they wanted: “we used the quadratic model, due to its AIC fit and because it matched our hypothesized pattern of blood glucose responses.” When not paired with a test of difference between the raw data, that should not be pass review.

Despite the claim that “Blood glucose levels increased in accordance with how much sugar participants believed they consumed rather than how much they actually consumed.” They tested all participants with the same amount of sugar, so there is no data at all on whether the psychological differences are trivially small compared to the actual difference of drinking the sugar or not.

science pedant out

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I think it’s more likely that thinking the carbs were high, their bodies released stress hormones, which raises blood sugar. If you could do the test with people who were naive about blood sugar, I bet the numbers wouldn’t change as much. I notice my blood sugar going up on stressful work days, and it is consistently low all summer. (I’m a teacher with summers off work.)

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So maybe I should be less critical of my dad’s diabetic management strategy of never learning anything about carbohydrates and glycemic index?

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That’s a great hypothesis as it seems like hormone interactions are much more likely to be explanatory than some sort of sub-conscious calculation.

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It sounds like they only tested that blood sugar levels were affected by perceived sugar levels so they didn’t compare the magnitude of the effect to a difference in actual sugar intake.

As a crude proxy you can look at the blood sugar level vs. time:

Participants given a sugary drink but told it was zero calorie had their blood sugar rise from 140 to 170. Those told it was high sugar rose to 185. You can’t actually isolate this from the rest of the effects that might have caused all participants blood sugar to change throughout the experiment, but taken at face value this means that the actual sugar caused a 30 point increase, while the label caused only an additional 15 points above that. I reiterate: this is not a particularly valid control, but it definitely does not support the conclusion that the label matters more than the contents.

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Interesting. I take it you mean the athlete continued onwards using their own glycogen and fat stores. That could have some application for weight loss for the rest of us.

I just ate 3 slices of sourdough bread. One slice would have done fine. Tomorrow I’ll try gumming the second slice, then spit it out. Might be hard though; with luck it will be a successful rye with anise seed, fennel, cardamon, and orange rind.

That’s why I suspect (expect?) that this will end up being one of those studies that can’t be replicated.

It doesn’t jibe at all with the treadmill study where a mouthwash of glucose (but not a mouthwash of artificial sweetener, or plain water) triggered the body to allow more energy reserves to be tapped.

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I dont think that’s what the study did. If we’re thinking of the same study, no one drank the carb drink. The idea is that the body itself, knowing from the taste on the tongue that more carbs are on the way, allowed the use of more reserves than it did for those who just tasted water or artificial sweetener.

But if the study indeed compared those who swallowed a carb drink and those who didn’t, it’s still a matter of the body allowing reserves to be tapped, since it takes an hour for ingested carbs to become available, so in that time span tasting and swallowing are equivalent anyway, i.e. the result should be zero benefit.

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Is that before or after the yeast has had a go at it?

The fact that semantic level knowledge does the trick is kind of mind blowing; but I suspect that there’s a lot in favor of ‘inferential’ control of digestive and similar processes based on things like taste and smell:

Especially if you are eating something reasonably bulky, with some fiber structure and cell walls and things(over evolutionary time almost certainly more common than absorption-optimized slurries and soda), there’s going to be a nontrivial time lag before you’ll get useful data about it from the gut because some digestion needs to happen before you can start absorbing the relevant bits of it. The process would presumably be longer and less efficient if it had to be done in a ‘blind’ and maximum-compatibility way that makes no assumptions about the food in your stomach until it has begun to be absorbed.

If, instead, you incorporate taste and smell, perhaps vision and recall of past eating experiences(possibly where the semantic-level knowledge can worm its way in) that would provide valuable hints about correct digestion parameters even before the food is down your esophagus; so the secretion adjustments can start immediately.

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May have to do with perceived sugariness of drink. If brain thinks it’s drinking something sweeter (which probably also tastes sweeter to person, even though it’s not), then brain tells pancreas “prepare for something really sweet”. Cool placebo (or not so placebo in higher sugar than declared case?) effect.

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The opposite of the placebo effect (where something has a detrimental effect because the patient thinks it will) is the nocebo effect

(The Latin word nocebo means “I will harm”, in contrast to placebo which means “I will please”.)

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