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How to know if you are metabolically healthy, with Kara Collier

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Paul Saladino1h 34m · 2021-10-26

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141 of 185 claims supported

Support rate

141 of 185 claims supported

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Well SupportedContinuous Glucose Monitors (CGMs) provide valuable insights into how various foods and lifestyle factors affect glucose levels, and can lead to behavioral modification.Well SupportedWearing a CGM can reveal glucose dysregulation in pre-diabetic and normal individuals.Well SupportedUsing a CGM and associated programs can help optimize food combinations, exercise, and sleep schedules for better blood glucose control and energy levels.Well SupportedCGMs are important tools for assessing internal metabolic health and predicting metabolic or lifestyle-related conditions.Well SupportedCGMs cost close to $3,000 per year but provide valuable real-time feedback that motivates health behavior changes.

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Bookmarking — the dossier-vs-overview split is the right call. Most of the time I want overview; sometimes I want receipts.

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Well Supported

Continuous Glucose Monitors (CGMs) provide valuable real-time feedback for understanding physiological responses.

Well SupportedMetabolic dysfunction can be identified by elevated fasting insulin and postprandial insulin resistance observed on a CGM.

Well SupportedMinimizing or eliminating seed oils from the diet improves overall health and can positively impact various bodily functions.

Well SupportedRaw honey, but not pasteurized honey, increases nitric oxide precursors, which are essential for endothelial cell function and vasodilation.

Well SupportedA fasting insulin level of 8.6 micro IU/mL is likely too high for most people, contributing to the high prevalence of metabolic syndrome.

Well SupportedPaul Saladino's hemoglobin A1c has remained between 5.2 and 5.4.

Well SupportedThe relationship between glycemic index, glycemic response, and disease outcomes is limited even in observational studies.

Well SupportedMetabolic dysfunction is a risk factor, potentially 8-10 times higher, for severe COVID-19.

Well SupportedPhysiologically normal glucose regulation involves a normal increase in glucose, especially after consuming carbohydrates, followed by a quick return to normal levels.

Well SupportedCGMs provide valuable data to track metabolic changes over time.

Well SupportedContinuous Glucose Monitors (CGMs) are likely only needed for 2-4 weeks to collect useful data on individual food responses because these responses are generally repeatable.

Well SupportedWearing a continuous glucose monitor (CGM) from NutraSense has provided Paul Saladino with insights into his body's response to food.

Well SupportedContinuous glucose monitors (CGMs) provide real-time feedback on how foods, food combinations, food timing, and exercise impact blood glucose levels.

Well SupportedTools like a continuous glucose monitor can help individuals determine their carbohydrate tolerance limits for managing insulin resistance and inflammation.

Well SupportedInappropriate signaling from excessive linoleic acid, particularly from seed oils, may lead to insulin resistance originating in the mitochondria.

Well SupportedInitial glucose dysregulation often appears first in the postprandial response, even in individuals with normal fasting glucose.

Well SupportedMonitoring both the peak glucose level and the speed of recovery to pre-meal glucose values is crucial for assessing metabolic health.

Well SupportedA single glucose spike to 140 mg/dL that recovers to 100 mg/dL within an hour is less detrimental than multiple spikes above 150 mg/dL throughout the day.

Well Supported88% of adults do not meet five criteria of metabolic health.

Well SupportedAverage glucose and standard deviation over a two-week period are key metrics for assessing metabolic health.

Partially SupportedA peak glucose value of 140 mg/dL is a reasonable ceiling to aim for to maintain health.

Partially SupportedCGMs are painless, easy to use, provide 24/7 glucose data for two weeks, and can be scanned with an NFC-enabled phone.

Partially SupportedOptimal blood glucose reference ranges include a ceiling of 140-155 mg/dL, a quick return to baseline, a small area under the curve, low glycemic variability, low fasting blood glucose, and fasting insulin ideally below 5, preferably below 3 micro IU/mL.

Well SupportedThe dawn effect, a rise in glucose upon waking, is correlated with insulin resistance.

Partially SupportedNutriSense simplifies the process of obtaining CGMs by handling the prescription and shipping logistics after a brief questionnaire.

Partially SupportedExcess polyunsaturated fats, such as linoleic acid, and potentially excess monounsaturated fat, may drive obesity and metabolic dysfunction.

Well SupportedTools like CGMs that provide knowledge and facilitate behavior change are powerful for early identification of health issues and creating actionable plans.

Partially SupportedPopulations worldwide consume large amounts of carbohydrates without developing insulin resistance, suggesting that carbohydrate intake alone is not the sole cause.

Partially SupportedThe supplement 'Whole Package' from Heart & Soil provides sustained energy, improves recovery, promotes deep sleep, and eliminates energy highs and lows.

Well SupportedIn states of insulin resistance or metabolic dysfunction, insulin signaling at the liver and muscle is impaired, leading to poor glucose uptake.

Well SupportedWhen calories are not controlled, low glycemic index foods tend to outperform high glycemic index foods, suggesting fiber content is a key factor.

Partially SupportedKara Collier is a registered dietitian, licensed dietitian and nutritionist, and certified nutrition support clinician specializing in glucose control and metabolism.

Partially SupportedIn an oral glucose tolerance test, only the 2-hour glucose measurement is typically used for diagnostic purposes.

Not SupportedLong-term ketosis from a strict carnivore diet can lead to electrolyte imbalances and energy crashes, suggesting a need to include some carbohydrates.

Not SupportedFasting blood glucose and hemoglobin A1C allow too many individuals to fall through the cracks in metabolic health assessment.

Partially SupportedElevated average blood glucose indicates tissue breakdown, leading to looking years older.

Not SupportedInsulin resistance in Pima Indians is not caused by carbohydrates per se, especially ancestrally consistent ones like honey or fruit.

Partially SupportedNormal non-diabetic fasting blood glucose is below 100 mg/dL, pre-diabetic is 100-126 mg/dL, and diabetic is above 126 mg/dL.

Not SupportedContinuous glucose monitors offer valuable information about metabolic health for non-diabetics.

Partially SupportedRemoving seed oils from the diet can help reverse the progression towards metabolic dysfunction.

Not SupportedThe current medical approach often delays intervention until a condition is advanced, rather than focusing on early prevention and identification.

Partially SupportedProper glucose regulation and metabolic health are crucial for preventing negative consequences, even before diabetic levels are reached.

Partially SupportedFasting blood glucose does not indicate how the body responds to meals in a fed state.

Partially SupportedIn the R. Borg study, 10% of non-diabetic individuals spent at least 2 hours per day above the 140 mg/dL glucose threshold.

Well SupportedContinuous glucose monitors (CGMs) are valuable for identifying glucose dysregulation in diabetes subtypes that may not be apparent through standard measurements like fasting glucose or HbA1c.

Partially SupportedA median of 30 minutes per day spent with blood glucose above 140 mg/dL may indicate underlying physiological problems for humans.

Partially SupportedAbnormal postprandial glucose responses indicative of pre-diabetes can occur and be corrected before standard lab detection.

Well SupportedReal-time feedback from devices like CGMs can act as an accountability coach, influencing behavior by making the impact of food choices immediately apparent.

Partially SupportedNutriSense's app and dietitian service make CGM data digestible, actionable, and accessible for users seeking to improve their health.

Partially SupportedPhysicians should recommend dietary changes, specifically advising against seed oils, for pre-diabetic ranges on lab work or CGMs.

Partially SupportedMonitoring glucose behavior after or between meals reveals postprandial morphologies and provides health insights.

Partially SupportedImmunomilk is a grass-fed, grass-finished, regeneratively farmed colostrum rich in immunoglobulins and immune factors.

Well SupportedUsing normal glucose sources like rice or potatoes for an OGTT may provide more accurate results than liquid glucose for some individuals.

Well SupportedAn abnormal postprandial glucose response may indicate prediabetes and warrants further investigation like a fasting insulin test.

Partially SupportedA healthy glucose response to a meal involves a moderate spike that returns to baseline within about an hour and a half.

Partially SupportedReducing seed oil intake can reduce insulin resistance and promote weight loss, even with a high carbohydrate diet.

Partially SupportedDerangements in fasting glucose can be a reflection of inappropriate gluconeogenesis by the liver.

Partially SupportedHigh-fat diets rich in polyunsaturated fatty acids from seed oils induce insulin resistance in animal models.

Partially SupportedGlucose levels below 140 mg/dL likely offer no additional metabolic benefit.

Not SupportedThe claim that glucose spikes above 140 mg/dL automatically trigger inflammation and endothelial cell damage is not supported by evidence.

Partially SupportedPositive dietary changes, such as cutting out seed oils, processed sugars, or kale, or increasing intake of animal meat and organs, can lead to noticeable improvements in appearance, including skin quality and the sclera of the eyes.

Partially SupportedPaul Saladino had a normal postprandial response to honey and fruit, which individuals with diabetes or metabolic dysfunction might not experience.

Partially SupportedThe area under the curve for glucose and insulin indicates the amount of insulin required to dispose of glucose.

Partially SupportedElevated glucose levels can damage DNA, lower natural antioxidant defenses, and advance the epigenetic clock.

Partially SupportedFood matrix sugars may have different effects on vascular permeability, endothelial function, and lipid peroxidation compared to pure sugars.

Partially SupportedA score from 1 to 10 can be used to assess metabolic health by considering glucose levels, AUC, and recovery time after eating.

Partially SupportedHigh serum glucose levels are associated with a higher perceived age.

Partially SupportedFasting glucose levels between 90-100 mg/dL are associated with increased risk factors.

Partially SupportedThe quality of skin, eyes, and sclera can reflect underlying physiological health.

Partially SupportedDietary changes, including limiting carbohydrates and reducing seed oil consumption, may be recommended for individuals with abnormal metabolic markers like high fasting insulin.

Partially SupportedRelying solely on average glucose levels and fasted state measurements may lead to missing critical health indicators of metabolic dysfunction.

Partially SupportedProlonged adherence to a strict ketogenic diet can lead to metabolic inflexibility, reducing the body's efficiency in utilizing glucose.

Partially SupportedA consistently high baseline glucose level around 110 mg/dL can represent a disordered metabolic profile.

Partially SupportedDysregulated postprandial glucose responses are linked to a decline in beta cell function, which impairs insulin release and sensitivity.

Partially SupportedImmunomilk helped Barbara M. recover from the common cold quickly.

Partially SupportedMalaysian Tualang honey can inhibit or reverse hydrogen peroxide-induced endothelial hyperpermeability, likely due to nitric oxide or other beneficial metabolites.

Partially SupportedThe body's response to whole foods like strawberries or honey can differ from pure sugars, potentially due to nitric oxide precursors in honey.

Partially SupportedHigher levels of glucose are an indication of underlying metabolic unhealth, rather than a direct cause of aging from small intakes like honey.

Partially SupportedHoney may play a role in relieving multiple facets of atherosclerosis.

Partially SupportedBy the time of a diabetes diagnosis, approximately 60% of pancreatic beta cells are damaged and 50% of individuals exhibit complications.

Partially SupportedPositive dietary changes, such as cutting out seed oils, processed sugars, or kale, can lead to visible improvements in appearance.

Partially SupportedOverall metabolic health is the most important metric for navigating life, including responses to COVID-19.

Partially SupportedElevated glucose levels may be linked to excess polyunsaturated fatty acids in mitochondria and cell membranes.

Partially SupportedNon-diabetics spend a median of 30 minutes per day with blood glucose levels above 140 mg/dL.

Partially SupportedGrazing or eating around the clock, even nutrient-dense foods, is often associated with elevated glucose and prolonged recovery times.

Partially SupportedMetabolic health is a risk factor for all major chronic conditions and impacts appearance, skin quality, and eye health.

Partially SupportedContinuous glucose monitors and fasting insulin blood draws are the best methods for assessing metabolic health.

Partially SupportedInterventions should aim to shift individuals from pre-diabetic or unhealthy metabolic ranges towards healthy, non-diabetic ranges.

Partially SupportedGlucose and insulin are not inherently harmful to humans.

Partially SupportedThe Nutrisense app provides a glucose score from 1 to 10 for logged meals based on glucose height, AUC, shift magnitude, and recovery time.

Partially SupportedMetabolic health has implications for COVID-19, cardiovascular disease, stroke, dementia, cancer, sexual health, libido, autoimmune conditions, and virtually all other health issues.

Partially SupportedHealthy glucose regulation involves physiologically normal responses and recovery, not a completely flat glucose line.

Partially SupportedReal-time measurement of biomarkers such as testosterone, estrogen, advanced glycation end products, amyloid peptide, or insulin could significantly aid behavior modification for overall health.

Partially SupportedFasting glucose and hemoglobin A1C metrics do not capture postprandial glucose response.

Partially SupportedDysregulated postprandial glucose responses are associated with increased chronic inflammation and insulin resistance.

Partially SupportedTraditional glucose metrics like fasting glucose and hemoglobin A1C are unable to capture postprandial glucose responses.

Partially SupportedContinuous glucose monitors are a beneficial application of technology for health.

Partially SupportedWhen glucose levels exceed 140-155 mg/dL, insulin levels may start to skew abnormally, potentially indicating inflammation and endothelial damage.

Partially SupportedA healthy individual with good insulin sensitivity will not have blood glucose levels above 200 mg/dL even after consuming 300g of carbohydrates.

Partially SupportedFrequent eating every 2 hours can lead to repeated glucose spikes and a high average glucose level.

Partially SupportedAn exaggerated glucose response is characterized by high elevation and slow recovery over 5 hours.

Partially SupportedA glucometer can capture postprandial glucose response, but requires multiple finger pricks to observe the glucose curve.

Partially SupportedEating honey can cause blood sugar to rise above 130 mg/dL, even in individuals with good insulin sensitivity.

Partially SupportedLong-term ketogenic or zero-carb diets can lead to elevated fasting and baseline blood sugars, and sometimes hemoglobin A1c levels above 6%.

Partially SupportedIndividual glucose responses to the same food can vary significantly due to microbiome composition, genetics, and epigenetics.

Partially SupportedA healthy fasting blood glucose level is generally between 70 and 90 mg/dL.

Partially SupportedBlood glucose levels above 200 mg/dL are an independent diagnostic criterion for diabetes and should be avoided.

Partially SupportedThe optimal fasting insulin range is lower than the standard reference range threshold of 30-40 mIU/L.

Partially SupportedIntervention for metabolic dysfunction should occur earlier than the point of diabetes diagnosis to prevent significant beta-cell damage.

Partially SupportedInfusing 75 grams of pure fructose or glucose after an overnight fast is detrimental to endothelial function, lipid peroxidation, and ADMA levels.

Partially SupportedFasting glucose can vary significantly day-to-day due to factors like sleep quality, meal timing, and food choices.

Partially SupportedMost individuals check morning fasting glucose using a glucometer rather than postprandial glucose.

Partially SupportedTracking personal A1C trends over time can indicate meaningful progress.

Partially SupportedPostprandial hyperglycemia impairs vascular endothelial function in healthy men by inducing lipid peroxidation and increasing ADMA.

Partially SupportedElevated 2-hour postprandial glucose levels above 83-100 mg/dL are linearly related to cardiovascular disease death.

Partially SupportedThe progression to diabetes is a gradual process occurring over years, not an abrupt event.

Partially SupportedPerceived age increases by 0.4 years for every 1 millimole increase in glucose in non-diabetic individuals.

Partially SupportedFasting blood glucose is a measure of blood glucose levels in a fasted state (at least 8 hours of fasting) and represents a snapshot in time.

Partially SupportedIndividuals should select foods based on their underlying metabolic health and unique responses to foods.

Partially SupportedDietary patterns of people consuming whole foods, including meat, organs, and fruit, are more likely to predict health outcomes.

Partially SupportedYears of poor metabolic health damage the immune system, blood vessels, gut function, and other bodily systems, affecting long-term health.

Partially SupportedHaving real-time feedback on physiological markers is incredibly powerful for improving overall health, even if occasional alcohol consumption is common and reasonable.

Partially SupportedThe goal is to ensure the body has the right amount of glucose exposure, processes fuel into usable energy correctly, and recovers appropriately when not eating.

Partially SupportedPostprandial refers to the period after eating.

Not SupportedTraditional advice for chronic conditions often involves simplistic recommendations like 'eat less, exercise more, take your medication' without providing adequate tools for success.

Partially SupportedOne millimole of glucose per deciliter is equivalent to 18 milligrams per deciliter.

Partially SupportedRecommendations for blood glucose ceilings are often based on Oral Glucose Tolerance Tests (OGTTs) involving infusions of glucose and fructose.

Partially SupportedTransiently elevated blood glucose levels after consuming honey are not convincingly harmful.

Partially SupportedMetabolic health significantly influences the immune system's response to infections and vaccine efficacy.

Not SupportedOral glucose tolerance tests are not ideal for capturing postprandial glucose response due to time constraints, unrealistic glucose solution, and limited patient appetite.

Not SupportedThe traditional healthcare system's approach of waiting until the end of the metabolic spectrum to intervene with medication is flawed.

Not SupportedWestern medicine uses arbitrary cutoffs to diagnose diabetes, overlooking preceding vascular damage.

Not SupportedTelling a pre-diabetic patient to 'just monitor it' and 'keep an eye on it' is unhelpful advice and misses the opportunity for early intervention.

Not SupportedLowering glucose levels to the lowest possible point may be counterproductive to normal physiological responses.

Not SupportedA flat glucose line is not recommended; glucose fluctuations are normal and expected.

Partially SupportedHemoglobin A1C has flaws including missing glucose variability and being skewed by anemia, blood loss, smoking, and B12 deficiency.

Partially SupportedHemoglobin A1C measures average glucose levels over the past 2-3 months by assessing sugar attached to hemoglobin.

Partially SupportedTraditional diabetes diagnosis relies on the 2-hour glucose mark after consuming a sugary solution, with a target below 140 mg/dL.