Why is our glucose demand high in the context of exercise? We see that our cells need a lot of energy. We're running from a bear or something like that we're not sitting there going, "Oh, I better slow down because my glucose is high." No. We are running for our lives so there is a reason for glucose to be high so that we have that immediate fuel available to us for that particular situation. --Dr. Shawn Baker
WHY you have high cholesterol may be very important!!! pic.twitter.com/I7MrBC5vED
— Dr Shawn Baker 🥩 (@SBakerMD) March 24, 2024
Blood glucose from the last week, March 18th to 24, 2024. Throughout most of the day, it's running high 70s, low 80s and there is this period of time when it gets up slightly over a hundred. Again this is an average over 7 days.
Can anyone guess what time of day I have been working out? #carnivore #cgm pic.twitter.com/be5lTv00LK
— Dr Shawn Baker 🥩 (@SBakerMD) March 24, 2024
Why is it up over 100? What's going on there? I will tell you that's when I exercise, and when I exercise my blood glucose goes up. Is that a bad thing, right, because we have often been told that we want to keep our blood glucose relatively low, and if it goes up during exercise is that problematic or is there a reason for that. In fact, we know that, for instance, world class athletes will see, and this has been recorded now is CGM data, that world class athletes during intense competition will sometimes see their blood glucose reach in excess of 400 milligrams per deciliter, astronomically high glucose levels. And yet they tend to be very healthy right they tend to not be diseased or have diabetes or anything like that so there is a reason for blood glucose to be elevated. For example, when you're sick, when you have stress, your blood glucose will elevate. There's a flight or fight response: there is a reason for your blood glucose to be elevated. When we're sick, the elevation of blood glucose actually can have a beneficial role in that it simulates certain immune cell that are more efficient in that high glucose environment at least temporarily.
Why is our glucose demand high in the context of exercise? We see that our cells need a lot of energy. We're running from a bear or something like that we're not sitting there going. "Oh, I better slow down because my glucose is high." No. We are running for our lives so there is a reason for glucose to be high so that we have that immediate fuel available to us for that particular situation. There are good reasons now for situationally higher blood glucose levels.
So let's look at lipids, blood lipids, things like free fatty acids. One thing that we notice is that when lipids are high that cholesterol will be high. Very often they run together because they traffic in often the same molecules or the same lipoproteins. Again let's use the bear as an example. Bears hibernate for around 6 months, five to seven months on average. What are bears eating during hibernation? Well, they're sleeping, so they're not eating anything; well they're eating their own body fat. What do they do before hibernation? They eat a bunch of food. They eat a lot of fruit and fish. They get big and fat, then they live on their own body fat for the next 6 months. And what happens to their cholesterol during that period of time well it goes up high it goes up over 400 mg per decimeter. Believe it or not, they went into a bear's den and tested hibernating bears and they found that they have super high cholesterol the entire 6 months. Why is that? They break down body fat that is then recycled through the liver and sent back to the other tissues that need it--the muscles, the brain, the heart, the lungs, the intestines, and so forth. So they're transferring high amounts of energy but it's coming from the peripheral fat and then being processed through the liver and with this high cholesterol guess what, do bears develop cardiovascular disease? No, there's never been a case of bears developing cardiovascular disease. They just don't get heart disease.
We see similar things going on in humans. A good example would be when I'm not consuming carbohydrates, but I am storing body fat and then transiently using it right away on a low-carb diet where I'm relatively lean, my cells require energy so we're just trafficking more fat. These are examples where high blood glucose levels may not be pathologic.
04:18. Where this may not be pathologic you know less contrast let's contrast that to another situation where I'm full my cells are stuffed full of glycogen their stuff full of triglycerides fatty acids they're stuffed to the brim and then when I eat there's literally no more room to show anymore it hangs out in the blood. So we have high energy in the blood glucose, perhaps fats and cholesterol. In that situation, then we start to see pathology. Again somewhat speculative in this but I think it makes sense it matches the observations remember we see in the low carb cohort population there is a meta-analysis of randomized control trials 41 randomized control trials showing that lean people on low-carb diets traffic more fat in their blood. Now, again the real question is going to be is this going to be pathological? My suspicion is that it will be found to not be.
