The Hemp Connection [Search results for postprandial blood glucose] 

I am so grateful I went to the educational meeting yesterday I almost didn't attend! For the majority of my career, the health benefits of vinegar is something that hasn't been taken seriously by colleagues in my profession. But when I saw the presenter for this topic was respected Arizona State University nutrition researcher Carol Johnston, I figured it was worth going to hear what she had to say.

Turns out, Dr. Johnston, a few years ago, while working on another project, quite by accident, found an obscure research article reporting that vinegar may be helpful in reducing insulin resistance. She decided to pick up on where the study left off, and what she has learned with her work has a lot of pertinence to PCOS.

One of the goals of better insulin function is to reduce a reading known as"postprandial blood glucose"…that is, the blood glucose reading you see after eating a meal. This reading can be important, because high numbers have been associated with heart disease as well as excessive baby weight gain in pregnancy (macrosomia). For those of you who experience the phenomenon of being hungry after eating a meal, part of the reason may be a high postprandial blood glucose.

Dr. Johnston's first study used nondiabetic subjects who were divided into two groups: insulin resistant and non-insulin resistant. None of these individuals were taking diabetes medications. If they were in the test group, they were asked to drink 20 grams of apple cider vinegar, wait 2 minutes, and then eat a (pretty high glycemic) test meal of a white bagel, butter, and orange juice. Both groups tried the vinegar and no vinegar protocols. Blood glucose 30 and 60 minutes later was measured.

They found that when vinegar was consumed before a meal, postprandial blood glucose was significantly reduced. Dr. Johnston proposes that vinegar actually may have activity similar to that of Precose or metformin. While she used apple cider vinegar in her studies, she shared that any vinegar will have the same effect. So whatever your preference, rice, balsamic, wine, or raspberry…get creative in the kitchen!

She also clarified that the difference between the action of cinnamon and vinegar is that cinnamon reduces fasting glucose and vinegar reduces postprandial glucose. So you can use both if you wish, they're not going to replace each others' benefit…they may actually complement each other.

It's important if you choose to try this, and you're on medication, to share this with your physician. The results may significantly affect the dose of medication you need. I can pretty much bet most physicians aren't informed about this, and since I was skeptical until yesterday myself, I'm providing all of the references used to write this article for anyone to download and share. The journals in which they were published are respected ones.

A really important caveat: you can overdo this advice. Large amounts of vinegar over time can cause low grade metabolic acidosis (Dr. Johnston studied this too, knowing the mentality of dieters and people desperate to get off of meds.), which is associated with osteoporosis. This acidosis can be prevented by making sure your diet has a good amount of high-potassium foods. Since those are notably fruits and vegetables, the obvious practical way to use this information is to eat a nice salad with each meal, topped with a vinaigrette dressing. Dr. Johnston recommends a ratio of 2 parts vinegar, 1 part oil, the reverse of what is traditionally used.

Keep in mind too, if you're planning to go to the health food store and buy the vinegar pills…they aren't going to work. Dr. Johnston did three separate studies with them (because she was so surprised they didn't work and she was so convinced they would), and did not get the same results the original vinegar produced.

We had the opportunity to try a new product by Bragg's, a line of vinegar beverages. inCYST intern Sarah Jones and I tried the apple-cinnamon and the concord grape-acai flavors. Both of us felt the drink was a little much to consume as packaged, but they would be fun to use in vinaigrettes, marinades, etc., in the kitchen. I'm going to try some recipes this weekend.

Keep in mind too, that any favorite foods made with vinegar will also be beneficial! Pickles, sauerkraut, Korean kimchi, there are many cultural favorites that can make this fun! Think of ways vinegar can be added to your own marinades and flip the oil to vinegar ratio.

If you're really adventurous, or just want a fun party gag, try these pickle pops we sampled yesterday! Sarah was not so keen on them but I'm German and found it pretty tasty. When I looked this up for you all,, I discovered there is even a jalapeno flavor. That's pushing it even for me, but hey, there's something for everyone.: )

Check back with us too if you're actually measuring your blood glucose after meals and let us know if this was helpful!

The cost of diabetes medications can exceed $6,000 per year, per person. And one of every 8 federal health care dollars, ($79.7 billion annually), is spent on diabetes care. Imagine what we could do to our personal budgets, not to mention that nagging national debt, if we all just walked into Costco and invested in an industrial-sized bottle of vinegar…

Ebihara K, Nakajima A. Effect of acetic acid and vinegar on blood glucose and insulin responses to orally administered sucrose and starch Agric Biol Chem 52: 1311-1312, 1988.

Johnston CS, Kim CM, Buller AJ. Vinegar improves insulin sensitivity to a high-carbohydrate meal in subjects with insulin resistance or type 2 diabetes. Diabetes Care 2004: Jan 27(1); 281-2.

White AM, Johnston CS. Vinegar ingestion at bedtime moderates waking glucose concentrations in adults with well-controlled type 2 diabetes. Diabetes Care. 2007 Nov;30(11):2814-5.
Johnston CS, White AM, Kent SM. A preliminary evaluation of the safety and tolerance of medicinally ingested vinegar in individuals with type 2 diabetes. J Med Food. 2008 Mar;11(1):179-83.

Johnston CS, White AM, Kent SM. Preliminary evidence that regular vinegar ingestion favorably influences hemoglobin A1c values in individuals with type 2 diabetes mellitus. Diabetes Res Clin Pract. 2009 May;84(2):e15-7.
Johnston CS, Steplewska I, Long CA, Harris LN, Ryals RH. Examination of the antiglycemic properties of vinegar in healthy adults. Ann Nutr Metab. 2010;56(1):74-9.

We've been doing some business with companies working with nopales (prickly pear cactus pads). I'd seen a lot of research suggesting that nopales are good for quite a few health issues, particularly blood glucose.

We started selling Ibitta's products a couple of months ago and I was amazed at where the orders were coming from — Memphis, Philadelphia, not simply Arizona and California like I'd expected! I finally called one customer to see why she'd ordered it. Apparently her mother had been bugging her to try it as it is a popular Mexican supplement for weight loss. When her mother finally gave her a bag, she felt it couldn't hurt to try it. She noticed that when she stirred a couple of spoonfuls of Pinalinaza into a glass of water and drank it before a meal, it helped her appetite. And over a couple of months she lost 20 pounds.

Another woman with PCOS, in military basic training, wrote:

I just wanted to give you an update. Although I knew that Nopales was used…in my Hispanic heritage, I didn't know that it would help me out with my sugar so much!! I ordered the products that you hosted on this site (Pinalinaz … a, etc…) and can't wait to start them! In the mean time, I am eating nopales I bought from the local store. For one week, I've eaten them in the morning every other day. I lost 3 pounds and during that week I was only able to walk for exercise as the week was too busy. I have kept track of my sugar and the nopales has regulated it so much so that now I am falling into a Hypoglycemic instead of Diabetic. I am determining how I can balance it, however this is an awesome break through for me. I was doing the military basic training for two months and only lost 5 lbs because of PCOS. Now that I incorporated nopales, the stubborn sugar is being removed!! I can't wait for shipment!! This is a big breakthrough for me, it is extremely hard for me to digest the sugar and the nopales are doing something right!!

Last Friday, I gave a presentation on PCOS at the local Indian Health Service Hospital here in Phoenix. One of my clients made a big batch of nopales salad for everyone to try. It was lunchtime about an hour and a half later, and several people noted that they weren't really very hungry.

There is research to support these testimonials. A 2007 study reported that 85 g nopales with a meal reduced the glycemic index of the meal. Way back in 1991, researchers reported that nopal had a glucose-lowering effect.

For the non-native eater, the prospect of de-stickering a cactus pad, not to mention what to do with the cactus once that's done, likely keeps many people from trying it. In Phoenix, we have a company, Oro Verde Products, that sells ready-to-prepare cactus pads as well as chopped nopales ready to add to your recipe. It's popular in salads, stews, and scrambled eggs. I've even heard of some people juicing it if they have a powerful blender. Check Oro Verde's website for information and recipes.

Ibitta's products are nice because they're powdered and mixed with flax. I've used them on my oatmeal, in smoothies, in vinaigrettes, and breadings. I even made a vanilla cheesecake with the hibiscus (Jamaica) flavored variety in the crust. They're very versatile and more user-friendly in the typical American kitchen.

These we do carry in the store, if you're interested in ordering.

If you live in Los Angeles, look for Nopatillas, a tortilla made with nopal. This would be super easy to include in breakfast burritos, lunch wraps, etc.

Wherever you are, however you eat it, be sure to try nopales. They could be a great way to help control your blood glucose.

Bacardi-Gascon M, Dueñas-Mena D, Jimenez-Cruz A. Lowering effect on postprandial glycemic response of nopales added to Mexican breakfasts. Diabetes Care.2007 May;30(5):1264-5. Epub 2007 Feb 26.

Frati AC, Gordillo BE, Altamirano P, Ariza CR, Cortés-Franco R, Chávez-Negrete A, Islas-Andrade S. Influence of nopal intake upon fasting glycemia in type II diabetics and healthy subjects. Arch Invest Med (Mex). 1991 Jan-Mar;22(1):51-6.

One of the things I love about social networking…is that I have more information at my fingertips than I would ever have access to if I had to find it all by myself.

One of the things I hate about social networking, especially Twitter, is how much bad information is passed along without any fact checking. I would have to say, 99% of all links that come across my screen were just retweeted without being read. People state their opinions as if they are facts, without providing any references. And the more followers a person has, the more entitled they seem to be, to state their opinion as if is fact, leaving their hundreds or thousands of followers thinking,"Well if _____ said so, it must be true."

Recently I've been reading a lot of things about stevia that are opinion-based, but not factual, which are being circulated without fact checking, so I went in to PubMed and found some references I thought I would throw out to help level the playing field.

Stevia is a natural sweetener. It is not sugar, but it is not a chemical artificially created in the laboratory. It is a plant native to Paraguay that is processed to be used as a sweetener. I have friends here in Phoenix who actually have stevia plants in their gardens in early summer.

Here are some other facts.

Stevia may or may not affect fertility. The very first article appearing in a stevia search, way back in 1968, reports that it does. Others follow with mixed results, looking at both male and female fertility. It does not appear to be related to any toxic aspect of the plant, merely how it affects hormone balance. Anyone using the right mix of references can create an argument leaning in either direction.

Stevia may improve glucose tolerance. It may actually improve function of the pancreatic cells (beta cells) that produce insulin. This is a pretty consistent finding.

Stevia is not cariogenic.

Stevia may help to reduce blood pressure.

Stevia is anti-inflammatory, has antioxidant characteristics, and may discourage tumor production.

Stevia does not cause you to eat more of other sweet foods. I have seen more than one dietitian assert this, and there is no reference (as of this date) to validate that.

For most of you, if you're not trying to conceive, stevia may be a very nice addition to what you're doing to balance your hormones. If you're trying to conceive, it gets a little tricky. If your main barrier to conception is insulin resistance, stevia may actually be beneficial. If it's another issue, such as sperm count, you may want to stay away. I'm providing references so that you can share this information with your reproductive physician and together decide which course of action is most appropriate for your personal situation.

Planas GM, Kucacute J. Contraceptive Properties of Stevia rebaudiana. Science. 1968 Nov 29;162(3857):1007.

Schvartzman JB, Krimer DB, Moreno Azorero R. Cytological effects of some medicinal plants used in the control of fertility. Experientia. 1977 May 15;33(5):663-5.

Yodyingyuad V, Bunyawong S. Effect of stevioside on growth and reproduction. Hum Reprod. 1991 Jan;6(1):158-65.

Das S, Das AK, Murphy RA, Punwani IC, Nasution MP, Kinghorn AD. Evaluation of the cariogenic potential of the intense natural sweeteners stevioside and rebaudioside A. Caries Res. 1992;26(5):363-6.

Melis MS. Effects of chronic administration of Stevia rebaudiana on fertility in rats. J Ethnopharmacol. 1999 Nov 1;67(2):157-61.

Jeppesen PB, Gregersen S, Poulsen CR, Hermansen K. Stevioside acts directly on pancreatic beta cells to secrete insulin: actions independent of cyclic adenosine monophosphate and adenosine triphosphate-sensitive K+-channel activity. Metabolism. 2000 Feb;49(2):208-14.

Chan P, Tomlinson B, Chen YJ, Liu JC, Hsieh MH, Cheng JT. A double-blind placebo-controlled study of the effectiveness and tolerability of oral stevioside in human hypertension. Br J Clin Pharmacol. 2000 Sep;50(3):215-20.

Lee CN, Wong KL, Liu JC, Chen YJ, Cheng JT, Chan P. Inhibitory effect of stevioside on calcium influx to produce antihypertension. Planta Med. 2001 Dec;67(9):796-9.

Jeppesen PB, Gregersen S, Alstrup KK, Hermansen K. Stevioside induces antihyperglycaemic, insulinotropic and glucagonostatic effects in vivo: studies in the diabetic Goto-Kakizaki (GK) rats. Phytomedicine. 2002 Jan;9(1):9-14.

Chan P, Tomlinson B, Chen YJ, Liu JC, Hsieh MH, Cheng JT. A double-blind placebo-controlled study of the effectiveness and tolerability of oral stevioside in human hypertension. Br J Clin Pharmacol. 2000 Sep;50(3):215-20.
Gregersen S, Jeppesen PB, Holst JJ, Hermansen K. Antihyperglycemic effects of stevioside in type 2 diabetic subjects. Metabolism. 2004 Jan;53(1):73-6.

Lailerd N, Saengsirisuwan V, Sloniger JA, Toskulkao C, Henriksen EJ. Effects of stevioside on glucose transport activity in insulin-sensitive and insulin-resistant rat skeletal muscle. Metabolism. 2004 Jan;53(1):101-7.

Hsieh MH, Chan P, Sue YM, Liu JC, Liang TH, Huang TY, Tomlinson B, Chow MS, Kao PF, Chen YJ. Efficacy and tolerability of oral stevioside in patients with mild essential hypertension: a two-year, randomized, placebo-controlled study. Clin Ther. 2003 Nov;25(11):2797-808.
Chen TH, Chen SC, Chan P, Chu YL, Yang HY, Cheng JT. Mechanism of the hypoglycemic effect of stevioside, a glycoside of Stevia rebaudiana. Planta Med. 2005 Feb;71(2):108-13.

Boonkaewwan C, Toskulkao C, Vongsakul M. Anti-Inflammatory and Immunomodulatory Activities of Stevioside and Its Metabolite Steviol on THP-1 Cells. J Agric Food Chem. 2006 Feb 8;54(3):785-9.

Ferreira EB, de Assis Rocha Neves F, da Costa MA, do Prado WA, de Araújo Funari Ferri L, Bazotte RB. Comparative effects of Stevia rebaudiana leaves and stevioside on glycaemia and hepatic gluconeogenesis. Planta Med. 2006 Jun;72(8):691-6. Epub 2006 May 29.

Chen J, Jeppesen PB, Nordentoft I, Hermansen K. Stevioside counteracts the glyburide-induced desensitization of the pancreatic beta-cell function in mice: studies in vitro. Metabolism. 2006 Dec;55(12):1674-80.

Ghanta S, Banerjee A, Poddar A, Chattopadhyay S. Oxidative DNA damage preventive activity and antioxidant potential of Stevia rebaudiana (Bertoni) Bertoni, a natural sweetener. J Agric Food Chem. 2007 Dec 26;55(26):10962-7. Epub 2007 Nov 27.
Shukla S, Mehta A, Bajpai VK, Shukla S. In vitro antioxidant activity and total phenolic content of ethanolic leaf extract of Stevia rebaudiana Bert. Food Chem Toxicol. 2009 Sep;47(9):2338-43. Epub 2009 Jun 21.

Melis MS, Rocha ST, Augusto A. Steviol effect, a glycoside of Stevia rebaudiana, on glucose clearances in rats. Braz J Biol. 2009 May;69(2):371-4.
Figlewicz DP, Ioannou G, Bennett Jay J, Kittleson S, Savard C, Roth CL. Effect of moderate intake of sweeteners on metabolic health in the rat. Physiol Behav. 2009 Dec 7;98(5):618-24. Epub 2009 Oct 6.

Anton SD, Martin CK, Han H, Coulon S, Cefalu WT, Geiselman P, Williamson DA. Effects of stevia, aspartame, and sucrose on food intake, satiety, and postprandial glucose and insulin levels. Appetite. 2010 Aug;55(1):37-43. Epub 2010 Mar 18.

Shukla S, Mehta A, Mehta P, Bajpai VK. Antioxidant ability and total phenolic content of aqueous leaf extract of Stevia rebaudiana Bert. Exp Toxicol Pathol. 2011 Mar 4. [Epub ahead of print]

And that is because I'm a strawberry nut. It's my absolute favorite fruit. I learned while researching this blog post that the average American eats 156 lbs. of added sugar a year…and only 8 lbs. of strawberries in the same time period.

Of course, the fact that you all are not eating enough strawberries means there's more for ME! Ha!

Seriously, though, this fruit is a wonderfully easy food to add to any diet. Put them in your cereal. In a smoothie. On waffles or pancakes. On top of ricotta cheese, sprinkled with almonds, on a Bran Crispbread. On a salad. Freeze them to eat like candy on a hot summer night. (That last one is my favorite.)

Strawberries are high in vitamin C, which is an important antioxidant. It's also important for the production of collagen, which keeps your skin looking young. As far as antioxidants go, it's the third best source of antioxidants when compared to the same serving size of other fruits.

And…did you know…even though they contain sugar, strawberries can also help reduce blood sugar spikes caused by other foods? I wouldn't recommend eating strawberries to counter a carbohydrate binge, but you certainly may want to consider including more strawberries in your overall diet as a way to make it easier for your body to handle carbohydrates. If you're enjoying the sweetness of the berries, you are likely going to want to eat less sugary food anyway, reducing your insulin load even more.

For those of you with high cholesterol, strawberries have also been shown to decrease markers of atherosclerotic disease. The benefits these tasty fruits provide far outweigh the sugar content many of you are concerned about.

One last thing, a recent study reported that organic strawberries are actually higher in antioxidants. So it may be worth it to spend a little extra, avoid the pesticides, and get the extra metabolic boost. If you don't have access to a farmer's market, look for the Driscoll's brand in your grocery store.

Basu A, Fu DX, Wilkinson M, Simmons B, Wu M, Betts NM, Du M, Lyons TJ. Berries modify the postprandial plasma glucose response to sucrose in healthy subjects. Br J Nutr. 2010 Apr;103(8):1094-7. Epub 2009 Nov 24.

Törrönen R, Sarkkinen E, Tapola N, Hautaniemi E, Kilpi K, Niskanen L. Strawberries decrease atherosclerotic markers in subjects with metabolic syndrome. Nutr Res. 2010 Jul;30(7):462-9.

http://articles.latimes.com/2010/sep/02/science/la-sci-organic-strawberries-20100902