ROB'S REPLY: 

Before I respond, I need more data. First, was insulin tested? If so, what were the readings. Also, have you have had your blood sugar tested before? If so, when and what were the readings? Assuming you weight train, when was your last workout in relation to the test? Also, when was your last meal in relation to the test.

ANSWERS TO ROB'S FOLLOW-UP QUESTIONS

ROB'S ANSWER:

I can help you "make sense of this," but I cannot answer your question for the following reason: the facts you have given me are limited, and in any event, I am not qualified to diagnose disease. I can help you understand the implications of blood lipid measurements in general, but not in relation to any disease that you may or may not have.

Of all the parameters you mentioned (LDL, HDL, triglycerides, and blood sugar), blood sugar is the least meaningful. Blood sugar can, and does, fluctuate for reasons unrelated to insulin. Here’s an example: someone pulls a knife on you - your blood sugar will skyrocket within seconds. One of the functions of catabolic hormones, like cortisol and adrenaline, is to raise blood sugar levels (that’s why these hormones are called glucocorticoids - they raise glucose levels to provide quick energy to fuel the "fight or flight" response). You’ll recall from NHE the discussion of gluconeogenesis - catabolic hormones convert muscle amino acids into sugar. The fight or flight response is much less useful these days than it was thousands of years ago when the energy burst was needed to run away from, or combat, predators. Maybe you were anxious about getting a needle stuck in you when you were getting blood drawn for the test. That can trigger a flight or fight response, and a corresponding blood sugar surge. Or, you could have been catabolic from an intense workout the night before.

An intense weightlifting workout can cause blood sugar levels to move around quite a bit (called "glucose flux"). I've tested this on myself by using ketostix (you pee on them and they darken if you are in ketosis). I was in ketosis several times, then went to work-out, then tested again post-workout, and the second test was completely negative for ketones. This in spite of the fact that I ate no food between the pre-workout test and the post-workout test. In fact, I've done extensive keto-testing on myself and I've never showed even a trace of ketosis after weight training - even if I was in ketosis before going to the gym. Why is this? Because the intense workout provoked a predictable catabolic response, which raised blood sugar levels. Remember from NHE that the post-workout catabolic response is a antecedent to anabolic supercompensation.

Remember also from NHE the relationship between food and catabolism/anabolism? Feeding is associated with anabolism, whereas fasting is associated with catabolism. You indicated that you fasted for many hours before the blood test was administered. A fat-burner fares better than a sugar burner in all respects. But like I've said many times, it’s a matter of degree. A fat-burner still uses sugar (especially bodybuilders who need sugar from glycogen to fuel their workouts), just less of it than a sugar-burner. And a sugar-burner still uses fat, just less of it than a fat-burner. Fasting when your muscles are “torn-down” from an intense workout the day before causes a greater catabolic rise (See NHE p. 297), and corresponding blood sugar increase, than if you hadn't worked-out at all.

The bottom line, in terms of blood sugar, is that people who weight train (and are deliberately stimulating catabolic hormonal release in order to generate a compensatory anabolic response) are subject to blood sugar fluctuations that non-exercisers are not.

You will recall that I was cautious in asking for more data before responding to this issue. I asked about insulin. Had your fasting insulin level been elevated, that would have been highly significant and ominous. But you said insulin wasn’t tested. Furthermore, you said, in response to my query on this, that there were no other “bad” blood sugar tests in the past. Had blood sugar registered high on other occasions, it would be significant. But given the many innocuous variables that can temporarily raise blood sugar, one sugar-high measurement does not warrant any negative inferences.

Moreover, not only are blood sugar readings inherently ambiguous, but there is strong evidence that your particular blood-sugar reading had nothing whatsoever to do with insulin. Insulin resistance is almost always accompanied by unfavorable blood lipids levels (see NHE). Insulin resistance means more insulin must be produced; consequently, insulin levels rise. Elevated insulin levels result in elevated triglycerides, elevated LDL cholesterol, and increased abdominal fat accumulation. For these reasons, Type II diabetes is highly associated with cardiovascular disease.

Unless you have a very unusual metabolic derangement, your healthy blood lipid readings and your decreasing bodyfat would strongly suggest that your insulin levels are not elevated. Rather, favorable cholesterol and triglyceride levels and low bodyfat percentage are associated with good cardiovascular health and efficient insulin function. Given that these parameters have improved since you began the NHE program, it is likely that your insulin levels are lower than they were before you began the NHE Eating Plan.

Based on what you have told me, it appears that your health status has improved since you began the NHE program. For all the reasons explained in this letter, blood sugar, by itself, is of questionable significance (especially for bodybuilders). And in light of the surrounding facts - particularly your favorable blood lipid levels and decreased bodyfat percentage - a one-time high blood sugar reading cannot be deemed indicative of an underlying health problem. But only your doctor, upon further testing, can determine whether in fact you have a medical condition.    

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Subject: a challenge to NHE's meal frequency recommendation