Continuous Glucose Monitoring

> I discovered that a bunch of things I thought were reasonably healthy actually caused huge glycemic spikes -- e.g., white bread in the morning, croissants, dried mangos, excessive amount of fruits, etc.

I wonder if this amounts to optimization of an easy-to-measure and reasonably-looking but incorrect metric, much like the previous "common sense" wave of "fat makes you fat" that led several generations into a dead end.

You assume above that glycemic spikes are unhealthy which I think was never proven for the general population. Eating too much sugar or eating too much in general is bad, but I'm not aware of evidence that croissants kill you if you eat reasonably.

Another thing to note: one of the potential suspects in the obesity epidemic is HFCS, and fructose doesn't actually cause glycemic spikes. If this turns out to be true, then parallels with the "fat makes you fat" theory become uncannily strong.

I tend to think this could be the case because it matches my personal observations. I moved to France a few years ago and the amount of croissants I and people around me consume is at the stereotypes level. My weight is stable but each time I go to US for a couple of weeks I bring back 3-5 extra kilos. Something is seriously different between the food here and there, and I don't think it's glycemic spikes per se.

i’m confused why you considered this healthy?

> white bread in the morning, croissants, dried mangos, excessive amount of fruits, etc.

white bread is basically 100% carbs (converts to sugar). croissants aren’t much better _and_ have unhealthy fat (butter). Dried mangoes pack the sugar of the fruit without much of the fiber and water (speeds up the processing of the sugar).

Healthy breakfast would be like 2 eggs with small slice of toast on the side. Or a small omelette with cheese and mushrooms and spinach. Or perhaps steel cut oats, with thin sliced banana.

Basically - real food that also not loaded with carbs and sugars. Carbs are OK if you actually need them (workouts, etc). Office workers don’t need lots of carbs.

Granted, “healthy” is a spectrum…some people would consider it a win to not smoke, drink soda, etc.

And you’re 100% right about eating fiber first. It greatly slows down sugar absorption/processing! And reduces the sugar spike. That’s an advanced tip most don’t know about.

> At this point I don't even need to wear a CGM every day; I can tell my glucose level just by thinking of what I ate earlier.

Would be interesting to create some form of model of that and see how accurately you could 'guess' gliglycemia levels for a specific individual just by knowing biometric info and accurate food intake.

As in could you potentially appify your newly acquired intuition?

> I discovered that a bunch of things I thought were reasonably healthy actually caused huge glycemic spikes -- e.g., white bread in the morning, croissants, dried mangos, excessive amount of fruits, etc.

It's baffling that those things are considered healthy in the first place - white bread, pasta, rice, potatoes contain so much starch(which is rapidly broken down into glucose) that their glycemic index is higher than that of table sugar.

Likewise, the entire reason why fruit are tasty is because they're sugar bombs. The absorption is slightly slowed by cell wall digestion, and they have antioxidants, vitamins, etc. But still. It's sugar.

> I also discovered the importance of what you eat for your first meal in the day (either breakfast or lunch), or how to better order what you eat (fibers, fat and protein first, carbs last), light movement after eating reduces 20+ mg/dl, and more.

Having read science on the topic, you're extremely right on botr counts - limiting carbs in the first meal of the day moderates glucose spikes for the entire rest of the day, and moving after high carb meals is critical because muscles uptake glucose independent of insulin signaling, massively reducing the stress on your metabolism.

Rather than show that such exercise is unhealthy, I think it simply shows you need to consume some glucose during.

There's a reason aside from taste that sports drinks all contain a helping of glucose. I can't recall if I saw them in the US but in Europe many supermarkets offer products like "Dextro Energy", which is essentially just a sugar tablet advertised to people who need glucose during sports.

as someone who eats relatively healthily but has no problem consuming processed foods (but tends to avoid excessive sugar), when I wore a cgm out of curiosity it was very clear that such a device offered me nothing, as a non-diabetic, non-pre-diabetic person the data showed that the body responds in line with input never exceeding tolerances.

It was impressive just how uninsightful it was, I love quantifying my workouts, my nutrient intake, etc, but the cgm added absolutely nothing.

Does not really matter. You are interested in the trend, not absolute numbers, anyway, which, aside from having some "propagation delay", tracks blood glucose pretty well.

Is that true? I have no perspective but it's relied on by diabetics and if since they can't regulate it themselves, if the readings are off and they gave themselves insulin, they would know it is wrong. Maybe the OTC ones is different than the diabetic one but I didn't think so

> accuracy range of 20% which is a fairly wide window

what backs this factoid?

It doesn't need to be accurate, just consistent.

> it doesn't seem like the BOM is the main factor in the price of existing CGMs anyway

No. A huge reason for the cost is (1) costs in R&D but also (2) the customer service/replacement requirements/etc required for medical devices.

If you were diabetic, and had a prescription for these devices, you'd be able to call Abott/Dexcom and get a replacement to a failed device shipped to you overnight. If the device didn't last the fully spec'd lifespan, you'd be eligible for replacements... etc

There is also an open-source project Nightscout (CGM in the Cloud) which supports Android and iOS: https://github.com/nightscout

I think it's definitely geek-bait, I wore one for a few months and would say that unless you have diabetes/pre-diabetes it's a waste of time.

It is geek bait — most people read too far into these “spikes” and cut out healthy foods in doing so. It’s taking literally one metric as gospel which is moronic to be frank.

Pizza is much more nutritionally complete than you'd think, especially if it has meat(or beans, for some reason), the only real problem is people eat SO MUCH at a time.

People also refuse to understand that juice is basically sugar water with some extra flavor, vitamins, and antioxidants that don't change how unhealthy it is for you.

White rice is basically pure carbs with barely any nutrients.

Fastfood is heavily processed but often contains enough vegetables, meat, etc to not be that bad all things told.

One of the more interesting findings is the impact of combining different food intakes at the same time. It can have a significant effect in lowering spikes.

I believe we will see integrated optical glucose sensors in a popular consumer wearable fairly soon.

I don't think they'll be as accurate as blood sensors, however they will be a game-changer for many people (pre-diabetics, or gestational diabetes etc).

Pretty sure optical glucose is already a thing- it's just not very accurate yet.

King's Hawaiian Roll.

It doesn't taste like it contains a lot of sugars, at least not as sweet as other desserts like a cake. But two rolls (weight wise, very small amount) would send my glucose to sky high.