2013-05-30

The doghouse: United Parcel Service

UPS doesn't only suck in St. Kitts - it also sucks in Costa Rica. I recently ordered a package from the US for my wife. It's been taking a while to arrive, so I checked tracking. Look at this:



They didn't contact us about the package even once. The address on the package is very detailed. There's a reception desk in our building that's staffed 24/7. The UPS contractor could bring the package over any time. They didn't even try to.

Instead, they're recording these fake notices about how we "requested delivery at a future date".

UPS. Unabashedly Pathetic Service. They should wear that on their uniforms, proudly.

2013-05-19

My brush with diabetes: Zero-calorie sweeteners and insulin resistance

Over the past few years, I've thought of myself as taking decent care of my body. I went from looking like that, in February 2006, to looking like this, in May 2013:

denis, February 2006denis, May 2013

The way I did this was through (1) some aerobic exercise, mainly at first, to get some initial weight down; (2) weight lifting, to develop muscle mass; and (3) a rigorous application of my diet, high in protein, restricted in calories, but not otherwise restricted in content.

Imagine my surprise, then, when I recently had a full blood test done - the first one in probably 15 years - and the results for my glucose and insulin were these:
Insulin:  150.5 uUI/mL (reference range: 2.0 - 27.0)
Glycemia: 155 mg/dL    (reference range: 60 - 100)
Glucose:  8.61 mmol/L  (reference range: 3.3 - 5.5)
HOMA-IR:  57.59
I hadn't been fasting when this blood sample was taken; an hour before the sample, I had eaten a breakfast of 410 kCal and 36 g of protein, the rest mostly carbs.

The doctor knew this, and he still assured me, these results were far from normal. A blood glucose level of 155 mg/dL, at any time, is dangerously close to Type 2 Diabetes Mellitus. According to the Wikipedia article on Gestational diabetes - which is different, but similar - "When a plasma glucose level is found to be higher than 126 mg/dl (7.0 mmol/l) after fasting, or over 200 mg/dl (11.1 mmol/l) on any occasion, and if this is confirmed on a subsequent day, the diagnosis of GDM is made, and no further testing is required."

But look at how I look! I eat, like, 7 measured meals a day. How could this be?

Two theories:
  • Although my diet had been strict about protein and calorie content, and for the most part I had fewer than 3 hours between meals, my diet was extremely liberal in artificial sweeteners. I had them everywhere. In protein bars, which were my go-to convenience food. In protein powder. In my morning cereal. And most of all, in my Coke Zero. I loved Coke Zero and Diet Coke, and I had recently been drinking as much as 3 liters of that per day. A recent study found that artificial sweeteners are associated with Type 2 Diabetes.
  • Lack of aerobic exercise. Even though I was in good shape, my exercise mostly consisted of body weight exercises, such as push-ups, pull-ups and squats. Prolonged exercise counters insulin resistance, and I wasn't doing enough.
So the doctor did what he could - prescribed me metformin, which lowers blood glucose - and I also did what I could; removed all artificial sweeteners from my diet, and started using the treadmill for 45 minutes a day, most every day. Two weeks later, I did a proper fasting for 10 hours before the blood test, and the results were as follows:
Insulin:  6.00 uUI/mL (reference range: 2.0 - 27.0)
Glycemia: 77 mg/dL    (reference range: 60 - 100)
Glucose:  4.27 mmol/L (reference range: 3.3 - 5.5)
HOMA-IR:  1.13
All normal! So I'm not going to be diabetic for now, after all.

Still, in addition to the exercise, and avoiding aspartame and sucralose, this was after 2 weeks of metformin. Since my insulin and glucose are both decent now, my doctor and I decided to try without metformin, but keep the lifestyle changes. We'll see what happens in another test, in about 3 weeks.

The role of zero-calorie sweeteners


Given my experience, my theory on zero-calorie sweeteners is this. When you eat something that tastes sweet, your pancreas releases insulin in expectation of a spike in glucose. But it just so happens that you had a zero-calorie drink sweetened with aspartame or sucralose, so your body isn't getting any glucose. Instead, you only get flooded with insulin. The big insulin spike causes the cells in your body to consume the glucose in your blood, and now: (1) you feel hungry, having burned through available glucose; and (2) since there's now all this insulin and no glucose, your cells develop a measure of insulin resistance.

I had been doing this to myself a lot. I liked to drink a Coke Zero or Pepsi Light after a meal, to "help with digestion". I did this because I felt heavy after a meal if I didn't, but refreshed if I did; perhaps the reason I felt refreshed was the insulin spike causing the body to absorb glucose. But shortly after I drank the Coke, I felt hungry: perhaps, all the insulin had caused my glucose to go low. Because it still wasn't time to eat, I had another drink, and then another. I had been spiking my blood insulin level, without ingesting calories my body was expecting. So I developed insulin resistance, and this showed up in the test.

Since I cut all zero-calorie sweeteners from my diet, I've found that following the diet has been easier. I now get hungry at the right time, instead of all the time.

If you are trying to lose weight, my current recommendation would be to avoid all foods with zero-calorie sweeteners. They may look appealing, but they'll just make you hungrier. And as the latest studies suggest, they may lead to Type II Diabetes, even independent of weight loss.

Follow-up


I posted a follow-up on this topic on December 30, 2013.

A study published in 2014 found zero-calorie sweeteners cause diabetes through changes in gut flora.