Bad Things Come in Small (Sugar) Packages, Too

Sugar is Regulated in the Bloodstream

The amount of sugar (or really glucose, technically speaking) is tightly regulated in the human bloodstream. A normal blood sugar (glucose) is under 100 mg/dL, and when the sugar rises to between 100 mg/dL to 125 mg/dL the serious medical conditions of glucose intolerance, pre-diabetes are diagnosed. Once above 125 mg/dL diabetes is diagnosed. As more research is done, the optimal blood glucose number goes lower and lower. The bottom line is you want to keep the blood sugar as low as you can for optimal health.

While we usually think in terms of blood sugar readings, or concentration of sugar in the bloodstream, let’s take a moment to reflect on what this means in the big picture about the amount of sugar we are dealing with. If we know the amount of sugar in the bloodstream, maybe that would give us an understanding of how foods can alter the amount of sugar in the blood.

The harsh reality is that there are only 5 grams of sugar in the entire adult human bloodstream – about the same amount as a heaping teaspoon of sugar!

Let’s go through the calculation. The concentration of sugar is mg/dL, or “milligrams per deciliter.” There are 1000 milligrams in every gram, and 10 deciliters in every liter. And, the average adult has about 5 liters of blood. Remembering high school math, the conversion looks like this:

100 milligrams/deciliter x 1 gram/1000milligrams x 10 deciliter/liter x 5 liters = 5 grams

For the blood sugar of 80 mg/dL, the amount of blood sugar is about 4/5 of a teaspoon. For a blood sugar of 126 mg/dL, the amount at which one becomes diabetic, the amount of sugar is about 1 ¼ teaspoon. So, the difference between having a blood sugar that is normal and one that is ‘diabetic’ is about a quarter of a teaspoon of sugar! That’s all.

Sugars AND Starches are Absorbed as Blood Sugar and Raise Your Blood Sugar

Remember that sugars AND starches in the diet are absorbed as blood sugar, and raise the blood sugar. Insulin is secreted from the pancreas to lower the blood sugar, but if there is excess energy intake relative to expenditure then insulin also tells your body to turn the sugar into fat. Considering that the average American diet is estimated to have 200-300 grams of carbohydrate per day in it (40 to 60 times the amount of sugar in the entire bloodstream), it is amazing that more people don’t have diabetes.

It appears that the medical establishment has “lost seeing the forest for the trees.” The clues are there if we pay attention to them. Children with type 1 diabetes (no internal secretion insulin at all) are instructed to increase their insulin dose to correspond to the number of servings of carbohydrates in the meal. One serving of carbohydrate is defined arbitrarily as 15 grams of carbohydrate. Most diabetics are advised to eat 3 servings of carbohydrate (45 grams) at each meal, for a total of about 135 grams for the day. Recall that this is still about 27 times the amount of sugar in the bloodstream. Without paying very close attention to the huge contribution of dietary carbohydrate on blood sugars, the pressure will be to prescribe medications to lower the blood sugar.

Another clue to the small amount of sugar in the bloodstream is to take the case of the amount of glucose that is necessary to ‘rescue’ an individual who has a very low blood glucose–a hypoglycemic reaction. A hypoglycemic reaction results from medications that lower the blood sugar, and the blood sugar is usually about 60 mg/dL (normal blood sugars range from 80-100 mg/s). A blood sugar of 60 mg/dL is treated by having the person eat 2 glucotabs (4g each). So, about 8 grams of glucose is all that is needed to increase the blood sugar out of dangerously low levels.

Looking back at the history of the treatment of diabetes, it was known that the most powerful nutritional component that could raise the glucose in the urine was the sugars and the starches. Since the early days of modern Western medicine, carbohydrate-restricted diets were employed to treat diabetes. In the late 1800s and early 1900s, the most widely recommended diet for diabetes mellitus was a low-carbohydrate, high-fat diet. To treat severe diabetes, Frederick Mason Allen employed fasting, then a stepwise reintroduction of macronutrients to find the threshold at which the glucose appeared in the urine.

Using this method the average diet recommendation for diabetes was a diet containing 70% fat, 18% protein, 4% alcohol, and only 8% of calories from carbohydrate: 10 to 50 grams of carbohydrate per day. Then Elliot Joslin, another prominent diabetes physician, recommended a 70% fat, 10% carbohydrate diet for the treatment of diabetes. Joslin categorized carbohydrate-containing foods by their carbohydrate content and advised his patients to eat vegetables with less than 5% carbohydrate content.

According to his classification, vegetables with carbohydrate content from 1% to 3% included lettuce, cucumbers, spinach, asparagus, rhubarb, endive, dandelion greens, swiss chard, celery, and mushrooms. Vegetables with carbohydrate content from 3% to 5% were tomatoes, Brussels sprouts, watercress, sea kale, okra, cauliflower, eggplant, cabbage, canned string beans, broccoli, and canned artichokes. Non-carbohydrate containing foods were not limited, such as meat, eggs, fish.

Only by understanding blood sugar numbers and how they are reflected in the foods we eat can we begin to gain the knowledge necessary to manage our health. Whether your immediate goal is to manage or your diabetes or to prevent the onset of the disease, it’s easy to see that restricting carbohydrate intake is a sensible way to help manage diabetes but to live a healthy life.

Food	Carbohydrates
Meat	0 grams (Does not contribute to bloodstream sugar)
Slice of bread	15 grams (3x the amount of sugar in the bloodstream)
An apple	20 grams (4x the amount of sugar in the bloodstream)
Juice (8 oz)	25 grams (5x the amount of sugar in the bloodstream)
Cereal (2 cups)	50 grams (10x the amount of sugar in the bloodstream)

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