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If you’re glucose intolerant ALWAYS carry an apple with you for EMERGENCIES

Posted by Dr Sandy on in Obesity | 183 Views | Leave a response

Apples are poisonous – don’t panic. The poison protects the fruit from fungal attacks. It doesn’t hurt you directly, but it does slow sugar uptake

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Why an apple a day keeps the doctor away

apple gangster shooting up a piece of bread

Apples are poisonous – don’t panic. The poison protects the fruit from fungal attacks. It doesn’t hurt you directly, but it does slow sugar uptake

It’s an old adage….

An apple a day keeps the doctor away.

Well,   thanks to research carried out by a team of Japanese researchers, we know one of the reasons why, apples are SO HEALTHY !   HINT : It’s poisonous.

Eating an apple with dinner

Our team served apples and bowls of white rice to two groups of volunteers. The first group were NORMALS, the second were people who were glucose intolerant i.e. prediabetic.

In terms of the specifics : The rice (150 g) was a retorted product i.e. it was a ready to eat.  You pop it in the microwave, press HEAT, peel and eat.  The apple  was a medium size Fuji apple (150 g).

In the study, the team mixed the order of the offering.

  • On one occasion the apple came first, followed by the rice, 5 minutes later.
  • On the second occasion the rice came first, followed by the apple.

In terms of the glycemic response – the order does matter.

Apples change the glucose curve

In the metabolically healthy

 

Glucose curve in normals

Changes in the postprandial blood glucose and insulin levels in healthy normal subjects.  The open circles show what happens when the rice comes first, the closed circles, show what happens when the apple is eaten first.  © 2022 Yutaka Inoue et al.

Above are the results for the NORMALS, the sugar spike is different.  Apples change the glucose curve, when they’re eaten at the  START of dinner.  They lower the levels, a little

Enough to write home about………..

Nope.  Although it looks quite spectacular on the graph, when they crunched the numbers, the difference was not big enough to be considered significant.

Think REAL.  It could simply have happened by chance.

So why are you telling us this ?   Odds are, you’re not in the metabolically NORMAL camp, you’re in the “it’s not working as well as it should”, so you’re more interested in what happened in this group of people and this is where things get interesting…

In the metabolically challenged

glucose curve in prediabetics

Changes in the postprandial blood glucose and insulin levels in prediabetics The open circles show what happens when the rice comes first, the closed circles, show what happens when the apple is eaten first.  © 2022 Yutaka Inoue et al. 

In the metabolically BROKEN, once again it’s pretty clear……….. eating the apple first takes the sugar spike down and keeps it down.

This time the difference IS SIGNIFICANT.

This is indicated by the little stars on the graph.  Translated into plain English, the team is 95 % sure, the difference is REAL.  But, if you’re like me, you’re not all that interested in whether the difference is statistically REAL, you want to know, whether it will make a difference, when you eat dinner.

And the short answer is………. YES.

If you’re glucose intolerant apples are helpful

I took the liberty of superimposing the graphs so you can see the impact….

apple

Changes in the postprandial blood glucose and insulin levels in healthy normal subjects. The maroon lines show what happens in the normal and the black lines is what happens in the glucose intolerant. As before, the open circles are rice first and the closed circles are apple first. © 2022 Yutaka Inoue et al.

The pattern that they observed would be clinically relevant.

Eating the apple, does not normalize the situation completely, the sugar levels still remain high for a protracted period of time. But it puts the initial sugar spike in the zone of what is seen in a NORMAL, eating a bowl of rice.

Apples are not magic

Unfortunately, the sugar levels still remain high for a protracted period of time.

So……………….

This is not a licence to eat bowls of rice for dinner.

NOTE :  Your biology is making you carb intolerant.  Smalls amounts are okay, but big amounts are going to have nasty consequences……….. it is what it is.   

But, it might be a tool to put in your tool bag, for times when you’re on the run………….and faced with an eating dilemma.

When it’s a high carb meal OR NOTHING

First prize

Now, NOTHING…………. would be first prize.   This is what I  would typically do, the body chemistry fall out from a sugar spike, is just not worth it.

Yes.  It can be super awkward and very anti-social.

Second prize

The second prize would be to add protein and/or fat, to the meal and this should be your standard operating procedure.   For more information on the Adding protein, fat and fibre to your diet, go here.

Third prize

Both of these are great options, but not always practical.  Protein is not an ON THE GO food, apples ARE !

Apples the easy fix

Apples are

  • relatively inexpensive
  • available all year round
  • easy to eat
  • TRANSPORTABLE

They’re small, don’t need refrigeration and fairly durable. You can pop them in a bag and use it for “EMERGENCIES”.

Munching on an apple, just before your carb heavy meal, can offer a little respite.

But isn’t the apple FULL OF SUGAR ?

Yes.  Apples are NOT by definition low carb…………… and if you are counting carbs, your default response to an apple, might be,  I don’t think so.  Although, if you use taste as a guide, you could be duped.

The carb count can be higher than one would think.

Not all sugars are created equal

Apples actually don’t trigger  an enormous “sugar” spike, because the sugar they’re made of is………..FRUCTOSE, not glucose.   Fructose has different biology to glucose – you can learn more about this on the fructose library page.

And for the record, your glucose meter is not equipped to measure fructose levels. In fact, fructose levels are not routinely measured, but there are a number of studies that hint,  high serum fructose levels, are something that goes hand in hand with metabolic problems and is NOT a good thing. 

Fuji apples are full of fructose

Our team confirmed the Fuji apple that was being munched on in this study was predominantly fructose, by running mushed up apple samples through an HPLC machine.

It came back…

girl working in lab with fuji apple composition data

But it is highly unlikely that the fructose is responsible for the glycemic benefits seen in this study.  The fructose might help give the apple a free pass, because insulin doesn’t respond to fructose.  But the magic is more than likely due to a pesticide found inside the apple.

Phlorizin – the apple pesticide

Pesticide – don’t panic.  This pesticide is all natural, it is produced by apple trees – to stop fungal growth.  It’s primarily found in the bark of the trees, but small amounts pop up in apples.

apple tree spraying pesticide to kill fungi

The highest concentrations are in the peel, but it also shows up  in the flesh.

Exactly how much, depends on the variety of apple, as well as how mature the apple is.  As a rule,  the “younger” the apple, the more is present.

The poison apple

one organisms meat is another organisms poison

Fortunately, you are not a fungi, so the tiny amounts of phlorizin, leave you largely untouched.  Largely.  It turns out, that the protein (SGLT1 transporter) responsible for getting glucose from inside your gut, to inside your circulation, is a little sensitive to phlorizin, because….

Slowing glucose uptake

The phlorizin is actually a glucose molecule, with a huge ring structure plopped on top.  And that enormous ring structure,  gets caught in the transporter.

phlorizin chemical and cartoon structure

Leaving the transporter unable to move the sugars across efficiently.

SGLT1 transporter blocked by phlorizin

The sugar molecules get  stuck in no man’s land.

A fortuitious  delay

The sugar is there………..

WAITING TO ENTER.

And eventually it does, but instead of a flood, hitting the liver, causing panic and consternation, the sugar trickles in.  The liver has more time to process it and insulin, arrives on the scene IN TIME, even if you’re metabolically challenged.  Yah !

But, the process of “dinner” is somewhat protracted.

And glucose levels end up taking a bit longer to return to NORMAL.

An unseen benefit

If you’re monitoring your glucose levels,  this benefit might appear as a non-event or even a FAIL, since the sugar reading is taken at the tail end of the drama. But, this is not where the benefit happens.

where the benefit of the apple happens in glucose curve

The sugar peak was never as high as it might have been.

So, your body chemistry is BETTER.

Prudent to carry an apple in your backpack

Poisoning your SGLT1 transporter is a strategy worth deploying …….especially if you’re glycemically challenged.

NOTE :  In this study it only “worked” in those who were  metabolically challenged, probably because their SGLT1 transporters are typically over expressed and this  amplified the benefit.   Blame insulin he is responsible for  their deployment.

The dose makes the poison

Exploiting this biology is not a new idea, numerous attempts have been made to bottle the apple poison and hit the drug development jackpot.

But phlorizin itself, is not very stable and at high doses, it can be potentially toxic.

Plus it can’t be patented.

Nevertheless, phlorizin has served as the inspiration behind the family of drugs, collectively known as the glifozins, they selectively inhibit the glucose transporter (SGLT2) in the kidney, causing you to pee out excess glucose.  The class includes canagliflozin, dapagliflozin, and empagliflozin – maybe I’ll tell you their story in an upcoming post.

You can exploit this chemistry

By eating apples………apples, unpeeled.  Not apple juice.  The phlorizin content of apple juice will be pretty low, because heating destroys it and a BIG fructose hit, without fibre is going to upset your liver.  BIG TIME !

Too much fructose  is definitely NOT YOUR FRIEND.

For more ideas on how to use science to minimize meal time sugar spikes visit this page.

use science to keep those carbs on your dinner plate

The milk machine is just not keeping junior adequately nourished………..

Effect of Apple Consumption on Postprandial Blood Glucose Levels in Normal Glucose Tolerance People versus Those with Impaired Glucose Tolerance. Foods (2022) 11: 1803.Yutaka Inoue , Lianne Cormanes , Kana Yoshimura , Aiko Sano , Yumiko Hori , Ryuichiro Suzuki and Ikuo Kanamoto

Phlorizin: a review. Diabetes Metab Res Rev 2005; 21: 31–38.  Joel R. L. Ehrenkranz, Norman G. Lewis, C. Ronald Kahn, Jesse Roth

Comparing the efficacy of apple peels and a sodium-glucose cotransporter 2 inhibitor (ipragliflozin) on interstitial glucose levels: A pilot case study. Current Therapeutic Research 93 (2020) 100597. Junichi Okada, Eijiro Yamada, Kazuya Okada, Shuichi Okada, Masanobu Yamada

Inhibition of the intestinal sodium-coupled glucose  transporter 1 (SGLT1) by extracts and polyphenols from apple reduces postprandial blood glucose levels in mice and humans. Mol. Nutr. Food Res. (2014) 58 : 1795–1808. Christine Schulze, Adina Bangert, Gabor Kottra, Kerstin Elisabeth Geillinger, Bettina Schwanck, Henning Vollert, Wolfgang Blaschek and Hannelore Daniel.  

Further reading

gut bacteria pinning granny smith apple

An apple a day only keeps the doctor away, if it’s a Granny Smith Apple

Granny Smith apples contain lots of UNDIGESTIBLE BITS, and it is the UNDIGESTIBLE BITS that matter, they encourage “skinny” bacteria to move into your colon

fruit catching the eye

How to turn fruit into a highly desirable snack

You want your family to eat a few more fruits and vegetables. Unfortunately, that apple doesn’t stand a chance, when pitted against a twinkie, but it can…

fructose tying leptin up

Is biting into too many “apples” the beginning of obesity ?

Human woes officially began, when Adam and Eve took a bite out of that fruit. Oops, biting into fruit sugar marks the beginning of another set of woes – obesity.

 

Want to discover more ways to create BETTER BODY CHEMISTRY ?

Posted in Obesity | Tagged apple, fructose, glifozins, glucose intolerant, glycemic response, high carb, pesticide, phlorizin, prediabetic, SGLT1, sugar spike

Sugar gremlins are REAL

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