Sugar and Heart Disease
Blood Sugar Control – The Single Best Predictor of Heart Disease
Every week, at least once, someone tells me that eating a high fat diet will give me a heart attack.
I’m sure you get the same types of things said to you.
Are they right? Or are we right?
Which is the best predictor of a future heart attack, eating fat or an out of control blood sugar?
Recently, I watched a fantastic video by Professor (Dr.) Tim Noakes entitled: UCT Faculty of Health Sciences Centenary Debate
In this video, at 26 minutes, 5 seconds he makes a very bold statement that begins to answer that question I just asked about fat and sugar:
“glucose is the single most important predictor of your risk”
Professor Noakes is saying your blood sugar, your blood glucose level of control, is the single most important predictor of your risk of having a heart disease related event or a bad outcome in this disease.
This is a bold statement, and it turns the common knowledge of most people upside down, because most people think fat is the thing that gives you heart disease, therefore, control the fat and control the disease.
Tim Noakes quotes study after study that show blood sugar control is the most accurate number that predicts a bad outcome for heart disease, not fat.
This article is my attempt to break down, Bob style, these complicated studies into small bite sized bits you can use as a comeback, when someone annoys you with their “all that fat is going to give you a heart attack” statements.
They call me Butter Bob, but . . .
There’s something more to my story than Butter.
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Saturated Fat and Heart Disease.
This is a study that looked at 347,747 subjects results, and the money quotes from that study are these:
Intake of saturated fat was not associated with an increased risk of CHD [coronary heart disease], stroke, or CVD [cardiovascular disease].
there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD [coronary heart disease] or CVD [cardiovascular disease].
This is the study I quoted from in my “Lard Makes You Lean” video, when I read a quote from the Time Magazine article “Eat Butter: Scientists labeled fat the enemy. Why they were wrong.”
Blood Sugar and Heart Disease.
The Higher the Blood Sugar Number – the Higher the Rate of Heart Disease and Heart Attacks.
From the study:
Benn, M, Tybjaerg-Hansen, A, McCarthy, MI et al., (2012). Nonfasting glucose, ischemic heart disease, and myocardial infarction: a Mendelian randomization study. Journal of the American College of Cardiology, 59 (25), 2356-2365.
The higher the Blood Sugar level is, the more likely you are to have heart disease and a heart attack.
The higher the blood glucose level, the younger you will be when heart disease and a heart attack occur.
Blood Sugar better than Total Cholesterol as a Predictor of Heart Disease Events
The above graphic is from this study:
This study is important for two reasons.
- The first is it shows that blood sugar levels are a better predictor of a future heart disease event than total cholesterol.
- And second, if you’ll look at the numbers they tested, you’ll notice that even at what would be considered normal numbers, as the blood sugar number goes up, so does the risk.
Here’s the most important quote from that study and I think it is something we need to really stress to ourselves and those we love.
Here, in America, blood glucose is measured in mg/dL, so for every 1 mg/dL increase of blood sugar, the risk for Cardiovascular Disease increase 7.6%. For those of you outside the USA, it takes close to 2 mg/dL to equal a 0.1 change on your blood sugar test.
Lower Blood Sugar, Lower risk of Stroke and Heart Disease
Here’s the best quote from this study:
Overall, each 1 mmol/l lower usual fasting glucose was associated with a 21% (95% CI 18–24%) lower risk of total stroke and a 23% (19–27%) lower risk of total IHDs [ischemic heart disease]
For people outside the United States, if you took your blood sugar reading down 1 full point, you would lower your risk of stroke by 21% and reduce your risk of heart disease by 23%.
In the United States, you can reduce your risk by the same amount by taking your blood sugar down 18 mg/dL.
The Higher the Sugar, the Higher the Rate of Amputation, Heart Attack and Stroke
In this article, Dysglycemia and Cardiovascular Risk in the General Population. Gerstein, quotes an interesting study called UK Prospective Diabetes Study (UKPDS) Group.
This Study looked at people with high fasting blood glucose levels of greater than 6.0 mmol/L (greater than 106 mg/dl – American style numbers)
Here’s what they found:
|Events||Per 1% increase in blood sugar level|
|Amputation or death resulting from peripheral vascular disease||43% increase|
|cataract extraction||19% increase|
|heart failure||16% increase|
|myocardial infarction [heart attack]||14% increase|
|all-cause death||14% increase|
The table above is amazing, with just a 1% rise in blood sugar, all these horrible outcomes dramatically increase.
The Higher the Blood Sugar, the More Likely to Die from Heart Disease
Here’s another study that shows the relationship of blood sugar to death from heart disease
Brunner et al. Relation Between Blood Glucose and Coronary Mortality Over 33 Years in the Whitehall Study
A1C and Heart Disease
The Hemoglobin A1c Test is the standard blood test used to diagnose type 1 and type 2 diabetes.
From the Mayo Clinic:
The A1C test goes by many other names, including glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C and HbA1c
The A1C test result reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated). The higher your A1C level, the poorer your blood sugar control and the higher your risk of diabetes complications.
Here’s how A1C level corresponds to average blood sugar level, in milligrams per deciliter (mg/dL) and millimoles per liter (mmol/L):
Table from Mayo Clinic:
|A1C level||Estimated average blood sugar level|
|5 percent||97 mg/dL (5.4 mmol/L)|
|6 percent||126 mg/dL (7 mmol/L)|
|7 percent||154 mg/dL (8.5 mmol/L)|
|8 percent||183 mg/dL (10.2 mmol/L)|
|9 percent||212 mg/dL (11.8 mmol/L)|
|10 percent||240 mg/dL (13.3 mmol/L)|
|11 percent||269 mg/dL (14.9 mmol/L)|
|12 percent||298 mg/dL (16.5 mmol/L)|
|13 percent||326 mg/dL (18.1 mmol/L)|
|14 percent||355 mg/dL (19.7 mmol/L)|
Increase in A1C – Increase in Heart events and Death
1% increase in hemoglobin A1c equals 20–30% increase in cardiovascular events and all cause mortality.
The following study is the real cream of the crop. As we who follow a high fat diet know, it reduces your A1c and now this study lets us know how much more important blood sugar control is than total cholesterol. As you can see in the graphic below, heart disease events and death go up along with an increasing A1c score.
Khaw KT, Wareham N, Bingham S, et al. Association of hemoglobin A1c with cardiovascular disease and mortality in adults: the European Prospective Investigation into Cancer in Norfolk. Ann Intern Med 2004;141:413–20.
Here’s the most important quote from this study:
1% increase in haemoglobin A1c concentrations was associated with a 20–30% increase in cardiovascular events and all cause mortality in men and women 45–79 years of age
Low Carb High Fat Diet Reverses These Risk Factors
This study says it all. The High Fat diet reduces glucose, triglycerides and insulin much more that the High Carb diet. And it increases the HDL, good cholesterol MUCH more than the High Carb Diet.
Volek JS, Fernandez ML, Feinman RD, Phinney SD. Dietary carbohydrate restriction induces a unique metabolic state positively affecting atherogenic dyslipidemia, fatty acid partitioning, and metabolic syndrome.
When you look at the graphic above compare it to this definition of Metabolic syndrome or insulin resistance:
Metabolic syndrome (what insulin resistance is called) is a disorder of energy utilization and storage, diagnosed by a co-occurrence of three out of five of the following medical conditions:
- abdominal (central) obesity – low carb, high fat reduces belly fat more
- elevated blood pressure – not in this chart, but here’s another study that does says a low carb diet reduces blood pressure
- elevated fasting plasma glucose – low carb, high fat reduces Blood Sugar more
- high serum triglycerides – low carb, high fat reduces triglycerides A LOT more
- low high-density cholesterol (HDL) levels – low carb, high fat INCREASES the good HDL a lot more.
Information on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional. Individual Results may vary.
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