DOES BLOOD SUGAR GO UP AFTER EACH MEAL ? NOT NECESSARILY, DEPENDS UPON THE QUALITY OF FOOD AND PERHAPS THE MICROBIOME

While we were reading Medicine at the University, we are taught about the glucose excursions after a meal, in such a fashion. A powerpoint goes up and the teacher explains:

Many of the Insulin algorithms were based on this conception and the now debunked sliding scale of insulin as well as the famous multiple injections of insulin for Diabetes popular in the USA for a long time and exported to other countries.

The Question rose, does the blood sugar rise each time when you eat? how does it change when you have diabetes, type 1 or 2 or when you are pre-diabetic or just plain overweight or of normal size ?

Then came Glycaemic Index, I always associated GI with Australia and the work of Dr. Brand-Miller and it sort of made sense..

in a generic sense .

Remember Australia until recently was not known for DIVERSITY and I remember Caledonian Day being celebrated with fanfare in my home town city of Melbourne. 

Technological advance, Innovative science from Israel and my own studies in Anthropology all entered my life as I began working exclusively with the Indigenous peoples around the world. 

People are not the same, microbiomes are influenced by many factors and there cannot be a generic ADA diet for patients with Diabetes, cannot be.

The idea of microbiome and how they influence many of the diseases in the Endocrine spectrum (my field of specialization) was fascinating.

It does not matter how many grams of Carbohydrates I am eating, whether it is processed or not (my microbiomes do prefer pristine food not processed) or what colour it is: if my microbiomes do not like them my stomach would swell up, you can expect the BP to go up a little bit. Tomato, Strawberries. no no . I was very disappointed that being historically connected to the Middle East, my microbiomes do not like any of the grains, whole or enriched. But there are long lists of things they love being fed, a feast for them..

Getting to know the composition of my Microbiome, a gift from my sister friend, ex-Nurse Director of the Yakama Tribe, has been a boon to my health. 

So would the blood sugar go up each time you eat ? NOT NECESSARILY, depends upon what you eat and in my case, 1. pleasing my microbiomes 2. imitating my ancestral diet but fitting in my microbiomial demands. What would i do now for a lovely Israeli meal cooked by my brother in Haifa .. 3. If you live too long in the USA, you will begin to look like Americans, girth wise. 

How to help our patients?

Here is a patient of mine, (among the Indians, you do not have patients, only friends you have and you have not yet made) who was at the Emergency Room, three weeks ago, with Extremely high Blood sugars and other parameters, including an impressive Cholesterol of 775 !

He is indigenous, Lakota and whose family I have known for a long time. Fortunately for him, his wife has excellent knowledge of Nutrition and FOOD and they live in a part of USA well known for its abundance of variety of fresh food.

This is his Blood sugar before Lunch, his Lunch and one hour and two hour after his lunch.

BEFORE LUNCH  97 MG/DL

Blood sugar one hour after Lunch 93 mg/dl

Blood Sugar two hours after Lunch 98 mg/dl

THIS WAS HIS LUNCH. I told you his wife is knowledgeable about FOOD and they live in a lovely area known for fresh food.

By trial and error, he and his wife learned, very quickly, which of the food were not compatible with him.

If you are skeptical, here is the blood sugar average over the last seven days.. Easy determinations like these would have not been possible just a few years ago and Continuous Glucose Monitoring has been a boon .  Looking at the graphs on his Glucose Monitor, you can see that the BS is as flat as the Plains.

I have worked with his tribe and was able to learn what his ancestors ate, most of which are not easily available, but the imitation of ancestral food had worked well with him, thanks to his erudite wife!

He has come off his Insulin and oral medications. I would like you to notice: JUST THREE WEEKS .. When you meet your METABOLISM on its terms, it blesses you with a good functioning body. The next step would be Microbiome determination.

Needless to say that there are many other metabolic benefits, one of which is weight loss. I wont mention it here, as it would make many people jealous!!

One more point, from the point of view of Culture. Among the Lakota there is a saying   MITAKUYE OYASIN. we are all related.

I have noticed that RELATIONSHIP with the patient, not in a technical sense, but in a human sense, brings results.

Being with Indigenous people, I have always felt, I am their friend, with a little bit of Medical Knowledge to give them.

In return, over the course of years, the Meskwakia, the UmonHon, the Kickapoo, the Ticuna, the Malayan, the Mah Meri, the Lakota among others, all have given me so much 

Thank You 

Toda Rabbah in the language of my ancestors. 

Gracias, Merci Beaucoup, Obrigado in the languages that I like.

PS This morning my Lakota friend sent me his 14 day average Glucose excursion. Flat Line. Do you have any doubts now ?

NOW, FOR INDIVIDUAL NUTRITION, BASED ON SCIENCE . MICROBIOME. NUTRIGENOMICS. AND LEARN FROM THE ISRAELIS

 I have had the privilege of working with Indigenous peoples, in many countries around the world, and had become absorbed in to studying how to make their metabolism recover from the onslaught from Europe 500 years ago and from elsewhere since then..

Nutritional Imperialism or Colonialism are fairly new.

I remember standing in front of a store front, announcing gleefully a gift to the Cambodians

It was just ten years ago

It was the first Kentucky Fried Chicken outlet in Cambodia 

At the same time, there was an Australian do-gooder visiting Cambodia, who declared that Carbohydrates are bad for you and that Khmer people (who have been consuming rice at least for 2000 years) cease and desist the use of this staple.

Why do Cuban immigrants in search of Economic freedom come to Miami, the first thing they accumulate is a growing waistline..Most Central Americans put on a hefty 25 lbs to their body in the first year or two..

Something pure or natural is being polluted and I can speak authoritatively from the point of view of the traditional tribes that I have worked with

Like the Yanomami of the Amazon with the most pristine Microbiome, the north american indians also had a pristine gastro intestinal landscape and the diversity of their microbiome began disappearing as they were being forced to change their Life Style (Religion, ways of getting food ).

Their metabolism is pure

When I say that, in these times of Political correctness, I mean that their metabolism, like they themselves in their ways of thinking is much closer to the Creation, while others had been polluted or added upon with their share of the hundreds and thousands of years of human history.

While moving around, being flexible and good respiration are important , no Gym in USA or Australia or UK will combat the ill effects of a badly chosen fast food or restaurant food. 

In each and every country, it is possible to eat well, in some, it is easier than the others. 

Blessed are those who are not YET been visited by the Highly Processed Foods or as my Ticuna Indian friend calls it: Industrialized food .

I am being enlightened by a Lakota friend of mine and his nutritionally erudite wife about how an INDIAN body can be brought back to health and the Diseases eliminated.

I may talk about the low glycaemic index or Fibre content, but they are already using mostly home grown (hydroponic) organic vegetables and I may mention the QUALITY of the food . 

Today is the 17th day of our conversation. He is no longer on oral medications for High Blood Sugar nor on Insulin. Both had to be stopped. He has lost an impressive 24 lbs and he has set a goal for himself that is congruous with his height. 

It is possible. Nutrition is constant. Exercise (our grandparents did not EXERCISE but they did EXERT to obtain their FOOD) is sporadic and Interior calm is essential. I have stressed the importance of Meditation. 

When I ask my patients whether they can maintain a self discipline when it comes to Nutrition, strangely enough the answer is NO. Our nutrition now is guided by the facility of obtaining food and leaving cooking to some machinery , ignorant of the QUALITY of the food ..

Some of the highest rates of cardiovascular diseases in the USA are among the Immigrants from Asia, especially the Indian subcontinent. It is tragic to trade CURRY for a CUPCAKE..

They keep an indoor hydroponic garden and you can witness the quality, the purity that compliments his metabolism . This is the food he ate today.

Amazon Prime delivered this book to me, a gift from my Lakota friend . I look forward to reading it and learning from it.

It does help being an Anthropologist when working with the Indigenous people. Humans are not machines and they come with long histories .. one of which is their Nutritional History.

Here is a snippet of our conversation today..

BT is the Patient 

Dr, its me.

J is his wife 

BT

I had popcorn today as a snack at it brought my blood sugar down as do sunflower seeds or pumpkin seeds. I crave these all often so J believes it was a way of self medicating for a long time

Dr :

Interesting 

One explanation 

The body needs magnesium for over 300 processes, including breaking down food for energy. Studies have suggested that some of the macromolecules in pumpkin seeds may help manage blood sugar. Low magnesium levels are common in people with insulin resistance, which is one reason why diabetes occurs

BT:

That would be consistent with what we are seeing. 

Dr :

Remember, your insides and metabolism are PURE, now you are making it even PURER with appropriate Nutrition and then the body tells you . 

Typical Indian diet “generalizing” of course. Is HIGH fibre and LOW glycemic index. Where as the Modern American diet is exactly opposite ..  I almost said wa si chu but some people do not like the word 

Ed: Wa si chu is the Lakota term for White Man

BT:

Makes sense. J in trying to incorporate more grains and fruit now that my blood sugars are down to normal range. It is interesting to experiment. We weren’t sure how I would react to beans or Wild rice but based on the ancestral link it shouldn’t have a negative impact. It is interesting to prove your theory correct. 

Dr :

Lakota is a wonderful language.  Healing is wa pee yah.  Joining together which is the same as YOGA or union 

Truly we need to let our Indian relatives know what has happened and KUDOS to you and J . I have always believed that the majority of the body related problems among Indians are related to FOOD .. there is of course Social Responsibility which Outsiders won’t understand and also spiritual connection ( or mind set in the American parlance). 

BT:

Definitely agree. We are learning so much through this journey and reflecting on how we were eating and how most of it negatively impacts the environment is eye opening. Trying to eat fresh locally grown produce as much as possible is helping. We live in a nice area that has many locally grown options fortunately. 

In the title, I used THANK THE ISRAELIS.. why?

Of course, they are my people but nationalism does not come into play here, many of the nutritional studies at the micro-molecular level and microbiome level were done in Israel first.

Epigenetics also has a heavy Israeli scientific input.

So thank you, Toda Rabah, to the Israeli scientific community.

IT IS WEDNESDAY IN IRAN, CHARSHANBEH SOORI... CAN NOWRUZ BE FAR BEHIND?

Charshanbeh soori

When did it all begin?

The White Balloon ?

or Kuala Lumpur, Malaysia an unlikely place for an introduction?

Fire

in all monotheistic religions, man is given the supreme messenger role and a God who gives it to him, Nature and the connections to it via the natural elements Wind Air Water Fire are left out..

Give yourself to such and such God, insinuates the monotheistic religions for spiritual salvation

A Nigerian paediatrician working in a strip mall in Houston, says here church is a Wealth Transfer Instrument.. 

Fire 

people walk over it Greece Fiji at the Beqa island 

South Indian tradition carried over to Mauritius and Reunion

It was how our ancestors connected with the nature around them and many of the rituals involved SELF SACRIFICE 

Now the monotheistic religions sacrifice others in their name of their G-D, whatever they call it

UmonHon Indians call it the Great Mystery because it is a mystery that cannot be known

It is the human universalistic appeal that even 1500 years after the Muslim armies marched across Persia, the Iranians of this century celebrate Charshanbeh Suri, Nowruz, Yalda to name just a few..

I remember a walk along the main street in a university town.

I remember drizzle from the Arabian sea.. 

I want to be back there to welcome the year 2022..

I will think of the Iranian people, they know how much i respect them and how very much I wish their suffering would come to an end.

The religion that conquered them 1500 years ago continue to pile up on them the suffering in the name of something or other, created by men in long robes and beards with their minds very safely tucked away in the 15th century..

I am thinking of them ..

CAN NOWRUZ BE FAR BEHIND 

This saturday will be Nowruz, more than just a New Year but so much more.. because people feel happy not because a Priest tells them to be happy or a Mullah wants them to be happy..

Being one with nature and with other human beings whether they are Iranian or not, Muslims or not.. all Iranians on Nowruz become our brothers and sisters, our mothers and our daughters and our relatives ..

WE TAKE PRIDE IN THE GLOBAL VILLAGE BUT IS IT BECOMING LESS FREE ?

 Regardless of which part of the world you live in, there is a slow slipping towards the right in body politics. Of course we will not talk about countries where there are no free elections: China, North Korea, Vietnam, Laos, Cambodia ..Russia, Turkey and most of the Arab world.. but democratically elected governments around the world.

Was the election in Uganda democratic?

What about the currently contested election in Cote d'Ivoire?

Senegal acting democratically against the leader of opposition?

Does Zimbabwe, South Africa have stable democracies? 

What about Tanzania whose covid denying leader is in hospital in neighbouring Kenya for covid related conditions? 

One of the biggest news items of the day was the new list of free /not so free/ no freedom list published in Sweden. They had downgraded the largest democracy in the world, India to the not so free, calling it an Elected Autocracy of the Hindu dominated political parties.

Of course one does not search for freedom in Turkmenistan or Uzbekistan, but the majority of the Muslim majority nations were under Not Free categories, including those who were once part of the British Empire.

The ex-British colonies normally follow the rule of law and going through the list, I was in a way proud of the fact that the majority of the ex.British colonies were in the Free column, with Pakistan, Bangladesh, Malaysia predominantly in the not so free column. 

How do they calculate these lists? must be a formidable task, lots and lots of experts, hundreds of them, go through a long list and rate the countries.

The consensus is that the world is moving towards the Right and there were even countries in the EU: Hungary and Poland those are becoming less Free. With the inclusion of India in the partially free column, it is sad to note that the covid 19 year of 2020, a grand majority of the people in the world were living in less than free countries 

in 2021, one of my favourite countries, Myanmar, also known as Burma/Birmanie lost its freedom. The resistance to the Army Generals continue in that lovely country and as a young man said: They chose the wrong generation to meddle with.

I wish success in their endeavour to the people of Myanmar. They tasted freedom and they are not going to let it go that easily. 

PS only three small ex-colonies of the Portuguese empire could be considered Free

Cabo Verde, home of the late diva pied nuis, Cesaria Evora

Timor L'este who got their occupiers to leave, the not so free Indonesia 

Sao Tome and Principe 

MEDITATION OR MEDICATION? EFFECTS OF MEDITATION ON YOUR BLOOD PRESSURE AND HEART RATE

 

This is my Blood Pressure before my meditation practice towards the end of the day.

a Systolic BP of 112 is very decent and a diastolic of 79 is acceptable. The pulse rate of 81 would be considered normal by many physicians, but for me, it is a bit rapid and would like it to be less. a naturally occurring pulse rate of 60 per minute is considered a sign of a healthy heart. 

I have been tinkering with Meditation in the past few months and after I came in contact with Isha Kriya, i liked it very much. It was short and to the point and produced benefits if it is carried out on a regular basis.

Lately I have been reading Yuval Noah Harari and he had mentioned that regardless of his very very busy schedule, he finds time to do two sessions of one hour long Vipassana meditation. and in one of his lectures in India, he mentioned that he was very reluctant to begin meditation but was instructed by the late S. N. Goenka a Burmese national from Mandalay who migrated to India where he established a presence. His name became synonymous with Vipassana meditation.

Tonight I did 45 minutes of Vipassana meditation and at the end of it this is the result on my BP and Pulse.

There was no change in the Systolic BP readings but an impressive reduction in the Diastolic BP. Most physicians would consider this bottom reading of your BP measurement to be more important to your heart health. The reduction is a good one and if you look at medical literature, a reduction in Diastolic BP of 12 using a medication whether it be Lisinopril or Amlodipine, would be considered a pharmacologic victory. 

Yesterday I listened to the BBC where they were discussing about the Vagus Nerve and that breathing slowly and deeply does influence the activity of vagus nerve and that it slows down the heart rate. (The vagus nerve also seems to be involved in the production of the Neurotransmitter Serotonin, which despite its name is produced mainly in the Gut). A reduction in the pulse rate of 12 is nothing to snicker about. 

Our modern life creates so much Lifestyle related diseases but instead of prescribing Life style changes to prevent these diseases, the western medical system has invented excellent medication so that the patient can continue to live the destructive lifestyle that gave rise to the problem in the first instance.

When I was introduced to the work of the Yoga Institute of Santa Cruz in Bombay by my friend MYC in Kuala Lumpur, I became aware of the multiple uses of Yoga and Meditation in prevention and treatment of modern chronic illnesses.

I am happy to see that all around the world, Yoga and Meditation and Mindfulness are being taught to pupils at elementary schools. I witnessed a class at the European School in Brussels. It was marvelous to see a group of 8 year olds meditating!

GOOGLE PAYS HOMAGE TO THE MALAYSIAN CHINESE INNOVATOR OF FACE MASK. BORN TODAY 142 YEARS AGO

Google Doodle celebrates surgical face mask inventor Dr. Wu Lien-teh's 142nd birthday

Unfortunately, the good doctor's country of brith a century later did not do well with the Pandemic. At least they can honour him for the great contribution of a native son, even if he was not a Muslim . (Malaysia is a Muslim majority country)

Nearly one year ago, when I was confined to the house in Miami because of the doom and gloom of this pandemic, I decided to look up the history of MASK and thus encountered for the first time, the erudite Penang Born Malaysian Chinese doctor scientist , Dr WU

I wrote this at that time. 

https://medicoanthropologist.blogspot.com/2020/04/malaya-mongolia-and-mask-story-of-dr-wu.html

From Bat to Pangolin to Human is the suspected route fo Covid 19 and dr Wu cleverly suspected that the immigrant marmot hunters from Shandong were infected with the Plague. He noticed that the indigenous communities of Buryat were protected because of the safe cultural practices. 

Coincidentally, I received a message from a good friend of mine, an UmonHon-Ponca spiritual leader and a good friend of my UmonHon teacher Pierre Merrick.

He had said  long ago:

I am glad to report that the Indian People of North America are still here and will be here in the future, praying for the people of the world, for the four legged, for the winged sky animals and the animals that swim in the waters, for all living things. In the end of time I know their will be an ndn with one pipe offering our prayers for the people. Our ancestors knew that the Creator was a living God and that same God lived within each of us. For them every breath was a prayer, we need to as ndn people embrace that concept again and give our lives up to Gods will.

here is his note this morning, 142nd birth anniversary of Penang born Dr Wu, I read it while looking at the beautiful sunshine and the gentle breeze caressing the green leaves of Ponciana trees (not yet in blossom) at my sister's home in Miami, Florida USA 

Aho Kage' Yes Nate, Calvin, Pierre and I, all have had our second shots, we have small sweat every now and then. This First Thunder has arrived, and it is a time of hope and renewal the Omaha's new year.  We miss you and think of you, please be well and stay safe, know that you are in our prayers.

Ethe' Wongithe' all my relations

Dwight

AS YOU CAN SEE, EVERYTHING IS RELATED..

MY FRIENDS IN PENANG, KUALA LUMPUR, UMONHON NATION AND THE MEMORY OF DR WU.

WHEN TIMES ARE UNCERTAIN, ADAPT AND RESPOND

If you work more than 40 hours a week, you are either an economic slave or an inefficient worker who needs psychologic care ..

We talk about efficiency but never about the capacity to deal with the unexpected. In Medical care, chaos is the norm rather than  orderly behavior or outcome prediction and to employ algorithmic allocations will not bear fruit.

Efficiency is good when you can predict the outcome and not when unexpected things happen.

In the care of patients with Diabetes where nothing is quite predictable, one has to be less robotic and more in the intuitive and imaginative mode.

I have been lucky to be working with Native populations for whom chaos is understandable and who do not insist on certainty (try to sell Life Insurance to them and you will find out their disbelief!)

So the lesson from Diabetes care to the Indians to the world outside is this : Adapt and respond, as Professor Heffernan UK would say.

There are situations where long ours of work are necessary, like front line workers during a pandemic. But in general most people can control the number of hours they can work. A wonderful colleague of mine, a Diabetes Educator, said to me: I tried to finish the work I have to do while at work, I never take my work home. 

Currently, during this pandemic, while a sector of the society have become unemployed , among the employed the working hours and situations have enormously increased, as the border between work and leisure has blurred, since there is not much of Leisure to speak of.

I have met during my travels, people who look perpetually fatigued boasting about their long hours of work, one of them even saying , I sleep with my iPhone and MacBook Pro (perhaps no one will want to sleep with her?). It is inefficient to work longer hours, then the hours put in would be to correct the mistakes you have made and thus chasing your tail.

Studies show that human efficiency falls off at around 40 hours, use those hours, take advantage of the efficiency and accomplish more.

Despite the pressures of Covid 19 and the desire to protect patients, clinical life has become a bit more difficult. But anthropologically speaking, I am living through a wonderful time, taking care of Diabetes when parameters of good health Indices are fluctuant: Food, Activity, Mental Health. and grateful that I am working with American Indians

Have been reading a bit of Yuval Noah Harari. He is a bit of an intellectual Guide for the Perplexed ! While other Yogic philosophers are dealing with the outcomes (Emotions, Sensations) and how to deal with them; Harari is looking at the origin of such sensations, in a rather objective fashion. A little bit of Vipassana meditation does help..

Beautiful day in Miami, hope the days are nice where you are ..Just waiting for the skies to open up to go wandering..

PS there are lots of immigrants to the USA who by necessity have to work for more than 40 hours a week, just out of necessity. I admire their work ethic and always wish them well and greet them when I see them doing the kind of work, earlier immigrants who call themselves Americans now do not wish to do.

This note dedicated to my friends Edward, Jessica and Michelle