Life Extension Magazine
Life Extension Magazine February 2012
As We See It

Suppress Deadly After-Meal Blood Sugar Surges

By Daniel Becker
Suppress Deadly After-Meal Blood Sugar Surges

High blood sugar is fast becoming the leading preventable killer of maturing individuals in the United States. In addition to the 26 million Americans with diabetes, the Centers for Disease Control estimate that more than a third of the general population is now pre-diabetic.1

This may be just the tip of the iceberg.

As Life Extension® members know, recent data confirm that risk for most degenerative diseases and death rise dramatically when fasting blood glucose exceeds 85 mg/dL.2

Yet the medical establishment persists in defining readings up to 99 mg/dL as "safe." By this measure, virtually all of us are vulnerable to diabetic complications.

Even more alarming is widespread physician ignorance of the stealth danger posed by blood sugar surges after meals that can reach diabetic levels and last for hours—or even days.

These after-meal glucose "spikes" inflict silent damage to cells via multiple mechanisms and have been linked to cardiovascular disease, cancer, Alzheimer’s disease, kidney failure, and retinal damage.3-16

The good news is there are documented ways to suppress deadly after-meal glucose surges.

The most recent is a green coffee bean extract shown to neutralize a key enzyme that facilitates after-meal glucose surges.

When tested on humans in a placebo-controlled study, this natural extract produced an extraordinary 24% drop in after-meal blood sugar in just 30 minutes!17

Silent Epidemic of High Blood Sugar

The percentage of adults suffering from dangerous, chronically high blood sugar has been vastly underestimated.

Currently, you aren’t considered diabetic unless your fasting blood glucose is higher than 125 mg/dL. The range from 100-125 mg/dL is considered "pre-diabetic," while anything lower is defined as normal.

Unfortunately, your risk for age-related disease is far greater at these "normal levels" than has been previously recognized. Optimal fasting glucose should be within the range of 70-85 mg/dL.

A recent study of 46,000 middle-aged individuals revealed that more than 80% had fasting blood sugar of 85 mg/dL or higher.18 A similar epidemiological analysis of 11,000 middle-aged and older people found that more than 85% had fasting blood sugar of 85 mg/dL or higher.19

As Life Extension®has long warned, a thorough survey of the scientific literature confirms that maturing individuals with blood sugar levels in these ranges—below 100 mg/dL—are nonetheless at substantially increased risk of virtually all degenerative diseases, including:

  • Cancer4,20-29
  • Cardiovascular disease5,9-15,17,30,31
  • Alzheimer’s disease17,32,33
  • Kidney disease8,34
  • Pancreatic dysfunction35
  • Diabetic retinopathy (which can lead to blindness)6,36
  • Neuropathy (nerve pain and dysfunction)37,38

One team of researchers found that the risk of developing diabetes itself was increased more than seven-fold in people with fasting glucose levels of 105-109 mg/dL, compared with people with fasting glucose levels less than 85 mg/dL.19

An analysis of 1,800 maturing individuals revealed that coronary artery disease rates over a 10-year period in individuals currently defined as "pre-diabetic" were nearly identical to those with full-blown diabetes.39

A similar analysis of 33,230 men found that high glucose within the "normal" range was independently associated with a 38% increase in deaths from digestive tract cancers.40

These results underscore the critical need to redefine diabetes as fasting glucose above 85 mg/dL.

Table 1: Increased Health Risks in People with "Normal" Glucose Levels

Condition Glucose Levels (mg/dL) Increased Risk
Developing Type 2 Diabetes 100-104 Up to 283%19
Stomach Cancer 95-105 Up to 130%49
First-time Heart Attack Above 88 242%47
Need for Coronary Bypass or Stent Procedure Above 95 73%50

Undetected Daily Diabetic Glucose Levels?

Conventional medicine’s approach to glucose control goes beyond the problem of outdated reference ranges. Fasting blood glucose concentrations alone do not identify individuals with an increased risk of glucose-related disease onset because they do not detect dangerous after-meal glucose spikes.41,42

The current diagnostic of fasting glucose readings is only a snapshot that does not adequately measure of an aging individual’s hour-to-hour glucose status over the course of the entire day.

By definition, fasting blood glucose tests are conducted eight or more hours or more after your last meal. This method fails to account for a vital risk marker specific to you as an individual: after each meal, your blood sugar rises sharply for at least two hours before returning to normal.

Depending on the number and frequency of meals consumed, an aging individual may sustain dangerously high blood sugar throughout the day that will not be detected by conventional measures.

A mounting body of scientific evidence suggests that after-meal glucose spikes inflict as much or more damage than high fasting blood sugar.43-46

For example, in aging individuals with "normal" blood sugar readings and "normal" glucose-tolerance tests, heart attack risk increases by 58% for a 21 mg/dL increase in after-meal blood sugar.47 And for a similar after-meal increase, risk of cardiac death increases by 26%.48

This means that if your blood sugar surges 63 mg/dL after a meal, your risk of cardiac death increases nearly twofold.

One research team found that risk of stroke increased when fasting glucose rose above 83 mg/dL. And every 18 mg/dL increase beyond 83 mg/dL resulted in a 27% greater risk of dying from stroke!5

This means that an individual with a fasting blood glucose level of 119 mg/dL has a 54% higher risk of stroke-related death compared to an individual whose fasting blood glucose is only 83 mg/dL. If you wonder why stroke continues to disable and kill so many—despite better control of hypertension than ever—look no further than the epidemic of high blood glucose plaguing aging humans.

These alarming data underscore the vital importance of suppressing after-meal glucose surges and controlling fasting blood glucose in order to prolong healthy life span.

Control After-Meal Glucose Surges
Control After-Meal Glucose Surges
  • Elevated blood sugar is a silent danger that increases the risk of cardiovascular disease, cancer, Alzheimer’s, kidney disease, neuropathy, and retinal damage.
  • More than a third of the American population is estimated to be pre-diabetic.
  • Currently, fasting blood sugar levels higher than 125 mg/dL are considered diabetic and levels between 100-125 mg/dL are considered pre-diabetic.
  • Life Extension advises that optimal fasting blood glucose levels are in the range of 70-85 mg/dL. A growing body of evidence shows that tissue damage and disease risk increase when fasting blood glucose levels are above 85 mg/dL.
  • Coffee consumption has been associated with a decreased risk of developing type 2 diabetes.
  • A beneficial compound in coffee called chlorogenic acid has been credited with coffee’s glucose-lowering effects.
  • In a clinical trial, individuals who received 400 mg of a green coffee berry extract containing 50% chlorogenic acid prior to an oral glucose challenge demonstrated a 32% reduction in blood glucose at 2 hours.

The Little-Known Enzyme Behind Chronic Blood Sugar Overload

Most people think blood sugar levels are determined by the amount of carbohydrates or sugar they eat and how well their pancreas is working.

The truth is more complex.

You won’t hear this from most physicians, but your liver also plays a key role in regulating blood sugar, one that contributes directly to dangerous blood glucose surges after heavy meals.

Under normal conditions, the liver keeps a certain amount of sugar in storage. If your blood sugar falls too low, it releases this stored sugar in order to boost blood glucose back to healthy levels in a process called glycogenolysis.

If its stores of sugar are depleted, your liver has another means at its disposal to boost blood sugar: making sugar on its own from other sources, including fats and protein through a process called gluconeogenesis.

Humans evolved this capability to prevent acute, potentially deadly hypoglycemia (low blood sugar) during near-starvation states.

In young, healthy individuals, both these processes—sugar release or glycogenolysis and blood sugar synthesis or gluconeogenesis—are naturally suppressed after a meal to prevent blood sugar from getting too high.

As you age, this balancing mechanism may become impaired. Your liver releases stored sugar and makes additional sugar after you finish a meal—precisely when your body needs additional blood sugar the least.

At the core of pathologic glycogenolysis (release of stored blood sugar) and gluconeogenesis (synthesis of new sugar) is the enzyme glucose-6-phosphatase. Heavy meals can activate this enzyme, which in turn tells your liver to release its sugar stores and helps it to make more sugar, despite the flood of glucose from the meal you just finished.

It is this age-related dysregulation of glucose-6-phosphatase activity that accounts for the difficulty many maturing individuals face in maintaining optimal glucose levels. The dual processes of glycogenolysis and gluconeogenesis triggered by glucose-6-phosphatase can keep blood sugar high even with a lower-calorie or low-carbohydrate diet since glucose can also be synthesized from proteins and fats. (Note those who practice calorie restriction are usually able to keep their fasting glucose below 86 mg/dL and after-meal glucose surges below 120 mg/dL.)

Suppressing the activity of glucose-6-phosphatase is a cornerstone strategy in maintaining control of after-meal blood sugar spikes and limiting their potentially destructive impact.

In the quest to identify compounds that might favorably target the glucose-6-phosphatase enzyme, researchers turned their attention to the fact that heavy coffee drinkers enjoyed dramatically lower risk of diabetes.

How Much Coffee to Drink or Chlorogenic Acid to Take?

Increased coffee consumption results in a substantially reduced risk of diabetes.57-61

The prestigious journal The Lancet published a 2002 population study that included over 17,000 people. The researchers found a 50% lower risk of diabetes among those who consumed 7 cups of coffee a day compared to those who drank only 2 cups a day.61

So why not just drink more coffee?

Coffee "beans" are the seeds contained inside the plant’s fruit, the coffee berry. They possess a significantly higher proportion of beneficial phenolic acids (50%) than the berry (about 35%).

An analysis of the proprietary green coffee bean extract used in clinical studies cited in this article reveals that just 350 mg supplies the same amount of chlorogenic acid found in 14 cups of dark roast coffee. The problem with dark roasted coffees is that the roasting process removes too many beneficial polyphenols such as chlorogenic acid.

Green coffee bean extract also supplies the antioxidant compound ferulic acid, shown to exert a therapeutic anti-glucose effect in tandem with chlorogenic acid.61

After analyzing the blood of subjects given this green coffee bean extract, one 2008 study published in the Journal of Nutrition confirmed the presence in their blood samples of the same major phenolic compounds—including chlorogenic acid—provided by drinking roasted, brewed coffee. The researchers added that the compounds in green coffee bean extract were highly absorbable and readily metabolized in humans.76

In addition to their high absorption rate, the compounds in green coffee bean extract are believed to furnish stronger glucose-lowering protection than roasted coffee. That’s because roasting destroys much of the coffee bean’s beneficial content.

Conventional "lightly roasted" coffee provides about 92 milligrams of chlorogenic acid per cup. Heavily roasted coffee provides far less chlorogenic acid. A cup of a new "polyphenol-retaining" coffee (with chlorogenic acid added back in after roasting) provides 172 mg of chlorogenic acid. So drinking one or two cups of this new polyphenol-retaining coffee provides 172 to 344 mg of chlorogenic acid, which are in ranges shown to demonstrate therapeutic efficacy.

Green coffee bean extracts are available in new dietary supplements that provide either 200 or 400 mg of chlorogenic acid per serving. The typical dose for most people is 200 mg of chlorogenic acid before most meals. Those with higher glucose levels should take 400 mg before most or all meals.

Chlorogenic Acid Combats Excess Glucose

An abundance of studies confirms that, in addition to protection against various diseases,5,51-56 increased coffee consumption results in a substantially reduced risk of diabetes.56-61

The prestigious journal Lancet published a 2002 population study that included over 17,000 people. The researchers found a 50% lower risk of diabetes among those who consumed 7 cups of coffee a day compared to those who drank only 2 cups a day.61

Coffee’s anti-diabetic benefits are dose-dependent. In other words, the more you drink, the greater the benefit. And therein lies the problem: drinking seven cups or more of coffee every day is impractical for most people. This set researchers on a quest to uncover the specific glucose-lowering agents contained in coffee.

Skyrocketing Rates of Diabetes
Skyrocketing Rates of Diabetes

In 2008, there were an estimated 347 million people with diabetes in the world, up from 153 million just 30 years earlier.86 Researchers attributed about 70% of that increase to the global population explosion, but the remaining 30% are related to the rapid rise in overweight and obesity.87

Another reason for the sharp rise is that epidemiologists are finally recognizing that standard definitions of diabetes are inadequate. Simply measuring fasting blood glucose fails to detect up to 70% of people with disturbances in blood glucose regulation.88 An oral glucose tolerance test is required to detect such disturbances, particularly dangerous after-meal sugar spikes.

What this means for you is that you simply cannot assume that you are not diabetic just because your routine fasting blood sugar measurement was normal. Know the facts, and take proper steps to ensure that you protect your tissues from the twin threats of chronically elevated blood glucose and after-meal sugar spikes.

Coffee’s contents are complex, containing more than 1,000 discrete compounds.62

Compelling new data reveal that the chlorogenic acid content in coffee is primarily responsible for its glucose-lowering effects via several interesting mechanisms.63,64

Chlorogenic acid inhibits the glucose-6-phosphatase enzyme that stimulates glycogenolysis and gluconeogenesis.65,66 As discussed earlier, excessive activity of this enzyme contributes to dangerous after-meal blood sugar spikes and high blood glucose levels between meals.67

Chlorogenic acid directly inhibits glucose absorption from the intestinal tract. Studies show that coffee with a high chlorogenic acid content delays intestinal glucose absorption.59

Chlorogenic acid inhibits the intestinal enzyme alpha-glucosidase that breaks apart complex sugars and enhances their absorption.68 Slowing the breakdown of those common sugars (including sucrose, or table sugar), dramatically limits after-meal glucose spikes.

Chlorogenic acid-rich plant extracts have been shown to reduce fasting blood glucose values by more than 15% in diabetic patients with poor response to medication.69 A similar effect was seen in healthy volunteers, whose intestinal absorption of glucose was reduced by 7% following a chlorogenic acid-enriched coffee drink.70 And a chlorogenic acid supplement of 1 gram reduced glucose levels by 13 mg/dL, 15 minutes after an oral glucose challenge, demonstrating its ability to lower the after-meal spike in humans.71

A chlorogenic acid-rich extract of green coffee beans is also effective in animal studies against weight gain, reducing total weight and body fat accumulation by inhibiting fat absorption and preventing new fat production in liver tissue.72,73 Chlorogenic acid reduces liver fat content in animal studies as well, a vital factor in reducing the impact of overweight and obesity.74

Disease Risks of High-Normal Blood Sugar

Cancer: Numerous studies—including one published in the May 17, 2010, online issue of The Oncologist that was so large that it included half of all type 2 diabetics in Sweden20—have found that the risk for cancer increases among diagnosed diabetics.14,23,24 Rising in lock-step with glucose levels as they edged up within the normal range were the risks for can­cers of the endometrium, pancreas, colon, and colorectal tumors of a more aggressive nature.21,25,26,28,29

Cardiovascular disease: Subjects showed risks for cardiovascular events, cardiovascular disease, and cardiovascular mortality that increased in direct relation to elevated—but still high-normal—glucose levels.9,11-13,15 One researcher commented that within limits, lower glucose levels, even among those without diabetes, resulted in lower cardiovascular risk. Coronary artery disease risk was twice as high in patients with impaired glucose tolerance, compared with patients with more normal glucose tolerance.77 While diabetes is defined as experi­encing regular after-meal glucose levels of 200 mg/dL, one research team found a risk for stroke that increased as fasting glucose levels rose above 83 mg/dL. In fact, every 18 mg/dL increase beyond 83 resulted in a 27% greater risk of dying from stroke.5

Cognitive impairment: As blood sugar rose—whether within the normal or the diabetic ranges—the risk for this mild cognitive impairment and dementia increased.32,33

Kidney disease: Surges in blood sugar promoted a greater production of fibrous kidney tissue—which causes kidney disease—than a high but constant blood sugar level.8 The study authors suggested it may be fluctuations in glucose—more than the levels themselves—that produce the vascular complica­tions implicated in kidney damage. Another study found a direct increase in chronic kidney disease as levels of hemoglobin A1c (a marker of long-term glucose control) rose.34

Pancreatic dysfunction: Beta cells located in the pancreas produce the insulin that helps con­trol blood sugar. But high glucose levels can make these cells dysfunctional, raising the risk of type 2 diabetes. Researchers discovered that mild beta cell dysfunction was already detectable in those whose glucose levels spiked two hours after eating, despite staying completely within the range considered by the medical establishment to be normal.35

Diabetic retinopathy: High glucose levels precipi­tate diabetic retinopathy—damage to the retina that can lead to blindness. In one study, retinopathy was diagnosed in 13% of people who later progressed to diabetes and in 8% of those who never progressed to diabetes.7

Neuropathy: As expected, patients with nervous system damage (neuropathy) whose postpran­dial (after-meal) glucose readings were above the diabetic threshold, showed damage to their large nerve fibers. However, neuropathy patients whose glucose readings—although elevated—remained well within the normal range still showed damage to their small nerve fibers. Within any blood sugar range, reported the journal Neurology in 2003, the higher the glucose, the greater the involvement of the large nerve fibers.37 Another nerve damage study in 2006 confirmed these results.38

Compelling Confirmatory Data

A team of Japanese researchers recorded a 43% drop in blood sugar levels after administering green coffee bean extract to mice after a heavy meal.75

In a clinical trial presented in 2011, researchers gave different dosages of standardized green coffee bean extract, each containing 50% chlorogenic acid, to 56 people. Next, they gave the participants 100 grams of glucose in an oral glucose challenge test. The oral glucose tolerance test is a standard method of gauging an individual’s response to after-meal sugar exposure.

Blood sugar levels dropped by an increasingly greater amount as the test dosage of green coffee bean extract was raised, from 100 mg up to 400 mg. At the 400 mg dosage, there was a full 32% decrease in blood sugar—two hours after glucose ingestion.17

This means that if you had a dangerous after-meal glucose reading of 160 mg/dL, the proprietary green coffee bean extract would slash it to 109 mg/dL.

These findings are in line with supportive data demonstrating green coffee bean extract’s numerous glucose-fighting mechanisms of action.

Other models reveal that chlorogenic acid favorably modulates gene expression to enhance the activity of liver cells and increase levels of the hormone adiponectin, which enhances insulin sensitivity and exerts anti-inflammatory, anti-diabetic, and anti-atherogenic effects.76

Summary

Twenty-six million Americans are now considered diabetic, while more than one in three are pre-diabetic. Recent data confirm that your risk for degenerative disease and premature death increases substantially when fasting blood glucose exceeds 85 mg/dL. Yet the medical establishment persists in defining readings up to 99 mg/dL as "safe."

Also overlooked in the effort to combat today’s diabetes epidemic is the insidious process of after-meal blood sugar surges. Regardless of whether your fasting glucose readings are "normal," these surges can cause a diabetic-like state in the body that lasts for hours, inflicting undetected, system-wide damage to healthy tissues.

Driving this danger is the little-known role your liver plays in creating and releasing additional glucose into the blood. This process, which regulates blood sugar in the absence of food when you’re young, becomes detrimentally stimulated after heavy meals by the enzyme glucose-6-phosphatase as you age. The result is a dangerous flood of sugar into your bloodstream after every meal.

A breakthrough weapon to control these after-meal blood sugar surges has been identified: green coffee bean extract. It contains a compound called chlorogenic acid shown to target glucose-6-phosphatase and blunt post-consumption blood sugar levels by up to 32% in human trials.

Understanding Gluconeogenesis
Understanding Gluconeogenesis

The enzyme glucose-6-phosphatase (G6P) helps to produce dangerous after-meal blood sugar spikes in two ways. It releases glucose from its storage area in the liver, and it promotes formation of new glucose molecules from non-sugar sources.78 The latter process is called gluconeogenesis.

Traditionally, scientists have assumed that amino acids from proteins were the only precursors of glucose in gluconeogenesis.79 Recent discoveries, however, suggest that fatty acids are also important precursors of this dangerous source of excess glucose.79,80

Fatty acids contribute to gluconeogenesis by at least three mechanisms. First, excessive fatty acids stimulate gluconeogenesis and provide G6P the energy it needs to convert traditional substrates such as amino acids into glucose.81-84 Second, when triglycerides break down to fatty acids, glycerol is released, and then converted into glucose by gluconeogenesis.85 Finally, advanced computer models have revealed new pathways by which fatty acids are directly converted into glucose; the final steps in those pathways involve G6P.79

These discoveries provide further insight into the causes of the deadly after-meal glucose spikes. They also provide further incentives to block the enzymes that participate in gluconeogenesis, such as G6P. Green coffee extracts are an excellent source of G6P-blocking nutrients.

If you have any questions on the scientific content of this article, please call a Life Extension® Health Advisor at 1-866-864-3027.

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