https://chrismasterjohnphd.substack.com/p/003-sometimes-sugar-is-better-than

I'm working my way through 120 hours worth of detailed nutrition and biochemistry podcasts during my commute and our last module was on glycemic management. I know it's an area of incredible confusion to the general public and a lot of frustration for people dealing with prediabetic management: patients are not always able to correlate carbohydrate intake with glycemic spikes, and in particular for some people going on very restricted carbohydrate diets, the improvement in blood sugar and body composition is not always visible and sometimes seems to paradoxically regress.

Glycemic management is overall very complicated and I could not do justice to it in a blog obviously. However this particular podcast episode was talking about a phenomenon that was yet unknown to me. Humans are equipped with salivary enzymes that quickly break down starch into glucose for oral absorption into the bloodstream, and the general understanding of this phenomenon is that the body is looking for early signaling of a carbohydrate load in order to be ready to respond with the appropriate insulin release.

It also appears that part of the population has genetic mutation in the amylase gene that makes them less responsive to oral exposure to starch, which means that their body is not as efficient at managing carbohydrate intake with the appropriate insulin response as people without that gene mutation. In those cases, those people may not utilize carbohydrate properly for energy, and could be dealing with post meal excessive elevation of blood glucose (leading to post meal fatigue and fat storage). For those people, paradoxically, having something very slightly sweet at the beginning of a meal or an appetizer drink may benefit them as it will give a stronger signal of appropriate insulin response and carbohydrate utilization from that meal. It may not apply to the majority of you reading this but it will apply to a small subset of people who have found themselves dealing with worsening post meal sugar spikes when they lowered the carbohydrate percentage of their meal.