Does Resveratrol Improve Blood Sugar Control?

Written by Dr. Steve Chaney on . Posted in Food and Health, Issues, Supplements and Health

Is The Promise of Resveratrol True?

Author: Dr. Stephen Chaney

blood sugar testIt was just a few years ago that resveratrol was the latest “miracle nutrient”. It was featured on Dr. Oz and on 60 Minutes. It was hot! Today you see dueling headlines. The headlines one week proclaim the benefits of resveratrol. Next week’s headlines say that it’s all hype. What’s a person to believe?

Let me take you behind the headlines to look at the actual studies and answer some important questions.

1)    What do we actually know about the benefits of resveratrol?

2)    Is the evidence for beneficial effects of resveratrol where it should be considering the number of clinical studies that have been published?

3)    What additional studies need to be done before we can be sure that resveratrol is beneficial?

4)    Should you wait until we are absolutely certain resveratrol is beneficial, before you start using it? This is perhaps the most important question of all.

To answer those questions, let’s examine the study behind one of the latest headlines, namely: “Resveratrol Improves Blood Sugar Control in Diabetics”. One of the promises of resveratrol has been that it might help diabetics and pre-diabetics who struggle with blood sugar control. However, this promise was based on animal studies. The study that generated the headlines in question was a meta-analysis of recently published human clinical trials in this area (Liu et al, Am. J. Clin. Nut., 2014, doi: 10.3945/ajcn.113.082024).

Does Resveratrol Improve Blood Sugar Control?

The meta-analysis included 11 published placebo controlled double blind clinical studies looking at the effects of resveratrol supplementation on fasting blood sugar levels, insulin levels, hemoglobin A1c (a measure of blood sugar control) and insulin resistance (a measure closely associated with type 2 diabetes).

A strength of this meta-analysis is the fact that it included 11 clinical studies. However, a weakness of this analysis is that these studies utilized a wide variety of resveratrol doses (10 mg/day to 1 gram/day), a wide variety of end points and both diabetic and non-diabetic patients. That means that there were only a few studies with common population groups, resveratrol doses, and end points.

The conclusions of the study (and the headlines you may have seen) were that:

•    Resveratrol appeared to improve blood sugar control (based on improvements in fasting blood sugar levels, insulin levels, hemoglobin A1c and insulin resistance) in diabetics.

•    No consistent effect of resveratrol on blood sugar control was seen in non-diabetics.

How Good Are These Studies?

While these studies are very promising, they are bot definitive.  There were only 3 published clinical studies in diabetics. While all 3 of the studies showed a positive effect of resveratrol supplementation:

•    The doses used were different in each study (ranging from 10 mg/day to 1 gram/day)

•    Each study measured different end points (one measured blood glucose, insulin levels, hemoglobin A1c and insulin resistance, one measured blood glucose and hemoglobin A1c and the third measured insulin resistance).

As a research scientist I would like to see more studies done at comparable doses and measuring the same end points – we scientists always want more studies.

Similarly, there was not enough consistency in the studies with non-diabetics to draw a firm conclusion. (3 were with obese patients, 3 were with patients with cardiovascular disease, 1 was with patients with metabolic syndrome and 1 was with perfectly healthy subjects.)

If you really wanted to see if something like resveratrol helps non-diabetics with blood sugar control, you would want to start with people who are already experiencing some difficulties with blood sugar control (pre-diabetics or patients with metabolic syndrome) and follow them for a couple of years to see if resveratrol reduces the number of them who become diabetic.

Are The Headlines Just Hype?

Newspaper HeadlinesDoes that mean that the blood sugar benefits of resveratrol are just hype? The answer is no. There is a difference between “very promising, but not yet definitive” and “hype”. We shouldn’t be surprised that human studies on the health benefits of resveratrol are not yet definitive. Science moves slowly. It often takes decades of scientific research before promising concepts are widely accepted by the scientific community.

When a research area is as young as this one, we sometimes need to go beyond the clinical studies and look at the totality of evidence. In this case:

•    In mice resveratrol exerts its beneficial effects by turning on a specific anti-aging gene called SIRT1 (Cell Metabolism, 15: 675-690, 2012). In humans, resveratrol appears to activate the same genetic pathways as in mice (Journal of Clinical Endocrinology & Metabolism, 96: 1409-1414, 2011).

•    In obese mice resveratrol improves markers of blood sugar control (Nature, 444: 337-342, 2006). Published clinical studies in diabetic humans also show improvements in blood sugar control (Journal of Clinical Nutrition, 2014, doi: 10.3945/ajcn.113.082024).

So while more and better clinical studies are needed to be absolutely certain that resveratrol helps improve blood sugar control, the evidence supporting that effect is substantial.

What Should You Do?

The ONLY important question for each of you is probably: “Should I wait a decade or two until we are absolutely sure about the health benefits of resveratrol before I take a resveratrol supplement?” That question is ultimately yours to answer. It’s all about benefits and risk.

Benefits – In animal studies resveratrol clearly improves blood sugar control. The human clinical studies published to date are consistent with the animal studies.

Risk – Current data suggest that resveratrol appears to be safe, even at high doses. For example, one recent study indicated that up to 5 gm/day is safe (Cancer Epidemiology BioMarkers & Prevention, volume 16:1246-1262, 2007), but I wouldn’t personally recommend exceeding 100-200 mg/day.

The Bottom Line:

1)     Don’t get too excited about the headlines suggesting that resveratrol might help improve blood sugar control in diabetics. The few human clinical studies that have been published to date are consistent with previous animal studies. That is very promising, but more studies are needed before we can be absolutely confident that resveratrol supplementation is beneficial for diabetics.

2)     Similarly, don’t be discouraged by the headlines suggesting that resveratrol does not help with blood sugar control in non-diabetics. Those results are preliminary as well.

3)     That doesn’t mean that the headlines are just hype. It takes decades to accumulate definitive proof that any kind of food or nutrient offers proven benefits, and the bulk of human clinical research on reveratrol has occurred in the last couple of years. We are exactly where we should expect to be at this point in time.

4)     With something as promising as resveratrol, the real question becomes whether you can afford to wait a decade or two until you know whether the potential benefits have been definitely proven. That question is up to you. On the plus side, current data suggest that resveratrol is highly promising for blood sugar control. In addition, resveratrol appears to be safe, even at high doses, but I wouldn’t personally recommend exceeding 100-200 mg/day.

5)     We already know that weight control, exercise and a healthy diet improve blood sugar control. You should think of resveratrol as something you may wish to add to a healthy lifestyle, not as a substitute for a healthy lifestyle.

6)     If you are diabetic and decide to try a resveratrol supplement, be sure to work with your physician so they can modify your dose of insulin or blood sugar medication as necessary.

7)     Finally, you may be asking whether resveratrol supplements are even necessary. Can’t you just get all the resveratrol you need from a glass or two of red wine? Stay tuned. I’ll have the answer to that question in a couple of weeks.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Should You Avoid Sugar Completely?

Posted October 24, 2017 by Dr. Steve Chaney

Is It The Sugar, Or Is It The Food?

Author: Dr. Stephen Chaney

 

Should we avoid sugar completely?  Almost every expert agrees that Americans should cut down on the amount of sugar we are consuming. However, for some people this has become a “sugar phobia”. They have sworn that “sugar shall never touch their lips”. Not only do they avoid sugar sweetened sodas and junk food, but they also have become avid label readers. They scour the label of every food they see and reject foods they find any form of sugar listed as an ingredient. Is this degree of sugar avoidance justified?

 

Should We Avoid Sugar to Keep it From Killing Us?

 

Let me add some perspective:

  • If you just take studies about the dangers of sugar at face value, sugar does, indeed, look dangerous. Excess sugar consumption is associated with increased risk of obesity, diabetes, and heart disease. However, when you look a little closer, you find that most of these studies have been done by looking at the correlation of each of these conditions with sugar sweetened beverage consumption (sodas and fruit juices).

A few studies have looked at the correlation of obesity and disease with total “added sugar” consumption. However, 71.6% of added sugar in the American diet comes from sugar sweetened beverages and junk food. None of the studies have looked at the sugar from healthy foods like fruits, vegetables, and whole grains. That’s because there is ample evidence that these foods decrease the risk of obesity, diabetes, and heart disease.

  • For example, if apples had a nutrition label, it would list 16 grams of sugar in a medium 80 calorie apple, which corresponds to about 80% of the calories in that apple. The sugar in an apple is about the same proportion of fructose and glucose found in high fructose corn syrup. Apples are not unique. The nutrition label would read about the same on most other fruits. Does that mean you should avoid sugar from all fruits? I think not.

Avoid Sugar or Avoid Certain Foods

 

avoid sugar from junk foodsThe obvious question is: “Why are the same sugars, in about the same amounts, unhealthy in sodas and healthy in fruits?” Let’s go back to those studies I just mentioned—the ones that are often used to vilify sugars. They are all association studies, the association of sugar intake with obesity and various diseases.

The weakness of association studies is the association could be with something else that is tightly correlated with the variable (sugar intake) that you are measuring. Could it be the food that is the problem, not the sugar?

If we look at healthy foods (fruits, vegetables, whole grains) they are chock full of vitamins, minerals, phytonutrients, fiber, and (sometimes) protein. Fiber and protein slow the absorption of sugar into the bloodstream. As a result, blood sugar levels rise slowly and are sustained at relatively low levels for a substantial period of time.

In sodas there is nothing to slow the absorption of blood sugar. You get rapid rise in blood sugar followed by an equally rapid fall. The same is true of junk foods consisting primarily of sugar, refined flour and/or fat.  Avoid sugar from those types of foods.

Another consideration is something called caloric density. Here is a simple analogy. I used to explain the concept of caloric density to medical students in my teaching days. There are about the same number of calories in a 2-ounce candy bar and a pound of apples (around 278 in the 2-ounce candy bar and 237 in a pound of apples). You can eat a 2-ounce candy bar and still be hungry. If you eat a pound of apples you are done for a while. In this example, the 2-ounce candy bar had a high caloric density (a lot of calories in a small package). Perhaps a more familiar terminology would be the candy bar was just empty calories.

Are Sodas and Junk Foods Killing Us?

avoid sugar from candyPutting all that together, you can start to understand why the foods the sugars are in are more important than the sugars themselves. When you consume sugars in the form of sugar sweetened beverages or sugary junk foods, your appetite increases. We don’t know for sure whether it is the intense sweetness of those foods, the rapid increase and fall in blood sugar, or the high caloric density (lots of calories ina small package) that makes us hungrier. It doesn’t matter. We crave more food, and it isn’t usually fruits, vegetables, and complex carbohydrates we crave. It’s more junk. That sets in motion a predictable sequence of events.

  • We overeat. Those excess calories are stored as fat and we become obese. [Note: The low carb enthusiasts will tell you our fat stores come from carbohydrates alone. That is incorrect. All excess calories, whether from protein, fat, or carbohydrate, are stored as fat.]
  • It’s not just the fat you can see (belly fat) that is the problem. Some of that fat builds up in our liver and muscles. This sets up an unfortunate sequence of metabolic events.
  • The fat stores release inflammatory cytokines into our bloodstream. That causes inflammation. Inflammation increases the risk of many diseases including heart disease and cancer.
  • The fat stores also cause our cells to become resistant to insulin. That reduces the ability of our cells to take up glucose, which leads to hyperglycemia and type 2 diabetes. [Note: The low carb enthusiasts will tell you carbohydrates cause type 2 diabetes. That is also incorrect. It is our fat stores that cause insulin resistance and type 2 diabetes. Our fat stores come from all excess calories, not just excess calories from carbohydrates.]
  • Insulin resistance also causes the liver to overproduce cholesterol and triglycerides and pump them into the bloodstream. That increases the risk of heart disease.
  • Sugar sweetened beverages and sugary junk foods also displace healthier foods from our diet. That leads to potential nutrient shortfalls that can increase our risk of many diseases.

However, none of this has to happen. The one thing that every successful diet has in common is the elimination of sodas, junk foods, fast foods and convenience foods. You should avoid sugar from those foods as much as possible. Once you eliminate those from your diet,you significantly enhance your chances of being at a healthy weight and being healthy long term.

 

What About Protein Supplements And Similar Foods?

Of course, the dilemma is what you, as an intrepid label reader, should do about protein supplements, meal replacement bars, or snack bars. They are supposed to be healthy, but the label lists one or more sugars. Even worse, the sugar content is higher than your favorite health guru recommends.  So, should you avoid sugar from supplements and the like?

In this case, a more useful concept is glycemic index, which is a measure of the effect of the food on your blood sugar levels. Healthy foods like apples may have a high sugar content, but they havea low glycemic index.

avoid sugar and consume protein to slow absorbptionThe same is true for the protein supplements and bars you are considering. Rather than looking at the sugar content, you should be looking for the term “low glycemic” on the label. That means there is enough fiber and protein in the food to slow the absorption of sugar into the bloodstream and stabilize your blood sugar levels.

What Does This Mean For You?

Don’t misunderstand me. I am not advocating for unlimited consumption of sugar. We should work on ways to avoid sugar or reduce the amount of sugar in our diet. On the other hand, we don’t need to become so strict that we and our family need to eat foods that taste like cardboard. We also don’t want to replace natural sugars with artificial sweeteners. I have warned about the dangers of artificial sweeteners previously.

We can go a long way towards reducing sugar by just eliminating sodas, other sugar sweetened beverages, junk foods, fast foods, convenience foods, and pastries from our diet. When considering fast foods and convenience foods, we should check the label for hidden sugar. For example, some Starbucks drinks are mostly sugar. When considering foods that are supposed to be healthy, we should look for the term “low glycemic” on the label.

So we don’t have to avoid sugar completely, but we should reduce sugar from sugar sweetened beverages and junk food.

 

The Bottom Line

 

We need to keep warnings about the dangers of sugar in perspective:

  • The studies showing that sugar consumption leads to obesity, diabetes, and heart disease have all been done with sodas and junk foods.
  • Many fruits have just as much sugar as a soda. They also contain about the same proportion of fructose and glucose as high fructose corn syrup. Yet we know fruits are good for us.
  • Diets rich in fruits, vegetables and whole grains decrease our risk of obesity, diabetes, and heart disease.
  • That is because the sugar in whole foods is generally present along with fiber and protein, which slows the absorption of sugar and prevents the blood sugar spikes we get with sodas and junk foods.
  • In the case of prepared foods like protein supplements, you should look for “low glycemic” on the label rather than sugar content. Low glycemic means that there is enough fiber and protein in the product to slow the absorption of sugar and prevent blood sugar spikes.
  • Don’t misunderstand me. I am not advocating for unlimited consumption of sugar. We should all work on ways to avoid sugar from junk foods or to reduce the amount of sugar in our diet. On the other hand, we don’t need to become so strict that we and our family need to eat foods that taste like cardboard. We also don’t want to replace natural sugars with artificial sweeteners.
  • We can go a long way towards reducing sugar by just eliminating sodas, other sugar sweetened beverages, junk foods, fast foods, convenience foods, and pastries from our diet. When considering fast foods and convenience foods, we should check the label for hidden sugar. When considering foods that are supposed to be healthy, we should look for the term “low glycemic” on the label.

For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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