We share an ancestor who probably lived no more than 640 years ago

This post is a revised version of a previous post. The original post has been or will be deleted, with the comments preserved. Typically this is done with posts that attract many visits at the time they are published, and whose topics become particularly relevant or need to be re-addressed at a later date.

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We all evolved from one single-celled organism that lived billions of years ago. I don’t see why this is so hard for some people to believe, given that all of us also developed from a single fertilized cell in just 9 months.

However, our most recent common ancestor is not that first single-celled organism, nor is it the first Homo sapiens, or even the first Cro-Magnon.

The majority of the people who read this blog probably share a common ancestor who lived no more than 640 years ago. Genealogical records often reveal interesting connections - the figure below has been cropped from a larger one from Pinterest.

You and I, whoever you are, have each two parents. Each of our parents have (or had) two parents, who themselves had two parents. And so on.

If we keep going back in time, and assume that you and I do not share a common ancestor, there will be a point where the theoretical world population would have to be impossibly large.

Assuming a new generation coming up every 20 years, and going backwards in time, we get a theoretical population chart like the one below. The theoretical population grows in an exponential, or geometric, fashion.

As we move back in time the bars go up in size. Beyond a certain point their sizes go up so fast that you have to segment the chart. Otherwise the bars on the left side of the chart disappear in comparison to the ones on the right side (as several did on the chart above). Below is the section of the chart going back to the year 1371.

The year 1371 is a mere 640 years ago. And what is the theoretical population in that year if we assume that you and I have no common ancestors? The answer is: more than 8.5 billion people. We know that is not true.

Admittedly this is a somewhat simplistic view of this phenomenon, used here primarily to make a point. For example, it is possible that a population of humans became isolated 15 thousand years ago, remained isolated to the present day, and that one of their descendants just happened to be around reading this blog today.

Perhaps the most widely cited article discussing this idea is this one by Joseph T. Chang, published in the journal Advances in Applied Probability. For a more accessible introduction to the idea, see this article by Joe Kissell.

Estimates vary based on the portion of the population considered. There are also assumptions that have to be made based on migration and mating patterns, as well as the time for each generation to emerge and the stability of that number over time.

Still, most people alive today share a common ancestor who lived a lot more recently than they think. In most cases that common ancestor probably lived less than 640 years ago.

And who was that common ancestor? That person was probably a man who, due to a high perceived social status, had many consorts, who gave birth to many children. Someone like Genghis Khan.

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The end of an era and the start of a new chapter

Well, there had to come a point when I pulled my finger out, pulled up my socks and opened my laptop to finally write a blogpost.

I know I've been utter pants over the last few months.

It's not as though I've had no news to share. I've probably had too much and I never even blogged about the impromptu moment I asked the legendary Michael Parkinson about his rubbish.

But now that the school holidays are upon us, this is the first occasion I've had to properly slow down since September last year and stay at home instead of gallivanting around the country.

And this holiday feels like a period of transition in more ways than one.

On a personal level, our youngest has just left primary school and is getting ready to start middle school in September.  Yes, that little man who was only 3 when I started this blog has just turned 9 and is growing up.  To watch him confidently leave one school and be ready to embark on the next stage of his life feels like a real milestone.

Elsewhere, I've spent the last 8 months coming to terms with my mother's unexpected death in December.  Nothing can prepare you for losing a parent and I'm very aware that the constant flow of activities and deadlines this year have kept me very distracted, so much so that when we completed the sale of her house last week, it kicked me so hard that it felt like she'd died all over again.  My mother taught me lots about what's important in life and much of that teaching was in her death.  One day, I hope to share her wisdom - not yet but soon - the wisdom of an average woman who would never have expected to have been considered remarkable but in many ways truly was.  I really wish she was still here to see what's around the corner.  I know she'd be one of the first to laugh at my misadventures and then, without me knowing, quietly share her pride.

For things are changing on The Rubbish Diet front and at a rate of knots too.  Remember that Nesta competition I entered last year in partnership with Cwm Harry and Rachelle Strauss from My Zero Waste?  We're still right in the middle of the challenge and following the success of running the Rubbish Diet in Suffolk and Shropshire (which even saw 22 households in one street taking part in Shrewsbury), the novel bin slimming action is spreading to Ludlow and very soon Powys, the latter of which will be launched during this year's National Zero Waste Week, 2-8 September.   If you haven't checked out Zero Waste Week yet, go and have a peek at its new website and do get involved, especially if you need to get tough with your food waste.

But there's lots happening between now and then.  Don't miss 'yours truly' helping a family slim their bin as part of the Throwaway Britain Tonight documentary, which is being broadcast this Thursday 1st August (9pm, ITV1).  Without giving away the final reveal, I can't wait for you to see how Sandra and her family tackled their waste. 

And to give you even further inspiration to reduce waste, I've been pulling together the first UK tour of the Clean Bin Project documentary, which will see my old Canadian blogging friend Jen and her partner Grant travelling around the UK, to attend screenings of their movie in Brighton, Suffolk, York, Shrewsbury (tbc) and Wiltshire.  The official dates and venues for late August will be published soon, but if you'd like to know more please email me.

But coming back to the most major thing that's happening in my life right now, although I'm taking time out to enjoy the events of the summer holidays and pause for reflection, it's also a time for significant change, especially as the success of The Rubbish Diet trials featured in the Nesta competition has led to much interest from a range of local authorities.

The Rubbish Diet has already travelled a long way from being just a random housewife with a blog.  In the last year, it has developed into a website and a team to support the Nesta Waste Reduction competition.  And now, still in conjunction with the 'Do Think' Tank Cwm Harry (the people who are also behind the People's Design Lab), we are preparing for the next stage, which will see The Rubbish Diet becoming a social enterprise, developed to help households and communities reduce their waste by 50% within as little time as eight weeks.  More info on the next stage will be available soon, as will the final results of the Nesta competition later in the year.  Meanwhile if The Rubbish Diet challenge launches in your neck of the woods, do join in and say hello.

With so much happening it really does feel like the end of an era and the beginning of an exciting and potentially nerve-wracking new chapter.

Thank you for sticking with the rubbish adventures of this Almost Mrs Average over the last five years.  I know there are lots more adventures to be had yet, but from now on it will be in a very different context.

I just hope I will still have time to blog about them.

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Could grain-fed beef liver be particularly nutritious?

There is a pervasive belief today that grain-fed beef is unhealthy, a belief that I addressed before in this blog () and that I think is exaggerated. This general belief seems to also apply to a related meat, one that is widely acknowledged as a major micronutrient “powerhouse”, namely grain-fed beef liver.

Regarding grain-fed beef liver, the idea is that cattle that are grain-fed tend to develop a mild form of fatty liver disease. This I am inclined to agree with.

However, I am not convinced that this is such a bad thing for those who eat grain-fed beef liver.

In most animals, including Homo sapiens, fatty liver disease seems to be associated with extra load being put on the liver. Possible reasons for this are accelerated growth, abnormally high levels of body fat, and ingestion of toxins beyond a certain hormetic threshold (e.g., alcohol).

In these cases, what would one expect to see as a body response? The extra load is associated with high oxidative stress and rate of metabolic work. In response, the body should shuttle more antioxidants and metabolism catalysts to the organ being overloaded. Fat-soluble vitamins can act as antioxidants and catalysts in various metabolic processes, among other important functions. They require fat to be stored, and can then be released over time, which is a major advantage over water-soluble vitamins; fat-soluble vitamins are longer-acting.

So you would expect an overloaded liver to have more fat in it, and also a greater concentration of fat-soluble vitamins. This would include vitamin A, which would give the liver an unnatural color, toward the orange-yellow range of the spectrum.

Grain-fed beef liver, like the muscle meat of grain-fed cattle, tends to have more fat than that of grass-fed animals. One function of this extra fat could be to store fat-soluble vitamins. This extra fat appears to have a higher omega-6 fat content as well. Still, beef liver is a fairly lean meat; with about 5 g of fat per 100 g of weight, and only 20 mg or so of omega-6 fat. Clearly consumption of beef liver in moderation is unlikely to lead to a significant increase in omega-6 fat content in one’s diet (). By consumption in moderation I mean approximately once a week.

The photo below, from Wikipedia, is of a dish prepared with foie gras. That is essentially the liver of a duck or goose that has been fattened through force-feeding, until the animal develops fatty liver disease. This “diseased” liver is particularly rich in fat-soluble vitamins; e.g., it is the best known source of the all-important vitamin K2.



Could the same happen, although to a lesser extent, with grain-fed beef liver? I don’t think it is unreasonable to speculate that it could.

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How can carrying some extra body fat be healthy?

Most of the empirical investigations into the association between body mass index (BMI) and mortality suggest that the lowest-mortality BMI is approximately on the border between the normal and overweight ranges. Or, as Peter put it (): "Getting fat is good."

As much as one may be tempted to explain this based only on the relative contribution of lean body mass to total weight, the evidence suggests that both body fat and lean body mass contribute to this phenomenon. In fact, the evidence suggests that carrying some extra body fat may be healthy for many.

Yet, the scientific evidence strongly suggests that body fat accumulation beyond a certain point is unhealthy. There seems to be a sweet spot of body fat percentage, and that sweet spot may vary a lot across different individuals.

One interesting aspect of most empirical investigations of the association between BMI and mortality is that the participants live in urban or semi-urban societies. When you look at hunter-gatherer societies, the picture seems to be a bit different. The graph below shows the distribution of BMIs among males in Kitava and Sweden, from a study by Lindeberg and colleagues ().



In Sweden, a lowest mortality BMI of 26 would correspond to a point on the x axis that would rise up approximately to the middle of the distribution of data points from Sweden in the graph. It is reasonable to assume that this would also happen in Kitava, in which case the lowest mortality BMI would be around 20.

One of the key differences between urbanites and hunter-gatherers is the greater energy expenditure among the latter; hunter-gatherers generally move more. This provides a clue as to why some extra body fat may be healthy among urbanites. Hunter-gatherers spend more energy, so they have to consume more “natural” food, and thus more nutrients, to maintain their lean body mass.

A person’s energy expenditure is strongly dependent on a few variables, including body weight and physical activity. Let us assume that a hunter-gatherer, due to a reasonably high level of physical activity, maintains a BMI of 20 while consuming 3,000 kilocalories (a.k.a. calories) per day. An urbanite with the same height, but a lower level of physical activity, may need a higher body weight, and thus a higher BMI, to consume 3,000 calories per day at maintenance.

And why would someone want to consume 3,000 calories per day? Why not 1,500? The reason is nutrient intake, particularly micronutrient intake – intake of vitamins and minerals that are used by the body in various processes. Unfortunately it seems that micronutrient supplementation (e.g., a multivitamin pill) is largely ineffective except in cases of pathological deficiency.

Urbanites may need to carry a bit of extra body fat to be able to have an appropriate intake of micronutrients to maintain their lean body structures in a healthy state. Obviously the type of food eaten matters a lot. A high nutrient-to-calorie ratio is generally desirable. However, we cannot forget that we also need to eat fat, in part because without it we cannot properly absorb the all-important fat-soluble vitamins. And dietary fat is the most calorie-dense nutrient of all.

Why not putting on extra muscle instead of carrying the extra fat? For one, that is not easy when you are a sedentary urbanite. Particularly after a certain age, if you try too hard you end up getting injured. But there is another interesting angle to consider. Humans, like many other animals, have genetic “protections” against high muscularity, such as the protein myostatin. Myostatin is produced mostly in muscle cells; it acts on muscle, by inhibiting its growth.

Say what? Why would evolution favor something like myostatin? Big, muscular humans could be at the top of the food chain by physical strength alone; they could kill a lion with their bare hands. Well, it is possible. (Many men like to think of themselves as warriors, probably because most of them are not.) But evolution favors what works best given the ecological niches available. In our case, it favored bigger and more plastic brains to occupy what Steve Pinker called a “cognitive niche”.

Even though fat mass is not inert, secreting a number of hormones into the bloodstream, the micronutrient “need” of fat mass is likely much lower than the micronutrient need of non-fat mass. That is, a kilogram of lean mass likely puts a higher demand on micronutrients than a kilogram of fat mass. This should be particularly the case for organs, such as the liver, but also applies to muscle tissue.

While gaining muscle mass through moderate exercise is extremely healthy, bulking up beyond one’s natural limitations may actually backfire. It could increase the demand for micronutrients above what a person can actually consume and absorb through a healthy nutritious diet. Some extra fat mass allows for a higher level of micronutrient intake at weight maintenance, with a lower demand for micronutrients than the same amount of extra lean mass.

Some people are naturally more muscular. Their frame and underlying organ-based capabilities probably support that. It is often visibly noticeable when they go beyond their organ-based capabilities. A common trait among many professional bodybuilders, who usually go beyond the genetic gifts that they naturally have, is an abnormal swelling of internal organs.

What complicates this discussion is that all of this seems to vary from individual to individual. People have to find their sweet spots, and doing that may not be the simplest of tasks. For example, even measuring body fat percentage with some precision is difficult and costly. Also, certain types of fat are less desirable than others – visceral versus subcutaneous body fat. It is not easy differentiating one from the other ().

How do you find your sweet spot in terms of body fat percentage? One of the most promising approaches is to find the point at which your waist-to-weight ratio is minimized ().

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An illustration of the waist-to-weight ratio theory: The fit2fat2fit experiment

In my previous blog post, I argued that one’s optimal weight may be the one that minimizes one’s waist-to-weight ratio. I built this argument based on the fact that body fat percentage is associated with lean body mass (and also weight) in a nonlinear way.

The fit2fat2fit experiment (), provides what seems to be an interestingly way to put this optimal waist-to-weight ratio theory to test. This is due to a fortuitous event, as I explain in this post.

In this experiment, Drew Manning, a personal trainer, decided to undergo a transformation where he went from what he argued was his fittest level, all the way to obese, and then back to fit again. He said that he wanted to do that so that he could better understand his clients’ struggles. This may be true, but it looks like he planned very well his experiment from a marketing perspective.

His fittest level was at the start, with a weight of 193 lbs, at a height of 6 ft 2 in. That was his fittest level according to his own opinion. At that point, he had a waist of 34.5 in, and looked indeed very fit (). At his fattest level, he reached the weight of 264.8 pounds, with a 47.5 waist.

As he moved back to fit, one interesting thing happened. Toward the end of this journey back to fit, he moved past the level that he felt was his optimal. He dropped down to 190.1 lbs, and a 34 in waist; which he perceived as too skinny. He talks about this in a video ().

As a self-defined “fanatic” personal trainer, I figured that he knew when he had gone too far. That is, he is probably as qualified as one can get to identify the point at which he moved past his optimal. So I thought that this would be an interesting way of putting my optimal waist-to-weight ratio theory to the test.

Below is a bar chart showing variations in waist-to-weight ratio against weight for Drew Manning during his fit2fat2fit experiment. I included only three data points in this chart because I would have to view all of his video clips to get all of the data points.



As you can see, at the point at which he felt he was too thin, his waist-to-weight ratio clearly started going up from what seems to have been its optimal at 34.5 in / 193 lbs. This is exactly what you would expect based on my optimal waist-to-weight ratio theory. You probably can’t tell that something was not right at that point, because he looked very fit.

But apparently he felt that something was not entirely right. And that is consistent with the idea that he had passed his optimal waist-to-weight ratio, and became too lean for his own good. Note that his waist decreased, and probably could go down even further, even though that was no longer optimal.

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What is your optimal weight? Maybe it is the one that minimizes your waist-to-weight ratio

There is a significant amount of empirical evidence suggesting that, for a given individual and under normal circumstances, the optimal weight is the one that maximizes the ratio below, where: L = lean body mass, and T = total mass.

L / T

L is difficult and often costly to measure. T can be measured easily, as one’s total weight.

Through some simple algebraic manipulations, you can see below that the ratio above can be rewritten in terms of one’s body fat mass (F).

L / T = (T – F) / T = 1 – F / T

Therefore, in order to maximize L / T, one should maximize 1 – F / T. This essentially means that one should minimize the second term, or the ratio below, which is one’s body fat mass (F) divided by one’s weight (T).

F / T

So, you may say, all I have to do is to minimize my body fat percentage. The problem with this is that body fat percentage is very difficult to measure with precision, and, perhaps more importantly, body fat percentage is associated with lean body mass (and also weight) in a nonlinear way.

In English, it becomes increasingly difficult to retain lean body mass as one's body fat percentage goes down. Mathematically, body fat percentage (F / T) is a nonlinear function of T, where this function has the shape of a J curve.

This is what complicates matters, making the issue somewhat counterintuitive. Six-pack abs may look good, but many people would have to sacrifice too much lean body mass for their own good to get there. Genetics definitely plays a role here, as well as other factors such as age.

Keep in mind that this (i.e., F / T) is a ratio, not an absolute measure. Given this, and to facilitate measurement, we can replace F with a variable that is highly correlated with it, and that captures one or more important dimensions particularly well. This new variable would be a proxy for F. One the most widely used proxies in this type of context is waist circumference. We’ll refer to it as W.

W may well be a very good proxy, because it is a measure that is particularly sensitive to visceral body fat mass, an important dimension of body fat mass. W likely captures variations in visceral body fat mass at the levels where this type of body fat accumulation seems to cause health problems.

Therefore, the ratio that most of us would probably want to minimize is the following, where W is one’s waist circumference, and T is one’s weight.

W / T = waist / weight

Based on the experience of HCE () users, variations in this ratio are likely to be small and require 4-decimals or more to be captured. If you want to avoid having so many decimals, you can multiply the ratio by 1000. This will have no effect on the use of the ratio to find your optimal weight; it is analogous to multiplying a ratio by 100 to express it as a percentage.

Also based on the experience of HCE users, there are fluctuations that make the ratio look like it is changing direction when it is not actually doing that. Many of these fluctuations may be due to measurement error.

If you are obese, as you lose weight through dieting, the waist / weight ratio should go down, because you will be losing more body fat mass than lean body mass, in proportion to your total body mass.

It would arguably be wise to stop losing weight when the waist / weight ratio starts going up, because at that point you will be losing more lean body mass than body fat mass, in proportion to your total body mass.

One’s lowest waist / weight ratio at a given point in time should vary depending on a number of factors, including: diet, exercise, general lifestyle, and age. This lowest ratio will also be dependent on one’s height and genetic makeup.

Mathematically, this lowest ratio is the ratio at which d(W / T) / dT = 0 and d(d(W / T) / dT) / dT > 0. That is, the first derivative of W / T with respect to T equals zero, and the second derivative is greater than zero.

The lowest waist / weight ratio is unique to each individual, and can go up and down over time (e.g., resistance exercise will push it down). Here I am talking about one's lowest waist / weight ratio at a given point in time, not one's waist / weight ratio at a given point in time.

This optimal waist / weight ratio theory is one of the most compatible with evidence regarding the lowest mortality body mass index (, ). Nevertheless, it is another ratio that gets a lot of attention in the health-related literature. I am talking about the waist / hip ratio (). In this literature, waist circumference is often used alone, not as part of a ratio.

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Dr. Jekyll dieted and became Mr. Hyde

One of the most fascinating topics for an independent health researcher is the dichotomy between short- and long-term responses in successful dieters. In the short term, dieters that manage to lose a significant amount of fat mass, tend to feel quite well. Many report that their energy levels go through the roof.

A significant loss of fat mass could be considered one of 30 lbs, or 13.6 kg. This is the threshold for weight loss used in the National Weight Control Registry. Ideally you want to lose body fat, not lean mass, both of which contribute to weight loss.

So, in the short term, significant body fat loss feels pretty good for the dieters. In the long term, however, successful dieters tend to experience the symptoms of chronic stress. This should be no surprise because some of the same hormones that induce a sense of elation and high energy are the ones associated with chronic stress. These are generally referred to as “stress hormones”, of which the most prominent seem to be cortisol, epinephrine (adrenaline), and norepinephrine (noradrenaline).

Stress hormones display acute elevations during intense exercise as well ().

This is all consistent with evolution, and with the idea that our hominid ancestors would not go hungry for too long, at least not on a regular basis. High energy levels, combined with hunger, would make them succeed at hunting-gathering activities, leading to a period of feast before a certain threshold of sustained caloric restriction (with or without full fasting) would be reached. This would translate into a regular and cyclical hunger-feast process, with certain caloric costs having to be met for successful hunting-gathering.

After a certain period of time under sustained caloric restriction, it would probably be adaptive among our ancestors to experience significant mental and physical discomfort. That would compel our hominid ancestors to more urgently engaged in hunting-gathering activities.

And here is a big difference between those ancestors and modern urbanites: our ancestors would actually be working towards getting food for a feast, not restraining themselves from eating what they have easily available at home or from a grocery store nearby. There are major psychological differences here. Dieting, in the sense of not eating when food is easily available, is as unnatural as obesity, if not more.

So what are some of the mechanisms by which the body dials up stress, leading to the resulting mental and physical discomfort? Here is one that seems to play a key role: hypoglycemia.

Of the different types of hypoglycemia, there is one that is quite interesting in this type of context, because it refers to hypoglycemia in response to intake of any food item that raises insulin levels; that is, food that contains protein and/or carbohydrates. More specifically, we are referring here to reactive hypoglycemia, of the same general type as that experienced by those on their way to type II diabetes.

But reactive hypoglycemia in successful dieters is often different from that of prediabetics, as it is caused by something that would sound surprising to many: successful dieters appear to become too insulin sensitive for their own good!

There is ongoing debate as to what is considered a blood glucose level that is low enough to characterize hypoglycemia. Several factors influence that, including measurement method and age. One important factor related to measurement method is this: commercial fingerstick glucose meters tend to grossly underestimate low glucose levels (e.g., 50 mg/dl shows as 30 mg/dl).

Having said that, glucose levels below 60 mg/dl are generally considered low.

Luyckx and Lefebvre selected 47 cases of reactive hypoglycemia for a study, from a total of 663 standard four-hour oral glucose tolerance tests (OGTT). They classified these 47 cases as follows, with the number of cases in each class within parentheses: obesity (11), obesity with chemical diabetes (9), postgastrectomy syndrome (3), chemical diabetes without obesity (1), renal glycosuria (7), and isolated reactive hypoglycemia (16).

Postgastrectomy is the period following a gastrectomy, which is removal of part of one’s stomach. The modern term for this stomach amputation procedure is “bariatric surgery”; admittedly a broader term, which many people say they would do as if they were referring to a walk in the park!

In the cases of isolated reactive hypoglycemia, the individuals had normal weight, normal glucose tolerance, and no glycosuria (excretion of glucose in the urine). As you can see in the paragraph above, this, isolated reactive hypoglycemia, was the category with the largest number of individuals. The figure below illustrates what happened in these cases.



The cases in question are represented in the left part of the graph with dashed lines (the full lines are for normal controls). There a reasonably normal insulin response, lower in fact in terms of area under the curve (AUC) than for the controls, leads to an abnormal reduction in blood glucose levels. They are 9 out of 16, the majority of the isolated reactive hypoglycemia cases. In those 9 individuals, insulin became “more potent”, so to speak.

Reactive hypoglycemia is frequently associated with obesity, in which case it is also associated with hyperinsulinemia, and caused by an exaggerated insulin response. About 40 percent of the reactive hypoglycemia cases in the study were classified as happening in obese individuals.

This study suggests that, if you are not obese, and you are diagnosed with reactive hypoglycemia following an OGTT, chances are that the diagnosis is due to high insulin sensitivity – as opposed to low insulin sensitivity, coupled with hyperinsulinemia. A follow-up test should focus on insulin levels, to see if they are elevated; i.e., to try to detect hyperinsulinemia.

I have been blogging here long enough to hear from people who have gone the full fat2fit2fat cycle, sometimes more than once. They start dieting, go from obese to lean, feel good at first but then miserable, drop the diet, become obese or almost obese again, then start dieting again …

Quite a few are folks who do things like ditching industrial foods, regularly eating organ meats, and doing resistance exercise. How can you go wrong doing all of these, generally healthy, things? Well, they all increase your insulin sensitivity. If you don’t build in plateaus to slow down your progress, you may not give your body enough time to adapt.

You may become too lean, too fast, for your own good. The more successful the diet, the bigger is the risk. No wonder the paleo diet is being targeted lately as a “bad” diet. How can you go wrong on a diet of whole foods; “real” whole foods, not “whole wheat”? Well, here is how you can go wrong. The diet, if not managed properly, may be too successful for your own good; too much of a good thing can be a problem, you know!

See the graph below, from a previous post on a related topic (). I intend to discuss a method to identify the point at which weight loss should stop, in a future post. This method builds on the calculation of a simple index, which is unique to each individual. Let me just say now that I suspect that, with exceptions, frequently people are hurting their health by trying to have six pack abs.



But what does all this have to do with stress hormones? The connection is this. Hypoglycemia is only “felt”, as something unpleasant, due to the body’s frequent acute stress hormone response to it. Elevated levels of stress hormones also increase blood glucose levels, countering hypoglycemia. Our body’s priority is preventing hypoglycemia, not hyperglycemia ().

And here is an interesting pattern, based on anecdotal evidence from HCE () users. It seems that folks who have abnormally high insulin sensitivity, also have medium-to-high HbA1c (a measure of glycation) and fasting blood glucose levels. By medium-to-high HbA1c levels I mean 5.7 to even as high as 6.2.

Since cortisol is elevated, one would expect higher fasting blood glucose levels – the “dawn phenomenon”. But higher HbA1c, how? I am not sure, but I believe that HbA1c will be found in the future to be something a bit more complicated than what it is believed to be: a measure of average blood glucose over a period of time. I am not talking here about cases of anemia.

One indication of this complicated nature of the HbA1c is the fact that blood glucose levels in birds are high yet HbA1c levels are low, and birds live much longer than mammals of comparable size (). Some birds have extremely high glucose levels, even carnivorous birds who consume no or very small amounts of carbohydrate (e.g. hawks), with fairly low HbA1c levels.

The title of this post is inspired in the classic short novel “Strange Case of Dr. Jekyll and Mr. Hyde” by the Scottish author Robert Louis Stevenson; who also authored another famous novel, “Treasure Island”. In “Dr. Jekyll and Mr. Hyde”, gentle Dr. Jekyll becomes nasty Mr. Hyde (see poster below, from Wikipedia).



Mr. Hyde had a bad temper, impaired judgment, and was prone to criminal behavior. Hypoglycemia has long been associated with bad temper, impaired judgment, and criminal behavior (, ).

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