If you follow my blog you're probably aware I don't tend to spend any time or energy critiquing influencers or celebrities. In general I feel like Gwyneth Paltrow is an easy target. And punch me for being judgmental but I think if people have decided actors are going to be their source of health and medical information, all is lost anyway.
Glucose Goddess (Jesse Inchauspé) is a different case, and I have erred for a while whether I should even address this particular area of scientific abuse. However, several people had sent me her interview with Steven Bartlett and his credulous visage on the Diary of a CEO podcast, and I'm realising there are some doctors and other scientists who seemed to think she's on to something. So here we go.
The first thing to note is that people like Inchauspé don’t sound unreasonable or wrong. Because successful dodgy-science purveyors always say a few things that are partly right. And perhaps people reading this might have enjoyed her work and think “well she’s making people aware of metabolism, and she talks about having more fibre and doing more physical activity so why do you have such a problem with it?”
Because - since people like Inchauspé lack the context and experience to understand the difference between single biochemical pathways and whole-body metabolism, or the magnitude of effect and why this matters, or physiological trade-offs - the advice they give can be harmful or just utterly pointless.
I think most people agree that getting people to focus on a non-existent risk factor* (normal post-prandial glucose rises) while ignoring or potentially worsening the stuff that does actually kill people prematurely (high cholesterol and blood pressure) is a really bad idea.
But I don’t think we pay enough attention to the crime of pointlessness.
Time is the most limited and irreplaceable resource we possess. To waste someone’s time or fill their mind with needless anxieties isn’t just an inconvenience—it is an existential affront. Every moment spent on things that don’t matter, or on worries that never come to pass, is a moment that could have been used for something more meaningful or fulfilling.
One of my favourite things to do in my clinic is to be able to tell people “your glucose is fine, chuck the CGM away, enjoy your food and enjoy your life”.
And my assessment of “your glucose is fine and so is your diet” isn’t based on a few years glancing at abstracts and a desperate need to bash out some podcast content for views, it’s the result of 15 years of working in glucose metabolism. I promise you, if I thought or think you have reason to worry I would tell you.
So let’s dig in and I’ll use the example of glycation to demonstrate why the Inchauspé glucose spike nonsense can be harmful, but just as important, is a complete waste of time.
OH GOD A GLUCOSE SPIKE CAUSES GLYCATION AND THAT’S BASICALLY LIKE BEING COOKED SLOWLY FROM THE INSIDE**
It's true that 1) glycation is part of the nonenzymatic browning reaction you get when cooking, 2) glycation does occur as a result of glucose going up, and 3) glycation is linked to damage to tissues and ageing. But because Inchauspé doesn’t understand (or pretends not to?), dose, duration of exposure and overall context, the end result is an omnishambles of wrongness.
Here's why:
Glycation is a normal metabolic process, but only in conditions of prolonged hyperglycaemia (diabetes) does it become pathogenic.
An acute rise in glucose after a carbohydrate-containing meal can contribute to glycation, but the key distinction is between reversible early-stage glycation and irreversible advanced glycation end-products (AGEs).
1. Reversible Early-Stage Glycation:
When glucose levels spike after a meal, glucose molecules can attach to proteins, forming reversible early glycation products like Schiff bases. This is the initial stage of glycation and can occur relatively quickly, even with transient rises in blood glucose.
2. Irreversible Advanced Glycation End-Products (AGEs):
If glucose levels remain elevated for extended periods (as seen in chronic hyperglycemia), these early glycation products can undergo further chemical reactions, leading to the formation of AGEs, which are irreversible. This is the “aging” part of what Inchauspé is talking about.
AGEs accumulate over time and contribute to tissue damage, particularly in conditions like diabetes where blood glucose is chronically high. However, short-term rises in people without diabetes should not lead to significant formation of AGEs, as the body typically returns to normal glucose levels before this irreversible stage occurs.
OK, but how does this make her advice bad? Surely, erring on the side of caution is a sensible approach, and limiting glucose spikes is a good idea just in case?
Because by focusing on the thing that probably doesn’t contribute to glycation in any meaningful way, Inchauspé misses the other things that definitely do contribute to the accumulation of AGEs in the body.
When people lack experience/or they are obsessed with one area of nutrition only/or it’s their brand, they tend to view everything - and search for studies [that support their view] - through that lens.
So Inchauspé doesn’t know that foods have AGEs in them. And when we eat those foods, AGEs accumulate in the body.
So you're going to limit your carbohydrate intake just in case the glucose rise after a meal causes too much glycation? What are you going to eat instead? Some meat or fish? Add a bit of fat in there to “dress the carbs”?
You’re probably going to be eating more of the foods that have actual AGEs in them. HAHAHAHAHAHAHA.
Starchy foods like grains tend to have amongst the lowest AGE content, and meat and dairy the highest.
Yes. What has happened here is that to avoid a theoretical and probably nonexistent risk of the in vivo production of AGEs from eating carbs, Inchauspé is unknowingly suggesting you consume more of the foods that have actual fucking AGEs in them…***
What else could you have done with the time spent on worrying about glucose spikes and glycation/oxidative stress/mitochondrial exhaustion/whether you should eat grapes**** or not?
Maybe you’ve spent 10 mins or so browsing through Inchauspé’s website, or reading through her scientific views in newspaper interviews. Maybe you’ve spent an hour or more listening to her on multiple podcasts. Maybe you bought a CGM just to check. Maybe you’ve spent a few seconds or minutes sat in traffic or when chatting with friends, and the anxiety hits you a bit, “ooh did that spike look a BIT HIGH?”. Maybe at some point you’ve actually been worried enough you’ve been to see a medical professional. And now you’ve spent another 10 minutes reading this, telling you it’s basically bollocks.
What could you have done with this time?
*not just because you want to lower your glucose excursion to protect your mitochondria
The crime of Inchauspé’s pseudoscientific output (and every gullible podcaster who entertains it) is a theft, because it robs people of opportunities for joy, growth and peace, replacing them with - and I cannot believe I am saying this - WHETHER THEIR GLUCOSE MIGHT BE GOING UP A BIT TOO MUCH AFTER THEY EAT.
*based on currently available evidence.
**this was one of the many piles of drivel on the podcast: “If you put a chicken in the oven, it goes from pink to brown]…This process of cooking is called glycation. It's the process of browning or of cooking…The interesting thing is, a human being, from the moment we're born, we're slowly cooking in that same way on the inside. We're slowly glycating, we're slowly browning, and then when we're fully glycated, when we're fully cooked, we die.”
***I don't want to freak you out here and scare you off eating meat and dairy because of AGEs. This would be me taking a reductionist approach to nutrition and it’s never that simple. Good health needs lots of inputs, and the nutrition in meat and dairy can be helpful for people to meet their requirements of things like amino acids and other vitamins and minerals if they like these foods. What the evidence does suggest is that avoidance of too much AGEs seems to be a good idea, and guess what dietary patterns are associated with a reduced AGEs and associated tissue damage? Diets which are high in grains, fruits, vegetables and whole plant foods.
****The rest of Inchauspé claims, whether on PCOS, mitochondrial function, risk of type 2 diabetes, mental health etc etc basically follow the same pattern here, with her understanding 2% of what’s going on, and missing the other 98%.
Disclaimer
As a dietitian, and not a medical doctor, I am not qualified to diagnose any health conditions.
Ah wow, I was once obsessed with Jessie and everything she said. Obsessed with CGM and spikes just led me to a one way street with an eating disorder!
Everything you wrote, the world needs to read and share. Thanks so much.
Thank you so much for covering this. As someone who is battling anorexia and othorexia, navigating recovery is made so much painfully harder by these people. I have become terrified of every, single, thing I eat - terrified (and everything around eating - the timing of when I eat, cooking method etc). I have made myself so unwell by trying to follow every food rule put out there by these 'experts'. I don't even seek them out, they just appear everywhere - and once I've heard it, I can't unhear it.
I have worked very hard to curate a feed of folk who are actual experts and who believe in enjoying food and establishing a good all round relationship with it, but these folk, as yourself is having to, then have to talk about the nonsense to be able to debunk it, so I am exposed to it that way - but at least I have the truth, with evidence, to replay to myself. Anyway, thank you for all that you do to debunk the nonsense.