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Toward a new science of glucometabology

Toward a new science of glucometabology

🎥 Video: Toward a new science of glucometabology 

Two thousand years ago, the advanced civilizations of the time, from Greece to Egypt to Mesopotamia to China, had an early concept of “science” — empirical thinking about the natural world — but did not have the wide range of disciplines we know today: biology, chemistry, physics and so on. As the Enlightenment took hold in Europe in the 1500s and beyond, those new disciplines crystallized as our expanding knowledge in each area “justified” the establishment of a specialty branch.

Today, we have even more degrees of precision: not just biology, but also microbiology, neurobiology, and others. The two most influential modern philosophers of science, Karl Popper and Thomas Kuhn, each brought to the table an analysis and framework that explains this flourishing of specialty study areas.

Popper asserted that science was about hypotheses that could be falsified — we can’t “prove” something, but merely make a hypothesis that is provisionally true until falsified using empirical data. As new data sets emerge, they form not only a foundational ‘key’ that unlocks the possibility of science, but also the possibility of new scientific disciplines altogether — and of new “paradigm shifts” in our scientific understanding.

It was Kuhn, in The Structure of Scientific Revolutions, who coined the phrase “paradigm shift” to articulate that science tends to move forward not in a smooth line of progress, but in phases: long periods of gradual evolution, punctuated by sudden wrenching shifts as a revolution in thought takes place. The most famous example is the shift from Newtonian physics to the stranger world of quantum physics, after Einstein.

Ian Hacking wrote in his preface to a recent edition of Kuhn’s book: “Normal science does not aim at novelty but at clearing up the status quo. It tends to discover what it expects to discover.” But as time goes on, and anomalies or dissatisfying flaws build up in the existing paradigm, the need for a new one becomes apparent. Says Kuhn: “a proliferation of compelling articulations, the willingness to try anything, the expression of explicit discontent, the recourse to philosophy and to debate over fundamentals” pushes us to a new mode of thinking, a new paradigm.

Empirical data — like the CGM provides — paves the way for a new paradigm

In many cases, an advance in technology precipitates a new paradigm, because it provides the hitherto missing dataset to allow new set of hypotheses to be tested and, in the Popperian model, (provisionally) validated, or falsified and set aside. For instance, the development and improvements in the microscope and the telescope opened the doors to new fields — microbiology and astronomy — because they offered vast new troves of observable data. With empirical testing, shining a light on the flaws of the existing paradigm, which accumulated over time into Kuhn’s “explicit discontents” — thus paving the way for a decisive shift to a new paradigm.

In the case of nutrition and energy in the body, the new technology that undergirds our proposed new paradigm is the "continuous glucose monitor" (CGM). Invented in the 1990s, but becoming mass-affordable and mass-produced in the 2010s, CGMs give us a “window into the body” not on an occasional point-in-time basis — like venal blood tests, or finger-prick glucose testing — but on a continuous basis. It’s a high-resolution dataset that brings new and powerful utility, just as ultra-high resolution satellite imagery bring new use cases, versus the low-res photos of the 1980s and earlier.

Invented in the 1990s, but becoming mass-affordable and mass-produced in the 2010s, CGMs give us a “window into the body”

A new science: glucometabology

In the sphere of physiology and biology, and the analysis of nutrition and energy in the body, we have exhausted the current dominant paradigm, dubbed “CICO” (calories in, calories out), and in this essay we are proposing to replace it with a new discipline, and paradigm, which we call glucometabology. This new paradigm is centered on the role of blood glucose in the body, and how the fluctuation of blood glucose is not just a key factor in the body’s homeostasis around energy levels, including the relationship of food and body mass, but the key factor.

For around 30 years, I have been investigating energy usage and repatriation in human physiology, and how manipulation of they body’s energy systems through food choices have a decisive impact on expressed phenotypes. During this research, conducted privately as part of my performance coaching system, I used the best technology available at any given timepoint — from 2017 on, the CGM — to formulate the central premises and principles of the discipline we propose to establish as the domain of glucometabology.

Research at Limbo has been a natural extension of that foundational work, but at greater scale: research cohorts of hundreds of people wearing CGMs, many of them specifically on a regimen designed for weight loss, to test and validate hypotheses. We have now established with large-scale and compelling empirical evidence how blood glucose is the sine qua non that unlocks a new and more accurate understanding of the mechanisms of the human body with regard to food, nutrition and energy.

The “fountainhead” for this regulation mechanism is the basal mean of our blood glucose. All regulation of energy in the body ultimately flows “downstream” from this central metric. As glucose levels rise above the basal mean, as happens after eating food with high carbohydrate or sugar content, the body takes measures to reduce glucose levels. And when levels fall below that mean, a different set of countermeasures kick in, such as feelings of hunger, and so on. In situations where there is dysregulation — ie metabolic syndrome — the impairment manifests itself as a host of diseases which are the downstream consequences of the malfunction in our glucose metabolism.

Beyond the calorie

Glucometabology rejects the paradigm of the “calorie” — a fundamentally flawed notion that confounds heat output (units of energy) with food inputs (units of mass) — and instead reorients our conceptual model around the universal common currency of energy in the body: blood glucose. With a high-resolution data set from a test cohort (n=202), including comprehensive metadata — blood glucose, notations of food and other activities (such as cold showers), plus additional biodata streams including heart rate, SpO2 and temperature — a picture has emerged that significantly undermines the CICO way of thinking, and paves the way for a very different conception of how the expressed phenotype of contemporary mankind comes into being.

The reason for coining a specific term, glucometabology, is that we believe a new paradigm needs a unique name and a unique set of naming conventions, that intentionally and pointedly demarcate the very different conceptual apparatus that underpins glucometabology from the fruitless dead end that CICO, as a paradigm, has led us to. The notion that all “calories” — whether sourced from fats, proteins, carbohydrates, or other food substrates — is fatally flawed, and has led to many abortive attempts to reduce obesity levels, such as “low fat” or “calorie-restricted” diets.

Key principles

In place of the CICO paradigm, the conceptual framework of glucometabology includes these central characteristics and principles:

  • Blood glucose is the central metric in understanding metabolism and energy in the body — in the superhighway of the bloodstream, glucose is the vehicle and “toll gate” through which every single unit of energy must pass
  • Blood glucose is also important beyond that key domain: it is a decisive “main player” that impacts all reactions around the body
  • There is no ‘standard’ amount of energy yield (eg calories/ATPs/other units) that isat the moment of consumption of food — the ultimate yield is a continuously shifting factor of body context.
  • The chief macronutrients — fats, proteins, carbohydrates — vary dramatically in terms of their actually-extracted energy, and their impact on hormones that regulate the body and how it manages energy and satiety.
  • To the extent that calories can be calculated at all, they are a lagging indicator of much more important metrics: macronutrients and their impact on blood glucose.
  • To understand the impact of food on the body, a point-in-time impact analysis (such as a list of calories on the packaging) is insufficient — an impact-over-time analysis, as revealed by the blood glucose curve in the hours after eating, is needed.

The CICO paradigm is now holding back human health and progress. As we face a large and growing global obesity crisis, it now looks probably that obesity, and its many comorbidities, will kill more people in the coming decade than famine and war. The widespread implementation of CICO thinking — calorie labels on packages, menus, in government guidance, and so on — has been highly ineffective, arguably useless, at slowing the rise of obesity. We hope and believe that glucometabology offers a fresh, and more compelling viewpoint on human food and energy, with the potential, over time, to arrest and reverse the obesity trend that is harming so many, and still growing.