Editor's note: This article was written by Dr. Kevin Sprouse of Provision Sports Medicine. Kevin is helping us with our 90 day test to see what, if any, changes come from eliminating added sugar and reducing carbohydrate from our diets.  We've written an introduction to this study, which you can read here. We've also undergone baseline VO2 max testing with Carson at FasCat Coaching that you can read all about here. Bloodwork Analysis, by Dr. Kevin Sprouse. As Bryan and Michael embark on their 90-day dietary journey of no added sugar and low carbohydrate intake, they have undergone both VO2 testing and blood analysis. They asked me to take a look at the labs which were drawn to establish a baseline prior to the 90 day test period. This is a look at how their bodies were functioning before making these dietary changes. This experiment is meant to be something that you can reproduce at home, and these labs are easy for you to obtain for yourself wherever you live. Your doctor can order them for you, or you can even use a lab service such as DirectLabs.com or WellnessFX.com. Be sure to have someone who can interpret the labs for you though, as the information is only as good as your ability to understand its impact on your health. The tests ordered were these: complete blood count (CBC), comprehensive metabolic panel (CMP), lipid panel (cholesterol), TSH (for thyroid), HemoglobinA1c (HgbA1c), and fasting insulin levels. Blood was taken first thing in the morning, while fasting. The most relevant values were these:
  • Fasting blood sugar level
  • Triglycerides
  • HDL and LDL cholesterol
  • HemoglobinA1c (an estimate of blood sugar levels over the past two to three months)
  • Fasting insulin levels
  • TSH (as a screening test for hormonal stress from training, diet, lifestyle, etc.)
So what did we find? It turns out that both of these guys are really very healthy! Their VO2 tests were quite different, but their blood work showed some similarities.
  • Optimal fasting glucose (“blood sugar”) levels are below 85mg/dL. When a person’s body is not able to handle their carbohydrate intake, this number starts to move upward. Both Bryan and Michael were under this threshold.
  • Total Cholesterol is determined by a formula which takes into account your various lipid levels. You don’t want this getting too high, but you also don’t want it too low. Your body uses fats and cholesterol to make hormones, maintain Vitamin D levels, to repair cells, and for other processes that help you recover from your training and racing. Bryan and Michael both have cholesterol levels that are getting a bit too low. Adding some healthy fat to their diets while decreasing sugar consumption will benefit both of them!
  • Triglycerides are lipid molecules (fats) which you don’t want hanging around in your bloodstream. Elevated triglycerides are linked to heart and artery disease, and their levels in your blood are directly affected by your carbohydrate intake. I like for my healthy, active patients to maintain a triglyceride level below 75mg/dL. Michael and Bryan are both fall below 75, but Bryan’s levels are nearly half that of Michael. While there is some debate, it does seem that the lower your triglyceride level, the better.
  • HDL is your “good” cholesterol. The higher this number, the better. Both guys have excellent HDL levels
  • LDL is your “bad” cholesterol, but it’s not all bad. There are more details involved than that, given that LDL is made up of multiple types of particles. Bryan and Michael have great LDL numbers, so they have plenty of room for this to increase a little without it being problematic. LDL may or may not go up with a change in diet, but it should not get anywhere near a worrisome level if they remain active, decrease sugar intake, and eat more healthy fats.
  • HgbA1c is a test that estimates a person’s blood sugar levels over the course of two to three months. In my experience, this is often one of the first places where athletes can start to see the metabolic impact of a high-sugar diet. Fortunately, Michael and Bryan are both doing fantastically in this regard.
  • Insulin is a hormone released by the body to regulate blood sugar levels. Long-term intake of a high-carbohydrate diet can lead to insulin resistance, which requires more and more insulin to be produced to manage blood sugar. Eventually, this can develop into Type 2 Diabetes. Insulin also works in concert with cortisol (a stress hormone), growth hormone, and other hormones in response to training and other stresses. Ultimately, a lower fasting insulin level is better for otherwise healthy, active individuals. Both of our test subjects are looking good in this regard as well.
  • TSH, or thyroid stimulating hormone, is an indicator of how well your thyroid is functioning, and your thyroid is the primary regulator of your metabolism. As your thyroid function declines, your TSH increases in an attempt to “turn up the volume” on your thyroid gland. Diet, training stress, illness, and many other variable impact your thyroid. There is some debate about what the upper limit of a normal TSH should be for otherwise healthy individuals. I like my patients to stay under 2.00. Some say 2.50. Regardless, there is a big difference in the TSH values reported for both Bryan and Michael. Bryan’s is slightly elevated (by my standards), but Michael’s is markedly raised. There are potential explanations for both...recent illnesses, recent intense training/racing, concerns with dietary intake. It will be interesting to see how their dietary changes impact this!
This is, of course, the “bird’s eye view” of their results. Most importantly, it will be fascinating to see how (and if?) they are affected by a 90-day shift in dietary intake. As I mentioned initially, both are very healthy guys! We may not see significant improvements in blood sugar regulation, as each is doing very well in this regard. However, it will be interesting to see if their lipid panel is adversely affected by their changes. (I think it will be an improvement here as well!) Many athletes that I work with have elevated fasting blood sugar, elevated triglycerides, and HgbA1c measurements that are approaching diabetic levels. Fortunately, these two have avoided that! Their goal will be to maintain health while improving their metabolic efficiency and fat utilization during training and racing.