The Energy Balance Podcast BV #25: Carb Confusion: Blood Sugar Spikes, Fat Gain, and the True Cause of Alzheimer’s
Mar 19, 2026
They debate whether fruit and CGM clips justify fear about glucose spikes. They unpack why low-carb or keto can cause transient high readings and cravings. They challenge claims that glucose becomes fructose and fat and explore brain glucose uptake versus spikes in relation to Alzheimer’s. They dig into NAD+/NADH chemistry, when ketones help, and practical ways to support healthy bioenergetics.
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Spikes From Reintroducing Carbs Usually Mean Adaptation Not Harm
- Blood sugar spikes after long-term low-carb or ketogenic dieting often reflect physiological insulin resistance rather than food being inherently 'evil'.
- Mike Fave and Jay Feldman explain Dr. Boz's grape spike was likely due to adaptation to fat oxidation and reduced pancreatic insulin response from keto and fasting.
Dr Boz’s Grape CGM Story Used As N=1 Example
- Dr. Boz shared a personal CGM story: after a sauna and ribs she ate grapes and her glucose jumped to 225, which she claimed caused tau production and fat storage.
- The hosts used this N=1 example to illustrate misinterpretation of spikes from ketogenic adaptation.
Alzheimer’s Links To Poor Glucose Use Not Single Glucose Spikes
- Acute high blood glucose does not directly cause tau or amyloid accumulation; the core problem in Alzheimer’s is impaired glucose utilization and brain hypometabolism.
- Jay and Mike cite animal models where blocking glucose metabolism worsens tau, showing the issue is inability to oxidize glucose, not brief spikes.