I'm very interested in the leptin research and hope that it can help people figure out how to overcome their hurdles to weight loss. In your experience can someone correct the leptin resistance with diet? I've been grain and sugar free for 11 weeks and have even energy all day. No more cravings and eat pretty much only when I'm hungry (4-5 hours between meals). The weight loss is slow but I realize that being 43, hormones probably play a role as well.

Thanks for doing what you do to help educate others on this topic.

Great post, Dr. Davis.

I blogged on leptin resistance at http://goo.gl/4lHbi, but my primary interest was the effect of high triglycerides due to a "standard American diet". There is some evidence that the high triglyceride levels block leptin from crossing the blood brain barrier and therefore prevent it from signaling that you have had enough to eat. In my own experience, going low carb eliminated the constant hunger I faced when I was 40 pounds heavier (and my trigylcerides were at 440).  Going low carb meant that I effectively eliminated wheat, as I eliminated nearly all bread, etc., and focused on animal protein and  green veggies exclusively. The effect happened very quickly, within a week, so I wonder if the wheat lectin was a factor here as well.

When I eliminated wheat from my diet in 1999 as part of my low-carb liftestyle chage, my arthritis went away (that alone provided more than enough motivation to stick with the diet for over a decade now), and I dropped 100 lbs with practically no effort. The problem is that I needed to lose *150* lbs, and that last 50 lbs refuses to budge, even on a low-carb diet. I'm beginning to wonder if I have permanently damaged my metabolism. I've noticed that I can drop about 10 lbs, and my morning body temperature goes below 80F, and eventually, I gain the 10 lbs back.

Your advice?

Hi, Howard--

This sounds an awfully lot like a thyroid issue. While I doubt that your temperature actually drops to 80 degrees F (since that is fatal), low temperatures can signal hypothyroidism. This can easily throw you off your weight plateau.

Hi, Frank--

The wheat lectin-leptin connection would indeed explain many things, especially why hunger drops and weight drops so quickly when wheat is eliminated, far larger effects than can be accounted for simply by wheat's carbohydrate content.

Thanks for the feedback, Dee!

Yes, you can correct leptin resistance with diet, though the effects are highly variable. In general, however, weight correlates quite cleanly with leptin serum levels.

A tougher question is how to deal with leptin resistance that somehow causes a weight loss effort to stall. A discussion for another day!

Hi Dr. Davis:
Have you seen this new study?
http://www.ncbi.nlm.nih.gov/pubmed/21943927

So what the heck does this mean?  Eating wild caught and pastured meats and non starchy veg as almost my only food (added coconut and olive oil), rarely a piece of fruit, I weighed 138 lbs.  As soon as I switched to an all plants, whole intact grains and potatoes and sweet potatoes based diet my weight dropped to 125 with zero change in activity level.  I have since switched most of the grains and potatoes for legumes and by more strenuous working out seem to have lost "hidden" fat and converted it to muscle.  Still at 120 but much more muscular...  This seems to be the opposite of what you espouse as  eat approximately 280 grams of carbs/day though probably 800 or so calories less than when I was eating meat, fat, and non starchy veg... Am I just an anomaly?

Is it possible that eliminating proteins resulted in the loss of muscle?

A question for you Doc,

Hoping you can give me some clarity on the genes issues of Celiac disease.  I have long suspected that I was wheat intolerant.  I suffered severe constipation since my teens, was laxitive dependant for lots of year taking handfuls a night just to be "regular".  I was able to get off the laxitives after 20 years by grinding my own wheat (and other grains).  It made all the difference in the world getting off pre-packaged foods, and dairy ( I am EXTREMELY dairy intolerant).  However, I never got "better".  I now know from your book that switching from a bad thing, to a less bad thing is not the answer, is advantagous, but still not the best .

I have known deep down inside that something was wrong with wheat because I am like a heroin addict when I eat it... I cannnot get enough, but since it did help me get off the laxitives, I kind of argued with myself over it my having "real" systemic issue with it.  My other health issues.. skin rash (chronic) which looked and felt like DH, dermititis herpetiformus.  Dermatologist said biopsy was not going to be 100% sure to diagnose it, so I should just get the gene test to see if I had DQ2 or DQ8.  My tests came back negative to both... but I still had a terrible chronic rash for going on 15 years on my legs, lower back and occasionally my torso, like a mirror, effecting both sides of my body in the same areas.  Dermatologist just shrugged and said he couldnt tell me what it was, but he put me on dapsone, and it cleared.  I finally had relief for the first time in a long time, but couldnt stay on the dapsone, due to liver enzyme issues.

Now, years later, and more health issues like osteoarthritis in my hands and spine and rib joints, BTW, I am only 43!!  I wind up back to questioning the wheat!!  When I found that you had written Wheat Belly, I thought, "maybe he knows something about wheat that I have been unable to find out"!?  After I read it (2 weeks ago) I immediatly changed my diet to a totally gluten free one.   ( we do not eat GMO's, and eat lots of veggies, green smoothies ect.. but I didnt realize just HOW genetically altered our wheat was.)

I am NOT an "undiagnosed" celiac for sure, as I do NOT have the DQ genes.  The biggest change I feel from being off the wheat is less drive to eat like a maniac.  I have not had any "health" changes, but it has only been 2 weeks.  I unfortunately am noticing the constipation creeping back up though, when I am off the milled wheat.

In your book, you seem to be speaking largely to people who have been told they do not have Celiac disease due to being misdiagnosed, or told they were NOT celiac due to false blood test results, or lack of proper biopsies...  What is y our opinion of serious immune system/ health issues happenning to folks like me, who are DQ2,DQ8 negative?  I know people WITH those genes can be reactiing (immune system) to wheat even if they are NOT actively in a Celiac disease state... but what about those of us who are not even ever going to get celiac?

I hope my questions dont sound stupid, perhaps I need to read the book again, or I just missed this specific issue of  where we, who are without the celiac genes, fit into this picture.  Could it be that there are other genes that we dont know about?  Or, are the genes simply irrelevant, due to the fact that the gluten content, and other harmful proteins and lectins are just so out of proportion to natural unmodified wheat?
I know for sure that my addiction is real, and has caused me much yo yo dieting in the past, never able to lose this pesky 30lbs, because once I eat a slice of toast, or a whole wheat muffin, I become like ravenous beast, who cant stop eating!!  I do know also, that to only be 43, and have such health issues already, that something has to be wrong...  Perhaps years of laxitives have injured my system... glad to have been off of them for 5 years now, but I really think your book has surely pointed me in the right direction of getting off the dwarf wheat!

Hi, Kim--

There is plenty more to this thing called wheat than "just" immune phenomena. I believe it is pure folly to believe that all potential adverse effects of wheat can be identified via HLA DQ markers or celiac blood markers. There are just too many undesirable components of this thing that are not identified with currently available blood tests.

You could be HLA DQ2 or DQ8 negative, with negative celiac markers, yet still have life-threatening disease reversed with wheat elimination.

Interesting, Olga.

If we were to extrapolate this to us hairless mice, it means that an extreme low-carb restriction makes it MUCH harder to express diabetes.

1) Only rectal temperature readings should be considered accurate. With other types of readings you have a certain heat loss - most for armpit readings, less for under tongue.
2) You should look into euthyroid sick syndrome/reverse T3 which is a possibility if you drop the carbs all the way...? Some research suggests that we should leave about 50g carbohydrates in the daily allowance to avoid this possibility.

Hi Dr. Davis!

First of all, I have to say that I love your book! The information is a God-send and the way that it is presented is clear with just enough humor to be riveting (at least, for a nerd like me).

I have a question tho’, and I hope that I am not being repetitive or redundant. All I hear and read is that by cutting wheat from the diet, a person can expect weight loss. I have read wonderful testimonials from people who have cut wheat and have lost 50 pounds in 6 months without doing anything else (exercise or caloric restriction).

But, this does not work for me. My diet is quite strict paleo since last spring (a la Robb Wolf). I eat NO grains (including quinoa or buckwheat or other “grain-ish” items). No dairy with the exception of cream in coffee (about 3 to 4 cups per day). No peanuts, legumes or beans. No rice, potatoes, corn or peas.  No fruit (again, at Robb Wolf’s suggestion that people who need to lose should eschew fruits until their goal is reached). Of course, nothing processed, no sugar and artificial sweeteners are kept to a minimum. I drink water as needed.

I eat nuts and seeds, eggs, all meats, fish and seafoods, green and colourful vegetables as well as coconut products (oil, milk and meat), avocados, fish oil and olive oil.

I am 43, and feel great as long as I eat this way. I am not celiac and have not been diagnosed with any medical problems by my doctor (MD). I do however have a strong family tendency towards DMT2. So far, I seem to be OK there, but do suspect insulin resistance due to physical features. I do notice that eating grains results in stomach upsets, water retention, RAPID weight gain, mood swings and a wicked distended belly (I have been congratulated on my pregnancy... LOL!)

I am very careful about my food intake, so I know that there are no hidden grains, sugars, etc. slipping in. This is very easy when you don’t eat anything processed. I take in, on average, about 1500 calories daily, and currently work out with weights 3 times per week. In the past, I have tried doing tremendous amounts of cardio... Again, no real results.

I also see an ND, and he has recently requested a saliva panel to check my adrenal hormones, notably AM DHEA’s, Cortisol Curve = C1,C2, C3,C4. I am 5’6” tall and weigh 190 pounds and gain weight mostly in the mid section. I obviously need to lose weight, but everything I try results in a small weight loss (< 10 pounds), followed by a frustrated week or 2 off of my diet, which only results in a big weight gain. Seriously... I went to Mexico for 10 days a year ago. I ate and did the same as everyone else. I GAINED 15 POUNDS. Everyone else’s weight stayed the same, or showed a very small gain... only about 3 pounds.

My regular doctor, when presented with this information shrugged his shoulders and said, “Weight loss is hard.” I am getting seriously stressed about this... This can’t possibly be normal. Close family and friends have observed and made comments like, “The way you eat and work out, you should have a near perfect body!”
I know that you would require much more detailed information about me, but is there anything that is striking to you, or have you encountered this before? Any info that I can pass along to my MD or my ND would be so much appreciated!

Barb

Dr. Davis,

Mat Lalonde gave a speech at the ancestral health symposium called "An Organic Chemist's Perspective on Paleo" - it was mostly about bad science circulating in the Paleo community. In his speech, he mentions an interesting study that demonstrates that wheat germ agglutinin is completely destroyed in the cooking process - literally not a trace is detectable. I can't provide you a reference, because none was given, naturally, during the speech. Perhaps you could get in touch with him and get the reference. I will try myself, and get back to you if I am able to. But if that is true, I seriously doubt WGA is relevant to weight gain, because I can't think of a single wheat product that people eat raw.

Nor do I believe that the high glycemic index of wheat is a cause of weight gain in people with healthy metabolisms. Numerous cultures have been found in great health eating high glycemic index carbohydrates such as potatos. So I find it a little hard to believe that the glycemic index of wheat initiates metabolic derangement and weight gain.

As far as your 'cycles of satiety and hunger' and 'high glucose and high insulin' points, those too would indicate a problem with carbohydrate in general, not just wheat. So I would think 'carb belly' would be a more intellectually honest title to your book. Especially, when one considers that you improve most of your patient's health with a low-carb diet - not too mention the supplements and exercise you recommend.

Also, Stephan Guyenet recently wrote a post outlining why insulin levels have nothing to do with fat mass.
http://wholehealthsource.blogspot.com/2011/08/carbohydrate-hypothesis-of-obesity.html
He presents very convincing arguments. Having read it, I personally am not swayed by your claim that wheat promotes weight gain by greatly increasing insulin levels - I dount anyone one who read that article is. He presents far more evidence that insulin levels are not relevant to weight gain than you do claiming they are. Given your claims, I think you are obligated to respond to this article.

This post offers nothing to single wheat as a unique cause of weight gain.

Also...
I recently had a debate with Tom Naughton regarding the validity of your claims. I made the following points: You claim that wheat is the greatest cause of weight gain, and removal of it from your patient's diets has yielded incredible results. But you don't treat your patients with simply a wheat-free diet. You place your patients on a low-carb, vegetable oil free, refined sugar free, processed food free diet. You also prescribe very important supplements, like omega-3 and vitamin-d, which have been shown to be beneficial independent of other changes. There are innumerable uncontrolled variables in your lifestyle recommendations - far beyond wheat removal - that could be bringing these results.

Tom's response to me was that you have had an undisclosed (by him) number of your patients try eliminating wheat alone. Apparently, you still saw improvements. Once again, the level of improvement remained undisclosed by Tom. I would like to know how many of your patients you had advised to just eliminate wheat, and what improvements you saw. Of all the patients you've treated, if 99% have undergone your complete recommendations, it is absurd to use their improvements as a case against wheat when you have left countless uncontrolled variables.

If you have seen improvements with strictly wheat elimination, that too cannot be effectively used as a case against wheat. Eliminating wheat creates far-reaching changes in ones diet that go beyond simply eliminating wheat. The vast majority of highly-palatable, engineered, processed junk food becomes inaccesible. No more doughnuts, no more McDonalds, no more cake. That alone is very significant. Also, when you advise your patients to eliminate wheat alone, I seriously doubt they carried on eating wheat-free junk food like deep-fried factory farm chicken wings, ice cream, and french fries in abundance. They likely embraced a healthier diet altogether that happened to disclude wheat.

No doubt, Roberto. The majority of real world patients in my clinic, as well as the online experience, have followed more than a wheat-free diet. Anecdotally, the people who have followed low-carb yet included wheat continued to experience issues like acid reflux, persistent small LDL, high HbA1c, etc. But anecdotal experiences cannot be used as sole proof.

If you've read the book, you will see that there is much more to this argument than my anecdotal experience. The fact that overweight celiac patients, for instance, lose on average 26 pounds in the first six months while not restricting calories, fats, polyunsaturates, etc. is among the arguments that are consistent with this proposition, that wheat underlies many health problems, including overweight.

No doubt: We need more data to fully document the full range of health effects of this incredibly unhealthy creation of geneticists.

Noted. I disagree.

Do one thing: Eliminate wheat. Do not limit calories or portion size.

Weight drops, usually at the rate of one pound per day. I can speculate why and I believe it is partly due to the unusually high glycemic index/insulin triggering. It might be the effects of wheat lectin on leptin receptors. But it is a very real effect.

Hi, Barb-

The most common weight confounder I see is low free T3 values, i.e., low T3 thyroid hormone.

Assess this by checking free T3, as well as reverse T3, along with TSH and free T4. I aim to keep TSH, by the way, 1.0 mIU or lower to maximize weight control, and keep free T3 and free T4 in the upper half of the quoted range, higher for T3 if reverse T3 is high.

The cortisol curve can also uncover high cortisol levels that can counteract the effects of your otherwise excellent diet.

"Weight drops, usually at the rate of one pound per day."

I'm having a very tough time envisioning that, especially if a person eliminates wheat without altering calorie intake and portion size. Let's assume the average sedentary obese person requires 2500 calories a day - a reasonable estimate I would say. If they stopped eating completely, a 2500 calorie deficit would amount to less than 3/4 of a pound weight loss per day. So how could they possibly maintain portion size and lose an entire pound per day? Perhaps if wheat was causing them sever water retention, and avoidance of wheat remedied that and led to massive amount of weight loss from water. But I doubt that is what you meant.
Did you mean to say a pound per week?

Thank you so much Dr. Davis!
I will take this information in to my docs... I have a feeling that I will get further with my ND than I will with my MD.

Thanks so much, and do not be discouraged by the naysayers. Cognitive dissonance can be a very unpleasant thing!

Barb

Nope. Literally a pound per day. I know it sounds crazy.

I don't know why. It certainly defies the "calorie in, calorie out idea." Calorie intake drops, on average, only 400 calories per day, so why would someone lose the equivalent of 3500 calories? It is definitely partly water weight, but there is a visible loss of abdominal fat for most people.

It's not everyone, of course, but a substantial proportion of people.

I was diagnosed with PreDiabetes in August and having a rough time Changing from eating Carbs, like that Bagel you referred to or a few cookies a day, to High Fat and High Protein. I am underweight and Still have around 7 pounds to gain  before I am at my goal. I have only My Diabetic MD who by the way is Diabetic Herself, Promoting me to Give Up the Grains and roots. All other MD's on my team have been against this saying that I am on the Cusp of Prediabetes at 5.7 and should not worry about it. I want to PREVENT being Diabetic, not come to them AFTER the fact. By the way, I have very HIGH cholesterol, so what you are saying sure seems to go right along with my Diabetic. MD. I feel torn because I know I need to gain weight and How Possibly DO I GAIN WHEN I LEAVE OFF FOODS THAT WILL HELP ME GAIN? Please respond if ANYONE has any advice. I am OPEN TO LISTEN.  I also dont feel the best after eating Sugars, but Crave them. Once I eat them, then I feel worse. CYCLE BEGINS AGAIN.

Hi, Tammy--

Tough situation.

While slashing carbs will reduce HbA1c and blood glucose, the fact that you are underweight yet still diabetic raises some unique issues. This may not be the run of the mill diabetes, but another condition such as the so-called late-onset diabetes of adulthood, a form of diabetes with features that overlap with type 1. So the comments directed at the very common overweight type 2 may not fully apply to you.

Let us know what you learn.

Dr D

I was wondering when you advise to eliminate wheat, does the same go for oats and oat bran too? Does this effect prediabetics the same way as wheat. I am very interested in your response.
thank you

Andrew

Hi, Andrew--

The problem with oats is somewhat different: It is a blood sugar and carbohydrate issue.

If you were to check a blood sugar 1-hour after a bowl of unsweetened whole oats, you would see sky-high blood sugars. So we do not include oat products in any form in the diet.

Here I was thinking that oat bran for breakfast was a good choice. Thanks Doctor D for the response

Hi Doc,

While I've significantly reduced the amount of carbs/wheat I eat, I often still find myself in situations where I can't avoid it (out with coworkers, and the run, etc).

My resting blood glucose was a little high on my last physical (105), so I want to keep an eye on things.

My question is this:   If you are stuck eating a meal that is going to spike your blood sugar, when would be the best time to take a 15-30min walk to try to help your muscles absorb some of the glucose?  I know insulin peaks around 90min afterwards or so.

Would I be better off walking immediately after eating (to start the glucose absorption right away), or delaying around an hour and then walking?

Could there be a beneficial increasing metabolic rate accounting for at least some of this weight loss? I used to be able to eat untold numbers of calories when I was (much) younger, without gaining weight. Quite a typical situation.
Now, if I could just get that quicker metabolism again  

Question - so, if I eliminate the modern wheat you are talkiing about, what about some of
the other grains that are being used? For example:
"Ancient grains", such as kamut and spelt. They taste great and if they are truly ancient grains
they wouldn't have the integral problems.

[...] http://blog.trackyourplaque.com/2011/10/why-wheat-makes-you-fat.html [...]

I've lost 52# and maintained the loss for 16 months. My total cholesterol went from 243 to 285. My HDL went from 58 to 91. Doctor wanted to put me on a statin. I said no because I don't tolerate them (muscle pain and very poor test results) and wanted a diagnosis of CHD if I was to undergo medical treatment for that condition. A coronary calcium scan showed 0 in 2, a 100 in one and 329 in the left anterior descending. Cardiologist ordered nuclear and treadmill stress tests with neither showing any restrictions in flow or supply to the heart. So, he says to exercise vigorously 5x week/1hr daily and exercise is 70% of my treatment, diet 20% and medication would be 10% if I took the statin which I am not.  Neither my Doc or the Cardiologist knew what the VAP scores of the fractionated LDL scores meant (117 1-2, 43 3-4) but the both recommended a low fat diet and the cardiologist told me to buy and follow Dean Ornish's newest book Spectrum.
1. Are all fractionated LDL tests of the same quality or is there one best?
2.  Why is this called a disease and not a condition?  How am I to know if any treatment is proceeding successfully other than I'm not dead?  
3. Years ago a physician put me on a synthetic Throid supplement to eliminate the possibility of thyroid cancer since he thought he could feel the thyroid and I had been treated with X-Ray to the head in 1946 for ringworm. My TSH scores have remained within the boundaries pretty well although my T4Free was 244.  Any comment.
4. I was diagnosed 33 years ago as being hypoglycemic and carried sugar with me to treat low blood sugar while exercising etc.  my CRP score is just over 1, well within the test limits of the tests I take. But that is 2x your recommendation of no more tham .5. BTW, since low carb, I've not had low blood sugar event and my tested glucose runs 90.  Is it likely that this hypoglycemic condition related to inflammation and arteriosclerosis?
5.  I'm taking antioxidant supplements, lumbrokinase, L-Carnitine, no flush Niacin, Vit D3 (6000 IU)
6.  I'm 73, no illnesses of consequence, blood pressure of 105/65.  I live in Naples FL. There are no cardiologistts I've heard of down here willing to discuss any regimen other than low fat and statins along with exercise. Do you have a colleague within 200 miles?  

Thank you for your work. I think my promoting your work along with Gary Taubes has caused a 500 lb weight loss for me and our friends and a nice, fat increase in HDL.