What's that in your mouth?

7. January 2010 William Davis (17)

Fat = triglycerides

In other words, eat fat, whether it's saturated, hydrogenated, polyunsaturated, or monounsaturated, and blood levels of triglycerides will go up over the next 6 hours. This remains true if there are carbohydrates in the meal, or if there are NO carbohydrates in the meal. It also remains true if you chronically consume fats.

While fats are the primary determinant of postprandial (after-eating) triglycerides, carbohydrates are the primary determinant of fasting triglycerides.

So, if your triglycerides are high on a fasting cholesterol (lipid) panel, it's most likely because you overconsume carbohydrates.

Thanks to cartoonist Eli Stein, who has generously allowed me to reprint his artwork on these pages. Mr. Stein has published his work in dozens of magazines and newspapers, including the Wall Street Journal, Barron's, and Good Housekeeping. More of his work can be found at Eli Stein Cartoons.

De Novo Lipo-what?

5. January 2010 William Davis (16)

Humans have limited capacity to store carbohydrates. Beyond the glucose and glycogen in our blood and tissues, we have relatively little carbohydrate to draw from in time of energy need. That's why long-distance runners and triathletes have to carry sugar sources to keep blood sugar from plummeting.

Fat, of course, is different. We have virtually unlimited capacity to store energy as fat.

Because we have limited carbohydrate storage capacity, what can the body do with the excessive quantities of carbohydrates that Americans ingest? What becomes of a bagel for breakfast, wheat crackers for snacks, a whole wheat sandwich for lunch, pretzels, and whole wheat pasta that many people eat every day, not to mention the chips, soft drinks, and juices?

Excess carbohydrates are diverted to an interesting metabolic pathway called de novo lipogenesis (DNL). This refers to the liver's ability to make triglycerides from excessive carbohydrates in the diet. Triglycerides are packaged for release into the blood as VLDL. VLDL, in turn, interacts with other lipoproteins, creating small LDL particles, reduced HDL and smaller, less protective HDL. High VLDL will be measured on a standard cholesterol panel as higher triglycerides.

A University of California (Berkeley, San Francisco) group has done much of the work describing DNL.

A diet weighed towards carbohydrates, especially if 50% or greater calories are carbohydrate, is sufficient to provoke plenty of DNL, even in slender people. DNL is a big part of the reason why low-fat (and, thereby, high-carbohydrate) diets result in higher triglycerides. DNL really gets turned on many-fold if the carbohydrates are "simple," rather than "complex."

Overweight people, however, can demonstrate five-fold greater DNL even with lesser quantities of carbohydrate intake (e.g., 40% fat, 46% carbohydrate, 14% protein):

From Schwarz et al 2003. Mean (± SEM) fractional de novo lipogenesis in lean normoinsulinemic (NI), obese NI, and obese hyperinsulinemic (HI) subjects after 5 d of consuming a high-fat, low-carbohydrate diet and in different lean NI and obese HI subjects after 5 d of consuming a low-fat, high-carbohydrate diet. Values with different superscript letters are significantly different.

Excessive carbohydrates, a la standard low-fat diets, are good for nobody. The concept of de novo lipogenesis fills in a theoretical hole that now explains why people who eat carbohydrates have higher triglycerides, VLDL, and, eventually, insulin resistance and diabetes.

Gretchen's postprandial diet experiment II

3. January 2010 William Davis (37)

I previously posted Gretchen's postprandial diet experiment, in which she consumed a low-fat diet for a day, followed by a low-carbohydrate diet for a day. Grethen monitored blood glucose and triglycerides with fingerstick checks. (Blood glucose can be checked on any widely available glucose monitor; triglycerides can be monitored with the Cardiochek device.)

Let's now discuss what happened.

On the low-carb, high-fat day, there was an initial surge in triglycerides to 250 mg/dl late morning, followed by a secondary peak several hours following dinner. Because fat is mostly triglycerides, Gretchen's high-fat (sausage, bacon, butter, whole-fat yogurt) breakfast provided a large quantity of triglycerides that needed to be absorbed. This generally occurs over approximately 6 hours, varying depending on body weight, how accustomed you are to fat, activity level during the day, the kind of fat in the meal. The high content of saturated fat in Gretchen's high-fat breakfast likely caused the somewhat slower drop in triglycerides over approximately 7 1/2 hours.

As Gretchen herself had noted, triglycerides the following day were lower, a typical low-carb response. Blood sugar throughout showed only minor variation, with only small postprandial increases.

Thus, Gretchen experienced what we'd expect with a low-carb, high-fat diet: an initial high surge in triglycerides, followed by a decline in fasting levels, while blood sugar shows a normal contour.

Now, the more confusing low-fat experience:

Blood glucose makes a striking peak at 200 mg/dl after the low-fat breakfast of pasta and rice, in contrast to the low-carb breakfast. Triglycerides behaved very differently from the low-carb experiment: While there was no initial postprandial surge, there was a late surge developing 6-24 hours later. The late surge continued into the next day, with fasting levels the following morning (210 mg/dl) exceeding the starting triglyceride level (60 mg/dl).

The one potentially confusing aspect of all this is Gretchen's late rise in triglycerides on the low-fat diet. This phenomenon is due to something called de novo lipogenesis, or the liver's conversion of carbohydrates to triglycerides that occurs when an excessive carbohydrate load comes through diet. Because the human body cannot store anything beyond a minor quantity of carbohydrates (as glucose and glycogen), carbohydrates are converted to fats.

Another factor causing the late triglyceride increase is insulin resistance, given the high blood sugar response. When insulin resistance is present, the activity of the enzyme, lipoprotein lipase, is reduced. Less lipoprotein lipase activity allows slower VLDL degradation, allowing VLDL (and thereby triglycerides contained in VLDL) to "stack up" in the blood. Thus, the higher triglycerides late after eating and into the next morning.

One issue to be aware of: Acute responses can differ from chronic responses. In other words, had Gretchen had the luxury (and time and money) to conduct the experiment over, say, 4 weeks, rather than a single day, there would be somewhat different responses. The best data on this come from Dr. Jeff Volek of the University of Connecticut, in which 4 weeks of low-carbohydrate eating modify fasting and postprandial responses over time.

Several conclusions can be made from Gretchen's experience:

1) Low-carb, high-fat acutely generates extravagant postprandial triglyceride responses.
2) Low-fat causes a late triglyceride surge and higher fasting triglycerides.
3) Low-fat leads to high blood sugars and, by implication, diabetes.

Both the low-carb and the low-fat responses are undesirable, both leading to increased risk for heart disease. Which is worse? I believe that low-fat is more destructive, since it leads over time to both high triglycerides and diabetes, while low-carb/high-fat only leads to postprandial triglyceride surges, at least acutely.

How to best balance the responses to reduce risk for heart disease? That's a discussion for future.

Again, my thanks to Gretchen and the substantial amount of effort that went into generating these numbers. More of Gretchens' own writing can be found on her blogs:
http://wildlyfluctuating.blogspot.com
http://www.healthcentral.com/diabetes/c/5068

A wheat-free 2010

2. January 2010 William Davis (22)

A Heart Scan Blog reader sent this fascinating description of his wheat-free adventure.

Whenever I discuss this notion of going wheat-free and the incredible health effects that develop, I invariably receive comments or emails saying something like "I eat wheat and feel fine. That can't be true." The problem is that not everybody needs to go wheat-free. 20-30% of people can include wheat in their diet and suffer little more than weight gain, some not at all.

But stories like Michael's (below) are commonplace in my experience. I've had many patients who, at first, refused to believe that wheat exposure might be the underlying cause for health struggles. But they finally give it a try and find that rashes, arthritis, acid reflux, irritable bowel symptoms, mood swings, anger, etc. are miraculously improved or gone.

Anyway, hear what Michael has to tell us:

Dr. Davis,

I want to thank you. I was browsing the web a while back and happened to stumble upon your blog post about wheat belly. The first thing that caught my attention was that I thought you had somehow gotten a photograph of me. The young man you posted an image of looked exactly like me. So I read what you had to say. After reading, I thought "Four weeks isn’t so bad. I think I can handle this."

It has now been nine weeks and all I can say is that I am completely amazed. Let me say first that twice in the past twenty years I have been tested for allergies. The first time I was tested I showed a slight reaction to Timothy Grass, but not enough to cause me any problems. The second testing I did not show a reaction to anything. So, I have always assumed that my chronic sinus problem were due to sensitivities to environmental pollutions. Now I am not so sure. I would like to list for you everything that has happened to me since I eliminated wheat from my diet.

1. I have lost a total of 12 pounds in the last 9 weeks.
2. I have lost 1 ¼ inches of belly fat
3. I have lost a tremendous amount of fat from my neck.
4. My entire life I have had problems with oily hair. I could wash my hair and three hours later I looked as if I hadn’t washed in a week. Now my hair stays clean and soft for two to three days without shampoo.
5. My hair was always flat and stringy. Now it has lots of body.
6. I used to have thick layers of dry skin on my scalp. It would come loose in chunks as large as a fingernail. That dry scalp is gone.
7. I used to have dry flaky skin that seemed to secrete oil. That no longer happens. My skin is now soft and smooth.
8. I have lived with bad acne for at least 35 years. Now it is hard to find a pimple on my body.
9. I have always had to fight dehydration. That is no longer a problem.
10. I used to drink two large cups of coffee every morning just to be able to function. I now have enough energy that I have eliminated caffeine from my diet.
11. I sleep more soundly than ever before and my dreams are clear and vivid.
12. My thought processes are more active and clear than they have ever been.
13. My chronic sinus issue is now a thing of the past.
14. I used to have problems with getting the “shakes” if I had gone more than a couple of hours without eating. It was as if I was suffering from low blood sugar. I would even be afraid that I would pass out. Now all I feel is hunger. I can go all day without eating and never feel in danger of losing consciousness.

Today is Thursday. This past Monday my wife and I were eating out and I ordered a burger without a bun. What I didn’t realize was that the burger would arrive covered in onion rings. I knocked the mountain of onion rings onto the plate but there were still a couple that were embedded in the cheese. I decided, what the hell, a couple of onion rings shouldn’t make that much of a difference. I will not make that mistake again anytime soon. Within 30 minutes I felt like there was a steel spike going through my left eye socket. I don’t remember ever being in that much pain. My sinuses were exploding. This morning, as I write this, I still feel the vestiges of that pain. Just enough that I know it is there. But after two and a half days, I am at least able to function again.

I owe you a debt of gratitude. You may have just saved my life. In the very least you have given me the means to improve my life in ways that I never thought possible.

Thank you so much,
Michael B.

Now, if wheat exposure can do that in Michael, what damage can it do in other people?

Personally, I previously experienced many of the same symptoms that Michael suffered, all gone with wheat elimination.

My advice: If you have any inkling that you might have a wheat sensitivity, make a New Year's resolution to stay wheat-free for 4 weeks and see whether you can feel any difference. Not everybody will, but many will be telling us about the dramatic health turnarounds they experienced.

Lipoprotein lipase and you

30. December 2009 William Davis (0)

Lipoprotein lipase can make the difference between having heart disease and not having it. Having sky-high triglycerides or normal triglycerides. It can mean dinner hanging around for over 12 hours in the bloodstream, rather than the usual 4-6 hours.

If you take niacin, you must exercise

30. December 2009 William Davis (23)

We use a lot of niacin in the Track Your Plaque program.

Niacin:

--Increases HDL and shifts HDL towards the large, protective fraction

--Reduces small LDL--In fact, niacin is the best treatment we have to reduce small LDL after wheat elimination and carbohydrate reduction.

--Reduces fasting and postprandial (after-eating) triglycerides

--Reduces heart attack risk by 20-28%--even as a sole agent.

But . . . niacin also triggers higher blood sugar because it partially blocks the effects of insulin (insulin "resistance").

While the net effect of niacin remains positive, the provocation of insulin resistance is not such a good thing. Can it be minimized or eliminated?

Yes, through exercise. Here's one interesting observation in obese (BMI 34.0), sedentary men given placebo, exercise, niacin (1500 mg Niaspan, once per day), or niacin + exercise:

From Plaisance et al 2008.

Blood was drawn following a high-fat meal challenge. (Yes, a high-fat challenge, not a carbohydrate challenge. In this study, there were only 17 grams carbohydrates in the test meal, but 100 grams fat. More on this in future.) Exercise consisted of walking for 50 minutes at a moderate pace one hour prior to the meal challenge.

You can see from the graph that exercise partially corrected the increased insulin level provoked by niacin.

Judging from this and other studies, exercise can help minimize the insulin-blocking effects of niacin. It doesn't take much, just moderate exercise for at least 30 minutes.

Adequate sleep can also help, since sleep deprivation is a potent trigger for insulin resistance, only worsened in the presence of niacin. Vitamin D supplementation to achieve desirable blood levels (which I define as 60-70 ng/ml) is also an effective means to minimize this effect.

To track small LDL, track blood sugar

24. December 2009 William Davis (28)

Here's a trick I learned after years of fussing over people's small LDL.

To gain better control over small LDL, follow blood sugars (blood glucose).

When you think about it, all the foods that trigger increases in blood sugar also trigger small LDL. Carbohydrates, in general, are the most potent triggers of small LDL. The most offensive among the carbohydrates: foods made with wheat. After wheat, there's foods made with cornstarch, sucrose (table sugar), and the broad categories of "other" carbohydrates, such as oats, barley, quinoa, sorghum, bulghur, etc.

Assessing small LDL requires a full lipoprotein assessment in which small LDL particles are measured (NMR, VAP, GGE). Not the easiest thing to do in the comfort of your kitchen.

However, you can easily and now cheaply check your blood sugar. Because blood sugar parallels small LDL, checking blood sugar can provide insight into how you respond to various foods and know whether glucose/small LDL have been triggered.

Here's how I suggest patients to do it:

1) Purchase an inexpensive blood glucose monitor at a discounter like Walmart or Walgreen's. You can buy them now for about $10. They're even sometimes free with promotional offers. You will also need to purchase lancets and test strips.

2) With a meal in question, check a blood sugar just prior to the meal, then again 60 minutes after finishing the meal. Say, for example, your pre-meal blood sugar is 102 mg/dl. You eat your meal, check it 60 minutes after finishing. Ideally, the postprandial (after-meal) blood sugar is no more than 102 mg/dl, i.e., no higher than pre-meal.

Perhaps you're skeptical that oatmeal in skim milk with walnuts and raisins will do any damage. So you perform this routine with your breakfast. Blood sugar beforehand: 100 mg/dl. Blood sugar 1 hour post: 163 mg/dl--Uh oh, not good for you. And small LDL will be triggered.

This approach is not perfect. It will not, for example, identify "stealth" triggers of blood sugar and small LDL like pasta, for the same reasons that pasta has a misleadingly low glycemic index: sugars are released slowly and not fully evident with the one-hour blood sugar.

Nonetheless, for most foods and meals, tracking your one-hour postprandial blood sugar can provide important insight into your individual susceptibility to sugar and small LDL-triggering effects.

C-reactive protein: Fiction from the drug industry?

21. December 2009 William Davis (0)

C-reactive protein (CRP) is the liver product of inflammatory responses anywhere in the body. If there's an inflamed left knee, CRP will be increased. If viral bronchitis is making you cough, then CRP will be increased.

The argument put forward by the drug industry is that, because CRP indicates underlying inflammation, very low-grade levels that can be measured in the absence of overt inflammation like the sore knee or bronchitis is associated with increased risk for cardiovascular events. There are now many studies that conclusively demonstrate that, the higher the CRP, the greater the cardiovascular risk.

Naturally, any marker of risk is followed by the inevitable study: Do statin drugs reduce the excess cardiovascular risk of excessive CRP?

And, yes, indeed they do. My statin-crazed colleagues rave about the so-called "pleiotropic," or non-lipid, effects of statins. CRP reduction and the reduction of risk associated with CRP result with statin treatment.

But is life really statin vs. placebo, as most statin trials are constructed? Are there strategies that can outdo statins like Crestor for reduction of CRP?

Watch your fish oil labels

17. December 2009 William Davis (36)

A quick quiz:

How much omega-3 fatty acids, EPA + DHA, are in each capsule of fish oil with the composition shown on the label below:

If you said 1340 mg (894 mg + 446 mg), sorry, but you're wrong. There are 670 mg EPA + DHA per capsule.

Did you notice that the composition, or "Supplement Facts," lists the contents of two capsules? Rather than the usual one capsule contents, this product label lists two capsules.

I don't know why some manufacturers or distributors do this. However, I have seen many people tripped up by this kind of labeling, taking half the omega-3 fatty acids they thought they were taking. This can be important when you are trying to obtain a specific dose of EPA + DHA to reduce triglycerides, reduce Lp(a), control abnormal heart rhythms, reduce bipolar mood swings, or other important effects.

I liken this to pulling up to a gas station where the sign says gasoline for $1.25. Wow! Can't beat that! You then find out that it's really $1.25 for a half-gallon, or $2.50 a gallon.

In truth, the labeling is accurate; it's just very easy to not notice the two capsule composition.

Why do I need a prescription for Olava?

16. December 2009 William Davis (0)

Imagine this:

What is OLAVA?

Olava is prescription olive oil. It is the purest, highest concentration of olive oil available.

Why Do I Need a Prescription for OLAVA?

Studies show that olive oil contains essential fatty acids, "good" fats that:

--Contain natural compounds your body needs for good health but can't produce on its own.

--Has antioxidants that may provide protection from heart disease.

So, it is common for people to ask why they need a prescription for OLAVA if it is made from a natural ingredient--olive oil. It's time to get the facts about OLAVA. Learn why OLAVA is different from olive oil you can buy at a store.

OLAVA Is an FDA-Approved Medication

OLAVA is the only FDA-approved medicine made from olive oil that's proven, along with diet, to reduce risk for heart disease

The FDA enforces standards to make sure that prescription medications like OLAVA are safe, effective, and quality controlled.

The way OLAVA is manufactured is reviewed and approved by the FDA.

OLAVA uses a 10-step purification process that helps remove lead and other environmental toxins that can be present in olive oil.

Each 1-gram capsule of OLAVA contains 1000 mg of pure olive oil.

The FDA-approved dose of OLAVA is 4 capsules per day. It could take up to 2 tablespoons per day of regular olive oil to provide the same amount of active ingredients proven to lower heart disease risk.

What Else You Should Know About Olive Oil

Regular olive oil has not been approved by the FDA to treat any specific disease like heart disease.

Olive oil doesn't have specific dosing information; it has a food label.

Olive oil does not go through an FDA-approved manufacturing process.

Talk to Your Doctor About OLAVA

If you have very heart disease, you may need a prescription medicine, along with diet, to treat your condition. Talk to your doctor about OLAVA. Print a trial offer to use on your first prescription of OLAVA.

For the sake of convenience: Commercial sources of prebiotic fibers

3. May 2015 William Davis (0)

Our efforts to obtain prebiotic fibers/resistant starches, as discussed in the Cureality Digestive Health Track, to cultivate healthy bowel flora means recreating the eating behavior of primitive humans who dug in the dirt with sticks and bone fragments for underground roots and tubers, behaviors you can still observe in extant hunter-gatherer groups, such as the Hadza and Yanomamo. But, because this practice is inconvenient for us modern folk accustomed to sleek grocery stores, because many of us live in climates where the ground is frozen much of the year, and because we lack the wisdom passed from generation to generation that helps identify which roots and tubers are safe to eat and which are not, we rely on modern equivalents of primitive sources. Thus, green, unripe bananas, raw potatoes and other such fiber sources in the Cureality lifestyle.

There is therefore no need to purchase prebiotic fibers outside of your daily effort at including an unripe green banana, say, or inulin and fructooligosaccharides (FOS), or small servings of legumes as a means of cultivating healthy bowel flora. These are powerful strategies that change the number and species of bowel flora over time, thereby leading to beneficial health effects that include reduced blood sugar and blood pressure, reduction in triglycerides, reduced anxiety and improved sleep, and reduced colon cancer risk.

HOWEVER, convenience can be a struggle. Traveling by plane, for example, makes lugging around green bananas or raw potatoes inconvenient. Inulin and FOS already come as powders or capsules and they are among the options for a convenient, portable prebiotic fiber strategy. But there are others that can be purchased. This is a more costly way to get your prebiotic fibers and you do not need to purchase these products in order to succeed in your bowel flora management program. These products are therefore listed strictly as a strategy for convenience.

Most perspectives on the quality of human bowel flora composition suggest that diversity is an important feature, i.e., the greater the number of species, the better the health of the host. There may therefore be advantage in varying your prebiotic routine, e.g., green banana on Monday, inulin on Tuesday, PGX (below) on Wednesday, etc. Beyond providing convenience, these products may introduce an added level of diversity, as well.

Among the preparations available to us that can be used as prebiotic fibers:

PGX

While it is billed as a weight management and blood sugar-reducing product, the naturally occurring fiber--α-D-glucurono-α-D-manno-β-D-manno- β-D-gluco, α-L-gulurono-β-D mannurono, β-D-gluco-β- D-mannan--in PGX also exerts prebiotic effects (evidenced by increased fecal butyrate, the beneficial end-product of bacterial metabolism). PGX is available as capsules or granules. It also seems to exert prebiotic effects at lower doses than other prebiotic fibers. While I usually advise reaching 20 grams per day of fiber, PGX appears to exert substantial effects at a daily dose of half that quantity. As with all prebiotic fibers, it is best to build up slowly over weeks, e.g., start at 1.5 grams twice per day. It is also best taken in two or three divided doses. (Avoid the PGX bars, as they are too carb-rich for those of us trying to achieve ideal metaobolic health.)

Prebiotin

A combination of inulin and FOS available as powders and in portable Stick Pacs (2 gram and 4 gram packs). This preparation is quite costly, however, given the generally low cost of purchasing chicory inulin and FOS separately.

Acacia

Acacia fiber is another form of prebiotic fiber. RenewLife and NOW are two reputable brands.

Isomalto-oligosaccharides

This fiber is used in Quest bars and in Paleo Protein Bars. With Quest bars, choose the flavors without sucralose, since it has been associated with undesirable changes in bowel flora.

There you go. It means that there are fewer and fewer reasons to not purposefully cultivate healthy bowel flora and obtain all the wonderful health benefits of doing so, from reduced blood pressure, to reduced triglycerides, to deeper sleep.

Disclaimer: I am not compensated in any way by discussing these products.

How Not To Have An Autoimmune Condition

20. April 2015 William Davis (0)

Autoimmune conditions are becoming increasingly common. Estimates vary, but it appears that at least 8-9% of the population in North America and Western Europe have one of these conditions, with The American Autoimmune Related Diseases Association estimating that it’s even higher at 14% of the population.

The 200 or so autoimmune diseases that afflict modern people are conditions that involve an abnormal immune response directed against one or more organs of the body. If the misguided attack is against the thyroid gland, it can result in Hashimoto’s thyroiditis. If it is directed against pancreatic beta cells that produce insulin, it can result in type 1 diabetes or latent autoimmune diabetes of adults (LADA). If it involves tissue encasing joints (synovium) like the fingers or wrists, it can result in rheumatoid arthritis. It if involves the liver, it can result in autoimmune hepatitis, and so on. Nearly every organ of the body can be the target of such a misguided immune response.

While it requires a genetic predisposition towards autoimmunity that we have no control over (e.g., the HLA-B27 gene for ankylosing spondylitis), there are numerous environmental triggers of these diseases that we can do something about. Identifying and correcting these factors stacks the odds in your favor of reducing autoimmune inflammation, swelling, pain, organ dysfunction, and can even reverse an autoimmune condition altogether.

Among the most important factors to correct in order to minimize or reverse autoimmunity are:

Wheat and grain elimination

If you are reading this, you likely already know that the gliadin protein of wheat and related proteins in other grains (especially the secalin of rye, the hordein of barley, zein of corn, perhaps the avenin of oats) initiate the intestinal “leakiness” that begins the autoimmune process, an effect that occurs in over 90% of people who consume wheat and grains. The flood of foreign peptides/proteins, bacterial lipopolysaccharide, and grain proteins themselves cause immune responses to be launched against these foreign factors. If, for instance, an autoimmune response is triggered against wheat gliadin, the same antibodies can be aimed at the synapsin protein of the central nervous system/brain, resulting in dementia or cerebellar ataxia (destruction of the cerebellum resulting in incoordination and loss of bladder and bowel control). Wheat and grain elimination is by far the most important item on this list to reverse autoimmunity.

Correct vitamin D deficiency

It is clear that, across a spectrum of autoimmune diseases, vitamin D deficiency serves a permissive, not necessarily causative, role in allowing an autoimmune process to proceed. It is clear, for instance, that autoimmune conditions such as type 1 diabetes in children, rheumatoid arthritis, and Hashimoto’s thyroiditis are more common in those with low vitamin D status, much less common in those with higher vitamin D levels. For this and other reasons, I aim to achieve a blood level of 25-hydroxy vitamin D level of 60-70 ng/ml, a level that usually requires around 4000-8000 units per day of D3 (cholecalciferol) in gelcap or liquid form (never tablet due to poor or erratic absorption). In view of the serious nature of autoimmune diseases, it is well worth tracking occasional blood levels.

Supplement omega-3 fatty acids

While omega-3 fatty acids, EPA and DHA, from fish oil have proven only modestly helpful by themselves, when cast onto the background of wheat/grain elimination and vitamin D, omega-3 fatty acids compound anti-inflammatory benefits, such as those exerted via cyclooxygenase-2. This requires a daily EPA + DHA dose of around 3600 mg per day, divided in two. Don’t confuse EPA and DHA omega-3s with linolenic acid, another form of omega-3 obtained from meats, flaxseed, chia, and walnuts that does not not yield the same benefits. Nor can you use krill oil with its relatively trivial content of omega-3s.

Eliminate dairy

This is true in North America and most of Western Europe, less true in New Zealand and Australia. Autoimmunity can be triggered by the casein beta A1 form of casein widely expressed in dairy products, but not by casein beta A2 and other forms. Because it is so prevalent in North America and Western Europe, the most confident way to avoid this immunogenic form of casein is to avoid dairy altogether. You might be able to consume cheese, given the fermentation process that alters proteins and sugar, but that has not been fully explored.

Cultivate healthy bowel flora

People with autoimmune conditions have massively screwed up bowel flora with reduced species diversity and dominance of unhealthy species. We restore a healthier anti-inflammatory panel of bacterial species by “seeding” the colon with high-potency probiotics, then nourishing them with prebiotic fibers/resistant starches, a collection of strategies summarized in the Cureality Digestive Health discussions. People sometimes view bowel flora management as optional, just “fluff”–it is anything but. Properly managing bowel flora can be a make-it-or-break-it advantage; don’t neglect it.

There you go: a basic list to get started on if your interest is to begin a process of unraveling the processes of autoimmunity. In some conditions, such as rheumatoid arthritis and polymyalgia rheumatica, full recovery is possible. In other conditions, such as Hashimoto’s thyroiditis and the pancreatic beta cell destruction leading to type 1 diabetes, reversing the autoimmune inflammation does not restore organ function: hypothyroidism results after thyroiditis quiets down and type 1 diabetes and need for insulin persists after pancreatic beta cell damage. But note that the most powerful risk factor for an autoimmune disease is another autoimmune disease–this is why so many people have more than one autoimmune condition. People with Hashimoto’s, for instance, can develop rheumatoid arthritis or psoriasis. So the above menu is still worth following even if you cannot hope for full organ recovery

Five Powerful Ways to Reduce Blood Sugar

4. April 2015 William Davis (0)

Left to conventional advice on diet and you will, more than likely, succumb to type 2 diabetes sooner or later. Follow your doctor’s advice to cut fat and eat more “healthy whole grains” and oral diabetes medication and insulin are almost certainly in your future. Despite this, had this scenario played out, you would be accused of laziness and gluttony, a weak specimen of human being who just gave into excess.

If you turn elsewhere for advice, however, and ignore the awful advice from “official” sources with cozy relationships with Big Pharma, you can reduce blood sugars sufficient to never become diabetic or to reverse an established diagnosis, and you can create a powerful collection of strategies that handily trump the worthless advice being passed off by the USDA, American Diabetes Association, the American Heart Association, or the Academy of Nutrition and Dietetics.

Among the most powerful and effective strategies to reduce blood sugar:

1) Eat no wheat nor grains

Recall that amylopectin A, the complex carbohydrate of grains, is highly digestible, unlike most of the other components of the seeds of grasses AKA “grains,” subject to digestion by the enzyme, amylase, in saliva and stomach. This explains why, ounce for ounce, grains raise blood sugar higher than table sugar. Eat no grains = remove the exceptional glycemic potential of amylopectin A.

2) Add no sugars, avoid high-fructose corn syrup

This should be pretty obvious, but note that the majority of processed foods contain sweeteners such as sucrose or high-fructose corn syrup, tailored to please the increased desire for sweetness among grain-consuming people. While fructose does not raise blood sugar acutely, it does so in delayed fashion, along with triggering other metabolic distortions such as increased triglycerides and fatty liver.

3) Vitamin D

Because vitamin D restores the body’s normal responsiveness to insulin, getting vitamin D right helps reduce blood sugar naturally while providing a range of other health benefits.

4) Restore bowel flora

As cultivation of several Lactobacillus and Bifidobacteria species in bowel flora yields fatty acids that restore insulin responsiveness, this leads to reductions in blood sugar over time. Minus the bowel flora-disrupting effects of grains and sugars, a purposeful program of bowel flora restoration is required (discussed at length in the Cureality Digestive Health section.)

5) Exercise

Blood sugar is reduced during and immediately following exercise, with the effect continuing for many hours afterwards, even into the next day.

Note that, aside from exercise, none of these powerful strategies are advocated by the American Diabetes Association or any other “official” agency purporting to provide dietary advice. As is happening more and more often as the tide of health information rises and is accessible to all, the best advice on health does not come from such agencies nor from your doctor but from your efforts to better understand the truths in health. This is our core mission in Cureality. A nice side benefit: information from Cureality is not accompanied by advertisements from Merck, Pfizer, Kelloggs, Kraft, or Cadbury Schweppes.

Cureality App Review: Breathe Sync

7. March 2015 William Davis (0)

Biofeedback is a wonderful, natural way to gain control over multiple physiological phenomena, a means of tapping into your body’s internal resources. You can, for instance, use biofeedback to reduce anxiety, heart rate, and blood pressure, and achieve a sense of well-being that does not involve drugs, side-effects, or even much cost.

Biofeedback simply means that you are tracking some observable physiologic phenomenon—heart rate, skin temperature, blood pressure—and trying to consciously access control over it. One very successful method is that of bringing the beat-to-beat variation in heart rate into synchrony with the respiratory cycle. In day-to-day life, the heart beat is usually completely out of sync with respiration. Bring it into synchrony and interesting things happen: you experience a feeling of peace and calm, while many healthy phenomena develop.

A company called HeartMath has applied this principle through their personal computer-driven device that plugs into the USB port of your computer and monitors your heart rate with a device clipped on your earlobe. You then regulate breathing and follow the instructions provided and feedback is obtained on whether you are achieving synchrony, or what they call “coherence.” As the user becomes more effective in achieving coherence over time, positive physiological and emotional effects develop. HeartMath has been shown, for instance, to reduce systolic and diastolic blood pressure, morning cortisol levels (a stress hormone), and helps people deal with chronic pain. Downside of the HeartMath process: a $249 price tag for the earlobe-USB device.

But this is the age of emerging smartphone apps, including those applied to health. Smartphone apps are perfect for health monitoring. They are especially changing how we engage in biofeedback. An app called Breathe Sync is available that tracks heart rate using the camera’s flash on the phone. By tracking heart rate and providing visual instruction on breathing pattern, the program generates a Wellness Quotient, WQ, similar to HeartMath’s coherence scoring system. Difference: Breathe Sync is portable and a heck of a lot less costly. I paid $9.99, more than I’ve paid for any other mainstream smartphone application, but a bargain compared to the HeartMath device cost.

One glitch is that you need to not be running any other programs in the background, such as your GPS, else you will have pauses in the Breathe Sync program, negating the value of your WQ. Beyond this, the app functions reliably and can help you achieve the health goals of biofeedback with so much less hassle and greater effectiveness than the older methods.

If you are looking for a biofeedback system that provides advantage in gaining control over metabolic health, while also providing a wonderful method of relaxation, Breathe Sync, I believe, is the go-to app right now.

Amber’s Top 35 Health and Fitness Tips

7. November 2014 Amber B (0)

This year I joined the 35 club! And in honor of being fabulous and 35, I want to share 35 health and fitness tips with you!

1. Foam rolling is for everyone and should be done daily.
2. Cold showers are the best way to wake up and burn more body fat.
3. Stop locking your knees. This will lead to lower back pain.
4. Avoid eating gluten at all costs.
5. Breath deep so that you can feel the sides or your lower back expand.
6. Swing a kettlebell for a stronger and great looking backside.
7. Fat is where it’s at! Enjoy butter, ghee, coconut oil, palm oil, duck fat and many other fabulous saturated fats.
8. Don’t let your grip strength fade with age. Farmer carries, kettlebells and hanging from a bar will help with that.
9. Runners, keep your long runs slow and easy and keep your interval runs hard. Don’t fall in the chronic cardio range.
10. Drink high quality spring or reverse osmosis water.
11. Use high quality sea salt season food and as a mineral supplement.
12. Work your squat so that your butt can get down to the ground. Can you sit in this position? How long?
13. Lift heavy weights! We were made for manual work,. Simulate heavy labor in the weight room.
14. Meditate daily. If you don’t go within, you will go with out. We need quiet restorative time to balance the stress in our life.
15. Stand up and move for 10 minutes for every hour your sit at your computer.
16. Eat a variety of whole, real foods.
17. Sleep 7 to 9 hours every night.
18. Pull ups are my favorite exercise. Get a home pull up bar to practice.
19. Get out and spend a few minutes in nature. Appreciate the world around you while taking in fresh air and natural beauty.
20. We all need to pull more in our workouts. Add more pulling movements horizontally and vertically.
21. Surround yourself with health minded people.
22. Keep your room dark for deep sound sleep. A sleep mask is great for that!
23. Use chemical free cosmetics. Your skin is the largest organ of your body and all chemicals will absorb into your blood stream.
24. Unilateral movements will help improve symmetrical strength.
25. Become more playful. We take life too seriously, becoming stress and overwhelmed. How can you play, smile and laugh more often?
26. Choose foods that have one ingredient. Keep your diet simple and clean.
27. Keep your joints mobile as you age. Do exercises that take joints through a full range of motion.
28. Go to sleep no later than 10:30pm. This allows your body and brain to repair through the night.
29. Take care of your health and needs before others. This allows you to be the best spouse, parent, coworker, and person on the planet.
30. Always start your daily with a high fat, high protein meal. This will encourage less sugar cravings later in the day.
31. Approach the day with positive thinking! Stinkin’ thinkin’ only leads to more stress and frustration.
32. You are never “too old” to do something. Stay young at heart and keep fitness a priority as the years go by.
33. Dream big and go for it.
34. Lift weights 2 to 4 times every week. Strong is the new sexy.
35. Love. Love yourself unconditionally. Love your life and live it to the fullest. Love others compassionately.

Amber B.
Cureality Exercise and Fitness Coach

To Change, You Need to Get Uncomfortable

25. September 2014 Amber B (0)

Sitting on the couch is comfortable. Going through the drive thru to pick up dinner is comfortable. But when you notice that you’re out-of-shape, tired, sick and your clothes no longer fit, you realize that what makes you comfortable is not in align with what would make you happy.

You want to see something different when you look in the mirror. You want to fit into a certain size of jeans or just experience your day with more energy and excitement. The current condition of your life causes you pain, be it physical, mental or emotional. To escape the pain you are feeling, you know that you need to make changes to your habits that keep you stuck in your current state. But why is it so hard to make the changes you know that will help you achieve what you want?

I want to lose weight but….

I want a six pack but…

I want more energy but….

The statement that follows the “but” is often a situation or habit you are comfortable with. You want to lose weight but don’t have time to cook healthy meals. So it’s much more comfortable to go through the drive thru instead of trying some new recipes. New habits often require a learning curve and a bit of extra time in the beginning. It also takes courage and energy to establish new routines or seek out help.

Setting out to achieve your goals requires change. Making changes to establish new habits that support your goals and dreams can be uncomfortable. Life, as you know it, will be different. Knowing that fact can be scary, but so can staying in your current condition. So I’m asking you to take a risk and get uncomfortable so that you can achieve your goals.

Realize that it takes 21 days to develop a new habit. I believe it takes triple that amount of time to really make a new habit stick for the long haul. So for 21 days, you’ll experience some discomfort while you make changes to your old routine and habits. Depending on what you are changing, discomfort could mean feeling tired, moody, or even withdrawal symptoms. However, the longer you stick to your new habits the less uncomfortable you start to feel. The first week is always the worst, but then it gets easier.

Making it through the uncomfortable times requires staying focused on your goals and not caving to your immediate feelings or desires. I encourage clients to focus on why their goals important to them. This reason or burning desire to change will help when old habits, cravings, or situations call you back to your old ways.
Use a tracking and a reward system to stay on track. Grab a calendar, journal or index card to check off or note your daily successes. Shoot for consistency and not perfection when trying to make changes. I encourage my clients to use the 90/10 principle of change and apply that to their goal tracking system. New clothes, a massage, or a day me-retreat are just a few examples of rewards you can use to sticking to your tracking system. Pick something that really gets you excited.

Getting support system in place can help you feel more comfortable with being uncomfortable. Hiring a coach, joining an online support group, or recruiting family and friends can be very helpful when making big changes. With a support system in place you are not alone in your discomfort. You’re network is there for you to reach out for help, knowledge, accountability or camaraderie when you feel frustrated and isolated.

I’ve helped hundreds of people change their bodies, health and lives of the eleven years I’ve worked as a trainer and coach. I know it’s hard, but I also know that if they can do it, so can you. You just need to step outside of your comfort zone and take a risk. Don’t let fear create uncomfortable feelings that keep you stuck in your old ways. Take that first step and enjoy the journey of reaching your goals and dreams.

Amber Budahn, B.S., CSCS, ACE PT, USATF 1, CHEK HLC 1, REIKI 1
Cureality Exercise Specialist

The 3 Best Grain Free Food Swaps to Boost Fat Burning

25. September 2014 Lisa G (0)

You can join others enjoying substantial improvements in their health, energy and pant size by making a few key, delicious substitutions to your eating habits. This is possible with the Cureality nutrition approach, which rejects the idea that grains should form the cornerstone of the human diet.

Grain products, which are seeds of grasses, are incompatible with human digestion. Contrary to what we have been told for years, eating healthy whole grain is not the answer to whittle away our waists. Consumption of all grain-based carbohydrates results in increased production of the fat storage hormone insulin. Increased insulin levels create the perfect recipe for weight gain. By swapping out high carbohydrate grain foods that cause spikes in insulin with much lower carbohydrate foods, insulin release is subdued and allows the body to release fat.

1. Swap wheat-based flour with almond flour/meal

One of the most dubious grain offenders is modern wheat. Replace wheat flour with naturally wheat-free, lower carbohydrate almond flour.
Almond flour contains a mere 12 net carbs per cup (carbohydrate minus the fiber) with 50% more filling protein than all-purpose flour.
Almond flour and almond meal also offer vitamin E, an important antioxidant to support immune function.

2. Swap potatoes and rice for cauliflower

Replace high carb potatoes and pasta with vitamin C packed cauliflower, which has an inconsequential 3 carbs per cup.
Try this food swap: blend raw cauliflower in food processor to make “rice”. (A hand held grater can also be used). Sautee the “riced” cauliflower in olive or coconut oil for 5 minutes with seasoning to taste.
Another food swap: enjoy mashed cauliflower in place of potatoes. Cook cauliflower. Place in food processor with ½ a stick organic, grass-fed butter, ½ a package full-fat cream cheese and blend until smooth. Add optional minced garlic, chives or other herbs such as rosemary.

3. Swap pasta for shirataki noodles and zucchini

Swap out carb-rich white pasta containing 43 carbs per cup with Shirataki noodles that contain a few carbs per package. Shirataki noodles are made from konjac or yam root and are found in refrigerated section of supermarkets.
Another swap: zucchini contains about 4 carbs per cup. Make your own grain free, low-carb noodles from zucchini using a julienne peeler, mandolin or one of the various noodle tools on the market.

Lisa Grudzielanek, MS,RDN,CD,CDE
Cureality Nutrition Specialist

Not so fast. Don’t make this mistake when going gluten free!

25. September 2014 Lisa G (0)

Beginning last month, the Food and Drug Administration began implementing its definition of “gluten-free” on packaged food labels. The FDA determined that packaged food labeled gluten free (or similar claims such as "free of gluten") cannot contain more than 20 parts per million of gluten.

It has been years in the making for the FDA to define what “gluten free” means and hold food manufactures accountable, with respect to food labeling. However, the story does not end there.

Yes, finding gluten-free food, that is now properly labeled, has become easier. So much so the market for gluten-free foods tops $6 billion last year. However, finding truly healthy, commercially prepared, grain-free foods is still challenging.

A very common mistake made when jumping into the gluten-free lifestyle is piling everything labeled gluten-free in the shopping cart. We don’t want to replace a problem: wheat, with another problem: gluten free products.

Typically gluten free products are made with rice flour (and brown rice flour), tapioca starch, cornstarch, and potato flour. Of the few foods that raise blood sugar higher than wheat, these dried, powdered starches top the list.

They provide a large surface area for digestion, thereby leading to sky-high blood sugar and all the consequences such as diabetes, hypertension, cataracts, arthritis, and heart disease. These products should be consumed very rarely consumed, if at all. As Dr. Davis has stated, “100% gluten-free usually means 100% awful!”

There is an ugly side to the gluten-free boom taking place. The Cureality approach to wellness recommends selecting gluten-free products wisely. Do not making this misguided mistake and instead aim for elimination of ALL grains, as all seeds of grasses are related to wheat and therefore overlap in many effects.

Lisa Grudzielanek MS, RDN, CD, CDE
Cureality Health & Nutrition Coach

3 Foods to Add to Your Next Grocery List

25. September 2014 Lisa G (0)

Looking for some new foods to add to your diet? Look no further. Reach for these three mealtime superstars to encourage a leaner, healthier body.

Microgreens

Microgreens are simply the shoots of salad greens and herbs that are harvested just after the first leaves have developed, or in about 2 weeks. Microgreen are not sprouts. Sprouts are germinated, in other words, sprouted seeds produced entirely in water. Microgreens are grown in soil, thereby absorbing the nutrients from the soil.

The nutritional profile of each microgreen depends greatly on the type of microgreen you are eating. Researchers found red cabbage microgreens had 40 times more vitamin E and six times more vitamin C than mature red cabbage. Cilantro microgreens had three times more beta-carotene than mature cilantro.

A few popular varieties of microgreens are arugula, kale, radish, pea, and watercress. Flavor can vary from mild to a more intense or spicy mix depending on the microgreens. They can be added to salads, soup, omelets, stir fry and in place of lettuce.

Cacao Powder

Cocoa and cacao are close enough in flavor not to make any difference. However, raw cacao powder has 3.6 times the antioxidant activity of roasted cocoa powder. In short, raw cacao powder is definitely the healthiest, most beneficial of the powders, followed by 100% unsweetened cocoa.

Cacao has more antioxidant flavonoids than blueberries, red wine and black and green teas. Cacao is one of the highest sources of magnesium, a great source of iron and vitamin C, as well as a good source of fiber for healthy bowel function.
Add cacao powder to milk for chocolate milk or real hot chocolate. Consider adding to coffee for a little mocha magic or sprinkle on berries and yogurt.

Shallots

Shallots have a better nutrition profile than onions. On a weight per weight basis, they have more anti-oxidants, minerals, and vitamins than onions. Shallots have a milder, less pungent taste than onions, so people who do not care for onions may enjoy shallots.

Like onions, sulfur compounds in shallot are necessary for liver detoxification pathways. The sulfur compound, allicin has been shown to be beneficial in reducing cholesterol. Allicin is also noted to have anti-bacterial, anti-viral, and anti-fungal activities.

Diced then up and add to salads, on top of a bun less hamburger, soups, stews, or sauces. Toss in an omelet or sauté to enhance a piece of chicken or steak, really the possibilities are endless.

Lisa Grudzielanek,MS,RDN,CD,CDE
Cureality Nutrition & Health Coach

3 Band Exercises for Great Glutes

15. August 2014 Amber B (0)

Bands and buns are a great combination. (When I talk about glutes or a butt, I use the word buns) When it comes to sculpting better buns, grab a band. Bands are great for home workouts, at gym or when you travel. Check out these 3 amazing exercises that will have your buns burning.

Band Step Out

Grab a band and place it under the arch of each foot. Then cross the band and rest your hands in your hip sockets. The exercise starts with your feet hip width apart and weight in the heels. Slightly bend the knees and step your right foot out to the side. Step back in so that your foot is back in the starting position. With each step, make sure your toes point straight ahead. The tighter you pull the band, the more resistance you will have. You will feel this exercise on the outside of your hips.

Start with one set of 15 repetitions with each foot. Work on increasing to 25 repetitions on each side and doing two to three sets.

Band Kick Back

This exercise is performed in the quadruped position with your knees under hips and hands under your shoulders. Take the loop end of the band and put it around your right foot and place the two handles or ends of the band under your hands. Without moving your body, kick your right leg straight back. Return to the starting quadruped position. Adjust the tension of the band to increase or decrease the difficulty of this exercise.

Start with one set of 10 repetitions with each foot. Work on increasing to 20 repetitions on each side and doing two to three sets.

Band Resisted Hip Bridge

Start lying on your back with feet hip distance apart and knees bent at about a 45-degree angle. Adjust your hips to a neutral position to alleviate any arching in your lower back. Place the band across your hipbones. Hold the band down with hands along the sides of your body. Contract your abs and squeeze your glutes to lift your hips up off the ground. Stop when your thighs, hips and stomach are in a straight line. Lower you hips back down to the ground.

Start with one set of 15 repetitions. Work on increasing to 25 repetitions and doing two to three. Another variation of this exercise is to hold the hip bridge position. Start with a 30 second hold and work up to holding for 60 seconds.