Wheat and the hunger factor

Low carbohydrate diets are becoming increasingly popular. In my experience, they also work exceptionally well.

However, I have observed a specific aspect of low-carb diets that deserves special attention: When wheat products in particular are eliminated, hunger plummets enormously.

It seems peculiar to wheat. Other high-glycemic index carbohydrates like a baked potato or white rice, for instance, don't seem to have the capacity to trigger appetite like a handful of pretzels or crackers can. There are exceptions: processed sweet drinks that contain high-fructose corn syrup can stimulate appetite, as do foods made with processed corn and corn starch.



However, wheat has grown to occupy an enormous part of diet, partly because of the "high-fiber" trickery that causes us to believe that wheat is healthy, but also, I'm convinced, because of wheat's hunger factor.


A reader of the The Heart Scan Blog recently made this comment:

I discovered this blog and Dr. Davis' TYP program at the beginning of September. I have relatively successfully cut carbs and grains from my diet thus far.

Because I've got some weight to lose, I have tried to keep the carb count low and I've lost 15 pounds since then.

I have also been very surprised at the significant reduction in my appetite. I've read about the experience of others with regard to appetite reduction and couldn't really imagine that it could happen for me too. But it has.

A few weeks ago, I attended a party catered by one of my favorite Italian restaurants and got myself offtrack for two days. Then it took me a couple of days to get back on track because my appetite returned.

Check out Jimmy Moore's website for lots of ideas about variations of foods to try. The latest thing I picked up from Jimmy is the good old-fashioned hard boiled egg. Two or three eggs with some spicy hot sauce for breakfast and a handful of almonds mid-morning plus a couple glasses of water and I'm good for the morning no problem.

I find myself thinking about lunch not because I'm really hungry but out of habit.

The cool thing too now is that the more I do this, the more I'm just not tempted much to do anything but this diet.



I, too, have personally experienced this effect. I also was skeptical. It made no sense. How can whole grain bread increase appetite? I don't know what it is about wheat products that make them especially powerful triggers of appetite. I think that it probably goes beyond glycemic index, perhaps some other component besides taste.

But if you want to seize control over appetite, elimination--not reduction--but elimination of wheat, as well as other processed carbohydrates, can really change the way you approach food. (Interestingly, The Wheat Foods Council estimates that the average American eats 144 lbs of wheat flour per year; they argue that it should be increased 210 lbs per year!)

Eliminating wheat products is also an effective tool in the Track Your Plaque program for raising HDL, reducing triglycerides, reducing small LDL, and reducing both blood sugar and blood pressure. And it can be among the most effective ways to control appetite, since eliminating wheat also eliminates its hunger factor.

Foods to consider to take up the calorie slack when eliminating wheat: cheese (fermented, of course, for vitamin K2 content); eggs, as our reader pointed out; other lean proteins like lean red meats, fish, chicken, turkey; more liberal use of healthy oils like olive and flaxseed; plenty of raw nuts and seeds; soy milk and tofu. Obviously, the center of your diet should remain vegetables.

Comments (20) -

  • Windminstrel

    10/28/2007 12:56:00 AM |

    Doc, what's your thoughts about oats as a wheat supplement? From what I've read, oats don't have the insulin effect of wheat, and have a positive effect on heart health.

  • Dr. Davis

    10/28/2007 2:25:00 AM |

    I think you mean as a wheat replacement? Yes, it is indeed a great replacement, along with flaxseed. Both exert effects on reducing both LDL and small LDL, opposite that of wheat.

  • Nancy M.

    10/28/2007 5:19:00 AM |

    I think it is a pretty easy explanation, wheat contains starches that cause a release of insulin.  Insulin is a powerful hormone that makes you hungry.  Gary Taubes book cites studies where insulin was injected directly into mice and guess what?  The mice eat like pigs.  Then the dropping blood sugar makes you hungry again.  

    Ever notice how you get hungrier when you start eating?  That's the first release of insulin and it whets the appetite.  The next release of insulin is slower and bigger (if you're eating lots of carbs).

    One of the nicest parts of a low carb diet is you get rid of all these cravings and crazy hunger because insulin is released much more normally.

  • jpatti

    10/28/2007 12:12:00 PM |

    Barley is a darned good grain also.  More antioxidants than blueberries!

  • Dr. Davis

    10/28/2007 12:48:00 PM |

    Yes, I agree.

  • dotslady

    10/28/2007 1:30:00 PM |

    This is absolutely true for me.  I was a victim of the '80s lowfat diet craze - doc told me I was obese, gave me the Standard American Diet and said to watch my fat (I'm not a big meat eater, didn't like mayo ... couldn't figure out where my fat was coming from!  maybe the fries - I will admit I liked fries).  I looked to the USDA food pyramid and to increase my fiber for the constipation I was experiencing.  Bread with 3 grams of fiber wasn't good enough; I turned to Kashi cereals for 11 years.  My constipation turned to steattorrhea and a celiac disease diagnosis!  *No gut pains!*  My PCP sent me to the  gastroenterologist for a colonscopy because my ferritin was a 5 (20 is low range).  Good thing I googled around and asked him to do an endoscopy or I'd be a zombie by now.

    My symptoms were depression & anxiety, eczema, GERD, hypothyroidism, mild dizziness, tripping, Alzheimer's-like memory problems, insomnia, heart palpitations, fibromyalgia, worsening eyesight, mild cardiomyopathy, to name a few.

    After six months gluten-free, I asked my gastroenterologist about feeling full early ... he said he didn't know what I was talking about!  *shrug*  

    But *I* knew -- it was the gluten/starches!  My satiety level has totally changed, and for the first time in my life I feel NORMAL!  

    Most of the above symptoms have resolved themselves, except the heart palpitations... Any suggestions?  (Doc seems to only look at thyroid:  Synthroid just reduced again to 100mcg from 175 mcg last year, but I’m still having them, esp w/low bp 96/59)   (I'm losing weight eating no white foods.)

    Just heard the tail end of a Gary Taubes interview on XM radio and he mentioned something about low bp and heart ... hmmm.

  • Anonymous

    10/28/2007 3:29:00 PM |

    My life changed when I cut not only all wheat, but all grains from my diet.

    For the first time in my life, I was no longer hungry -no hunger pangs between meals; no overwhelming desire to snack.  Now I eat at mealtimes without even thinking about food in between.

    I've dropped 70 pounds, effortlessly, come off high blood pressure meds and control my blood sugar without medication.

    I don't know whether it was just the elimination of grain, especially wheat, or whether it was a combination of grain elimnation along with a number of other changes, but I do know that mere reduction of grain consumption still left me hungry.  It wasn't until I elimnated it that the overwhelming redution in appetite kicked in.

    As a former wheat-addicted vegetarian, who thought she was eating healthily according to all the expert advice out there at the time, I can only shake my head at how mistaken I was.

  • Nyn

    10/28/2007 6:16:00 PM |

    I've been reading your blog for some time, and eliminating wheat sounds like a great thing...but what do you eat? I'm hypothyroid and have been told to avoid soy products because it interferes with the absorption of thyroid meds. I'm lactose intolerant, so I'm avoiding dairy as much as possible (I miss cheese!), and I've recently been given a diagnosis of IBS. My MD said to avoid raw vegetables and fruits. That leaves eggs, lunch meant, and almonds for protein. Cooked vegetables are very difficult to include in my daily diet when the majority of my meals must be transported. I am at a loss as to where to even begin...and I already eat too much rice because that's one of the things I can consume without discomfort. Needless to say, I am gaining weight... What does someone in my predicament eat to control hunger?

  • Cindy Moore

    10/28/2007 6:44:00 PM |

    While I have no doubt some are sensitive to wheat, personally I think it's the total carbs in any given meal that regulates appetite. For me, an piece of fruit increases my appetite just as much, if not more than a piece of bread!

  • Dr. Davis

    10/28/2007 8:28:00 PM |

    Wow. Tough predicament.

    I won't pretend to have a full solution but some thoughts:

    1) Many lactose intolerant people can handle yogurt and cottage cheese, often some cheese.

    2) You've just got to bit the bullet and cook your vegetables. If vegetables are the number one most important food in your diet, you simply need to find a solution.

    3) Nuts-lots! Seeds, too, like sunflower and pumpkin.

    4) Low-glycemic index grains like oats, barley, and flaxseed (ground). Perhaps Ezekiel bread might be a compromise worth trying.

    5) More oils.

    6) Rice should be wild.

    7) Squashes

    8) Avocados-transportable, too.

    9) Do you and your doctor feel that ALL raw vegetables trigger IBS symptoms? In my experience, it's just selected vegetables.

    No doubt about it. You've got it tougher than most.

  • Dr. Davis

    10/28/2007 9:18:00 PM |

    dotslady--

    Re: palpitations. Have you addressed the omega-3 and magnesium issues? There may also be real issues to consider by your doctor, e.g., your potassium level and blood pressure control. Underappreciated high blood pressure issues can trigger palpitations. In my experience, this is very common.

  • Nancy M.

    10/29/2007 6:35:00 PM |

    I'm betting the doctor told nyn to cook her veggies, and avoid soy, because many are goitrogenic (work to make thyroid hormone unusuable).  I think any of the veggies in the brassica family are like broccoli, brussel sprouts.  I know turnips are (I love raw turnips), and soy is too.

    If you've got refrigeration and a microwave handy, bringing your meals is pretty easy.  I used to bring all kinds of things to work that would probably work for you.  One of my favorites is a big salad with meat, nuts and a simple olive oil and rice vinegar dressing.  Cooking veggies shouldn't be a problem reheating them in the microwave.  I tend to use lots of frozen veggies and just microwave them and drizzle butter or EVOO on them.

    I follow the Paleo diet pretty closely.  It eliminates all grains, legumes, and dairy products.  My autoimmune diseases are much, much better now too.

  • Nyn

    10/29/2007 6:44:00 PM |

    nancy m & all, thank you for the suggestions. I will look into more cooked veggies. I hate cooking, and am very unhappy with this new way of eating and lifestyle. I am trying to plan ahead, and this site has really helped me. I'm trying to get past the denial stage and move on with things. I wish there was a list of things to eat, like a meal plan, somewhere. I am still looking. Great advice here.

  • G

    11/2/2007 5:33:00 AM |

    hi nyn -- i've never heard that you have to avoid certain foods when you are taking Synthroid -- you do need to avoid taking calcium and other minerals being co-adminstered at the same time as the Synthroid. Calcium (or magnesium or other cation minerals bind Synthroid and inactive the drug). A recent study showed that taking thyroid replacement medications at bedtime on an empty stomach has the most optimal effects and absorption. so i tell patients to take Levothroid or synthroid when they brush their teeth at night (assuming they brush daily) and at least 1-2 hrs AFTER any dairy, milk, ice cream, multivitamins (esp containing minerals), TUMS, antacids, etc.  I don't see a food interaction otherwise with thyroid medications.
    I hope your doc is aware that the new AACE Hypothyroid guidelines is to shoot for TSH between 0.2 and 3.0.  Many labs still have 5.5 as the 'normal' upper limit.  This is no longer correct.  So, if your TSH is greater than 3.0, you are likely still suffering from hypothryoid signs and symptoms. getting corrected (meaning, more medication) will get the TSH down to optimal goal < 3.0 and will prevent complications related to hypothyroidism (ie, high BP, insulin resistance, dyslipidemia, PALPITATIONS, feeling plain crappy, wt gain and even osteoporosis!)  i hope that helps!  IBS is tough -- my husband has it too -- developed when he commuted 1h each way to see me during pharmacy school!  aint stress bad bad bad!!!  once you get IBS you never get rid of it... good news, it can be improved...
    sugar-free metamucil (or other fiber source -- take 1-2 scoops with a VERY LARGE glass of water daily) is the cornerstone treatment (it works for most people I know) along with stress REDUCTION! go to a day spa weekly and get yourself a therapeutic massage (*doctor's orders!*  *ha haaa* no kidding!  good luck!!

    (of course i hope you followed DR. D's advice on getting checked out for your baseline vitamin 25(OH)D test?  Hashimoto's hypothyroidism is autoimmune and therefore can be associated with hypovitaminosis D, ie, inadequate Vitamin D stores in the body.  get your sunlight/ supplements if you need it!! I'm deficient myself... and in denial...  but i'm so grateful I came across this blog to even become aware of this epidemic)

  • dotslady

    11/4/2007 3:32:00 PM |

    Dr. D - Re: magnesium and potassium, last check they were in range.  I wanted to get baselines before trying supplements, so I just got my vit D checked also (not sure he did correct test, but D3 was 20, D2 was 10 = 30 and he said it was fine!).  I haven't been taking omega-3s, so will start and let you know how it goes!  Thanks for your help.  I appreciate everything you write!

    nyn - another thought re: IBS.  Could be a symptom of celiac disease at worst, gluten sensitivities at least.  Maybe giving up gluten grains will help repair your villi/gut(if indeed that's a problem) and allow fresh veggies, etc. at a later time once healed.  Smile Have you done an elimination diet and rotated foods before?

    Healing time varies depending on severity of villi damage.  Consider researching celiac symptoms & websites, maybe read about the Specific Carbohydrate Diet by Elaine Gottschall(google)?  Read:  Gluten-Free Living for Dummies by Danna Korn before changing your diet.  Consider if you want a celiac diagnosis on your health or life insurance records ...

  • G

    11/6/2007 3:31:00 AM |

    I'm an incurable yoga addict now(nothing special... just 'gym' *translation... 'FREE'* yoga!) but i've done some research and the benefits are huge. it's been around forever > hundreds of years and there must be a reason...

    benefits:
    1. reduction in stress/cortisol and improved relaxation (cortisol is 'toxic' injuring brain cells, increasing visceral fat in the abdom cavity which clogs arteries to the heart, liver and other organs, and increases glucose and therefore inflammation/free radicals)
    2. many poses  'massage' internal endocrine glands including the adrenals, parathyroid and THYROID tissue (which help remove stagnant toxins and improve internal circulation)
    3. has helped me to make the magnficient realization that all things are connected in life (whether we like it or not, ie friends-foes, black-white, ying-yang, et cetera) -- just like how all the organs and limbs and the mind are uniquely linked in our own bodies. when one thing is injured/hurt/malignant, it goes and affects e-v-e-r-y-t-h-i-n-g else. For instance I had a recent shoulder injury, and now if I don't do the appropriate exercises to maintain its strength, I unfortunately get referred pain and tension to my neck and back.
    4. all the tendons, ligaments and small muscles in the back need to be exercised and kept strong in order to support the back. yoga helps to accomplish this otherwise the back cannot do what it needs to do effortlessly and painlessly.  MUCH LIKE THE AMAZING COMMUNITY HERE -- we all support each other and keep our bodies, minds, and spirit STRONG. I'm so grateful to Dr. D for all his advice, accessibilty and ever endeavoring persistence to improve our greater health. May you ALWAYS be blessed. (and that your house doesn't get TP'd when more truths are exposed). Keep up the excellent work! THANK YOU, G

  • Dr. Davis

    11/6/2007 12:10:00 PM |

    Thanks for the kind comments, G.

    I agree with you about the yoga. Having tried it over the years and doing it on occasion with my wife, I believe that you are absolutely right.

    Bring on the TP!

  • Anonymous

    11/12/2009 3:47:54 AM |

    heartscanblog.blogspot.com is very informative. The article is very professionally written. I enjoy reading heartscanblog.blogspot.com every day.

  • Anonymous

    8/10/2010 5:21:38 AM |

    I have been wheat free for 2 and 1/2 months, and have to agree 110% on the hunger factor.  Thanks for getting the word out there.  It has made me wonder if companies know this and use it in their favor? Also if this is one of the big triggers in the US weight problem?  And how sad if people don't know this, that they think they simply have no will, when it is really the wheat.  We have also noticed that it is difficult to find cat or dog food (dry) without wheat in it!   Our outdoor cats are constantly hungry, even though it seems like they have more than enough food, I wish we could find a wheat free cat food, and see if they eat less.  Thanks again for the article.

  • buy jeans

    11/3/2010 2:23:48 PM |

    But if you want to seize control over appetite, elimination--not reduction--but elimination of wheat, as well as other processed carbohydrates, can really change the way you approach food. (Interestingly, The Wheat Foods Council estimates that the average American eats 144 lbs of wheat flour per year; they argue that it should be increased 210 lbs per year!)

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All posts by william-davis

When MIGHT statins be helpful?

I spend a lot of my day bashing statin drugs and helping people get rid of them.

But are there instances in which statin drugs do indeed provide real advantage? If someone follows the diet I've articulated in these posts and in the Track Your Plaque program, supplements omega-3 fatty acids and vitamin D, normalizes thyroid measures, and identifies and corrects hidden genetic sources of cardiovascular risk (e.g., Lp(a)), then are there any people who obtain incremental benefit from use of a statin drug?

I believe there are some groups of people who do indeed do better with statin drugs. These include:

Apoprotein E4 homozygotes

Apoprotein E2 homozygotes

Familial combined hyperlipidemia (apoprotein B overproduction and/or defective degradation)

Cholesteryl ester transfer protein homozygotes (though occasionally manageable strictly with diet)

Familial heterozygous hypercholesterolemia, familial homozygous hypercholesterolemia

Other rare variants, e.g., apo B and C variants

The vast majority of people now taking statin drugs do NOT have the above genetic diagnoses. The majority either have increased LDL from the absurd "cut your fat, eat more healthy whole grains" diet that introduces grotesque distortions into metabolism (like skyrocketing apo B/VLDL and small LDL particles) or have misleading calculated LDL cholesterol values (since conventional LDL is calculated, not measured).

As time passes, we are witnessing more and more people slow, stop, or reverse coronary plaque using no statin drugs.

Like antibiotics and other drugs, there may be an appropriate time and situation in which they are helpful, but not for every sneeze, runny nose, or chill. Same with statin drugs: There may be an occasional person who, for genetically-determined reasons, is unable to, for example, clear postprandial (after-eating) lipoproteins from the bloodstream and thereby develops coronary atherosclerotic plaque and heart attack at age 40. But these people are the exception.

Advanced topics in nutrition

Nutrition in the modern world has become an increasingly problematic topic. From genetic modification to commercialized methods of mass production, we are having to navigate all manner of complex issues in food choices, particularly if ideal health, including maximal control over coronary plaque, is among our goals.

We will therefore be releasing a series of discussions on the Track Your Plaque website in the coming months, a series I call "Track Your Plaque Advanced Topics in Nutrition." These will be, as the series title suggests, discussions for anyone interested in more than the "eat a balanced diet" nonsense that issues from "official" sources. Among the topics to be covered:

1)Advanced Glycation End-products--both endogenous and exogenous, including peripheral issues like lipoxidation and acrylamides.

2)Dietary influences on LDL oxidation--including the concept of "glycoxidation." Protection from oxidative phenomena is not just about taking antioxidants.

3) Foods you MUST eat--We've talked a lot about foods that you shouldn't eat. How about foods you should eat?

The New Track Your Plaque Guide now available

The New Track Your Plaque Guide is now available!

The Track Your Plaque program has evolved over its 8 year history. While the original Track Your Plaque book reflected the program details that got the program started back in 2003-2004, plenty has changed.

This new version of the book, what I call the program Guide, represents version 2.0 of Track Your Plaque and includes:

--Updated lipoprotein treatment strategies--including new and expanded treatment choices for small LDL and lipoprotein(a).

--An entire chapter on vitamin D and its crucial role in cardiovascular health and plaque control.

--A new and expanded diet--All the reasons why the New Track Your Plaque Diet can achieve spectacular improvement in lipids/lipoproteins, reversal of insulin resistance/pre-diabetes/diabetes, weight loss, reduction in blood pressure, etc. are discussed in considerable detail. The diet is crafted to achieve maximum control over both metabolic responses and coronary plaque.

--An entire chapter on the role of omega-3 fatty acids is included.

--A detailed discussion on the role of iodine and thyroid health--One of the newest additions to the Track Your Plaque menu of strategies is to achieve and maintain ideal thyroid health. This tips the scales in your favor for improved control over lipids/lipoproteins, weight, blood sugar, and coronary plaque.


The new guide, as well as our new Member kits that include the new Track Your Plaque Recipe Book, At-Home Lab Test kits, and nutritional supplements, are all available in the Track Your Plaque Marketplace.

Don't wet yourself

While there is more to wheat's adverse effects on human health than celiac disease, studying celiac disease provides important insights into why and how wheat--the gluten component of wheat, in this case--is so destructive to human health.

Modern wheat, in particular, is capable of causing "celiac disease" without intestinal symptoms---no cramping or diarrhea--but instead shows itself as brain injury (ataxia, dementia), peripheral nervous system damage (peripheral neuropathy), joint and muscle inflammation (rheumatoid arthritis, polymyalgia rheumatica and others), and gastrointestinal cancers.

One neurological manifestation of wheat's effect on the human brain is a condition called cerebellar ataxia. This is a condition that can affect adults (average age 48 years) and children and consists of incoordination, falls, and incontinence.

Because brain tissue has limited capacity for healing and regeneration, symptoms of cerebellar ataxia usually improve slowly and modestly with meticulous elimination of wheat and other gluten sources.

Such observations are relevant even to people without celiac disease. Celiac disease sufferers are more susceptible to such extra-intestinal phenomena, but it can also happen in people without positive celiac antibodies.



Some references:

Neurological symptoms in patients with biopsy proven celiac disease

A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 +/- 15 years, mean disease duration 8 +/- 11 years) were recruited through advertisements. All participants adhered to a gluten-free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment.



Gluten ataxia in perspective: epidemiology, genetic susceptibility and clinical characteristics

Two hundred and twenty-four patients with various causes of ataxia from North Trent (59 familial and/or positive testing for spinocerebellar ataxias 1, 2, 3, 6 and 7, and Friedreich's ataxia, 132 sporadic idiopathic and 33 clinically probable cerebellar variant of multiple system atrophy MSA-C) and 44 patients with sporadic idiopathic ataxia from The Institute of Neurology, London, were screened for the presence of antigliadin antibodies. A total of 1200 volunteers were screened as normal controls. The prevalence of antigliadin antibodies in the familial group was eight out of 59 (14%), 54 out of 132 (41%) in the sporadic idiopathic group, five out of 33 (15%) in the MSA-C group and 149 out of 1200 (12%) in the normal controls. The prevalence in the sporadic idiopathic group from London was 14 out of 44 (32%). The difference in prevalence between the idiopathic sporadic groups and the other groups was highly significant (P < 0.0001 and P < 0.003, respectively). The clinical characteristics of 68 patients with gluten ataxia were as follows: the mean age at onset of the ataxia was 48 years (range 14-81 years) with a mean duration of the ataxia of 9.7 years (range 1-40 years). Ocular signs were observed in 84% and dysarthria in 66%. Upper limb ataxia was evident in 75%, lower limb ataxia in 90% and gait ataxia in 100% of patients. Gastrointestinal symptoms were present in only 13%. MRI revealed atrophy of the cerebellum in 79% and white matter hyperintensities in 19%. Forty-five percent of patients had neurophysiological evidence of a sensorimotor axonal neuropathy. Gluten-sensitive enteropathy was found in 24%. HLA DQ2 was present in 72% of patients. Gluten ataxia is therefore the single most common cause of sporadic idiopathic ataxia.

Wheat brain

Among the most common effects of wheat are those on the brain.

Consume wheat and susceptible individuals will experience a subtle euphoria. Others experience mental cloudiness or sleepiness. (This is what I personally get.)

It gets worse. Children with ADHD and autism have difficulty concentrating on a task and have behavioral outbursts after a cookie. Schizophrenics experience paranoid delusions, auditory hallucinations, and worsening of social detachment. People with bipolar disorder can have the manic phase triggered by a breadcrumb. All these effects are blocked by administering drugs that block the brain's opiate receptors. (This is why, by the way, a drug company is planning to release an oral agent, naltrexone, formerly administered to heroin addicts to help control addiction, for weight loss: block the euphoric effect, take away the temptation, lose weight.)

Here is Heart Scan Blog reader, Nicole's, mental fog story:

I have been grain-free (no gluten free grains either) for quite a long time (about a year and a half). Earlier this week, I decided to try white bread and pasta. The experiment only lasted two days. I had horrible terminal insomnia both nights, causing me on the second night to wake up at 2:30 am unable to get back to sleep at all. I felt drugged and in a mind-fog all the next day and even dozed off a few times! Luckily I had the day off work.

I had very bad forgetfulness also. I forgot that I left my bag and groceries at work, so I had to go back for them. Then I had to use my husband's keys to get in because I thought my keys were in my bag, but it turns out they were in my pocket. Then I got my bag, set the alarm, locked the door and then realized I forgot my groceries. So I had to re-open the door, unset the alarm, and go back for the groceries. Then I locked the door, forgetting to set the alarm, so I had to unlock it, open up and set the alarm. It was just ridiculous, I am NEVER like that!

In addition to the insomnia and forgetfulness, I also had horrible anxiety and paranoia, almost to the point of panic. Which I NEVER have, I am usually very easy-going, even-tempered, and worry-free. But this was horrible, I really was quite paranoid and anxious about everything. Weird!

And the worst, was that in just two days of eating wheat, I gained 4 lbs and 2% bodyfat!! It's two days wheat-free now, and it's finally going back down, but wow. Just two days of wheat-eating caused that much weight and fat gain!

Anyway, I've learned my lesson and will continue to avoid grains (including gluten free grains) entirely.


Eat more "healthy whole grains"? Modern dwarf Triticum aestivum, perverted even further by agricultural geneticists and modern agribusiness, subsidized by the U.S. government to permit $5 pizza, is better than any terrorist plot to discombobulate the health and performance of the American people.

The Westman Diet

Dr. Eric Westman has been a vocal proponent of carbohydrate restriction to gain control over diabetes, as have Drs. Richard Bernstein, Mary Vernon, Richard Feinman, and Jeff Volek.

Several studies over the years have demonstrated that reductions in carbohydrate content of the diet yield reductions in weight and HbA1c (glycated hemoglobin, a reflection of average blood glucose over the preceding 60-90 days).

Among the more important recent clinical studies is a small experience from Duke University's Dr. Eric Westman. In this study, obese type 2 diabetics reduced carbohydrate intake to 20 grams per day or less: no wheat, oats, cornstarch, or sugars. Participants ate nuts, cheese, meats, eggs, and non-starchy vegetables.

After 6 months, average weight loss was 24.4 lbs, BMI was reduced from 37.8 to 34.4. At the end of the study, 95% of participants on this severe carbohydrate restriction reduced or eliminated their diabetes medications.

That was only after 6 months. Note that the ending BMI was still quite well into the obese range. Imagine what another 6-12 months would do, or achieving BMI somewhere closer to ideal.

Curiously, this idea of severe low-carbohydrate restriction to cure or minimize diabetes is not new. Sir William Osler, one of the founders of Johns Hopkins Hospital and author of the longstanding authoritative text, Principles and Practice of Medicine, advocated an diet identical to Dr. Westman's diet. So did Dr. Frederick Banting, discoverer of the pancreatic extract, insulin, to treat childhood diabetics. Before insulin, Banting and his colleagues at the University of Toronto used carbohydrate elimination (less than 10 g per day) to prolong the lives of children with diabetes.

This lesson was also learned many times during war time, when staples like bread were unavailable. The Siege of Paris in 1870 yielded cures for diabetes in many (or at least they stopped passing urine that tasted--yes, tasted--sweet and attracted flies), only to have it recur after the siege was over.

These are lessons we will have to relearn. As long as the American Diabetes Association and most physicians continue to advocate a diet of reduced fat, increased carbohydrate that includes plenty of "healthy whole grains," diabetics will continue to be diabetics, taking their insulin and multiple medications while developing neuropathy (nervous system degeneration), nephropathy (kidney disease and failure), atherosclerosis and heart attack, cataracts, and die 8 to 10 years earlier than non-diabetics.

All the while, we've had the combined wisdom from antiquity onwards: Carbohydrates cause diabetes; elimination of carbohydrates cures diabetes.

(This applies, of course, only to adult overweight type 2 diabetics, not type 1 or some of the other variants.)

Handy dandy carb index

There are a number of ways to gauge your dietary carbohydrate exposure and its physiologic consequences.

One of my favorite ways is to do fingerstick blood sugars for a one-hour postprandial glucose. I like this because it provides real-time feedback on the glucose consequences of your last meal. This can pinpoint problem areas in your diet.

Another way is to measure small LDL particles. Because small LDL particles are created through a cascade that begins with carbohydrate consumption, measuring them provides an index of both carbohydrate exposure and sensitivity. Drawback: Getting access to the test.

For many people, the most practical and widely available gauge of carbohydrate intake and sensitivity is your hemoglobin A1c, or HbA1c.

HbA1c reflects the previous 60 to 90 days blood sugar fluctuations, since hemoglobin is irreversibly glycated by blood glucose. (Glycation is also the phenomenon responsible for formation of cataracts from glycation of lens proteins, kidney disease, arthritis from glycation of cartilage proteins, atherosclerosis from LDL glycation and components of the arterial wall, and many other conditions.)

HbA1c of a primitive hunter-gatherer foraging for leaves, roots, berries, and hunting for elk, ibex, wild boar, reptiles, and fish: 4.5% or less.

HbA1c of an average American: 5.2% (In the population I see, however, it is typically 5.6%, with many 6.0% and higher.)

HbA1c of diabetics: 6.5% or greater.

Don't be falsely reassured by not having a HbA1c that meets "official" criteria for diabetes. A HbA1c of 5.8%, for example, means that many of the complications suffered by diabetics--kidney disease, heightened risk for atherosclerosis, osteoarthritis, cataracts--are experienced at nearly the same rate as diabetics.

With our wheat-free, cornstarch-free, sugar-free diet, we have been aiming to reduce HbA1c to 4.8% or less, much as if you spent your days tracking wild boar.

Battery acid and oatmeal

Ever notice the warnings on your car's battery? "Danger: Sulfuric acid. Protective eyewear advised. Serious injury possible."

Sulfuric acid is among the most powerful and potentially harmful acids known. Get even a dilute quantity in your eyes and you will suffer serious burns and possibly loss of eyesight. Ingest it and you can sustain fatal injury to the mouth and esophagus. Sulfuric acid's potent tendency to react with other compounds is one of the reasons that it is used in industrial processes like petroleum refining. Sulfuric acid is also a component of the harsh atmosphere of Venus.

Know what food is the most potent source of sulfuric acid in the body? Oats.

Yes: Oatmeal, oat bran, and foods made from oats (you know what breakfast cereal I'm talking about) are the most potent sources of sulfuric acid in the human diet.

Why is this important? In the transition made by humans from net-alkaline hunter-gatherer diet to net-acid modern overloaded-with-grains diet, oats tip the scales heavily towards a drop in pH, i.e., more acidic.

The more acidic your diet, the more likely it is you develop osteoporosis and other bone diseases, oxalate kidney stones, and possibly other diseases.

Here's one reference for this effect.

What'll it be: Olive oil or bread?

We frequently discuss the advisability of consuming fats, carbohydrates, and various types within each category.

But what's the worst of all? Combining fats with carbohydrates.

Putting aside the wheat-is-worst form of carbohydrate issue and treating bread as a prototypical carbohydrate, let's play out a typical scenario, a make-believe feeding study in which a theoretical person is fed specific foods.

John is our test person, a 40-year old, 5 ft 10 inch, 210 lb, BMI 27.7 (roughly the mean for the U.S.) He starts with an average American diet of approximately 55% carbohydrates and 30% fat. Starting lipoproteins (NMR):

LDL particle number 1800 nmol/L
Small LDL 923 nmol/L


(The LDL particle number of 1800 nmol/L translates to measured LDL cholesterol of 180 mg/dl, i.e., drop last digit or divide by 10.)

Also, calculated LDL cholesterol is 167 mg/dl (yes, underestimating "true" measured LDL), HDL 42 mg/dl, triglycerides 170 mg/dl.

We feed him a diet increased in carbohydrates and reduced in fat, especially saturated fat, with more breakfast cereals, breads and other wheat products, pasta, fruit juices and fruit, and potatoes. After four weeks:

LDL particle number 2200 nmol/L
Small LDL 1378 nmol/L

Note that LDL particle number has increased by 400 nmol/L due entirely to the increase in small LDL particles triggered by carbohydrate consumption. Lipids show calculated LDL cholesterol 159 mg/dl--yes, a decrease, HDL 40 mg/dl, triglycerides 189 mg/dl. (At this point, if John's primary care doctor saw these numbers, he would congratulate John on reducing his LDL cholesterol and/or suggest a fibrate drug to reduce triglycerides.)

John takes a rest for four weeks during which his lipoproteins revert back to their starting values. We then repeat the process, this time replacing most carbohydrate calories with fats, weighed heavily in favor of saturated fats like fatty red meats, butter and other full-fat dairy products. After four weeks:

LDL particle number 2400 nmol/L


Let's

Chocolate peanut butter cup smoothie

Here's a simple recipe for chocolate peanut butter cup smoothie.

The coconut milk, nut butter, and flaxseed make this smoothie exceptionally filling. If you are a fan of cocoa flavonoids for reducing blood pressure, then this provides a wallop. Approximately 10% of cocoa by weight consists of the various cocoa flavonoids, like procyanidins (polymers of catechin and epicatechin) and quercetin, the components like responsible for many of the health benefits of cocoa.


Ingredients:
1/2 cup coconut milk
1 cup unsweetened almond milk
2 tablespoons cocoa powder (without alkali)
2 tablespoons shredded coconut (unsweetened)
1 tablespoon ground flaxseed
1 teaspoon almond extract
1 1/2 tablespoons natural peanut, almond, or sunflower seed butter
Non-nutritive sweetener to taste (stevia, Truvia, sucralose, xylitol, erythritol)
4 ice cubes

Combine ingredients in blender. Blend and serve.

If you plan to set any of the smoothie aside, then leave out the flaxseed, as it absorbs water and will expand and solidify if left to stand.

For an easy variation, try adding vanilla extract or 1/4 cup of sugar-free (sucralose) vanilla or coconut syrup from Torani or DaVinci and leave out the added sweetener.

The compromise I draw here is the use of non-nutritive sweeteners. Beware that they can increase appetite, since they likely trigger insulin release. However, this smoothie is so filling that I don't believe you will experience this effect with this recipe.