Glucomania

As I suggested in a previous Heart Scan Blog post, a glucose meter is your best tool to:

1) Lose weight
2) Cure diabetes
3) Reduce or eliminate small LDL particles
4) Achieve anti-aging or age-slowing effects


But it means getting hold of a glucose meter and applying it in a very different way.

Diabetics typically check fasting morning glucose and again several times during the day to assess medication effects. But you and I can measure blood glucose to assess the immediate effects of food choices--two very different approaches.

The concept is simple: Check a blood glucose just prior to a food or meal of interest, then one hour after finishing.

Let's take two hypothetical breakfasts. First, oatmeal, a so-called "low-glycemic index" food. Slow-cooked, stone ground oatmeal with skim milk, a handful of walnuts, just a few blueberries.

Blood glucose just prior: 95 mg/dl
Blood glucose one hour after finish: 175 mg/dl

I made those numbers up, but this is a fairly typical response for many adults. (This is why "low-glycemic index" is an absurd notion.) This kind of response causes 1) glycation, the adverse effects of glucose modification of proteins that leads to cataracts, kidney disease, cartilage damage and arthritis, atherosclerosis, skin wrinkles, etc., 2) high insulin response that cascades into fat deposition, especially visceral fat ("wheat belly"), and 3) glucotoxicity, i.e., direct damage to the pancreas that can, over years, lead to diabetes.

Next day, let's try a breakfast of 3-egg omelet made with green peppers, sundried tomatoes, and olive oil.

Blood glucose just prior: 95 mg/dl
Blood glucose one hour after finish: 93 mg/dl

This is a meal of virtually zero-glycemic index. This kind of response triggers none of the effects experienced following the oatmeal. Repeated over time and you fail to trigger glycation, you stop provoking insulin, and visceral fat mobilizes rather than accumulates: you lose weight, particularly around the middle.

We therefore aim to keep the one-hour blood glucose 100 mg/dl or less. If you start with a high fasting blood glucose of, say, 118 mg/dl, then we aim to keep the one-hour after-eating blood glucose no higher than the pre-meal.

It works. Plain and simple.

This makes the primary care docs crazy: "How dare you check your blood sugar! You're not diabetic." In truth, blood glucose meters are relatively simple devices to use. The test strips and lancets will cost a few bucks. (The meters themselves are either low-cost or free, just like Gillette sometimes sends you a beautiful new razor for free but expects you to buy the blades). These are direct-to-consumer products. While a prescription written by your doctor for a glucose meter and supplies helps insurance cover the costs, you can easily get these devices without a prescription. Some stores, like Target, keep their devices out on the shelves with the shampoo and bath soap.

Warning: Anyone taking diabetes drugs will have to consult with their doctors about the safety of such an approach. Because this approach can actually cure diabetes in some people, if you are taking some diabetes drugs, especially glyburide, glipidize, and glimepiride, you can experience dangerously low blood sugars, just as any non-diabetic taking these drugs would.

Comments (52) -

  • Robert Burton Robinson

    2/8/2011 3:47:09 PM |

    Had a bowl of oatmeal less than one hour ago. Old-fashioned oats, artificial sweetener, cinnamon. Now I am wiped out. Tired, sleepy. I don't even need a glucose meter to tell me the oatmeal reeked havoc on my blood sugar.

    I always feel this way after eating certain carbs. Used to think old-fashioned oatmeal was okay. But it's just not. Not for me anyway. By the way, I'm hypoglycemic.

  • Steve Cooksey

    2/8/2011 3:50:18 PM |

    Agreed Dr. Davis... wish all would "Read and Heed" this advice.

    Question: you are referring to Type 2 Diabetes only, right?

    All the best.

    Steve

  • Jonathan

    2/8/2011 3:53:13 PM |

    Most drug stores including Walmart and Target carry a small disposable meter that looks like a 35mm film bottle.  Very cheap and includes 50 test strips.  Next cheapest I've found is the Walmart ReliOn Ultima meter which is around $9 and you buy the strips at the Pharmacy (only since people steal them) for around $39 for 100.  When I first started Primal, my sugar readings were all over the place and then within 3-4 months of eating low-carb my reading became really stable all day long.  I think I had to burn through my over abundant glycogen stores first (it was mostly causing high waking pre-breakfast readings).

  • Desia

    2/8/2011 4:39:06 PM |

    I'm going to try this with the BG meter we use for our diabetic cat. It measures in mmol/L and the recommended BG targets are 4.0-7.0 before meals/5.0-10.0 2hrs. after. (for humans)
    Is this similar to your recommendation of100 mg/d,l Dr Davis?

  • Anonymous

    2/8/2011 4:41:35 PM |

    Can it cure type I diabetes as well?

  • Steve Cooksey

    2/8/2011 5:04:04 PM |

    I am a diabetic and I find the inexpensive Wallmart brand ReliOn Micro is a great value.

    @ $20 for meter and strips. Refill strips @ $12 per 20.

  • Anonymous

    2/8/2011 5:22:48 PM |

    Just a "heads up" for others.  I ordered the Walmart Relion BG meter ($9) and a supply of strips and lancets online only to have Walmart CANCEL the BG meter (no reason available) and send me the strips and lancets (which I will have to return as they are useless to me without the Relion BG meter).  Walmart's website still says the BG meters are "in stock" when clearly they are not and customer service had no explanation for that either.

    I'll visit your earlier post to find a comparable meter.

  • Jeff

    2/8/2011 5:41:44 PM |

    Dr. Davis: "This is why low-glycemic index is an absurd notion."

    Does this mean the Dreamfields pasta claim of being low-carb is misleading, at best?

    I've been contemplating trying it, but fear it really isn't low carb.

  • Jack

    2/8/2011 5:48:20 PM |

    i am curious about the effect that the oatmeal that i sometimes eat would have on my blood glucose levels.

    i take 3 cups of raw oats, soak them in warm water with 8 tablespoons of raw whey and add 2 heaping tablespoons of organic buckwheat flour and let them soak for 24 hours. drain and rinse thoroughly. pour the oats into a baking casserole dish and add some coconut oil, blueberries, pure vanilla, cinnamon, buttermilk. bake at 350 for 40 minutes.

    the result is a very delicious and highly altered form of oats. the whey and buckwheat drastically reduce the phytic acid and 'ferment' or predigest the oats. when it's done, i just add a couple spoons of pasture butter and enjoy. i've noticed a significant change in texture as a result. the oats are no longer firm. they feel quite 'broken down' and they do not sit in my stomach like a brick.

    why go through all that trouble? well... you should taste it. it is quite the treat.

  • ~Amy Jo~

    2/8/2011 5:55:34 PM |

    I appreciate the information in your blog.  I started checking my blood sugar and was shocked at the results of some 'low glycemic index' foods.  Besides the basic health benefits of maintaining healthy blood glucose, I've also lost a few pounds.  Bonus!

  • Anne

    2/8/2011 6:02:39 PM |

    Desia,

    I'm diabetic and from the UK where we measure blood glucose in mmol/L - to convert from mg/dl to mmol/L just divide by 18 - so 100 is 5.5. Multiply by 18 to convert your mmol/L to mg/dl.

  • revelo

    2/8/2011 6:06:01 PM |

    Oatmeal and other high-carb foods won't cause blood sugar spikes if you are lean, get regular exercise,  eat high-carb foods on a regular basis, and don't have health problems. All 4 of the above conditions must be met. In particular, you MUST exercise, though the exerciser doesn't have to be lengthy.

    I find keeping my bodyfat under 15% (I'm a 50 year-old male, women would have a higher percentage) and doing 5 to 10 minutes of one-legged squats, which gets my blood pumping and is much more convenient than running, is enough to keep my insulin sensitivity high enough to avoid blood sugar surges.

    Yesterday, for example, I had a single large meal in the late afternoon, due to being too busy to eat most of the day: a half can of salmon, a large salad, 300g (dry) of cooked oats mixed with about 6 grams of cinnamon all eaten within about 30 minutes. My blood sugar never exceeded 110 mg/dL during the subsequent 3 hours (I measured every 30 minutes) and eventually fell back to the normal level of about 85.

    When I experimented with a paleo diet for a while, my insulin sensitivity plummeted, so that when I broke the paleo regime temporarily and ate a mere 100g (dry) of cooked oats, my blood sugar skyrocketed to 195 mg/dL 30 minutes later. And note that those oats were eaten together with 2 eggs and some veggies, which would normally tend to mute the glycemic index as opposed to eating oats by themselves. Evidently, what happened while eating paleo is that my body's cells had down-regulated their insulin sensitivity. This makes sense, since there is no need for high insulin sensitivity when eating paleo, and the greater danger under these conditions is low blood sugar rather than high blood sugar. Only when glucose is abundant (regularly eating a high carb diet) does the body upregulate insulin sensitivity. But the upregulation won't occur if the body is fat or doesn't get regular exercise. And, of course, it obviously won't occur for someone with a "burned out" pancreas, such as Type II diabetics supposedly have.

  • Desia

    2/8/2011 7:43:01 PM |

    Anne, thanks for the info. (I'm from Canada)

  • AndreAnna

    2/8/2011 7:56:23 PM |

    Has there been any studies citing any differences in regular oats versus soaking/sprouted oats? I wonder if the neutralizing of the phytic acid that helps in digestions would also help the way the body breaks down the oats and, therefore, insulin response.

  • Brent

    2/8/2011 9:36:23 PM |

    Jeff -

    I have used Dreamfields for about 6 months now.  They claim the carbs are "locked up" and can't be digested.  I have found they do not affect blood glucose like regular pasta would.

    However they are still wheat, which has it's own problems even if the special processing prevents blood glucose spikes. I still have it once or twice a month when the rest of my "non-low carb" family has pasta, but I know I have to quit wheat all together soon, just hard to do. For now it's the lesser of two evils.

  • donny

    2/9/2011 1:34:07 AM |

    "Oatmeal and other high-carb foods won't cause blood sugar spikes if you are lean, get regular exercise, eat high-carb foods on a regular basis, and don't have health problems."

    Absolutely. But this is a blog about reversing heart disease...

  • Gretchen

    2/9/2011 2:02:45 AM |

    It's dangerous to talk about "curing" diabetes with a low-carb diet. Someone with type 2 who goes on a LC diet may be able to maintain normal blood sugar levels as long as s/he stays on the diet. But the diabetes is not cured. Returning to a standard American diet would result in high blood sugar again.

    A diabetes cure would mean you could eat cereal, skim milk, orange juice, toast, and jam and keep your blood sugar levels normal.

    The danger of telling someone he/she is cured is that the person will believe it, will return to a regular diet, and will stop testing, not realizing how high blood sugars are and will end up in a worse situation than he/she started with.

  • Galina L.

    2/9/2011 2:49:37 AM |

    That is it! I am buying a glucosameter! I sometimes get a little bit lethargic from any big meal, if I simple add cabbage soup to my usual stake + sauerkraut lunch.

    To Gretchen:
    It is very dangerous to be so stupid(or reluctant to think) as the individual you just described.

  • Anonymous

    2/9/2011 3:36:25 AM |

    I enjoy this blog, but I do frequently agree with those who say that the grandiose effects of eating grains that you present are often times found more common place in people with metabolic problems. For example, while I was in college, I had a dorm mate who read some random article about gluten and suddenly believed herself to be suffering from Celiac Disease. My friends and I labeled her an hypochondriac, going so far as feeding her a deadly, lethal oatmeal cookie (gasp!) which we passed off as consisting of "a grain-like substance produced from the dried roots of a Japanese plant." My dorm mate ate the cookie and low and behold - nothing. Weeks prior she claimed to have taken a few bites of Frosted Mini Wheats in the cafeteria and subsequently suffered a debilitating pain in her stomach. Moral of the story is that her fear of gluten and the pain she felt from consuming Frosted Mini Wheats were purely psychosomatic.

    I guess what I'm at getting at is you provide good information, but often times the entries you write are reminiscent of the blogs/journals/prose/essays written by individuals such as the Unibomber. In a half-serious, half-jocular manner, I always feel like one day I'll read/hear in the news, "Man opens [gun] fire within an oatmeal factory," and [to no one's surprise] it'll be you. I'm not accusing you of actually perpetuating such an act, but you write with such vigor about something like wheat/grains, and it gives off the "vibe" that you are harboring some hardcore resentment.

    Once again, I enjoy your overall blog, but your hasty generalizations and confusing cause-and-effect can be misleading and overly exaggerated.

  • Dr. William Davis

    2/9/2011 3:40:26 AM |

    Hi, Steve--

    Actually, the same advice applies to all forms of diabetes. Type 1 and "intermediate" types, i.e., slender people with diabetes, LADA, etc., can still follow a similar program with equally extravagant results.

    However, the blood sugar tightrope is much more difficult to walk for these people and should be undertaken with the assistance of the (sadly, rare) assistance of a knowledgeable expert in doing so.

  • Dr. William Davis

    2/9/2011 3:45:38 AM |

    Hi, Amy Jo--

    Ahh. Your comment alone made writing this post worth it. Thank you.

    There is an odd sentiment that sometimes prevails: If it doesn't apply to me, it must not be true. As if everyone wore a size 13 shoe.

  • Anonymous

    2/9/2011 4:42:37 AM |

    How about oatmeal (steel cut)if:
    15 min blood sugar 127
    30 min blood sugar 150s
    45 min blood sugar 125
    60 min blood sugar back to 95?

  • Anonymous

    2/9/2011 5:45:11 AM |

    As much as this wheat-free idea kills me, I'm going to try to at least quit my sweetened cereal habit each morning. My fasting sugar is good - 81, but my triglycerides are still monstrous at 292 even with niacin and fish oil. On a semi-related matter, I confirmed for myself that dry Vitamin D doesn't work. I've been using Life Extension brand cholecalciferol 5,000 units a day for months, and my levels barely rose - from 33 to 36. Got a shipment of the carlson oil caps and I'm going to try 8,000 and see where that leads.

  • Anonymous

    2/9/2011 9:05:42 AM |

    Hi,
    Thank you for this great post!  
    I was diagnosed borderline diabetic, glucose intolerant/insulin resistant over 10 years ago. I figured out that a glucose meter could really help improve my health so I used it faithfully for many years. Now the strips are very expensive so I have cut back. But I learned an incredible amount while  using the glucometer.
    This is a fabulous method, and I highly recommend it.

  • Peter

    2/9/2011 12:24:20 PM |

    My friend started feeding his diabetic cat low carb chow, and the cat went into shock when she got her insulin shot.
    The vet said her blood sugar had returned to normal, should no longer get insulin.

  • Anonymous

    2/9/2011 4:18:10 PM |

    Thanks Dr. Davis.  I have been following your advice to use the meter to lose weight and I find it really works!  I am finding the food that sends my blood sugar high and I am trying to avoid them.  
    Char

  • notrace

    2/9/2011 6:30:24 PM |

    Here's a way of using the glucose meter that I came across just this week: don't eat unless blood glucose has dropped to a normal level even if it means eating once a day.

    http://shurie.com/lee/writing_defeat_diabetes.htm

  • Might-o'chondri-AL

    2/9/2011 8:07:30 PM |

    Heart effect of Doc's recommendation is very important if you are not young. Human ageing is accompanied by histological (molecular and cellular) changes in the vascular smooth muscle cells of the artery wall. It means that over time formation of atheroscleroma (plaque) becomes easier to develop - even if it has not done so, yet.

    Technically the molecules that are big players in the pro-inflammatory cycle are MCP-1 (monocyte chemo-attractant protein 1), MMP-2 (matrix metallo-proteinase type-II) and TGF-B1 (transforming growth factor beta-1). With age these are found circulating in elevated amounts; even in individuals without clinical problems. In other words genetic expression of them is upregulated, and it appears that age induces this epigenetic activation even if there is no diagnosable pathology.

    Now, Doc's clinical instruction is to hold down the small LDL production and reign in circulating triglycerides. This is because those are what will provide the fodder for the pro-inflammatory molecules' loop of interaction to actually go on to "make" actual plaque.

    Blood sugar spikes, according to Doc, are apparently the stalking horse for setting up our aged vascular system for pathological problems. We are accustomed to think of blood sugar as only a diabetics dilema; and so, many non-diabetics mistake Doc's insistance as not applicable to them.

    And, to those readers who have their own method of carbohydrate consumption it would be instructive to learn if any have tested, and might share, your small LDL percentage (mine is unsatisfactory to me, based on Doc's recommended %). This can add some perspective to see if this blog's "glucomania" is somewhat overblown.

  • Anonymous

    2/9/2011 8:34:29 PM |

    Ebay is also a good source of meters and test strips.  Some out of date, but less important for non diabetic purposes.

  • revelo

    2/9/2011 8:34:41 PM |

    donny wrote: "But this is a blog about reversing heart disease..."

    It's for Dr. Davis and not me to say what this blog is about, but my impression is that the goal is not just reversing but also preventing heart disease in the first place (and also the other ailments mentioned in the current post).

    Many of the people on the blog are healthy and want to stay that way, as opposed to being sick and wanting to be cured. I think I am in the first category myself, though I'm still awaiting the results of blood tests to know for sure. Already, I have made the following changes in my life due to reading this blog:

    1) taking 2000 IU/day of vitamin D3 in gel capsule.
    2) vitamin D blood test after a few months of the D3 supplement regime.
    3) using the glucose monitor to learn about my response to carbs.
    4) getting a VAP test to learn if I have Lp(a) and also get my VLDL numbers.
    5) Hb1Ac test.

    I am quite grateful for Dr Davis for pushing me to making these changes, but I think the anti-grain/anti-oatmeal focus is misguided.

    There is an epidemic of obsesity and type II diabetes in Pacific Islanders who eat junk food nowadays, but who were formerly lean on their traditional paleo low-carb diet of fish and coconuts. So why don't they go back to the fish and coconuts? BECAUSE CARBS ARE TASTY AND LOW-CARB DIETS ARE BORING. And there you have the argument against the paleo low-carb diet in a nutshell. The evidence is clear: Atkins works in the short run, but not the long run (at least for most people) because we naturally crave carbs. Sure, if you have willpower, you can hold off a year or so, but eventually you'll fall off the wagon. And when you do, you'll go ape over those carbs, because you haven't learned how to manage them. Whereas if your normal diet is high-wholegrain-carb (after using Atkins for losing weight in a hurry), then there is much less danger of losing control of yourself when you eat some sugar in addition to your usual wholegrains.

    High-carb diets are tricky to manage, because there is nothing to stop you from overeating, unlike with Atkins, where the body tends to resist overeating. But tricky is not the same as impossible. Part of the trick, in my experience, involves eating lots of wholegrains or tubers: wheat, rice, oats, corn, potatoes, etc. (Another part involves staying lean, and by lean, I mean ribs showign for men, as is a little strenuous exercise each day.) And that is why I keep arguing against this blanket indictment by Dr Davis against grains, and especially against oatmeal, which is the most health-inducing of the common grains for many people.

  • revelo

    2/9/2011 8:49:22 PM |

    @Might-o'chondri-AL: The chemistry panel I got back in December shows the following:

    Total chol: 152
    HDL       :  70
    Trig      :  39
    VLDL calc :   8
    LDL calc  :  74

    The two LDL scores are calculated, not measured. I just got back this very morning from getting blood drawn for a VAP test (ordered through lef.org), so I'll know my tested, as opposed to calculated, VLDL numbers in a week or so.

  • revelo

    2/9/2011 9:31:41 PM |

    @Might-o'chondri-AL:
    The chemistry panel I had back in December showed:

    Total chol: 152
    Trig      : 39
    HDL chol  : 70
    VLDL calc : 8
    LDL calc  : 74

    Just this morning, I had blood drawn for a VAP test (ordered through lef.org), so when the results come back, I'll know the measured VLDL percentage numbers, as opposed to the calculated values from the chemistry panel. (I'll also learn if I have Lp(a)).

    My diet back in December was similar to now: 200g to 400g (dry) per day of rolled oats, 1/3 to 1/2 can salmon, salad, sometimes low-fat cottage cheese or eggs instead of salmon, plus small quantities of "forbidden foods" that I'm allowed to eat on the way home from the grocery but am not allowed to keep in my apartment: chocolate, nuts, fruit.

    I should note that I spent October and November hiking the Appalachian trail, and so was in extremely good cardiovascular condition, and also quite lean, but I was feeling damaged internally from the constant alternation of famine and feast. The feasts typically involved a gallon of ice cream, a package or two cookies, plus anything else that struck my fancy. These feasts during town stops were to avoid losing too much body fat, since it was getting cold as November progressed and I needed to retain some body fat to stay warm. It was because of that feeling of being internally damaged that I began researching health on the internet and came across this blog.

    (I posted this comment before and it got deleted somehow.)

  • free diabetic meters

    2/9/2011 9:39:52 PM |

    Fascinating! This is such a great idea! Thanks!

  • Dr. William Davis

    2/10/2011 2:24:03 AM |

    Hi, Revelo--

    Great comments.

    However, it helps to keep one thing in mind: The reduction or elimination of grains is not just about weight control (though it certainly does help that); it's about reduction of small LDL, triglycerides, other inflammatory phenomena, blood pressure, visceral fat, and glycation.

    Wheat and oats increase blood sugar, small LDL, triglycerides, etc. to extravagant degrees.

  • Might-o'chondri-AL

    2/10/2011 2:35:45 AM |

    @Revelo,
    Very good reading lipid panel profile; can see why you speak up against "glucophobia".

  • B

    2/10/2011 1:45:19 PM |

    @revelo: Hey, this is the only lipid panel I have ever seen anyone post that's close to my last one! At the time, I was eating 200-300g of carbs per day, mostly from grains. Of course I am only in my mid-20s now, but it's worth noting that this kind of lipid profile is typical for my extended family and we have absolutely no history diabetes or heart disease despite most of us being over. Bodies can handle carbohydrate so, so differently.

    Like you I am lean and need to put effort into gaining body fat, but I wasn't very active when I was eating high carb, lots of grains (and plenty of junky food too as I was trying to put on weight), and it made me ill in various ways.  

    I do feel my best with starch in my diet, but stick to potatoes, other tubers/root veg, and white rice - and not too much, I have always had issues with blood sugar 'crashes' although I haven't tested with a blood glucose meter to see just what's going on there. I feel awful an hour or two after eating too many carbs (and more ill after eating smaller amounts of oats, whear).

  • Anonymous

    2/10/2011 4:46:38 PM |

    I have a question as a breakfast cereal junkie trying to kick the wheat and sugar habit: would something like rice crispies be significantly better? No wheat as far as I can tell, but there is some fructose and some malted barley involved...

  • Anonymous

    2/11/2011 1:13:36 AM |

    For those interested in blood glucose I recommend the presentation 'What is Normal Glucose? – Continuous Glucose Monitoring Data from Healthy Subjects' by Professor Christiansen.

    He uses a continuous blood glucose monitoring for 30 or so patients over a 5 day trial.  Days 2-3 set meal in clinic and days 4-5 free meals at set times.

    This should give you an idea of  the expected daily ranges are for healthy subjects.

    He then does an additional study on breakfast and comes to the conclusion that perhaps the fast adsorbing breakfasts we've be told to eat arn't that good for us.  Ref this blog post on oatmeal vs omelet.

    Finally he looks at mortality vs blood-glucose levels.

    http://www.diabetes-symposium.org/index.php?menu=view&source=&sourceid=0&chart=1&id=322

    Enjoy.

  • Anonymous

    2/11/2011 1:34:34 AM |

    Here is another presentation that y'all may find interesting as part of the 'cut grains out' argument is vLDL production that is the bad cholesterol.  I'm no biochemist but this presentation on Sugar focusing on Fructose and how it treated by the liver may interest.

    Other carbs though seem to get converted to Glucose and only a tiny amount to vLDL / triglycerides.

    The huge vLDL / Triglycerides production comes from fructose.  I limit my fructose to less than 10g/day.

    'Sugar: The Bitter Truth'

    http://www.youtube.com/watch?v=dBnniua6-oM

    Enjoy.

  • Tom

    2/11/2011 3:21:39 AM |

    I recently bought a ReliOn micro glucometer from Walmart after reading your recommendations, Dr. Davis. I'm 31, in excellent health, eat low-grain/starch most of the time, frequent anaerobic and aerobic exercise. My fasting glucose seems to rest in the 70-90 range.

    Recently I decided to measure my glucose response after eating oatmeal. I used organic instant rolled oats and soaked them > 1 day in water with salt and lime juice, WAPF-style. I made a huge bowl of oatmeal (about 20 fluid ounces) and added blueberries and an appropriately huge amount of butter before eating. One hour later I measured my blood glucose using 2 separate test strips. I got 79 and 78. This surprised me, and I thought I'd add my data point to the discussion here.

    No doubt a high fat load slowss gastric emptying and helps minimize the spike in blood glucose. Perhaps my reading would have been higher 2 hours after the meal.

  • Anonymous

    2/11/2011 2:20:27 PM |

    What about 1 carb whey protein isolate with unsweetened almond milk?  Why does it raise blood glucose?

  • Anonymous

    2/12/2011 4:56:41 AM |

    http://www.futurepundit.com/archives/007893.html

    Fructose Alters Brain Metabolism
    One of the competing theories to explain the obesity epidemic is a rise in fructose consumption causing alterations in hormone levels that increase appetite. UCSF med school prof Robert Lustig has a pretty good rant-lecture on the evils of fructose. Well, here's another study on part of the mechanism in the brain of how fructose might be causing increased obesity.

    PORTLAND, Ore. – The dietary concerns of too much fructose is well documented. High-fructose corn syrup has become the sweetener most commonly added to processed foods. Many dietary experts believe this increase directly correlates to the nation's growing obesity epidemic. Now, new research at Oregon Health & Science University demonstrates that the brain – which serves as a master control for body weight – reacts differently to fructose compared with another common sweetener, glucose. The research is published in the online edition of the journal Diabetes, Obesity and Metabolism and will appear in the March print edition.

    In humans the cortical brain control areas of the brain were inhibited by the influx of fructose.

    Functional MRI allows researchers to watch brain activity in real time. To conduct the research, nine normal-weight human study subjects were imaged as they received an infusion of fructose, glucose or a saline solution. When the resulting brain scans from these three groups were compared, the scientists observed distinct differences.

    Brain activity in the hypothalamus, one brain area involved in regulating food intake, was not affected by either fructose or glucose. However, activity in the cortical brain control areas showed the opposite response during infusions of the sugars. Activity in these areas was inhibited when fructose was given but activated during glucose infusion.

    This is an important finding because these control brain areas included sites that are thought to be important in determining how we respond to food taste, smells, and pictures, which the American public is bombarded with daily.

    The result increases the plausibility of fructose as a causal agent.

    "This study provides evidence in humans that fructose and glucose elicits opposite responses in the brain. It supports the animal research that shows similar findings and links fructose with obesity," added Purnell.

    If you want to reduce your weight also consider other theories for the cause of obesity including grains as a possible major cause.

    By Randall Parker 2011 February 09 05:42 PM  Brain Appetite

  • Anonymous

    2/15/2011 12:45:07 AM |

    Oats are often cross contaminated with wheat.  Would certified gluten free oats give the same results?

  • semsons.group

    2/21/2011 4:04:55 PM |

    I think this post is really very important. Looking forward to future extensions of it.

      I've been able to control my cholesterol cutting wheat to zero, a moderate version of paleo diet, and a little of supplements with DHA/EPA, as suggested by Dr. Davis. Now is the turn of glucose Wink

      After reading this post I bought a glucometer (Bayer USB device) and I'm slowly learning some important things. My fasting glucose is good, about 80, however I've just seen (measured) that a simple dish of rice with fried egg rises my glucose one hour after lunch to  170!. My wife experienced a similar change. Amazing. I have lunch at work, and these measures of glucose are going to be very helpful to help me decide what to choose for the menu. I plan to continue measuring my glucose for the next weeks, so I guess news surprise will come.

    I just want to thank Dr. Davis for the great help  he's providing to many people from his blog.

      Best.

  • Anonymous

    2/26/2011 7:01:06 PM |

    Hi,

    I have bought a glucometer and wnted to ask you a question.
    This morning my bg was 4.9 (fasting) so very good then I ate pork then I had cashews and at 5pm I felt shakey not right, hungry so I checked it and it was 4.3 (isnt it a bit low?) so I had a pear and an hour after the pear it was 6.1, is it normal? does it mean i should avoid fruits?

    thanks for your help!

  • Anonymous

    3/31/2011 2:36:10 PM |

    I know I'm late to this party, but I took your advice and got a free glucose meter from Walgreens (came with 10 strips). Fasting blood sugar 75, ate a giant meal of steak, eggs, bacon, sausage, and sliced tomatoes, it went up to 85. On seperate days, a plain protein shake with a tad of reds powder spiked it to 112 (!!!) and my "low-carb" meat chili (no beans, just meat) launched it to 102 (lots of tomato paste/sauce). Needless to say, it's been an eye opener, especially since so-called "healthy" foods are raising my blood sugar more than I'd like, and of course stopping fat loss in it's tracks.

  • Duncan

    5/5/2011 8:21:07 AM |

    Hi,

    Am late to this party too but had a question.

    I too bought a blood glucose monitor and, following almost exactly the info above, I've been tracking my numbers for a few days now. And I have a few questions I was hoping someone could help me with...

    A few facts first:

    Age - 45
    Male
    Do Crossfit 3-4 times per week

    So far my BG levels have not gone over 108 and are averaging around 91/92, fasting BS is around 86.

    The 108 number came 1 hour after a breakfast of uncooked oatmeal, some apple sauce. milk and a handful of almonds - all blended. BUT last night I ate a green salad, chicken and vegetables, with a piece of thin pie crust (!) and 2 lattes (!!) that only gave me a BS  number of 85 after 1 hour and 83 after 3 hours.

    Do these numbers sound right? And how 'bad' is a BS level of 108?

    Hoping someone can advise...

    Duncan

  • Fred

    7/25/2011 5:36:21 AM |

    Insulin is meaningless. All the answers are on this site - http://carbsanity.blogspot.com/. Thank you and have a blessed day.

  • tam

    7/25/2011 7:52:13 PM |

    I've been testing stuff after 20 minutes.  The highest things were: whole wheat bread, whole wheat cereal, potatoes, and whole oranges.  But so far I've only had the 'low carb flu' or 'reactive hypoglycemia', and I've actually gained some weight.  But I think I'm on the right track.

  • LS

    10/4/2011 1:46:16 PM |

    Dr. Davis,
    If a person has a high fasting number, is the goal to stay at the original number?  I have a fasting glucose number of 83-85, so should my ideal number one hour or so post meal be close to or identical to the start or just below 100?  I'm a little confused.

  • Dr. William Davis

    10/5/2011 1:43:44 AM |

    At this low a starting value, just staying below 100 mg/dl is a great goal.

    The "no higher" advice was meant for people who start at 100 mg/dl or higher blood sugar.

  • jpatti

    5/29/2012 3:11:45 AM |

    Those who can keep tight control of bg with diet are not "cured" of diabetes anymore than those who avoid peanuts are "cured" of peanut allergies.

    Minimizing carb content keeps bg lower, yes, and many diabetics can control bg with just that.  Others need meds regardless of how clean their diets are.  

    Managing the disease is NOT curing it.  Unless they can pass a GTT, they're still diabetic.

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All posts by william-davis

Diet by LDL

Conventional notions of heart healthy diets, such as that advocated by the American Heart Association, are largely based on observations of total and LDL cholesterol.

So, cut the saturated fat in the diet, cut the overall fat content, and replace them with polyunsaturated oils like safflower, corn, and vegetable oils and increase consumption of whole grains and total and LDL cholesterol show a modest downturn. Thus, diets like the American Heart Association Total Lifestyle Change approach advocate limiting total fat to no more 25 to 35% of calories and saturated fat to no more than 7% of calories.

Orange Cream Cookies

If you loved Creamsicles as a kid, you'll love these Orange Cream Cookies. (Sorry, no photo: We ate them up before I realized we hadn't taken the photo. And, worse, we did it twice!)

Ingredients:
2 cups almond meal
2 tablespoons coconut flour
1 teaspoon baking soda
½ teaspoon sea salt
¼ cup golden raisins
½ cup chopped pecans
Sweetener equivalent to 1 cup sugar
2 tablespoons finely-grated orange rind
1 large egg
2 tablespoons coconut oil, melted
½ cup whipping cream (or coconut milk)
1 tablespoon vanilla extract

Preheat oven to 350º F.

Combine almond meal, coconut flour, baking soda, salt, raisins, pecans, sweetener and orange zest in bowl and mix.

In separate bowl, whisk egg, then add coconut oil, whipping cream, vanilla extract and mix together. Pour wet mix into dry and blend by hand thoroughly.

Spoon onto parchment paper-lined baking pan (or oiled pan) and flatten with spoon to ½-¾ inch thickness. Bake for 20-25 minutes or until toothpick withdraws dry.

Why are heart attacks still happening?

I'm a cardiologist. I see patients with heart disease in the form of coronary artery disease every day.

These are people who have undergone bypass surgery, received one or more stents or undergone other forms of angioplasty, have survived heart attacks or sudden cardiac death, or have high heart scan scores. In short, I see patients every day who are at high-risk for heart attack and death from heart disease.

But I see virtually no heart attacks. And nobody is dying from heart disease. (I'm referring to the people who follow the strategies I advocate, not the guy who thinks that smoking a pack of cigarettes a day is still okay, or the woman who thinks the diet is unnecessary because she's slender.)

Two high-profile deaths from heart attacks occurred this week:

Davy Jones--The iconic singer from the 1960s pop group, the Monkees, suffered sudden cardiac death after a large heart attack, just hours after experiencing chest pain.

Andrew Breitbart--The conservative blogger and controversy-generating media personality suffered what was believed to be sudden cardiac death while walking.

It's a darn shame and it shouldn't happen. The tools to identify the potential for heart attack are available, inexpensive, and simple. The strategies to reduce, even eliminate, risk are likewise available, inexpensive, and cultivate overall health.

The followers of the Track Your Plaque program who

1) get a heart scan that yields a coronary calcium score (for long-term tracking purposes)
2) identify the causes such as small LDL particles, lipoprotein(a), vitamin D deficiency, and thyroid dysfunction
3) correct the causes

enjoy virtual elimination of risk.

My letter to the Wall Street Journal: It's NOT just about gluten

The Wall Street Journal carried this report of a new proposed classification of the various forms of gluten sensitivity: New Guide to Who Really Shouldn't Eat Gluten

This represents progress. Progress in understanding of wheat-related illnesses, as well as progress in spreading the word that there is a lot more to wheat-intolerance than celiac disease. But, as I mention in the letter, it falls desperately short on several crucial issues.

Ms. Beck--

Thank you for writing the wonderful article on gluten sensitivity.

I'd like to bring several issues to your attention, as they are often neglected
in discussions of "gluten sensitivity":

1) The gliadin protein of wheat has been modified by geneticists through their
work to increase yield. This work, performed mostly in the 1970s, yielded a form
of gliadin that is several amino acids different, but increased the
appetite-stimulating properties of wheat. Modern wheat, a high-yield, semi-dwarf
strain (not the 4 1/2-foot tall "amber waves of grain" everyone thinks of) is
now, in effect, an appetite-stimulant that increases calorie intake 400 calories
per day. This form of gliadin is also the likely explanation for the surge in
behavioral struggles in children with autism and ADHD.
2) The amylopectin A of wheat is the underlying explanation for why two slices
of whole wheat bread raise blood sugar higher than 6 teaspoons of table sugar or
many candy bars. It is unique and highly digestible by the enzyme amylase.
Incredibly, the high glycemic index of whole wheat is simply ignored, despite
being listed at the top of all tables of glycemic index.
3) The lectins of wheat may underlie the increase in multiple autoimmune and
inflammatory diseases in Americans, especially rheumatoid arthritis and
inflammatory bowel diseases (ulcerative colitis, Crohn's).

In other words, if someone is not gluten-sensitive, they may still remain
sensitive to the many non-gluten aspects of modern high-yield semi-dwarf wheat,
such as appetite-stimulation and mental "fog," joint pains in the hands, leg
edema, or the many rashes and skin disorders. This represents one of the most
important examples of the widespread unintended effects of modern agricultural
genetics and agribusiness.

William Davis, MD
Author: Wheat Belly: Lose the wheat, lose the weight and find your path back to health

60-year old man dies of high cholesterol

Never saw a headline like this? Neither have I. That's because it doesn't happen.

Cholesterol doesn't harm, maim, or kill. It is simply used as a crude--very crude--marker. It is, in reality, a component of the body, of the cell wall, of lipoproteins (lipid-carrying proteins) in the bloodstream. It is used a an indirect gauge, a "dipstick," for lipoproteins in the blood to those who don't understand how to identify, characterize, and quantify actual lipoproteins in the blood.

Cholesterol itself never killed anybody, any more than a bad paint job on your car could cause a fatal car accident.

What kills people is rupture of atherosclerotic plaque in the coronary arteries. For all practical purposes, you must have atherosclerotic plaque in order for it to rupture (much like a volcano erupts and spews lava). It's not about cholesterol; it's about atherosclerotic plaque. Plaque might contain cholesterol, but cholesterol is not the thing itself that causes heart attack and death.

So why do most people obsess about cholesterol? Good question. It is, at best, a statistical marker for the possibility of having atherosclerotic plaque that ruptures. High cholesterol = higher risk for heart attack, low cholesterol = lower risk for heart attack. But the association is weak and flawed, such that people with high cholesterol can live a lifetime without heart attack, people with low cholesterol can die at age 43.The same holds true for LDL cholesterol, you know, the calculated value based on flawed assumptions about LDL's relationship to total cholesterol, HDL cholesterol, and VLDL cholesterol.

A crucial oversight in the world of cholesterol: There are many other factors that cause atherosclerotic plaque and its rupture, such as inflammatory phenomena, calcium deposition, artery spasm, hemorrhage within the plaque itself, degradative enzymes, etc., none of which are suggested by cholesterol measures.

But one observation has held up, time and again, over the past 40 years of observations on coronary disease: The greater the quantity of coronary atherosclerotic plaque, the greater the risk of atherosclerotic plaque rupture. An increasing burden of atherosclerotic plaque along the limited confines of coronary arteries, just a few millimeters in diameter and a few centimeters in length, is like a house of cards: It's bound to topple sooner or later, and the bigger it gets, the less stable it becomes.

If you are concerned about future potential for heart disease and heart attack, don't get a cholesterol panel. Get a measure of coronary atherosclerotic plaque.

Back to basics: Coronary calcium

After having my attentions pulled a thousand different directions these past 6 months, with the release of Wheat Belly and all the wonderful media attention it has attracted, I've decided to pick up here with a series of discussions about the fundamental issues important to the Track Your Plaque program and prevention and reversal of coronary atherosclerotic plaque.

I fear the discussions at times have drifted off into the exotic. This is great because this is how we learn new lessons, but we can never lose sight of the basics, else we risk losing control over this disease.

Imagine you've got a beautiful new car. You wax it, gap the spark plugs, rotate the tires, etc. and it looks brand-new, just like it came off the dealer's lot. 50,000 miles pass, however, and you realize you've forgotten to change the oil. Ooops! In other words, no matter how meticulous the attention to transmission, tires, and paint job, neglect of the most basic responsibility can ruin the whole thing. We can't let that happen with heart health.

If we propose to reverse coronary atherosclerotic plaque, we've got to have something to measure. First, it tells us whether we have atherosclerotic plaque in the first place, the stuff that accumulates and blocks flow and causes anginal chest pains, and ruptures like a little volcano and causes heart attacks. Second, it gives us something to track over the years to know whether plaque has grown, stopped growing, or been reduced. Without such a measure, you will be driving without a speedometer or odometer, just guessing whether or not you've gotten to your destination.

Of course, the conventional approach to heart disease and heart attack is not to track atherosclerotic plaque in your coronary arteries, but to track some distant "risk factor" for atherosclerotic plaque, especially LDL cholesterol. But LDL cholesterol is flawed at several levels. First, it is calculated, not measured. The nearly 50-year old Friedewald equation used to calculate LDL cholesterol is based on several flawed assumptions, yielding a value that can be 20, 30, or 50% inaccurate as a rule, only occasionally generating a value close to the real value. (No point in publicizing this problem, of course: Why compromise a $27 billion annual cash cow?) It also ignores the effect of diet. (No, cutting fat does not reduce LDL for real, only the calculated value. Cutting carbohydrates, especially wheat--"healthy whole grains"--slashes measured LDL values like NMR LDL particle number and apoprotein B.)

But all risk factors are, at best, snapshots of the situation at that moment in time. They change from day to day, week to week, month to month, year to year. If you do something dramatic in health, like lose 50 pounds, you can substantially change your risk factors values, like LDL cholesterol and HDL cholesterol. But you may not modify the amount of atherosclerotic plaque in your heart's arteries.

Measuring the amount of atherosclerotic plaque in your heart's arteries is, in effect, a cumulative expression of the effects of risk factors up until the moment of measurement.

There are several stumbling blocks, however, in the concept of measuring coronary atherosclerotic plaque. We cannot measure all the unique components of plaque, such as fibrous tissue like collagen, or degradative enzymes like collagenases, or inflammatory proteins like matrix metalloproteinase, or the debris of hemorrhage and inflammation. We struggle to contemporaneously mix in measures of bloodborne inflammation, coagulation and viscosity, and physiological phenomena of the artery itself, like endothelial dysfunction, medial (muscle) tone, and adventitial fat.

So we are left with semi-static measures of total coronary atherosclerotic plaque like coronary calcium, obtainable via CT heart scans as a calcium "score." No, it is not perfect. It does not reflect that moment's blood viscosity, it does not reflect the inflammatory status of the one nasty plaque in the mid-left anterior descending, nor does it reflect the irritating sheer effects of a blood pressure of 150/95.

But it's the best we've got.

If anyone has something better, I invite you to speak up. Carotid ultrasound, c-reactive protein, ankle-brachial index, stress nuclear studies, myoglobin, skin cholesterol, KIF6 genotype . . . none of them approach the value, the insight, the trackability of actually measuring coronary atherosclerotic plaque. And the only method we've got to gauge coronary atherosclerotic plaque that is non-invasive and available in 2012? Yup, a good old CT heart scan calcium score.

Myocardial infraction

I've seen a few heart attacks this past year . . . but none in the people who follow this program.

I saw a heart attack in a priest, a wonderful man who was unable to say "no" to his parishioners who insisted on bringing pies, cakes, and cookies every day.

I saw an impending heart attack in a 74-year old man, a football coach who thought the whole wheat-free, low-carb thing was some wacko trend. Four stents later, he's changed his mind.

A 69-year old woman had to be hospitalized for heart failure due to partial closure of an artery. She repeatedly told me that she simply could not follow the diet because it was "too restrictive."

There were a few others. Interestingly, all felt they were eating healthy, minimizing junk foods and avoiding fatty foods. None were wheat-free nor restricted carbohydrates.

In other words, in the people who follow the basic advice of the Track Your Plaque program to do such simple things as eliminate wheat, don't indulge in junk carbohydrates, normalize vitamin D status, supplement omega-3 fatty acids, supplement iodine and correct any thyroid dysfunction . . . well, they have no heart attacks.

Diet is superior to drugs

Might-o’chondri-AL left this wonderful record of his lipoprotein experience in the comments to the last Heart Scan Blog post. It is a great example of what is achievable with diet and a few supplements . . . without drugs.


(A) Jan. 2011 1st ever NMR lipo-protein analysis was done after 4 months of consistent home food prep of pretty low fat (only olive oil and 1 tablespoon coconut oil daily) but plenty of whole wheat and half potatoes:
* LDL # of particles (P) = 1,676 in nmol/L————being a LDL cholesterol (C) reading of 139 mg/dL
* small LDL # P = 1,021 nmol/L —————yikes! you advise smLDL be less than 117 nmol/L
* HDL # of particles = 28.8 umol/L ————–being a HDL C reading of 45 mg/dL
* Triglycerides = 90 mg/dL ————– true, I never struggled with my weight

(B) May 2011 2nd NMR after another 4 months but added in more fat (1 teaspoon highly concentrated fish oil daily, 90% chocolate, handfulls of nuts, more olive oil and kept coconut oil at 1 tablespoon daily for a controlled experiment), added 500 mg Niacin 3 times a day (in stages up to1,500 mg. total daily), 6000 IU daily vitamin D, deliberately cut out all grains except for social politeness and substituted in daily Koji fermented brown rice (rustic Amazake):
** LDL # P……………= 976 nmol/L ——————————– being LDL C of 100 mg/dL
** small LDL # P …. = 96 nmol/L ——————————– nice surprise
** HDL # P ………… = 27.3 umol/L ——————————being an increase to HDL C of 64 mg/dL
** Triglycerides …… = 42 mg/dL ——————————– despite daily carbs over 150 gr. daily

(C) Dec. 2011 3rd NMR after another 7 more months thinking Doc’s advice is worthwhile I added in yet more fat (mainly daily 2 tablespoons of coconut oil, more 90% chocolate), bumped Niacin up to 1,000 mg twice a day (2,000 mg. total daily), cut out the Amazake, kept up the vitamin D adding daily vitamin K & daily ate main mid-day meal out as lunch on spicy Thai & Chinese fish/shrimp/soup/rice meals (my next control):
*** LDL # P ………. = 764 nmol/L ————— being LDL C of 107 mg/dL ( 2x coconut’s saturated fat)
***small LDL # P… = less than 90 nmol/L ——–surprised me NMR can’t count lower
***HDL # P ……… = 41.4 umol/L ——————– being an increase to HDL C of 88 mg/dL
*** Triglycerides ….= 43 mg/dL ——————- daily carbs below ~ 120 gr. & lost too much weight

Isn't that great? Spectacular job, Might!

MIght achieved values that are superior to that achievable with, say, a high-dose statin strategy. Statins only reduce total LDL particles, reducing small LDL in a non-selective way. And, of course, this diet does not cause muscle aches, memory loss, nor liver problems.

Something to consider: As the diet has become so effective, we can reduce our reliance on niacin. In fact, the benefits of niacin diminish substantially, as small LDL is reduced, HDL increased, triglycerides decreased, and postprandial lipoproteins subdued with the diet only.

Low-carb is heart healthy

Anybody following the discussions in these pages know that: Limiting carbohydrate intake reduces risk for coronary heart disease and heart attack.

First of all, why do conventional diets advocate restricting saturated and total fat? From the standpoint of surrogate markers of cardiovascular risk, cutting saturated and total fat reduces total cholesterol; reduces calculated LDL cholesterol; and may reduce c-reactive protein modestly (an index of inflammation). It also increases blood sugar and HbA1c (reflecting the prior 60 days blood sugars), increases glycation of the proteins of the body leading to cataracts, arthritis, and hypertension.

Problem: Total cholesterol is a combination of HDL cholesterol, an estimate of VLDL cholesterol (triglycerides), and LDL cholesterol. It is a composite of both "good" things (HDL) and "bad" things (LDL and VLDL). Cutting saturated and total fat results in reduced HDL, increased VLDL/triglycerides, and a reduction in calculated LDL. Pretty weak stuff. The last item, i.e., reduction in calculated LDL, is not even a real phenomenon. In fact, the net effect in most genotypes (genetic types) may be negative: increased heart disease risk.

In contrast, what is the effect of reducing carbohydrate without restricting fat? (In the approach I use, we start with elimination of the most destructive of carbohydrates, wheat, followed by reducing exposure to other carbohydrates, especially cornstarch and corn products, sugar, and oats.) If, say, we cut carbohydrate intake into the range of a truly low-carbohydrate diet of 10-15 grams per meal ("net" carbs, or total carbohydrates minus fiber), then we witness a number of metabolic transformations:

Reduced fasting triglycerides and VLDL
Reduced postprandial (after-eating) triglycerides, chylomicrons, and chylomicron remnants
Increased HDL and shift towards large HDL particles (presumably more protective)
Reduced small LDL particles
Reduced glycation and oxidation of small LDL particles
Reduced hemoglobin A1c
Reduced c-reactive protein and other inflammatory markers
Reduced blood pressure

By slashing carbohydrates, we also witness weight loss from visceral fat, reversal of pre-diabetes and diabetes, and reduced phenomena of glycation. And, if the wheat-free part of low-carb is maintained, you can also see marked improvement in gastrointestinal health, relief from joint pains, relief from leg edema, relief from migraine headaches, improved behavior and ability to concentrate in children with impaired learning, ADHD, and autism, better mood, deeper sleep. You will see multiple inflammatory and autoimmune diseases improve or completely relieved, such as rheumatoid arthritis and ulcerative colitis.

Having personally gone down the diabetic path and back by cutting the fat in my diet, now maintaining a HbA1c of 4.8% with fasting glucose 84 mg/d; (without medications), there should be no remaining doubt: Low-carb diets, especially if wheat-free, dramatically reduce the factors leading to heart disease; low-fat diets worsen the factors leading to heart disease.

Mocha Walnut Brownies

Richer than a cookie, heavier than a muffin, brownies are ordinarily an indulgence that leaves you ashamed of your lack of restraint. Have one . .  . or two or three, and you will surely pack on a pound of belly fat.

But these mocha walnut brownies, as with other recipes I provide, will not pack on the pounds. With no wheat to trigger appetite, nor any readily-digestible carbohydrate to generate blood sugar highs and lows, you can have a nice brownie or two or three and nothing bad happens: You don’t send blood sugar sky-high, don’t trigger formation of small LDL particles and triglycerides, you don’t trigger appetite, you don’t gain a pound of belly fat. You simply have your brownie(s) and enjoy them.

Serve these brownies plain or topped with cream cheese, natural peanut or almond butter, or dipped in coffee.


Ingredients:
8 ounces unsweetened baking chocolate (100% chocolate)
4 tablespoons coconut oil or butter, melted
2 large eggs, separated
½ cup coconut milk (or sour cream)
2 teaspoons vanilla extract
2 cups ground almonds
2 tablespoons coconut flour
1 cup chopped walnuts
¼ cup unsweetened cocoa powder
2 teaspoons instant espresso
Sweetener equivalent to 1 cup sugar or to taste (e.g., liquid stevia, Truvía, erythritol)


Preheat oven to 350º F.

Melt chocolate using double boiler method or in 15-second increments in microwave. Stir in melted coconut oil or butter.

In small bowl, beat egg whites until frothy. Add egg whites, egg yolks, coconut milk, and vanilla extract to chocolate mixture and mix thoroughly by hand.

In separate bowl, combine ground almonds, coconut flour, walnuts, cocoa powder, espresso, and sweetener. Mix thoroughly.

Add dry mix to chocolate mix and mix together thoroughly. If dough is too stiff, add additional coconut milk, one tablespoon at a time.

Place mixture in 9-inch baking pan and bake for 25 -30 minutes or until toothpick withdraws dry.