Postprandial pile-up with fructose

Heart disease is likely caused in the after-eating, postprandial period. That's why the practice of grazing, eating many small meals throughout the day, can potentially increase heart disease risk. Eating often can lead to the phenomenon I call triglyceride and chylomicron "stacking," or the piling up of postprandial breakdown products in the blood stream.

Different fatty acid fractions generate different postprandial patterns. But so do different sugars. Fructose, in particular, is an especially potent agent that magnifies the postprandial patterns. (See Goodbye, fructose.)

Take a look at the graphs from the exhaustive University of California study by Stanhope et al, 2009:



From Stanhope KL et al, J Clin Invest 2009. Click on image to make larger.

The left graphs show the triglyceride effects of adding glucose-sweetened drinks (not sucrose) to the study participants' diets. The right graphs show the triglyceride effects of adding fructose-sweetened drinks.

Note that fructose causes enormous "stacking" of triglycerides, meaning that postprandial chylomicrons and VLDL particles are accumulating. (This study also showed a 4-fold greater increase in abdominal fat and 45% increase in small LDL particles with fructose.)

It means that low-fat salad dressings, sodas, ketchup, spaghetti sauce, and all the other foods made with high-fructose corn syrup not only make you fat, but also magnifies the severity of postprandial lipoprotein stacking, a phenomenon that leads to more atherosclerotic plaque.

Comments (20) -

  • KENNY10021

    11/12/2009 2:01:55 PM |

    What if spaghetti sauce is NOT made with HFCS? I love my spaghetti sauce over my chicken.......in moderation.

  • LynneC

    11/12/2009 2:58:34 PM |

    Nice find.... this really demonstrates the insidious nature of HFCS, on multiple fronts.

  • homertobias

    11/12/2009 3:04:43 PM |

    Dr. Ron Krauss again.  Any research with his name on it is superb in my book.  I wonder if he knows Dr. Lustig (UCTV Fructose lecture).  They are neighbors.  So is BG.  Thanks for the whole reference.

  • LPaForLife

    11/12/2009 3:50:40 PM |

    Dr. Davis,

    Given this information. If someone has a good BMI and good overall diet without grains, how much fruit should they limit themselves to in a day. Should they only eat this fruit with a meal and not eat it alone between meals?

  • Anonymous

    11/12/2009 5:47:48 PM |

    Is Grazing on protein and vegetables also bad?

    Thanks,
    Penny

  • Will

    11/12/2009 9:42:57 PM |

    Wow. I guess fructose of any source would be bad, not just HFCS but eating an apple as well? It's hard to rationalize why something that is found in nature, is a whole food, and appeals to our sense of taste, would be bad for us. Maybe the fact that the fructose in the the study was in liquid form, versus being held up in some fiber, had something to do with the results but this isn't the first time that I have read that fruit is bad for you.

  • Dr. William Davis

    11/12/2009 10:32:50 PM |

    Keep in mind that the design of studies like this are often meant to yield exagerrated effects for the purposes of clean observations. It does not necessarily mean that every time you eat, you get similar postprandial phenomena.

    Nonetheless, I believe there are important lessons from such studies.

  • Anonymous

    11/12/2009 11:39:36 PM |

    This study suggests that a rice cracker or a potato (converted directly to gluclose) might be more healthful than a piece of fruit

  • pmpctek

    11/13/2009 3:33:20 AM |

    I've been able to adapt relatively easily to everything in your TYP program Dr. Davis, but this one seems to be the toughest for me.

    I don't think I can eat one meal a day.  I have always been blessed with a fast metabolism and need at least 3,000 (LC) calories even on a moderately active day, or I start to lose weight, which at 5' 9" 165# @ 8% BMI, I don't want to do, and probably shouldn't.

    3,000 calories is simply too much for me to eat in one meal.  Plus, it seems so counter-intuitive to good health, like maintaining a good energy/thermogenic/glucose/insulin/nitrogen balance throughout the day.  It just seems a perfect recipe for storing fat at the expense of lean mass, which is the complete opposite of paleolithic man's highly muscular, lean composition. I don't know, maybe just I wouldn't survive well back then...

  • Anonymous

    11/13/2009 9:43:58 AM |

    This is an excellent point- the reverse of intermittent fasting and variation in calorific consumption. Excess macronutirent calories, in the wrong form, at frequent intervals. No surprise there are adverse implications. OB

  • moblogs

    11/13/2009 10:40:00 AM |

    It rings a bell. My maternal grandfather died not long after a meal.

  • LynneC

    11/13/2009 2:29:51 PM |

    Re fructose from fruit vs HFCS, I don't think that there's much comparison.

    There are benefits to eating fruit (antioxidants, fiber, vitamins).  There is no benefit to consuming HFCS.

    Choose your fruits carefully and eat in moderation...

  • Helen

    11/14/2009 12:27:30 AM |

    I doubt that eating fruit is the same as eating refined fructose.  Not all fruit is high in fructose, for instance.  Also, the fiber in the fruit slows absorption, and this may give time for the fructose to be fermented by bacteria in the gut, producing, for instance, acetic acid, which may be beneficial to fat deposition patterns. (This is just a personal theory of mine.)  

    Furthermore, fruit contains vitamins, minerals, antioxidants, and flavoniods, which can benefit glucose metabolism, prevent lipid oxidization, and dampen the tide of free radicals and advanced glycation end-products (AGEs) produced by glucose and fructose metabolism.

    Those concerned with the effects of fructose from fruit should focus on eating whole fruits only (no juice), and eat mostly berries (low in fructose, high in flavonoids).

    I think it would be wise to separate the valid concerns about refined fructose from fruit.  We could be as off-base about vilifying fruit as people were about eggs.

    Just because a food contains a substance that can is harmful when it's been refined from its source doesn't mean that it has the same effect when found in a whole food.  The digestion and metabolism of whole foods is far more complex than can be understood by studying a single factor.

    If it's something humans have eaten for millennia, and it's safe to say that fruit is, I think it's probably innocent until proven guilty.  Just don't eat refined stuff (including juice), and you'll be fine.

  • Jim Purdy

    11/14/2009 11:13:36 AM |

    I am now trying to eat a diet that is very low in carbohydrates, moderate in protein, and high in fats like butter, omega-3 eggs, and cream cheese.

    This kind of diet seems to prevent the blood glucose spikes and the very unpleasant tachycardia that I get from high-carb meals.

    And it is frequent small meals that best control my blood glucose and the tachycardia.

  • Dr. William Davis

    11/14/2009 1:47:09 PM |

    Pmp--

    Eating once a day was not the intended message.

    This discussion is simply part of a larger discussion on the effects of various foods on postprandial patterns. We must all eat and preferably do so 3 times a day.

  • camilynn

    11/19/2009 7:08:46 AM |

    Good one on "Postprandial pile-up with fructose".I'm using the methods from http://debtfreeliving.lose20.com to reduce weight and it really works.

    Thanks,
    Edwin-   Lose 20 - Losing weight may save your life

  • Walter

    11/27/2009 6:00:10 AM |

    Hey, not all  spaghetti sauce has added fructose. Those made with sugar and or fructose cost more, because they are cheating on the ingredients.

    And yes, sugar is (half) fructose.

    Dr. William Davis, do we have any studies that show 3 times a day is optimal? One could hardly do a double blind study on this.

  • Anonymous

    10/19/2010 10:29:18 PM |

    I ate 50 grams of grapefruit (with extra fiber), with my last meal of the day and it spiked my blood sugar from 120 to 170 in 1 hr and I think I felt the beta cell damage for several hours - fruit is worse than oatmeal WITH sugar! I am pre-diabetic. I am trying to give up all bad things, but I am starving and I have to eat. I have chewing problems, so this complicates things. I tried soymilk, but it seemed to destabilize me, which is not good - I'll try it with fiber next time. I am underweight now. I am in a real bad place. I can't eat fruit anymore and even veggies give me problems. I hope I can avoid scurvy. Does anyone know if vitamin C pills truly prevent scurvy?

  • Documentaries

    11/1/2010 9:06:16 PM |

    I don't think I can eat one meal a day. I have always been blessed with a fast metabolism and need at least 3,000 calories

  • slash

    4/9/2011 4:25:19 AM |

    This website information is very good and helped me, success for you. friends, I have a website about dangerous disease mesothelioma, please visit the http://metastaticmesothelioma.blogspot.com/

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Fat and fiber composition of nuts

Fat and fiber composition of nuts



From Mukuddem-Petersen J, Oosthuizen1 W, Jerling JC. J Nutr 2005.



If you haven't yet done so, adding raw nuts to your health program yields a broad panel of health benefits.

Contrary to conventional advice, nuts can be eaten in unlimited quantities. Provided they are raw--unroasted, unsalted (since salting only accompanies roasted nuts), not roasted in unhealthy oils like hydrogenated cottonseed or soybean (very common)--they do not make you fat, regardless of the quantity consumed. Beer nuts, honey-roasted nuts, mixed nuts roasted in unhealthy oils with salt added are either fattening or exert other unhealthy effects (e.g., hypertension, rise in Lp(a), and cancer from the hydrogenated fats).

Some notable observations from the chart:

--Hazelnuts and macadamians are the richest in monounsaturates
--Walnuts are the richest in the omega-6 linoleic acid, while also richest in the "omega-3" linolenic acid.
--From a fat composition standpoint, raw cashews and dry roasted peanuts aren't so bad.
--Pistachios figure pretty favorably in this analysis, rich in monounsaturates.
--Coconuts are unusually rich in saturated fat, though about half is lauric acid--an issue for future conversation.



Here's a listing of the fiber composition of nuts per 1 oz serving (about a handful):

Almonds (24 nuts) 3.5 g
Brazilnuts, dried (6-8 nuts) 2.1 g
Cashew nuts, dry roasted, with salt added (18 nuts) 0.9 g
Hazelnuts or filberts 2.7 g
Macadamia nuts, dry roasted, with salt added (10-12 nuts) 2.3 g
Mixed nuts, dry roasted, with peanuts, with salt added 2.6 g
Peanuts, all types, dry-roasted, without salt 2.3 g
Pecans (20 halves) 2.7 g
Pine nuts, dried 1.0 g
Pistachio nuts, dry roasted, with salt added (47 nuts) 2.9 g
Walnuts, English (14 halves) 1.9 g

Data courtesy USDA Nutrient Database


Note that almonds are the winners with 3.5 grams fiber per ounce, pistachios a close second. Pine nuts and cashews place last on the fiber content chart.

Not addressed by the charts is protein content of nuts, as well as the low sugar content, all additional beneficial aspects of nuts. Nuts are also a moderate source of magnesium (though seeds like pumpkin and sunflower shine in the magnesium content area).

Rather than micromanage the specific fat and fiber content of your diet, why not get a little of the good of everything on the list and just mix and match the nuts? (Mixed and matched on your own, of course, not a hydrogenated cottonseed oil nut mixture).

Comments (16) -

  • Anna

    12/1/2008 4:00:00 AM |

    Great chart!

    But it's getting hard to find truly raw nuts anymore, unless one has or knows someone with a nut tree (cashews, even when labeled raw,  are always heat treated to remove their toxic skin).  

    Industrially produced almonds in California's Central Valley had some food-borne illness contamination problems a while back and now must be pasteurized by steam or gassing, with a  few exceptions for very small producers.  Driving through that area and seeing the trees trimmed straight across for mechanical harvesting machines and the mountains of almonds by the side of the road waiting for pickup, it's a far cry from way our hunter-gatherer ancestors sourced their nuts.  

    For the freshest nuts (least damaged PUFA oils), buy them in the shell and shell them at home.  It's hard to overindulge in nuts when one has to shell them.  

    Additionally, nuts contain substances that inhibit digestion and nutrient absorption (these prevent the nut germ from sprouting prematurely).  The best way to prepare raw nuts for consumption is to soak them in salted water for hours or overnight (depending on the nut variety) to activate the sprouting enzymes and neutralize the anti-nutrients, then drain and dry.  A food dehydrator is very efficient for drying nuts, but it can also be done in the oven.  I soak and dry about 4 pounds at time, using sheet pans and setting the oven on the lowest possible temp (170°F on my oven), then cracking the door open with a wooden spoon to keep the temperature no higher than 150°F and allow for moisture evaporation.  It varies on how long the nuts must be dried, but 24 hours is a good average.  For safety I turn the oven off overnight or if I leave the house (keeping the door cracked open) and turn it back on when I am around and can keep an eye on things.  Otherwise, it is very passive hands off  "work" and can easily fit into other activities at home.  

    The resulting nuts are not roasted, so the delicate oils aren't damaged, and are easier to digest than plain raw nuts, as well as being tasty and crunchy.  My husband and son love these "crispy nuts".  We always have a few pounds of several varieties on hand for snacking, school lunches, salad toppings, etc.

  • Anonymous

    12/1/2008 5:49:00 AM |

    Ornish, McDougall, et al., advise not eating nuts if you have atherosclerosis. Why the disagreement?

  • Zbig

    12/1/2008 10:36:00 AM |

    dear doc,
    apart from nuts(some of which, btw, are always in my fridge and I eat them daily)
    - what do you think about the Pauling's protocol - could you spare a post on it some time?

  • Micawber

    12/1/2008 1:15:00 PM |

    Dr. Davis,

    I absolutely love your blog - thank you so much for such an invaluable source of information.  

    I'm wondering whether dry (& lightly) roasted (trader joes) almonds are okay?  Or if it's essential to eat them raw?  

    Thanks!

  • Gretchen

    12/1/2008 2:27:00 PM |

    This is a little confusing: "Provided they are raw--unroasted, unsalted (since salting only accompanies roasted nuts), not roasted in unhealthy oils like hydrogenated cottonseed or soybean."

    If they're unroasted, obviously they're not roasted in unhealthy oils.

    Please clarify your position on dry-roasted nuts. Is it the heat of roasting that is the problem? Or just the oils they're roasted in.

    BTW, I find that almonds, which I dry roast myself, are a great antidote to the constipation that often accompanies low-carb diets.

  • steve

    12/1/2008 3:12:00 PM |

    interesting, but not to those of us allergic to nuts!  We lose out. I for one can eat peanuts which are really legumes, but raw peanuts i have heard are not good for you.  Hard to tell what oil it is roasted in as well.

    Is non hydrogentated peanut butter with no salt ok?

  • IggyDalrymple

    12/2/2008 12:22:00 AM |

    This physician claims that coconut oil improved her husband's Alzheimer's.

    http://www.tampabay.com/news/aging/article879333.ece

  • Anonymous

    12/2/2008 12:26:00 AM |

    I also am curious about dry-roasted vs. raw nuts and hope for some clarification on this subject.

  • Healthy Diet for Quick Weight Loss

    12/2/2008 9:14:00 AM |

    Great post......I like your blog so much...... Thanks for your valuable efforts. Good Job.....

    Quick Weight Loss


    Thanks!

  • stephen_b

    12/2/2008 10:55:00 PM |

    Instead of peanut butter which is roasted, try raw almond butter. I don't miss peanut butter now.

    StephenB

  • Andrew

    12/3/2008 8:28:00 PM |

    I enjoy salted nuts, but I am a bit concerned about the hypertension effects.  As stated in the chart, lots of salt is bad.  So, I was wondering about doing some home-roasting of raw nuts in something like peanut oil or palm oil and mixture of salt and potassium chloride salt substitute.

  • Scott Miller

    12/5/2008 12:16:00 AM |

    Here's what I do, as a nutty nut fan:

    Buy several types of raw nuts at a local market and/or whole foods.  Also include Brazilian nuts, pine nuts, sunflower seeds and pumpkin seeds (none of these on the chart, but each has a healthy fat profile).

    I mix all of these in roughly equal quantities in a large bowl.  Then I add several tablespoons of olive oil.  Why, to make the nuts sticky for what comes next: seasonings!  I'll add black pepper, cayenne (chili) pepper, and sea salt -- all to taste, but I use a lot of sea salt.  (Note, sea salt is not like table salt, which is 99% sodium chloride and not healthy. Sea Salt is a composition of numerous mineral salts, and not only healthy, but required for longevity.)

    I also throw in about 50 grams of unflavored egg white protein powder, which, when everything is all shaken up, helps keep the nuts from feeling oily to the touch.

  • Dr. B G

    12/6/2008 3:56:00 PM |

    Scott,

    Thanks for the delish recipe!

    We just switched to sea salt (for the Mag and electrolytes) -- GREAT TYP!!

    What an interesting way to use egg white powder (besides making royal icing).

    -G

  • Pablo

    11/6/2009 9:00:39 AM |

    Dr. Davis,

    I'm wondering about your comment that "Contrary to conventional advice, nuts can be eaten in unlimited quantities. Provided they are raw..."

    You see, 100 grams of Cashews has approx. 550 calories. While I'd love to eat a pound of 'em, that'd be over 2,000 calories.

    Your thoughts, sir?

    Paul

  • Anonymous

    10/20/2010 2:54:05 AM |

    I can't eat nuts, they are too high glycemic and give me headaches. Almonds are supposed to be low glycemic, but my headache after eating almonds is proof that nuts spike my blood sugar. I hope to mix nut butter with a fiber complex to lower the glycemic response in the future. I'll stick with seeds for now, like sesame.

  • buy jeans

    11/3/2010 3:41:47 PM |

    Not addressed by the charts is protein content of nuts, as well as the low sugar content, all additional beneficial aspects of nuts. Nuts are also a moderate source of magnesium (though seeds like pumpkin and sunflower shine in the magnesium content area).

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