Fat Head: Tom Naughton's manifesto for low-carb eating

12. March 2010 William Davis (16)
I just got back from Jimmy Moore's low-carb cruise to the Bahamas.

Among the many interesting people I met on the cruise was the creator of the documentary film, Fat Head, Tom Naughton.

Tom brings both creative insights into low-carbohydrate eating as well as humor. Low-carb eating can be a pretty contentious issue, but Tom made it fun. He will make you laugh about many of the odd notions we have about diet.

Among the best parts of Fat Head is Tom's portrayal of the effects of carbohydrates on insulin and fat metabolism:






Fat Head joins the ranks of films like Food, Inc, that make nutrition information entertaining. For anyone interested in a unvarnished look at diet, weight loss, along with a few laughs along the way, Tom Naughton's Fat Head is worth viewing.

Oatmeal: Good or bad?

11. March 2010 William Davis (67)

You've heard it before: oatmeal reduces cholesterol. Oatmeal producers have obtained permission from the FDA to use a cholesterol-reducing claim. The American Heart Association provides a (paid) endorsement of Quaker Oats.

I've lost count of the times I've asked someone whether they ate a healthy breakfast and the answer was "Sure. I had oatmeal."

Is this true? Is oatmeal heart healthy because it reduces LDL cholesterol?

I don't think so. Try this: Have a serving of slow-cooked (e.g., steel-cut, Irish, etc.) oatmeal. Most people will consume oatmeal with skim or 1% milk and some dried or fresh fruit. Wait an hour, then check your blood sugar.

If you are not diabetic and have a fasting blood sugar in the "normal" range (<100 mg/dl), you will typically have a 1-hour blood glucose of 150-180 mg/dl--very high. If you have mildly increased fasting blood sugars between 100 and 126 mg/dl, postprandial (after-eating) blood sugars will easily exceed 180 mg/dl. If you have diabetes, hold onto your hat because, even if you take medications, blood sugar one hour after oatmeal will usually be between 200 and 300 mg/dl.

This is because oatmeal is converted rapidly to sugar, and a lot of it. Even if you were to repeat the experiment with no dried or fresh fruit, you will still witness high blood sugars in these ranges. Do like some people and pile on the raisins, dried cranberries, or brown sugar, and you will see blood sugars go even higher.

Blood sugars this high, experienced repetitively, will damage the delicate insulin-producing beta cells of your pancreas (glucose toxicity). It also glycates proteins of the eyes and vascular walls. The blood glucose effects of oatmeal really don't differ much from a large Snickers bar or bowl of jelly beans.

If you are like most people, you too will show high blood sugars after oatmeal. It's easy to find out . . . check your postprandial blood sugar.

In past, I recommended oat products, specifically oat bran, to reduce LDL, especially small LDL. I've changed my mind: I now no longer recommend any oat product due to its blood sugar-increasing effects.

Better choices: eggs, ground flaxseed as a hot cereal, cheese (the one dairy product that does not excessively trigger insulin), raw nuts, salads, leftovers from last evening's dinner.

Mustard: Super health food?

6. March 2010 William Davis (32)
Could mustard--yes, the yellow condiment you smear on hot dogs--be a super heart healthy food in disguise?

Consider that mustard contains:

Vinegar

Turmeric

No appreciable sugar


The vinegar slows gastric emptying, resulting in slower absorption of any carbohydrates and a reduced glucose area-under-the-curve. Of the little fats contained (about 3 grams per 1/4 cup), most are desirable monounsaturates. Mustards are relatively rich in selenium, with 20 mcg per 1/4 cup, helpful for protection against cancer and thyroid disease, and magnesium, 31 mg per 1/4 cup.

Turmeric is added to most mustards. One of the constituents of turmeric, curcumin, the substance that confers the bright yellow color, has been a focus of interest for its anti-inflammatory effects. Curcumin has been documented to reduce activity of the inflammatory enzymes cyclooxygenase-2 (COX-2), lipoxygenase, and reduce activity of inflammatory signal molecules, tumor necrosis factor-alpha (TNF-a), interleukin (IL)-1,2,6,8, and 12, and monocyte chemoattractant protein (MCP). Curcumin also has been shown to reduce LDL oxidation, a potentially important step in atherosclerotic plaque formation. Turmeric is used as a tea by Okinawans. (Hmmmm . . . )

Turmeric content of mustard can vary, of course. Likewise, sugar content. Look for mustards that are not sweetened, so avoid honey mustard in particular. Look for hot, brown, horseradish, Dijon, etc. If there is a downside to mustard, it's sodium content, though the 709 mg per 1/4 cup should only be a problem for those who are sodium-sensitive (African Americans, in particular).

So perhaps mustard isn't exactly a super health food. But it may have some bona fide health effects and should be used generously especially if you are concerned about blood sugar and inflammatory phenomena.

Exercise and blood sugar

5. March 2010 William Davis (30)
There is no doubt that exercise yields benefits across a spectrum of health: reduced blood pressure,  reduced inflammation, reduced blood coagulation, better weight control, stronger bones, less depression, reduced risk for heart attack.

Exercise also influences blood sugar. Diabetics understand this best: Exercise reduces blood sugar 20, 30, 50 or more milligrams. A starting blood sugar, for instance, of 160 mg/dl can be reduced to 80 mg/dl by jogging or riding a bicycle. (I recently had brunch at an Indian restaurant with my family. Blood sugar one-hour postprandial: 134 mg/dl. I was sleepy and foggy. I got on my stationary bike and pedalled at a moderate clip for 60 minutes. Blood sugar: 90 mg/dl.)

Could the reduction of blood sugar with exercise be THE reason that exercise and physical activity provide such substantial benefits?

Think about it. Reduced blood sugar:

1) Reduces risk for future cardiovascular events.
2) Reduces glycation of proteins, i.e., reduced glucose binding to proteins like the ones in artery walls and the lenses of your eyes.
3) Reduces blood coagulation
4) Reduces endothelial dysfunction (abnormal artery constriction that leads to atherosclerosis)

This might explain why it doesn't require high levels of aerobic activity to derive benefit from exercise, since even modest efforts (e.g., a 15-minute walk after eating) reduce blood sugar substantially.

The incredible 33-year, 18,000-participant Whitehall study tells us that a postprandial (after-eating) blood sugar of an impossibly-difficult 83 mg/dl is required to erase the excess cardiovascular risk of blood sugar. Could this simply be telling us that physical activity or exercise is required to suppress blood sugars to these low levels?

It makes me wonder if an index of the adequacy of exercise is your post-exercise blood glucose.

The most important weight loss tool

4. March 2010 William Davis (15)

Question: What is the most effective tool available to help you lose weight? 


A pedometer (walk 10,000 steps, etc.)?

A treadmill? 




A bicycle?






No. None of the above. 

The most important tool you can use to achieve weight loss is your glucose monitor:



Timing of blood sugars

3. March 2010 William Davis (5)
Because different foods generate different blood sugar (glucose) responses, the timing of your blood sugar is an important factor to consider.

This question has come up a number of times. Commenters have asked whether the one-hour postprandial glucose is timed with the start of the meal or the conclusion of the meal.

In my view, if we simply ignored all aspects of meal composition, then blood glucose should be obtained one hour after the conclusion of a meal. This is because most mixed meals (i.e., mixed in composition among proteins, fats, and carbohydrates) yield peak blood glucose levels at 60-90 minutes after consumption. Timing blood glucose to 60 minutes after the conclusion of a meal puts the sample right about at the peak.

But this is an oversimplification. For instance, here is the blood glucose behavior after so-called "complex" carbohydrates wheat bread, rye bread, rye made with beta glucan, and whole wheat pasta (50 grams carbohydrates each) in slender, healthy volunteers, mean age 29 years:


From Juntunen et al 2002

Note that blood glucose peaks at 35 minutes postprandial. (To convert glucose in mmol/L to mg/dl, multiple by 18. Thus, whole wheat bread increased blood glucose from 94 mg/dl to 122 mg/dl. Also note the lower peak glucose for pasta, but sustained higher glucose levels hours later.)

In another study, older (mean age 64 years), overweight (BMI 27.9) females with diabetes were given 50 grams carbohydrate, 50 grams carbohydrate with olive oil, or 50 grams carbohydrate with butter:


From Thomsen et al 2003. Control meal of soup plus 50 g carbohydrates ({blacktriangledown}), the control meal plus 80 g olive oil ({circ}), and the control meal plus 100 g butter (•).

In this experience, note that postprandial glucose peaks 60-120 minutes after the meals (consumed within 10 minutes), delayed more when either oil is included. Blood glucose started at 144 mg/dl and peaked as high as 230 mg/dl with carbohydrates only; peaks were reduced (along with AUC) when oil was included. (Note the differential effect, olive oil vs. butter.)

These two sets of observations give you a range of blood glucose behavior. One side lesson: Carbohydrates should never consumed by themselves, else you will pay with a high blood sugar (not to mention the hypoglycemic response later for many).

Psssst . . . There's sugar in there

1. March 2010 William Davis (13)
You non-diabetics who check your postprandial blood sugars already know: There are hidden sources of sugar in so many foods.

By now, everybody should know that foods like breakfast cereals, breads, bagels, pretzels, and crackers cause blood sugar to skyrocket after you eat them. But sometimes you eat something you thought was safe only to find you're showing blood sugars of 120, 130, 150+ mg/dl.

Where can you find such "stealth" sources of sugars that can screw up your postprandial blood sugars, small LDL, inflammation, blood pressure, and cause you to grow visceral fat? Here's a few:

Balsamic vinaigrette
Many commercially-prepared balsamic vinaigrettes, especially the "light" varieties, have 3 or more grams carbohydrates per tablespoon. Generous use of a sugar-added vinaigrette can therefore provide 12+ grams carbs. (Some, like Emeril's and Wish Bone, also contain high-fructose corn syrup.)

Hamburgers
I learned this lesson the hard way by taking my blood sugar after having a hamburger, turkey burger, or vegetarian burger (without bun): blood sugar would go way up. The effect is due to bread crumbs added to the meat or soy.

Tomato soup
If it were just tomatoes, it would still be somewhat high in sugars. But commercially-prepared tomato soup often contains added high-fructose corn syrup, sucrose, and wheat flour, bringing sugar totals to 12 to 20+ grams per half-cup. A typical 2-cup bowl of tomato soup can have upwards of 80 grams of sugar.

Granola
Sure, granola contains a lot of fiber. But most granolas come packed with sugars in various forms. One cup of Kellogg's Low-fat Granola with Raisins contains an incredible 72 grams (net) carbohydrates, of which 25 grams are sugar.


Given modern appetites and serving sizes, you can see that it is very easy to get carried away and, before you know it, get exposed to extraordinary amounts of sugar and carbohydrates eating foods you thought were healthy.

And don't be fooled by claims of "natural" sugar. Sugar is sugar--Just check your blood sugar and you'll see. So raw cane sugar, beet sugar, and brown sugar have the same impact as white table sugar. Honey, maple syrup, and agave? They're worse (due to fructose).

How low should blood sugar be?

28. February 2010 William Davis (0)
What should your blood sugar (glucose) be after eating?

Take a look at the data from the Whitehall study reported in 2006. The Whitehall Study stands apart from other studies in that it was very large (over 18,000 participants) who were observed for an unusually long time (33 years). All participants were administered a 50 gram glucose "challenge" at the start with glucose levels checked after the glucose challenge.

Here's what they found:




From Brunner et al 2006.
No BS weight loss

No BS weight loss

13. April 2009 William Davis (18)
If there's something out there on the market for weight loss, we've tried it. By we, I mean myself along with many people and patients around me willing to try various new strategies.

Maybe you say: "Well that's not a clinical trial. How can we know that there aren't small effects?"

Who cares about small effects? If a weight loss strategy causes you to lose 1.2 lbs over 3 months--who cares? Sure, it may count towards a slight measure of health in a 230 lb 5 ft 3 inch woman. But it is insufficient to engage that person's interest and keep them on track. That little result, in fact, will discourage interest in weight loss and cause someone to return to previous behaviors.

What I'm talking about is BIG weight loss--20 lbs the first month, 40 lbs over 4 months, 50-60 lbs over 6 months.

Right now, there are only three things that I know of that yield such enormous effects:

1) Elimination of wheat, cornstarch, and sugars

2) Thyroid normalization (I don't mean following what the laboratory says is "normal")

3) Intermittent fasting


Combine all three in various ways and the results are accelerated even more.
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Comments (18) -

  • TedHutchinson

    4/13/2009 11:48:00 AM |

    January last year I eliminated wheat,cornstarch and sugars.
    I started Dr Dalhqvist's way of eating
    Jan 28th at 205lbs Target weight 160lbs was achieved July 2008 and since maintained.
    Height: 69inches
    before after photos on Jimmy Moore's forum
    I think we all know what the waistline in the before  photo predicts.
    2.25lbs lost each week over 20 weeks. I lost a bit more after but then restarted drinking red wine and that seems to have stopped further weight loss.
    Because I suffer from late effects of polio I am unable to exercise much so all this weight loss was through changing the TYPE not amount of food I was eating NOT by increasing the exercise I do. Those who can exercise will obtain extra health benefits but extra calorie burning is IMO the least of those advantages.
    I found eliminating wheat stopped my food cravings. I didn't snack between meals. Reduced hunger also meant it was easy to Intermittent fast when I thought weight loss may be slowing.

    I didn't calorie or carb count at all.

    I did start using Coconut oil.

    I had previously corrected Vitamin D, Omega 3 status I think reducing Omega-6 Linoleic Acid vegetable oils also improved matters
    Stephan WholeHealthSource "Omega-6 Linoleic Acid Suppresses Thyroid Signaling"

    Looking back I really don't know why I resisted eliminating wheat for so long. I had been reading this blog for long enough so I can't say I didn't know.

  • Dr. David Robinson

    4/13/2009 1:48:00 PM |

    Your three points for greater weight loss are commendable.    Having been a D.C. and cert. personal trainer for over 15 years, I only wish there were more of a push to educate the public, i.e. "weight loss" vs. "body contouring" and "deiting" vs. "proper nutrition", in order to inform them about the realities of mere weight loss and dieting vs. proper exercise and proper nutrition.  This is something I go into in my book (StrategicBookPublsihing.com/TransformingBodyMindAndSpirit.html) and have always educated clients on. Thank You, Dr. David Robnson

  • dogscapes

    4/13/2009 3:10:00 PM |

    I would like clarification on the thyroid levels mentioned in some of your posts, as well as the Hunt Study.  Should the tsh level be at 1.5 or below?  Is the higher the level the higher the risk of heart attack? I'm on thyroid rx(armour90mgs)and my test shows levels in the normal range, not sure the exact level but I will check.  If I am higher than 1.5 tsh should I lower my dose to bring that down?

    Thanks.

  • David Govett

    4/13/2009 7:51:00 PM |

    The essential first step to permanent weight loss is to have a doctor scare you to your core. Without that crucial step, diets are foredoomed because of the magic of denial. As long as you believe that somehow, despite all your bad habits, you might prove the exception and not have to pay for your foolishness, you will not change permanently.

  • Kismet

    4/13/2009 7:59:00 PM |

    Isn't slower weight-loss healthier? I believe that if someone's morbidly obese and/or obese and suffers from CVD (-risk factors), losing weight ASAP is the way to go.
    But if someone's rather healthy and only a little on the chubby side? I'd rather go with slow weight-loss whenever possible. When CRd animals lose weight too quickly, many if not all benefits of CR are lost. Maybe strict CR as a life extension diet is not comparable to a simple obesity avoidance diet, but I believe caution won't hurt.

  • xenolith_pm

    4/14/2009 1:04:00 AM |

    Notice that Dr. Davis did not say anything about calorie restriction.

    Nine months ago I stopped eating anything with any amount of grains, sugar, starch, or HFCS.  I even abstained from eating any of the very sweet fruits like bananas, mangoes, or oranges.

    I'm a 5'9" 47 y.o. male and I had started at 192 lbs., had 15% body-fat (skin fold method), and had a 34 inch waist.  I'm now at 167 lbs., have 6% body-fat, and have a 29 inch waist.

    The volume and intensity of my exercise routines remained about the same. I believe I have gained a small amount of muscle while losing a significant amount of abdominal fat.  I used no kind of fat burning supplement.  I can actually see my abdominal muscles for the first time since I was 16 years old.

    And the biggest irony is... my total daily fat and calorie intake over this period of time went up!

  • CosmicRainbowColours

    4/14/2009 11:01:00 AM |

    I only wish I had known about the connection between unexplained fluctuating weight and the thyroid, instead it took many years and in turn much weight gain before my official diagnosis of hypothyroidism. No wonder none of the diets I had tried had worked!!

  • RichE95

    4/14/2009 1:51:00 PM |

    After my heart scan it was obvious I needed to lose weight - that was about a year ago.  Along with your recommended supplements I did change my eating habits to significantly reduce fat consumption, especially saturated.  That seemed to carry a calorie reduction along with it and. The weight loss was a painless and respectable 20 pounds (210 to 190) along with the amazing reduction in cholesteral, tryglicerides, etc.  I can't wait to see heart scan results in June.

  • Megan Bagwell

    4/16/2009 7:18:00 PM |

    Have you personally tried Fat Fasting?  The 90% fat diet.  I use that to jump start some seriously fast weight loss (like after having babies, in my case.)  When I do this I go for a few days of "Fat Fasting" followed by a few days of normal low carbing (40 grams or below/day)  I've also thrown IFing in the mix, too.  Needless to say, those 3 things took the baby weight off nice and quickly and I kept muscle, too!  I'm now pregnant with my 3rd and I'll be returning to these shortly after giving birth to get to my desired weight/size, now that I know what works...it won't take as much work, though, as I'm keeping a much lower carb, whole foods diet while pregnant than before.

  • David

    4/18/2009 3:51:00 AM |

    @Megan--

    Dr. Atkins promoted the "fat fast" for those who had trouble getting into noticeable ketosis. It works really well, but is usually recommended as a pretty short-term endeavor.

    Interestingly, Dr. Eades talks about an "all meat" diet (along with Intermittent Fasting, which I believe is a revolutionary concept-- especially when combined with Paleo/low-carb) for times when weight loss has hit a plateau. This appears to be safe and effective, even for extended periods (see Stefansson, 1929).

    Dr. Jan Kwasniewski (the Optimal Diet) promotes fat intake of 70% or above-- with spectacular results.

  • D

    4/29/2009 8:05:00 PM |

    great blog. I’m on a diet right now, so this really helps

    http://f07928-c3omazme8bd-bkbnh0u.hop.clickbank.net/

  • Jamie Krause

    6/1/2009 1:07:10 AM |

    Thank you for the useful information. Nice blog!

  • Lose Weight Quick

    6/18/2009 8:36:46 AM |

    Hi Dr,

    great read i agree people wanting to lose weight ideally want to see results early on in the program,
    if it takes a person over 3 months to lose 1.2lbs it is highly unlikely they will continue to give 100%

  • Auto 1

    6/20/2009 11:36:22 AM |

    Hello Dr

    interesting read there... i agree with what Ted said it's certainly not how much you eat it's what you eat i'm all for a snack so long as it's an apple or something like that

  • Nissan 4x4

    6/23/2009 7:32:25 AM |

    Great information here, i have just started a diet.. and i agree coconut oil is better for you.. thanks for the tips this will help me..

  • Rx Pharmacy

    7/1/2009 10:50:21 AM |

    Your post is really great. Its will be help for those person who wants to lose weight. Thank you

  • Nicole M., MS, RD, LD

    7/29/2009 11:00:45 PM |

    Sorry, I completely disagree with your recommended weight-loss. Twenty pounds in 30 days for an average, overweight/obese American is not optimal. And 90% fat in the diet, especially saturated fat (coconut oil!?), is NOT heart-healthy!

  • Megaera

    2/23/2011 9:09:00 PM |

    Um, I call BS on this whole post.  Don't believe a word of it.  The people who lose weight on it are people who will lose weight on any diet.  But there are people like me and others who post on your website -- who you ignore because they don't fit your pattern -- who don't lose weight on this diet.  Sucks to be us, right?

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