Interesting story from the UK:

How can a fit, clean-living 32-year-old have a heart attack? For Martin the answer was in his genes. Like thousands he suffers from INHERITED high cholesterol

"He was diagnosed with familial hypercholesterolaemia (FH), an inherited condition where the body cannot clear ‘bad’ LDL cholesterol from the blood."

His arteries were so clogged that he needed a triple heart bypass — where blood vessels are taken from elsewhere in the body, usually the chest and legs, and used to create a new route for the blood to flow around the blockages.

An estimated 100,000 people in Britain are living with FH but don’t know it, according to a report published last week by the Royal College of Physicians.

The condition could kill them at any moment.

So how could an apparently healthy man have such dangerous levels of cholesterol? Cholesterol is a waxy ­substance produced by the liver from the saturated fat we eat.

It plays a vital role in the function of cells and production of hormones and vitamin D.

Once it has done its job in the body, it’s also the liver’s job to remove it. In healthy people, this happens automatically.

‘The liver has “finger receptors” that reach out and grab hold of “bad” LDL cholesterol particles as they pass,’ says Professor Steve Humphries, the new report’s author and director of the Centre for Cardiovascular Genetics at University College London.

‘Good’ HDL cholesterol travels to the ­arteries to help unblock them before it also goes back to the liver to be removed by another set of receptors.

‘Once inside the liver, the cholesterol gets broken down, sent to the intestines and is then passed out of the body,’ says ­Professor Humphries.

‘But in people with FH, these receptors don’t work properly, so the cholesterol builds up in the blood.’

(With the more common form of high cholesterol, the problem is that the patient has too much LDL for the receptors to cope with.)

Over time, cholesterol deposits build up in the arteries, restricting blood flow to the heart and increasing the risk of heart attacks and strokes.

By the age of 55, if left untreated, half of men with FH will have developed heart disease, while a third of women with it will develop heart disease by 60.

While most FH sufferers have heart attacks in their 50s and 60s, some, such as Martin, can be affected in their 30s and 40s — with no warning signs."

http://www.dailymail.co.uk/health/article-1352284/How-fit-clean-living-32-year-old-heart-attack.html

Dr
what is better to use regular glutten bread or whole wheat?

Doc Davis,

I am a fan of your blog, follow it religiously and have commented many times. You provide great advice and we are all thankful for it.

That being said it, the content has become repetitive. Wheat is unhealthy. It has many negative side effects. It hates puppies and kittens. And babies. We get it.

I'd love to read more content about other health subjects.

Please take this in the spirit it was intended.
-WheatFreeSince2003NotReallyButItRhymes

Anon

there are new ppl in this blog like me ,that did not reed all the posts

For me ,it is a new thing as for many newcomers

I never liked wheat, but I thought that was healthy

We eat challah every Friday, my wife wanted to change it for whole wheat challah


I dunno if to keep the same challah or to change for whole wheat

Hi, Chaim--

Makes no difference. All the same.


Hi, Anonymous--

I hear you. However, as Chaim points out, there are usually several hundred new people here per day who still ask questions like "why no wheat?" So I re-explore some of the most common concerns.

Dr Davis - I read your blog regularly, and have for a year or two now.

I do NOT find your posts about the ills of wheat to be at all repetitive. What you have to say is always informative and often very funny.

Please do NOT stop posting about wheat.

Bedside manners may not be Doc's strong point. Once he almost   insulted Frankengrain's Aunt Butter (newbies can scroll blog's Labels, click "butter" & view comments).

Any evidence for any of this? And I mean real and solid evidence, not a bunch of anecdotes.

You still haven't explained why the traditional people of Sardinia and Crete were so long-lived and healthy in old age (shepherds carrying heavy loads up steep mountain trails at the age of 90, etc), despite eating huge amounts of wheat (we're talking upwards of 750 grams of wheat bread per day for an active worker). For poor folk, the diet was mostly wheat, olive oil and wine, plus fruits, nuts and vegetables in season. Those with some money supplemented with dairy products, fish and meat. The Cretans and Sardinians were notoriously healthy, but the other traditional people of the Mediterranean basin plus the mountains of central Asia were also quite healthy on this wheat-based diet.

Note that I use the past tense, because now that most of these peoples have moved to the cities, they are all becoming obese and diabetic and plagued with heart disease and other ailments.

Hi, Revelo--

I don't know for certain, but I suspect that they are consuming a different genetic strain, e.g., emmer or a different, non-dwarf, variant.

Wheat is literally 25,000+ different strains. While the majority are quite destructive, there are likely a few less destructive forms. This is one of the reasons I discuss the appeal of einkorn.


DK and others--

The evidence for much of this is actually overwhelming. It will be fully articulated in my forthcoming book from Rodale, Wheat Belly,

Thanks for the tip on Einkorn wheat. I have now added pasta back into my diet. I had eliminated it due to the huge blood sugar spikes. After eating pasta made from Einkorn wheat my blood sugar tests 100-108 just one hour after eating.  Traditional durem wheat pasta was producing 140+ even 2 hours later. Plus it is good.

This is great! I'll be sure to share with the doubters.

Here's what would be more helpful: what to eat once you swear off wheat?
What are we supposed to do for carbs? Potatoes and rice are glycemic bombs, we're told. Corn doesn't belong in a human diet either. High fructose corn syrup is in absolutely everything. Too much fruit is no good.  Short of somehow becoming a traditional Inuit or living in the induction phase of Atkins the rest of my life, I'm at a loss for ideas. I allow myself some pizza each week and a nice bowl of breakfast cereal, but I'm not extravagant with wheat, yet I have a trigylceride level of 292, HDL of 35, even with fish oil and niacin, and three days a week in the gym.

Anonymous, my own Triglyceride levels came down from 214 just a year ago (at some point they were in the 300s) to 89 just before Christmas. This was by seriously cutting down on all sorts of carbs, I.e, only minimal amounts of bread, pasta, rice, etc. Hilariously, the doctor commented: “but remember, you don't need to cut fat from your diet completely!”. I just grinned. Having said that, I know exactly what you mean. If you go out for food, it is virtually impossible to avoid refined carbs in huge amounts in just about any dish. If you prepare your own food, you will have to discard the bulk of your favorite recipes from the past, and focus on stews etc. It's not easy. Regards, neuroscan.

There is lot of CH in vegetables.

For instance, 100g of brussels sprout has around 4g of CH.
Its so delicious when cooked for few minutes in olive oil and/or butter that you can easily eat around 300g per day which gives you 16g.

Potato is good alternative. Its hi GI (and GL) but, high GI foods in small amounts don't rise sugar. Amount is important. One boiled potato for instance.

Other stuff: carrot, black chocolate (75%++ cocoa), oat brans, cashews, cranberries.

Those are extremely healthy foods with good amount of slow carbs.

Hi Revelo,
Twice here I've seen mention of Crete & Sicily intake. Those islands' heat and humidity foster unique symbionts.

Temperature will influence the varieties of soil bacteria. Based on the prophylactic gastro-intestinal affect of Japan's Natto I'd look to a local strain of Bacillus subtilis found on the drying wheat stalks.

Humidity will influence the varieties of mycotic (fungi) strains post-harvest grain is exposed to. Rural storage isn't hermeticly controlled conditions.
Based on human prophylactic gastro-intestinal affect of Japan's Koji (Amazake)I'd look for fungal mycellium of a local Aspergillus strain.

Swine, whether kept as pigs or feral boars, expose country folk to non-symptomatic helminths (worms). Human immune system modulates away from auto-immune response in reaction to them. I'd look at the swine Whipworm species interaction.

Robust rural 90 year olds are gaunt and conditioned. Carbohydrate based diets facilitate this by producing triglycerides to send out from the liver. In between the muscle cell's, and not fat, these are stored as di-acyl-glycerides.

A genetic/epigentic determined copy number variation of an enzyme influences our ability to convert "di-" back into tri-acyl-glyceride (triglycerides). The muscle then "burns" this on site for a lot of energy. My 2000 decade co-villagers relied on tubers (carbohydrate); one reputedly closing in on 100 years regularly walked many kilometers.

That pretty much sums it up...  I love this blog.

Anonymous...
It might be repetitive but he does update his blog EVERY day... this in addition to being a doctor, husband, parent.  The fact is that wheat really is so destructive and addictive for some people that it's worth repeating every day.  
Keep at it Doc and I am looking forward to your book!

Regarding the connection between Urinary incontinence and wheat ...

A connection has also been noted between Vitamin D3 deficiency and urinary incontinence.  There was a study from SUNY Upstate Medical University in Syracuse, N.Y from March 2010:
http://www.webmd.com/urinary-incontinence-oab/news/20100322/low-vitamin-d-linked-incontinence

I began to optimize my VD3 levels late in 2009 and this was one of the first benefits I realized - within a few months this situation had improved dramatically for me.  

Then we started to cut way back on our wheat consumption in the fall of last year.

It would be hard at this point for me to determine that having cut back on wheat is also having an impact - but there has been no obvious improvement.  Perhaps complete wheat elimination would have a more telling effect - but I do feel my situation now is near normal, whereas before it was an inconvenient problem of considerable concern.
*

I know Dr. Davis did some baking (experiments) with Einkorn wheat.  I've found a few other sites for "heirloom wheat" flours ....
Anson Mills:
http://www.ansonmills.com/wheatflour.htm
and ...
Kamut: Ancient Grain in Modern Times:
http://www.suite101.com/content/kamut-ancient-grain-in-modern-times-a89648

... and I'm sure there are more.

These grains also predate the dwarf wheat mutant, and I wonder if anyone here has any experience with these flours?

I now consider that cutting back on wheat consumption is a lifestyle choice for us and we won't be going back.  But I do occasionally bake a cake, or use a bit of flour to thicken a sauce, and sometimes bake bread.  

I would like to have an alternate flour in the house that I feel comfortable cooking with.

Dr Davis, you have the patience of a saint to humour anonymous coward(s). I DO like reading the reminders of how bad wheat is, because people like me with ambiguous symptoms may or may not ever get a diagnosis of gluten intolerance or celiac disease. My last wheat cheat involved blood, so it's very possible that I have CD, but I dread the diagnostic process. Either way, it is emotionally draining to swim against the tide! Your posts help keep me on the straight and narrow.

Doc, are there any references or further info on the issue of wheat triggering bipolar manic episodes? I'm having a major "a-ha" moment over this one. I'd love to read more about it. I've been reading your blog and that of Dr Emily for a while, and I don't recall seeing any info on that. Pardon me if I missed it.

I can't give up wheat products.  Because if this website I've drastically reduced my intake but haven't been able to make a total break.  Dr D's continual wheat-is-bad theme is pushing me toward my goal.  I do not want him to change this web's focus.  Without it I'd probably revert.  

kevin

Aren't corn and soybeans just as bad?  I thought he was going to end up with corn.  Remember, 95% aren't eating enough whole grains!  Zero is enough for me!

Chaim -

Shalom!  If you make your own hallah try to find some emmer or einkorn and see if that helps.

If not try making sourdough, since at least the phytic acid is removed by the fermenation.

It is possible that many Jews are not as sensitive to wheat since we have been eating it for a long time (of cource that was einkorn and emmer).

Keep in mind you only need to eat a cbeya to wash with a bracha and czayit to bench on.  That's 2oz of bread - really not such a big deal if you're not eating wheat the rest of the week.

I will also point out that Abraham served cream, butter, and organ meats to his guests.

[...] The Perfect Frankengrain – Dr William Davis [...]

Amen, brother! This is the dirty little secret that proponents of the lipid-hypothesis of CAD continually try to sweep under the rug. Looks like the cat's out of the bag, though, thanks to the internet.

But what can be done about post-meal elevated triglycerides?  Would it be best to avoid fats too, and just eat fruits and vegetables, if one had the will power to do it?

Perhaps we should just give up eating altogether.

I think that worrying about post-meal elevated triglycerides is probably shortening your life more than post-meal elevated triglycerides.

so what does this mean?

"It also remains true if you chronically consume fats."

my understanding is that it is actually in support of normal metabolic functioning for us to "chronically" eat fat. low carb eating, in my lay-person's opinion, means therefore eating good fats (and i am of the un-pc standpoint that saturated animalfats are a-ok) , not just green veggies alone. low-car and low-fat would be no fun! but that's just my 2 cents.

I've had two non-fasting cholesterol tests performed in the last year.  My fasting triglycerides are around 40.  My triglycerides three hours after eating a meal with 10g carbs and 59g of fat were 91.  The time prior to that, they were 79 eight hours after breakfast and three hours after lunch (both were high-fat meals).

Yeah, they go up, but not that much.

So what about the other side of the equation? Decreasing the absorption rate of fat (or spreading it out over more meals) might not help any. But if you can optimize the deposition of fat where it really belongs, in subcutaneous fat tissue-- that is, if fat is deposited in fat tissue where it belongs until needed, at a rate close to the rate at which new dietary fat is absorbed into the bloodstream-- then there shouldn't be a problem.
Interventions that raise HDL generally increase adiponectin. Eating less wheat, beer, fructose, or adding in fish oil, niacin, vitamin d, even being born a woman. And they also associate with less wheat belly.

http://www.springerlink.com/content/dpy09vbc0r8jxnm9/

-----------------------------------
Conclusion/interpretation. These data suggest that adiponectin concentrations are determined by intra-abdominal fat mass, with additional independent effects of age and sex. Adiponectin could link intra-abdominal fat with insulin resistance and an atherogenic lipoprotein profile.
--------------------------------
Maybe they've got cause and effect reversed here? I read a study in mice that were leptin-deficient. Adding extra adiponectin made the mice fatter. So adiponectin is probably not so much a reaction to deposited fat as it is a promoter, maybe a facilitator of proper fat storage.

?

Thanks, interesting post. Just wondering: what about proteins?

So if I eat cheese slices with butter as snacks all day, my triglys will be chronically high and I can get heart problems?

Does this mean that intermittent fasting is very important if you eat low carb/paleo style?

Where Oh Where can I find a Doctor like Doctor Davis in the New Jersey area?

My doc who is a cardiologist referred to by local medicenter when it was found out my Trigs were 235 and Total Cholesterol were 295, LDL 195, HDL 57, promptly put me on 5 mg Crestor to lower trigs and LDL, never discussed diet or anything with me. His office plastered with Pfizer Lipitor posters and Crestor bags given by pharma reps.

Heres the kicker, this was all done with blood work that was NON-FASTING. I had blood drawn an hour after I had eaten eggs and bacon. This was also around halloween time too when I was over indulging on ALOT of Sub sandwiches and bread and lots and lots of candy. I love peanut butter cups. But I know 5 a day is excessive, which was my intake.  Was I getting a DOUBLE Whammy increasing my Trigs?

Since I found this blog, I've been taking my Crestor which I don't want too. But have taken up the no wheat diet and HFC out of my diet that Dr Davis suggests. Dropped 18 pounds in a matter of weeks.

Took my own cholesterol with one of those home machines after 4 weeks of Crestor. Doctor wants to test after 3 months. But my Total Cholesterol was 151, calculated LDL 87, HDL 50 and Trigs 69. I wonder how much was the Crestor doing the change or the change in my diet and 18 pound weight loss?

Sorry for the rambling, but Dr. Davis your blog does give great info and brings peace of mind to me.

Anonymous,

Absolutely not. Having elevated triglycerides immediately after a meal is not a dangerous thing. It's only when they are chronically elevated that you are in danger. Same thing with insulin. Chronically elevated levels are the problem.

Both of these are caused by excessive sugar/carb consumption.

-Bryce Lee

Bookmarked this. Sometimes non-standard due to you after sharing. Positively value my time.

Dr. Davis: a friend of mine recently had triglycerides trending up to 700 and more. I pointed him to your blog, recommended low carbs and fish oil, and after *one month* his TGs are around 200.

Kudos to you.

Interesting series of posts. But keep one thing in mind: Excess blood glucose is converted to palmitic acid by the liver...a saturated fat.

(This fact alone should give the anti-saturated-fat crowd pause...if the body could have evolved to convert glucose to any type of fat, why did it evolve to produce a saturated fat? Can't be too bad for you...)

Anyway, if the body through DNL produces a saturated/healthy fat after only a very brief (and normal) spike in blood glucose - after which the glucose returns to a normal fasting level - then high starch (not fructose) diet appears to be quite healthy. This would answer the question of why a rice-base culture can maintain good health while consuming a diet high in starches...in effect, they are eating a high saturated fat diet.

If they don't eat continuously, allowing their bodies time to eliminate the excess blood glucose and the attendant insulin spike before the DNL triglycerides (palmitic acid) hits their blood stream, then there is no insulin-driven storage of the fats. Instead, they have elevated blood-borne fats that remain available for a consistent energy source of over time, of a type that their body prefers and has evolved to produce.

Can you get the same effect from eating saturated fat in the first place? Yes. But to assume that this is better than the starch-driven approach you have to accept that higher levels of ANY saturated fat in the bloodstream is unhealthy. Which runs counter to the viewpoint of paleo and low-carb eaters.

As Stephen has pointed out, there is no evidence that post-prandial glucose spikes are dangerous to someone with a healthy metabolism (i.e. not a type I or II diabetic). So, if there is no evidence of danger from a post-starch-meal spike, why would your body care where it got its saturated fat? Either dietary or liver-produced, it’s all the same once it is in your blood.

Following the chain of reasoning further, a high-starch diet that leads to DNL production of palmitic acid would be healthier than a high fat diet composed of vegetable oil or other undesirable fats.

We have to be very careful about quickly latching onto bits of "evidence" that confirm our biases. Remain scientific, think it through. The human body is an amazingly complex organism; when we begin to isolate its responses to prove our points, we can start down a path that leads to conclusions that may satisfy our dietary worldview, but are not entirely accurate.

Scott W

Note: If we are being carefully scientific in our approach, we should be careful to distinguish our descriptive terms for non-fat and non-protein calorie sources. "Carbohydrates" is too general. It encompasses fructose, which as a much different effect on the liver than glucose. My discussion above focuses on starches for a reason; they break down to glucose, which the body has evolved to handle efficiently, even in large quantities. It can handle fructose, too, but did not experience it in large quantities prior to modern times. Even using the term "sugar" is inaccurate, since it is half fructose and half glucose. By extension of my discussion above, eating pure glucose powder (dextrose) would be as healthy for a rice-based culture as eating white rice itself. You are simply giving the body the end product of rice digestion (glucose), from which it can produce palmitic acid.

There's no question that postprandial triglyceride-rich lipoproteins are causally related to atherosclerosis, regardless of whether they were fat-driven or carbohydrate-driven.

However, these brief posts are NOT meant to endorse low-fat diets. They are meant to show that a simple low-fat vs. low-carb approach is too simple-minded. There are other aspects of diet that count for substantial effects. Postprandial phenomena are one important class of effects that cannot be fully controlled by just controlling carbohydrate or fat content of the diet.

You still haven't explained why the chart in your previous post (Di Novo Lipo-what?), where normoinsulinemic people have lower DNL on a high-fat diet, is in marked contrast to the chart of Gretchen in the post before that (Gretchen's postprandial diet experiment II) when she was eating high-fat.  From those two posts, it seems that peoples' postprandial triglyceride level is dependent on the amount of insulin they produce (and obviously how sensitive they are to that insulin).  Therefore a high-fat diet is not problematic unless one is also hyperinsulinemic.