In search of wheat: We bake einkorn bread

With the assistance of dietitian and health educator, Margaret Pfeiffer,MS RD CD, author of Smart 4 Your Heart and very capable chef and breadmaker (previously, before she gave up wheat), we made a loaf of bread using Eli Rogosa's einkorn wheat. Recall that einkorn wheat is the primordial 14-chromosome wheat similar to the wild wheat harvested by Neolithic humans and eaten as porridge.

The essential question: Has wheat always been bad for humans or have the thousands of hybridization experiments of the last 50 years changed the structure of gluten and other proteins in Triticum aestivum and turned the "staff of life" into poison? I turn to einkorn wheat, the "original" wheat unaltered by human manipulations, to figure this out. While einkorn wheat is still a source of carbohydrates, is it something we might indulge in once in a while without triggering the adverse phenomena associated with modern wheat?   

Here's what we did:

This is the einkorn grain as we received it from Eli's farm. This was enough to make one loaf (approximately 3 cups).











The einkorn grain is a dark golden color. I tried chewing them. They taste slightly nutty. They soften as they sit in your mouth.





Here's Margaret putting the einkorn grain into the electric grinder.









We tried to grind the grain by hand with mortar and pestle, but this proved far more laborious than I anticipated. After about 15 minutes of grinding, this is what I got:



Barely 2 tablespoons. That's when Margaret fired up the electric grinder. (I can't imagine having to grind up enough flour by hand for an entire family. Perhaps that's why ancient cultures were thin despite eating wheat. They were just exhausted!)

We added water, salt, and yeast, then put the mix into an electric breadmaker to knead the dough and keep it warm.

We let the dough rise for 90 minutes, much longer than conventional dough. The einkorn dough "rose" very little. Margaret tells me that most dough made with conventional flour rises to double its size. The einkorn dough increased no more than 20-30%.

The einkorn dough also distinctly smelled like peanut butter.





After rising, we baked the dough at 350 degrees F for 30 minutes. This is the final product.

Because I want to gauge health effects, not taste, the bread we made had no added sugar or anything else to modify taste or physiologic effect.

On first tasting, the einkorn bread is mildly nutty and heavy. It had an unusual sour or astringent taste at the end, but overall tasted quite good.

Next: What happens when we eat it? I'm going to give the einkorn bread (I've got to make some more) to people who experience acute reactions to conventional wheat and see if the einkorn does the same. I will also assess blood sugar effects since, after all, hybridizations or no, it is still a carbohydrate.



Margaret Pfeiffer's book is available on Amazon:

Ezekiel said what?

Some people are reluctant to give up wheat because it is talked about in the Bible. But the wheat of the Bible is not the same as the wheat of today. (See In search of wheat and Emmer, einkorn and agribusiness.) Comparing einkorn to modern wheat, for example, means a difference of chromosome number (14 chromosomes in einkorn vs. 42 chromosomes in modern strains of Triticum aestivum), thousands of genes, and differing gluten content and structure.

How about Ezekiel bread, the sprouted wheat bread that is purported to be based on a "recipe" articulated in the Bible?

Despite the claims of lower glycemic index, we've had bad experiences with this product, with triggering of high blood sugars, small LDL, and triglycerides not much different from conventional bread.

David Rostollan of Health for Life sent me this interesting perspective on Ezekiel bread from an article he wrote about wheat and the Bible. David argues that the entire concept of Ezekiel bread is based on a flawed interpretation.

"I Want to Eat the Food in the Bible."


Are you sure about that?

Some people, still wanting to be faithful to the Bible, will discard the "no grain/wheat" message on the basis of biblical example. After all, God told Ezekiel to make bread, he gave the Israelites "bread from heaven," and then Jesus (who is called the "Bread of Life"!) multiplied bread, and even instituted the New Covenant with what? Bread and wine! If you're going to live the Bible, it seems that bread and/or wheat is going to play a part.

But this is unnecessary. Sure, the Bible can and does tell us how to live, but this doesn't mean that everything in the Bible is meant to be copied verbatim. Applying the Bible to our lives requires wisdom, not a Xerox machine.

The Bible was written in a historical context, and the setting happened to be an agricultural one. Because of this, the language used to describe blessing spoke of things like fields full of grain, or barns overflowing with wheat. Had the Bible been written in the context of a hunter-gatherer culture, the language describing blessing probably would have been about the abundance of wild game, or baskets full of vegetables. Whatever is most valuable in your time and in your culture is a blessing. God accommodated His message to the culture as it existed at the time. This is done throughout Scripture.

There is a danger, then, in merely copying what the Bible says, instead of extracting the principles by which to live. Take the above example of Ezekiel, for instance. There's a whole product line in health food stores called "Ezekiel Bread" that supposedly copies the recipe given in Ezekiel 4:9. This is from the website:

"Inspired by the Holy Scripture verse Ezekiel 4:9., 'Take also unto thee Wheat, and Barley, and beans, and lentils, and millet, and Spelt, and put them in one vessel, and make bread of it...'"

Believing that this "recipe" has some kind of special power just because it's in the Bible is ridiculous. How ridiculous is it? I'll tell you in a moment, but first let me say that this is why it's so important not to confuse descriptives with prescriptives. Is the Bible telling a story, or is it telling us to do something? We would be well-advised not to confuse the two.

In the case of the Ezekiel Bread, what is going on in the passage? There's a siege going on, with impending famine, and Ezekiel is consigned to eating what was considered back then to be some of the worst possible food. It was basically animal chow. But that's not the worst thing going on in this passage. Apparently, when the makers of Ezekiel Bread were gleaning their inspiration for the perfect recipe, they stopped short
of verse 12:

"And thou shalt eat it as barley cakes, and thou shalt bake it with dung that cometh out of man, in their sight."

Um...what? Well, there was a good reason for this. God was judging His people, and by polluting this really bad bread with dung (which was a violation of Mosaic law; Lev. 5:3), He was saying that they were no different from the unclean Gentiles.

So why would we take this story and extrapolate a bread recipe from it? Beats me. If you were going to be consistent, though, here's what you'd have to end up with:



Let that be a lesson to you. We don't just go and do everything that we see in the Bible.

Low-carb gynecologist

I met infertility specialist, Dr. Michael Fox, on Jimmy Moore's low-carb cruise just this past March.

Dr. Fox is quiet and unassuming, but had incredible things to say about his experience with carbohydrate restriction in female infertility and pregnancy. While readers of The Heart Scan Blog already know that I advocate a diet free of wheat, cornstarch, and sugar for heart health and correction of multiple lipoprotein abnormalities, it was fascinating to hear how a similar approach seems to yield extraordinary benefits in this entirely unrelated area of female health. Obviously, female infertility and pregnancy are unrelated to heart health, but the extraordinary benefits witnessed by Dr. Fox in this area suggest that some fundamental lessons in human physiology can be learned. The results are so incredible that we are all sure to hear more about this approach as experience grows.

So I tracked Dr. Fox down in his busy Jacksonville, Florida practice to fill us in on some details.

WD: Dr. Fox, could you tell us something about yourself and what led you to use carbohydrate restriction in your female patients?

MF: I have been in practice as a reproductive endocrinologist for 15 years. During that time, I have seen our specialty move from a broad based practice of reproductive endocrinology to a narrow IVF [in vitro fertilization] focus, with patients being pushed through IVF in a cookie-cutter fashion without any emphasis on non-medical therapy.

Our focus has been to remain as a broad practice where we individualize care and attempt in every case to achieve pregnancy short of IVF. Five years ago, this continued quest for better care led us into the insulin resistance, low-carbohydrate metabolic world that has transformed our practice, although our practice offers all aspects of reproductive endocrinology including sub-specialized minimally invasive surgery, and all available infertility options.


WD: I have been intrigued by your comments about improved fertility with the low-carb diet. Could you elaborate on this?

MF: Yes, five years ago, as more information regarding Polycystic Ovarian Disease or Syndrome (PCOD/S) and its relationship to insulin resistance (high insulin levels) was emerging, we had a simple realization. As we've known for some time, insulin stimulates excess male hormone levels in the ovary, which disrupts ovulation and fertility. Then our job was to lower or virtually eliminate high insulin levels. Again, in simple fashion, we looked at physiology and realized that insulin is released only in response to dietary carbohydrates. Thus, elimination of carbohydrates should resolve the problem. This, in fact, is the effect that we have seen.

In our previous approaches to PCOD, we utilized oral ovulation medicines generating pregnancy rates in the 40% range overall. Now, with the nutritional approach, for those patients that follow our recommendations, our pregnancy rates are over 90%! This has dramatically reduced the need for in vitro fertilization in these patients.

To extend this idea further, we first started with relative low-carbohydrate diets, such as the South Beach diet, but quickly realized this didn't produce a metabolic effect. Over time, it has borne out that only the very low-carbohydrate diet (VLCD) approach produces significant metabolic change. Our impression then was that the current U.S. nutritional exposure probably increases insulin levels and that this has a detrimental effect on fertility.

To counter this effect, we now recommend the VLCD to all fertility patients and their spouses. The pregnancy rates do seem much better overall, as well as seeing a reduction in miscarriage rates. For the first time at our national meeting last year, there were three articles that showed improved pregnancy rates in patients without PCOD or insulin resistance in IVF when Glucophage was used. This drug decreases insulin. This supports the idea that our entire population is subjected to fertility-reducing high-carbohydrate diet.

WD: Do you see any other changes in these patients on the diet?

MF: Yes. All metabolic parameters, as well as many common complaints, improve. Cholesterol and triglyceride levels improve, while "good" HDL cholesterol levels increase. Weight drops at a pace of 12 lbs per month very steadily and we have many many patients who have experienced 50lb wt loss. Blood pressure decreases steadily in these patients and we are often able to get them off of cholesterol and blood pressure medicines. Common symptoms such as anxiety, sleep disturbances, decreased energy, migraine headaches and depression all dramatically improve. Again we can often get patients off depression and migraine suppression medications. So this approach helps in a multitude of areas.



WD: I was also interested in hearing more about your experience with morning sickness and the effects of a low-carb diet. Could you tell us more about this? Also, any thoughts on why this happens?

MF: As we continued to expand our thoughts about VLCD and fertility/pregnancy, we began to extend the nutritional approach into pregnancy. We know that pregnancy hormones dramatically worsen insulin resistance that is responsible for the condition, gestational diabetes. If insulin resistance is worsened, then reactive hypoglycemia is worsened. One of the biggest symptoms of hypoglycemia is nausea. So, in response to this, we have counseled our patients on the diet in pregnancy and have found a dramatic reduction in nausea. We recommend snacking every two hours in pregnancy.

The other "traditional" issue in pregnancy are cravings. These also likely stem from hypoglycemia. I have had many husbands tell us later that their wives, in contrast to friends etc, were calm and not moody or anxious during their pregnancies. Hypoglycemia probably is a serious issue for the fetus as well and may be the "signal" that turns on the insulin-resistant gene. Many theorists feel this might be an activated gene during the pregnancy.


WD: Do you use any unique approaches to the low-carbohydrate approach, e.g., inclusion of dairy, meal frequency, "induction" strategies (i.e., induction to the diet, not of labor!), etc.?

MF: Yes. As I'm sure everyone who works in the VLCD world does, we also have some tricks to make this work better. My biggest push, although hard to get patients to agree, is to see a counselor along with our follow-up in order to deal with "addictive behaviors" and "stress eating" that so many of our patients relate to us. Good stress management and cognitive behavioral therapy go a long way in helping this become a permanent change.

We also really push frequent calorie intake or "snacking." I think again that hypoglycemia produces an inborn drive to "cure" or "fix" starvation and leads to dramatic overeating. We have a short list of snacks that we recommend. The concept of hunger is offered as a failure of the program. We aim to eliminate hunger, as it represents hypoglycemia. The analogy I use is, if you drove your car until you ran out of gas before you ever sought to find gas, your life would be miserable. So it is the same with your metabolic engine: If you let it run out, the measures your system takes to fix it are very detrimental to life and certainly to nutritional health.

Our other big push is fat. People can wrap themselves around protein and vegetables, but they totally miss the high-fat (animal fat) part of the conversation. We have to really push that aspect. In regards to dairy, we allow for non-processed cheeses and minimal milk. An alternative is to mix about 4 oz whole milk with 4 oz of heavy whipping and 4 oz of water to create a "milk" with less sugar. Similarly, shakes and smoothies can be made with heavy whipping cream with pure whey protein powder added to create a liquid meal for those who "don't have time" to cook.


WD: Thanks, Dr. Fox. We look forward to hearing more about your approach in future.

Contact information:

Michael D. Fox, MD
Jacksonville Center
Reproductive Medicine
www.JCRM.org
Phone 904-493-2229

Track Your Plaque reduces healthcare costs 35%

Allow me to wear my Track Your Plaque hat for this post.

Mr. Richard Rawle is CEO of Utah company, Tosh, Inc. Mr. Rawle has been an avid follower of the Track Your Plaque program and has introduced the program to company employees. Here's what he has to say about the experience:

“Our company has been utilizing the principles of TYP [Track Your Plaque] for over a year and has experienced great results that have positively impacted the lives of our employees and our health care costs.

Since we began our wellness program, we have presented the TYP diet and lifestyle guidelines to all of our employees and their families. Although the overwhelming majority of our employees do not have cardiovascular issues, the preventative nature of TYP is too important not to be utilized. The TYP principles along with our increased focus on healthy living have already changed our group’s blood chemistry. HDL levels in particular have increased significantly and resulted in a large percentage of our employees having HDL levels of 60 or higher. Vitamin D levels have substantially increased and LDL levels have significantly decreased in the majority of our employees. Subsequently, in the 12 months just ended, our health care costs are some 35% less than other groups of comparable size and age.

I believe the TYP program has been an integral part of the success of our company's vast improvement in employee health/wellness, resulting in significant health care cost reductions."

Richard Rawle
CEO Tosh Inc.


Track Your Plaque saves lives. Track Your Plaque also saves money . . . lots of it. Despite the upfront costs of some additional blood testing and a heart scan, the dramatic reduction in need for medications, reduced heart attack, diabetes, and many other chronic conditions add up to a huge cost savings, much as Tosh, Inc. employees have enjoyed.

The Federal government has been looking towards large hospital systems to lead the way in healthcare delivery, systems that employ their physicians and possess economies of scale. But I say the answer to reducing healthcare costs will NEVER be found in hospital systems. Healthcare cost savings will be realized by delivering truly effective health solutions directly to people themselves, much as we do in Track Your Plaque.

In search of wheat

Many people ask: "How can wheat be bad if it's in the Bible?"

Wheat is indeed mentioned many times in the Bible, sometimes literally as bread, sometimes metaphorically for times of plenty or freedom from starvation. Moses declared the Promised Land "a land of wheat, and barley, and vines, and fig trees, and pomegranates; a land of oil olive, and honey" (Deuteronomy 8:8).

Wheat is a fixture of religious ceremony: sacramental bread in the Eucharist of the Christian church, the host of the Holy Communion in the Catholic church, matzoh for Jewish Passover, barbari and sangak are often part of Muslim ritual. Wheat products have played such roles for millenia.

So how can wheat be bad?

What we call wheat today is quite different from the wheat of Biblical times. Emmer and einkorn wheat were the original grains harvested from wild growths, then cultivated. Triticum aestivum, the natural hybrid of emmer and goatgrass, also entered the picture, gradually replacing emmer and einkorn.

The 25,000+ wheat strains now populating the farmlands of the world are considerably different from the bread wheat of Egyptians, different in gluten content, different in gluten structure, different in dozens of other non-gluten proteins, different in carbohydrate content. Modern wheat has been hybridized, introgressed, and back-bred to increase yield, make a shorter stalk in order to hold up to greater seed yield, along with many other characteristics. Much of the genetic work to create modern wheat strains are well-intended to feed the world, as well as to provide patent-protected seeds for agribusiness.

What is not clear to me is whether original emmer, einkorn, and Triticum aestivum share the adverse health effects of modern wheat.

Make no mistake about it: Modern wheat underlies an incredible range of modern illnesses. But do these primitive wheats, especially the granddaddy of them all, einkorn, also share these effects or is it a safe alternative--if you can get it?

I've ordered 2 lb of einkorn grain, unground, from Massachusetts organic farmer, Eli Rogosa, who obtained einkorn seed from the Golan Heights in the Middle East. We will be hand-grinding the wheat and making einkorn bread. We will eat it and see what happens.

Super-carbohydrate

Wheat starches are composed of polymers (repeating chains) of the sugar, glucose. 75% of wheat carbohydrate is the chain of branching glucose units, amylopectin, and 25% is the linear chain of glucose units, amylose.

Both amylopectin and amylose are digested by the salivary and stomach enzyme, amylase, in the human gastrointestinal tract. Amylopectin is more efficiently digested to glucose, while amylose is less efficiently digested, some of it making its way to the colon undigested.

Amylopectin is therefore the “complex carbohydrate” in wheat that is most closely linked to its blood sugar-increasing effect. But not all amylopectin is created equal. The structure of amylopectin varies depending on its source, differing in its branching structure and thereby efficiency of amylase accessibility.

Legumes like kidney beans contain amylopectin C, the least digestible—hence the gas characteristic of beans, since undigested amylopectin fragments make their way to the colon, whereupon colonic bacteria feast on the undigested starches and generate gas, making the sugars unavailable for you to absorb.

Amylopectin B is the form found in bananas and potatoes and, while more digestible than bean amylopectin C, still resists digestion to some degree.

The most digestible is amylopectin A, the form found in wheat. Because it is the most readily digested by amylase, it is the form that most enthusiastically increases blood sugar. This explains why, gram for gram, wheat increases blood sugar to a much greater degree than, say, chickpeas.

The amylopectin A of wheat products, “complex” or no, might be regarded as a super-carbohydrate, a form of highly digestible carbohydrate that is more efficiently converted to blood sugar than nearly all other carbohydrate foods.

Emmer, einkorn, and agribusiness

10,000 years ago, Neolithic humans did not obtain wheat products from the bagel shop, grocery store, or Krispy Kreme. They obtained wheat by locating a nearby wild-growing field of wild emmer or einkorn wheat grass, then harvesting it with their stone sickles.

Neolithic humans, such as the Natufians of the Fertile Crescent, carried their freshly-cut wheat home, then ground it by hand using homemade mortar and pestle. As yeast-raised bread was still some 5000 years in the future, emmer and einkorn wheat was not used to bake bread, but was consumed as a porridge in bowls. Einkorn has the simplest genetic code of 14 chromosomes, while emmer has 28 chromosomes.

A third variety of wheat appeared on the scene around 9000 years ago, a natural hybridization between emmer and goat grass, yielding the 42-chromosome Triticum aestivum species. Egyptians learned how to cause wheat to rise around 3000 BC, yielding bread, rather than the unleavened flatbreads of their predecessors.

From the original three basic varieties of wheat available to Neolithic man, over the past 30 years wheat has exploded to over 25,000 varieties. Where did the other 24,997+ strains come from?

In the 1980s, thousands of new wheat strains arose from hybridization experiments, many of them conducted in Mexico. Then, in the late 1980s, genetic engineering quietly got underway in which geneticists inserted or deleted single genes, mostly designed to generate specific characteristics, such as height, yield per acre, drought resistance, but especially resistance to various pesticides and weed killers. The fruits of these efforts were introduced into the market in 1994. Most of the genetically modified foods were thought to be only minor modifications of the unmodified original and thus no safety testing in animals or humans was conducted.

We now have many thousands of wheat strains that are different in important ways from original emmer, einkorn, and Triticum aestivum wheat. Interestingly, it has been suggested that einkorn wheat fails to provoke the same immune response characteristic of celiac disease provoked by modern wheat gluten, suggesting a different amino acid structure in gluten proteins. Another difference: Emmer wheat is up to 40% protein, compared to around 12% protein for modern wheat.

In other words, the wheat of earlier agricultural humans, including the wheat of Biblical times, is NOT the wheat of 2010. Modern wheat is quite a different thing with differing numbers of chromosomes, different genes due to human manipulation, varying gluten protein composition, perhaps other differences.

Somewhere in the shuffle and genetic sleight-of-hand that has occurred over the last 30 years, wheat changed. What might have been the "staff of life" has now become the cause of an incredible array of diseases of "wheat" intolerance.

Near-death experience with nattokinase

This is a true story that I personally witnessed.

A 60-some year old man heard that nattokinase "thinned the blood." So he had been taking it for the past 6 months.

One week before he came to see me, he abruptly became quite breathless. He was unable to walk more than 20 feet or bend over to tie his shoes due to the breathlessness.

He came to see me in the office. I was alarmed by how breathless he was without signs of heart failure or other obvious explanation. I sent him for an immediate CT pulmonary angiogram. Within 30 minutes, we had the diagnosis: a large "saddle" pulmonary embolus, meaning a large blood clot that straddled the right and left main pulmonary arteries. One wrong move and . . . bang! He would have been dead within a couple of minutes, since a large clot can completely occlude the large arteries feeding the lung, essentially corking any blood circuiting through the lungs and back to the left side of the heart. (Causing, incidentally, electromechanical dissociation, in which the heart keeps beating for a few minutes but no blood is being pumped. CPR can keep you alive for a few minutes, then it's over.)

When I advised the patient of the diagnosis (after initiating the REAL anticoagulants), he said, "But I was taking nattokinase!"

Exactly. Blood clots are no laughing matter. They are potentially fatal events. Betting your life on some company's advertisement is nothing short of foolish.

Anyone who reads The Heart Scan Blog knows that I am an avid supporter of nutritional supplements. I even write articles and consult for the supplement industry. But I truly despise hearing unfounded marketing claims that some supplement companies will make in the pursuit of a fast buck.

There is no doubt that we need better, safer methods to deal with dangerous blood clots, whether in the lung, pelvis, or other areas. But, before anyone takes a leap based on the extravagant marketing claims made by a supplement manufacturer, you want to be damn sure there are real data--not marketing claims, REAL data--before you use something like nattokinase in place of a proven therapy.

Don't confuse the very interesting, though unpalatable, natto with nattokinase. Natto contains vitamin K2 and some other interesting compounds, including nattokinase.

Blame the gluten?

Wheat is among the most destructive components of the human diet, a food that is responsible for inflammatory disease, diabetes, heart disease, several forms of intestinal diseases, schizophrenia, bipolar illness, ADHD, behavioral outbursts in autistic children . . . just to name a few.

But why?

Wheat is mostly carbohydrate. That explains its capacity to cause blood sugar to increase after eating, say, a turkey sandwich on whole wheat bread. The rapid release of sugars likely underlies its capacity to create visceral fat, what I call "wheat belly."

But neither the carbohydrate nor the other components, like bran and B vitamins, can explain all the other adverse health phenomena of wheat. So what is it in wheat that, for instance, worsens auditory hallucinations in paranoid schizophrenics? Is it the gluten?

First of all, what is gluten?

Gluten protein is the focus of most wheat research conducted by food manufacturers and food scientists, since it is the component of wheat that confers the unique properties of dough, allowing a pizza maker to roll and toss pizza crust in the air and mold it into shape. The distinctive “doughy” quality of the simple mix of wheat flour and water, unlike cornstarch or rice starch, for instance, properties that food scientists call “viscoelasticity” and “cohesiveness,” are due to the gluten. Wheat is mostly carbohydrate, but the 10-15% protein content is approximately 80% gluten. Wheat without gluten would lose its unique qualities that make it desirable to bakers and pizza makers. Gluten is also the component of wheat most confidently linked to immune diseases like celiac.

The structure of gluten proteins has proven frustratingly elusive to characterize, as it changes over time and varies from strain to strain. But an understanding of gluten structure may be part, perhaps most, of the answer to the question of why wheat provokes negative effects in humans.

The term “gluten” encompasses two primary families of proteins, the gliadins and the glutenens. The gliadins, one of the protein groups that trigger the immune response in celiac disease, has three subtypes: a/ß-gliadins, ?-gliadins, and ?-gliadins. The glutenins are repeating structures, or polymers, of more basic protein structures.

Beyond gluten, the other 20% or so of non-gluten proteins in wheat include albumins, prolamins, and globulins, each of which can also vary from strain to strain. In total, there are over 1000 other proteins that serve functions from protection of the grain from pathogens, to water resistance, to reproductive functions. There are agglutinins, peroxidases, a-amylases, serpins, and acyl CoA oxidases, not to mention five forms of glycerinaldehyde-3-phosphate dehydrogenases. I shouldn’t neglect to mention the globulins, ß-purothionin, puroindolines a and b, tritin, and starch synthases.

As if this protein/enzyme smorgasbord weren’t enough, food processors have also turned to fungal enzymes, such as cellulases, glucoamylases, xylanases, and ß-xylosidases to enhance leavening and texture. Many bakers also add soy flour to enhance mixing and whiteness, which introduces yet another collection of proteins and enzymes.

In short, wheat is not just a simple gluten protein with some starch and bran. It is a complex collection of biological material that varies according to its genetic code.

While wheat is primarily carbohydrate, it is also a mix of gluten protein which can vary in structure from strain to strain, as well as a highly variable mix of non-gluten proteins. Wheat has evolved naturally to only a modest degree, but it has changed dramatically under the influence of agricultural scientists. With human intervention, wheat strains are bred and genetically manipulated to obtain desirable characteristics, such as height (ranging from 18 inches to over 4 feet tall), “clinginess” of the seeds, yield per acre, and baking or viscoelastic properties of the dough. Various chemicals are also administered to fight off potential pathogens, such as fungi, and to activate the expression of protective enzymes within the wheat itself to “inoculate” itself against invading organisms.

From the original two strains of wheat consumed by Neolithic humans in the Fertile Crescent 9000 years ago (Emmer and Einkorn), we now have over 200,000 strains of wheat virtually all of which are the product of genetic manipulations that have modified the protein structure of wheat. The extraordinary complexity of wheat proteins have therefore created a huge black box of uncertainty in pinpointing which protein causes what.

But there's an easy cure for the uncertainty: Don't eat it.

Glycemic gobbledygook

The concept of glycemic index is meant to help determine what foods raise blood sugar a lot vs. what foods raise blood sugar a little. Dr. Jennie Brand-Miller's searchable database can be found here.

I have to admit that glycemic index provided me with a sense of false assurance for some years. It screwed up my health until I came to understand the issues a lot better.

For those of you just starting out in nutritional conversations, glycemic index (GI) represents a comparison of the blood glucose area-under-the-curve (AUC) over 2 hours after consuming 50 grams of the food in question compared to the AUC of glucose or white bread. Volunteers involved in developing these values are healthy people who are generally of normal weight.

Glucose, by definition, has a GI of 100. An equal quantity of sucrose (50% glucose, 50% fructose) has a GI of 60, lower than glucose. An equal quantity of whole wheat bread has a GI of 68-77 (Yes: The GI of whole wheat is higher than sucrose). Non-carbohydrate foods, such as eggs or avocado, have no GI since they do not impact on blood glucose.

Because the GI is also sensitive to how much carbohydrate is contained, the concept of Glycemic Load (GL) was introduced:

GL = (GI x amount of carbohydrate) / 100

GL is therefore the GI that incorporates the glycemic potential of the food of interest. GI does not vary with portion size; GL varies with portion size.

Let's take whole wheat pasta, a food regarded by most people as a healthy choice. Whole wheat pasta has a GI of 55--fairly low--and a GL of 29. A serving of 180 g (approximately 6 oz cooked) provides 50 g carbohydrates.

People who advocate that low-glycemic index foods would say that this is a desirable profile and should therefore replace high-glycemic index foods.

I say WRONG. First of all, most of us are not slender 20-somethings. We will therefore not show the same response as a young, slender person (like the GI volunteers), but will show exagerrated blood sugar responses. So this much low-glyemic index whole wheat pasta will typically yield a blood sugar of 120-200 mg/dl in non-diabetic people, high enough to trigger glycation. Sure, a high-glycemic index food, such as white flour birthday cake with plenty of sugary icing, might trigger a blood sugar of 140-250 mg/dl, much worse. But that doesn't make the lower blood sugar following pasta any less bad--it's still terrible.

Another issue: GI is assessed over a 2-hour timeline. What if blood sugar remains high in a sustained way, say, over 6 hours? That's precisely what whole wheat pasta will do: Keep blood sugar high for an extended period.

So not only does a low-glycemic index food like pasta increase blood sugar in most of us extravagantly, it does so in a sustained way.

Lastly, low-glycemic index pasta still triggers small LDL particles to an extreme degree, as I discussed in the previous Heart Scan Blog post, Small LDL: Complex vs. simple carbohydrates.

Don't be false reassured by the notion of low GI or GL. In fact, I'd go so far as to say that NO glycemic index is a GOOD glycemic index (or load). The foods we want to dominate our diet are the foods that aren't even listed in the GI database.
More on blood sugar

More on blood sugar

Take any of the following foods:

One chicken breast
Quarter-pound ground beef
6 oz salmon steak
½ cup raw almonds
3 eggs scrambled in olive oil

How much is blood sugar increased by any item in the above list?

If you said virtually zero, you’re correct. Eat any of these foods, regardless of portion size, and blood sugar won’t change substantially. If you started with a blood sugar of, say, 90 mg/dl, 1-2 hours later it would be 90 mg/dl. It might go up or even down a few milligrams, but for all practical purposes it remains substantially unchanged.

How much is blood sugar increased by the foods in this list:

2 slices multigrain bread
1 whole wheat bagel
4 oz high-fiber breakfast cereal
2 whole grain pancakes, 2 oz maple syrup

The foods in this list are a different story from the first. Depending on your body weight, exercise habits, and other factors, a typical blood sugar response in an otherwise healthy non-diabetic person would be 120 mg/dl to 160 mg/dl. In someone with diabetes, it could easily exceed 200 mg/dl.

That isn’t good. Large blood sugar excursions to 140 mg/dl have been clearly associated with greater risk for heart attack, progression to diabetes, inflammatory responses, and other adverse health effects. In fact, blood sugars as low as 100 mg/dl after eating have been associated with increased cardiovascular risk.

Then why are the USDA, American Heart Association, the American Dietetic Association, and the American Diabetes Association telling us to eat more of the foods that shoot blood sugar up to such high levels? “Eat more healthy whole grains”?

To see how much the issue of exaggerated blood sugars after eating applies to you, a simple blood sugar check 1-2 hours after eating can show you. Either your doctor can have the test drawn or you can purchase your own inexpensive glucose meter (e.g., Walmart, Wagreens).

My prediction: You will be very surprised at blood sugar responses after common foods, including “healthy whole grains.” And, by the way, keeping blood sugar excursions to a minimum will facilitate weight loss.

Comments (36) -

  • Anonymous

    1/25/2010 5:20:16 PM |

    Dr. Davis,

    Does the context of a mixed meal blunt the impact of some of those grain choices listed? For example, if you have someone who consumes a lean source of protein and some fibrous vegetables at a meal but also happened to add a bagel or a slice or two of bread, would there be the same exaggerated response or would it be lessened on account of the protein and added fiber?

    Or in the case of protein and a source of quality, undamaged fat, would this also mitigate the impact at all?

    I'm not looking for a license to eat grains and such, just curious if the impact is at all close to what it is in someone who ate the grains or the pancake/syrup combo as a standalone as a standalone.

    ~Ralph Backstrom

  • Laura

    1/25/2010 7:10:51 PM |

    I started checking my post meal glucose last Saturday.  So far, the only thing that raised it was the diluted cup of fruit juice.  I don't drink juice any longer and this provided some evidence as to why.

    Thanks for the wisdom!

  • Anonymous

    1/25/2010 7:35:04 PM |

    Behold the power of the dominant paradigm.  Go to Google and you find:

    2,160,000 for "whole grain"
    1,770,000 for "healthy whole grain"
    502,000 for "heart-healthy whole grain"

    4,980,000 for saturated fat/fats
    524,000 for "limit saturated fat"
    245,000 for "artery-clogging saturated fat"
    206,000 for "unhealthy saturated fat"

    And the voices in the wilderness
    152,000 for "healthy saturated fat"

    Freya

  • Anonymous

    1/25/2010 7:50:31 PM |

    Alas, this is only true for someone who doesn't already have T2 diabetes.  I am a small woman, 5'2", weighing about 120 pounds.  If I ate 6 oz of salmon at one sitting my blood sugar would easily go to 130 at the least, and would stay high for awhile --and I'd be insulin resistant for a day or so after. I can handle only 3 ounces of protein food at a time, and even then I get some rise.

    But your point is well taken for someone who can handle larger portions.

  • lindaharper

    1/25/2010 7:57:56 PM |

    You are so correct.  I really try to eat properly for my diabetes doing this very thing and testing what raises it and what does not.  I recently got home from a trip with family where I could not control my eating but I still kept track of my blood sugars.  I was shocked at what changing my diet did to me for those few days (while still taking some diabetic medication).  I am so glad to be home so I can eat properly!

  • Kurt

    1/25/2010 9:12:40 PM |

    And checking your blood sugar helps you determine your individual response to different foods. For example, my blood sugar increases more when I eat rice than when I eat potatoes, even when the amount of carbs is the same.

    Using a glucose meter, I have been able to keep my postprandial glucose under 120 mg/dl. Thanks for the suggestion.

  • I Pull 400 Watts

    1/25/2010 9:39:53 PM |

    What are your thoughts on fruit and veggies. With their effect on BG and a low carb diet, are you recommending lowering those as well? The only problem I have with a low carb diet is it may mean low fruit and vegetables as well.

  • Dr. William Davis

    1/25/2010 11:43:42 PM |

    Hi, Ralph--

    It does indeed. However, the effect of the precise mix of foods and portions can be best gauged by checking your postprandial blood sugars to be certain.

  • Dr. William Davis

    1/25/2010 11:44:18 PM |

    Hi, Freya--

    That's fabulous!

    It offers an interesting insight into what the "masses" are thinking.

  • Katelyn

    1/26/2010 1:25:16 AM |

    We don't need fruits and vegetables at all, particularly the former. Fruit are sugar bombs with trace nutrients.

  • steve

    1/26/2010 1:39:08 AM |

    is it really necessary to do this if you do not eat grains except ground flax with a diet of vegetables, meat fish, chicken and Greek yogurt such as Fage and only a handful of berries a couple times a week with a Whey protein shake?

  • Anonymous

    1/26/2010 5:45:09 AM |

    I think some of us are going a bit overboard on the anti-fruit/vegetable crusade here.  It is impossible to eat too much kale, broccoli, and other greens.  Vegetables are the healthiest things you can eat, and I've made them the center of my diet.  Fruit jucies are dangerous, definitely.  (I wish I knew that when I was younger.)  But fruits, I think, are much, much better, because of the fiber content. Really, eating a bowl of blueberries, and apple, and a banana is not going to give you diabetes, and will do far more good than harm.  

    - Vladimir

  • Anonymous

    1/26/2010 11:30:17 AM |

    So what about 4 oz of rolled oats?

    I avoid 95% of grains except for oats.

    Here they claim that oats are low- glycemic...

    http://blog.nutritiondata.com/

    Others say that oats do not have gluten...or at least not the same type as in wheat.

    If one would avoid all fruits...vegs...grains...that would be a carnivore's diet?

  • Kamila

    1/26/2010 1:40:09 PM |

    Dr Davis,

    You have been writing about the benefits of a low-carb diets for yeears.  So why is only now that it "mainstream" doctors are catching up.  This article from BBC News:

    http://news.bbc.co.uk/1/hi/health/default.stm

    Low-carb diet 'heart benefits'
    A low carbohydrate diet, like Atkins, is better at cutting blood pressure than weight loss drugs, according to US research.

    In this related article, the efficacy of the "high-carb" DASH diet when used alone for the control of high blood pressure is questioned:

    http://www.reutershealth.com/archive/2010/01/25/professional/links/20100125clin014.html

    Weight management needed for DASH diet to optimize heart health

    In overweight individuals with hypertension, the health benefits of the DASH (Dietary Approaches to Stop Hypertension) diet can be substantially increased by weight loss and exercise, according to early results of the ongoing ENCORE study.

    National guidelines for controlling high blood pressure (BP) recommend the DASH diet, which is high in low-fat dairy products, fruits and vegetables, lower in fats, and rich in fiber. However, studies in "real life" situations have questioned its value independent of other lifestyle changes.

  • Dr. William Davis

    1/26/2010 2:10:32 PM |

    Anonymous--

    Please don't regard to "no fruits and vegetables" as my advice. I believe that vegetables and SOME fruit should be the core of your diet.

    You can always know whether a specific carbohydrate food is good for you if you check your one-hour after eating blood sugar. That will tell you for certain.

  • Laurie

    1/26/2010 8:58:30 PM |

    So, I have been eating very low carb for a few months now.  I don't have type 2 diabetes, but I am trying to lose weight, and my research is leaving me with NO doubt as to the importance of low carb eating.  My son is type 1 diabetic, so we have several meters lying around, unused.  

    Since starting low carb, I haven't really checked my blood glucose readings.  But, when I read your last two blog posts, I had just eaten a low carb lunch about an hour previous.  So, I checked my blood glucose and it was 79 mg/dl.  Perfect!

    I was curious how high it would be if I ate a high carb meal.  But since I hardly ever do that anymore, I didn't know when I'd get a chance.

    Today I got my chance.  I went out to eat with my husband to a Japanese restaurant.  I ate rice, tempura shrimp, and a salad dressing that had some sugar in it.  So, after I got home, I checked my blood glucose at 1 hour postprandial, and guess what it was...167 mg/dl!  I was very surprised to see it that high!  I checked again at 2 hours postprandial, it had dropped to 140 mg/dl.  

    So, are those pre-diabetic numbers?

    In any case, I'm glad that I'm not eating that way anymore.  I'm down almost 20 lbs, and I feel great.  I'm totally convinced that the world needs to hear your message!

  • Flowerdew Onehundred

    1/27/2010 12:24:17 AM |

    Bought a blood sugar meter on your recommendation, and it's been informative.  I found out why I can't do intermittent fasting without feeling like crap - BG was 63 before my meal!!!

  • Anonymous

    1/27/2010 1:15:01 AM |

    Laurie, I'm not an expert, but I don't think you've got enough data to know.  If you began eating rice daily, and your numbers didn't normalize, then yes, there's a problem.  However, I'm uncertain what, if anything, you'd need to do about it, given that your typical way of eating probably doesn't spike glucose.

    Yesterday's high readings are probably the result of 2 things: (1) an unprepared pancreas, and (2) physiologically insulin resistant muscle tissue.  

    Your pancreas uses the past as a predictor of the future.  On a low carb diet, your pancreas assumes that it won't need much insulin for the next meal.  It doesn't have a large stockpile waiting just in case you decide to eat high carb one day.  

    So a pancreas used to a VLC diet won't be prepared to prevent a blood sugar spike if you eat an unusual meal.  

    However, if you ate higher carb for a few days, a healthy pancreas would start making more insulin.  At that point, the spike from a rice & tempura meal would (hopefully!) be lower.

    Also, when your diet is low enough in carbs, your muscles become insulin resistant.  This is referred to as physiological or peripheral insulin resistance, which is not the same as pathological type II diabetes-causing insulin resistance.  

    When VLC, your muscles are being fueled by fatty acids, and they don't need much glucose, so they stop accepting it from your bloodstream.  Muscle insulin resistance may also help to conserve scarce glucose for your brain and red blood cells.

    Assuming that you're nondiabetic, if you ate higher carb for a while, that type of insulin resistance should reverse.

    Clear as mud?  Laughing

  • Anonymous

    1/27/2010 3:02:35 PM |

    I have a question pertaining to what the above poster said about about physiological or peripheral insulin resistance.  I believe that this is what I experienced while on a low-carb diet.  After several months, my fasting blood sugars had risen to readings in the upper 110s and even low 120s.  Throughout the course of the day, they would hover around 100.  Previous to beginning the low-carb diet, my fasting blood sugars were typically in the upper 80s to low 90s, but my one-hour postprandial sugars would rise to 140 or higher with a meal containing a moderate to high amount of carbs.

    So my question is, if this type of insulin resistance can occur even when keeping carbs to a minimum, how can that be healthy in the long-term if even sugars in the 100s can cause problems?

  • Anonymous

    1/27/2010 4:41:29 PM |

    (Apologies if this is a duplicate submission.  I got an error the first time I hit the publish button.)

    Peter over at Hyperlipid has written about physiological insulin resistance and fasting blood sugar.

    http://high-fat-nutrition.blogspot.com/2007/10/physiological-insulin-resistance.html

    He's written other posts on the topic as well, which you can find by scrolling down to the labels section on the right hand side of the blog.

    Peter's argument may explain your fasting blood glucose, but that doesn't necessarily mean everything is okay.

    What is your HbA1c?  If your A1c is at or above 6%, you might want to refer to an older post on this forum (link below) and/or Bernstein's book on diabetes.

    http://heartscanblog.blogspot.com/2008/04/low-carb-eating-for-diabetes.html

  • Anonymous

    1/27/2010 10:15:51 PM |

    I think you should clarify things a bit. Protein certainly does get converted to glucose via gluconegenesis, and the incretin process will give you a bit of a sugar rush as well per Dr, Bernstein. Us type 1's attempting low carb lifestyles know very well that BGs most definately are affected by all consumed foods.

    John

  • Vladimir

    1/28/2010 8:42:23 AM |

    I am really confused here now.  Dr. Davis' post says that eating beef won't raise blood sugar.  But Drs. Oz & Roizen, the authors of the "You" series, and who strike me as learned and straightforward fellows, not captured by any particular industry, say that *saturated fat* -- whether from animals or coconuts or palm trees --  causes insulin resistance.  If that's right, then eating beef and other saturated fats will reek havoc on blood sugar -- if not now, then later.  

    So what gives?  Who is right?  Is the science just hopelessly confused at this point?

  • Fred

    1/28/2010 4:22:45 PM |

    For T1 and T2 diabetics:

    See Dr. Richard Bernstein's book "Diabetes Solution" for the ultimate low carb eating plan.  He advocates 30 grams of carbs per DAY - sounds extreme but he's been living with T1 diabetes (juvenile, insulin dependent) for 64 YEARS!

    Good luck

    Ed

  • malpaz

    1/29/2010 7:58:20 PM |

    im consfused too... so if saturated fat causes insulin resistance(which precedes or follow leptin resistance), and protein will spike blood sugar...

    makes meat sound like the WORST of both world... im so confused

  • Dr. William Davis

    1/30/2010 2:31:16 PM |

    A clarification: Protein and fats, including saturated fats, DO increase blood sugar. However, the magnitude of effect is much smaller than that of carbohydrates.

  • Vladimir

    1/30/2010 6:03:42 PM |

    Now I'm starting to understand why you're against grazing, Dr. Davis!  It seems like not eating for several hours -- i.e., sticking to meals -- would be quite helpful in keeping blood glucose down.

  • stcrim

    1/30/2010 8:34:43 PM |

    Dr. Davis,

    I've heard and read that sprouting grains (and beans) changes their starch content into a vegetable sugar making them much safer.  Some examples are 100 percent sprouted breads like Ezekiel Bread.

    Any truth to this that you know of???

    Steve

  • Kamila

    1/31/2010 12:51:52 AM |

    Dr Davis,

    Another article on the dangers of a "low-fat" diet:

    http://www.dailymail.co.uk/news/article-1247216/The-Big-Fat-Lies-Britains-obesity-epidemic.html

    "While we've all been brainwashed into thinking that fat is the killer we must avoid and food manufacturers bring out more and more profitable 'low-fat' versions of foods, starch - in the shape of pasta, bread, cereals, potatoes and rice - has been quietly adding on the pounds, while we are being told that it's good for us."

  • Kamila

    1/31/2010 12:57:40 AM |

    The article title is:

    The Big Fat Lies about Britain's obesity epidemic

    "While it showed some benefits from cholesterol-lowering drugs, the assumption made by the researchers was that if you eat a diet low in cholesterol, that would have the same effect as taking cholesterol-lowering drugs.

    This conclusion prompted various agencies in the U.S. to start a campaign to lower the amount of saturated fats in our diet.

    At no time did this study look at the effect of saturated fats on heart attacks or heart disease.

    So, on the basis of a study looking at drugs lowering cholesterol, we ended up with a message to eat less saturated fat.

    This plea for sanity over the advice on fats is not a lone cry.

    Several very influential experts such as Dr Laura Corr, consultant cardiologist at Guys and St Thomas' Hospital in London, and Dr Michael Oliver, from the National Heart and Lung Institute, have asked those in power to stop propagating an unproven message.

    Where does the FSA find such certainty among the pile of published science which is not conclusive in its findings?

    In fact, there are some statistics showing quite the contrary, especially when mixed with a low- starch and low-sugar diet.

    One report looked at 27 individual studies into the link between fats and heart disease and no link could be found."

  • stcrim

    2/2/2010 1:14:44 AM |

    The following are my cholesterol and Triglyceride numbers from 1-13-10 and 1-30-10 (dates are when the reports were issued.

    I am a male 54 year of age and considered myself in fair shape at 5’8” and 184lbs.   My starting total cholesterol was 295, LDL was 200, HDL was 46 and my VLDL was 49.  Triglycerides were 242.  Two weeks later my total cholesterol is 156, LDL is 102, HDL is 32, and VLDL is 22.  My Triglycerides are 109.

    My doctor is a huge fan of Dr. Davis.  Dr. Brock outlined a program for me that includes 10,000IU of Vitamin D (my values 2 weeks ago were 28.6, was not taken this time), one tablespoon of Carlson’s Fish Oil, K and K2 complex and magnesium.  There are several other nutrients such as mixed Vitamin E included

    On top of that I have modified my diet to a more plant based, lower saturated fat plan.

    This is where is may become a little controversial.  From what I understand, none of the above could account for a Drop from 295 t o156.

    Though my Doctor, like Dr. Davis feels the jury is still out, I decided to take 1400mg of disodium EDTA every morning and have those 2 weeks.  My goal in taking the EDTA was not to clean out calcium.  I understand that it doesn’t do that as far as anyone knows.   I had read multiple times that it lowers cholesterol and normalizes blood platelet aggregation.  

    Since there appeared to be little or no risk it seemed worth a try.  I can’t say that EDTA was the reason for such good numbers now but I also can’t find any other reason for them.  The only cholesterol test I had done before those 2 was 7 years ago and my total was 270.  295 two weeks ago and 156 today.

    I’m not posting this to drive the EDTA controversy.  I believe the second chance I have been given is a combination of Dr. Davis and Dr. Brocks research for which I am hugely grateful.  If EDTA had anything to do with the numbers so far, I also have Dr. Garry Gordon to thank for his research.

    A year from now I plan to have a second CT scan.  As you might guess my CT score was not go.  I was in the top 10 percent for my age.  Scary given that my grandfather died in 1932 of “acute indigestion” (wink) and my father died in 1989 of a heart attack.

    Thank you Dr. Davis.  By the way, Dr. Brock would not let me leave is office without a copy of “Track Your Plaque”.

    Steve

  • Santiago

    2/5/2010 1:46:59 AM |

    I bought the onetouch mini today and Im gonna do some pre-post eating tests next week.
    One thing I noticed is the manual says that after a meal the samples taken from a finger can be as much as 70 mg/dl higher than samples taken in a lab. Adding this to the 20% accuracy means that getting a 150 mg/dl after a meal with this device could be 50 mg/dl if tested in a lab

  • jpatti

    2/6/2010 3:13:47 PM |

    Protein raises bg.  I use insulin and have to use half as much for protein as for carbs; i.e. 1 unit Novolog covers 5g carb or 10g protein.

    Both protein and fat can be converted to glucose via gluceoneogenesis.  

    However, in practical experience, fat has no effect except to slow the raise caused by carb and protein (the "peak" bg after a fatty meal occurring later than for a lower-fat meal).

  • Anonymous

    3/29/2010 12:20:48 AM |

    Whoa! Not only does protein raise BG (via gluconeogenesis), but for someone on a low-carb diet, their average BG (and A1C) will be dominated by the glucose produced by protein. In fact, this is why advanced diabetics cannot ultimately control their condition by low-carb diets alone - the protein they need to survive is enough to raise their BGs to unacceptable levels.

  • C. Holesterol

    6/28/2010 6:47:14 AM |

    Stress is always a very big factor in stimulating all diseases as they arise from the mind.salt and sodium in excess also leads to many diseases of the body.

  • buy jeans

    11/3/2010 3:18:01 PM |

    That isn’t good. Large blood sugar excursions to 140 mg/dl have been clearly associated with greater risk for heart attack, progression to diabetes, inflammatory responses, and other adverse health effects. In fact, blood sugars as low as 100 mg/dl after eating have been associated with increased cardiovascular risk.

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