Cholesterol effects of carbohydrates

24. March 2009 William Davis (31)
Let's take a hypothetical person, say, a 50-year old male. 5 ft 10 inches, 160 lbs, BMI 23.0. He's slender and in good health.

Our hypothetical man eats a simple diet of vegetables, some fruit, nuts, and meats but avoids processed industrial foods. By macronutrient composition, his diet is approximately 30% protein, 40-50% fat, 20-30% carbohydrate. His starting lipid panel:

Total cholesterol 149 mg/dl
LDL cholesterol 80 mg/dl
HDL 60 mg/dl
Triglycerides 45 mg/dl

His starting lipids are quite favorable (though I don't often see this kind of starting panel nowadays except in athletes). We begin here because this hypothetical man is going to serve as our test subject.

We ask our hypothetical man to load his diet up on "healthy whole grains." He complies by eating whole grain cereals for breakfast, whole wheat toast; sandwiches made with whole grain bread; dinners of whole wheat pasta; snacks of granola bars, whole wheat pretzels and crackers.

Three months later, his lipids show:

Total cholesterol 175 mg/dl
LDL cholesterol 130 mg/dl
HDL 45 mg/dl
Triglycerides 150 mg/dl


You can see that LDL cholesterol has increased, HDL has dropped, and triglycerides have increased. This wave of change is the hallmark of carbohydrate excess, but more specifically of overreliance on wheat products. Beyond his lipid panel, the man has gained 10 lbs, all concentrated in a soft roll around his abdomen, his blood sugar is now in the "borderline range" of between 110 and 126 mg/dl, i.e., pre-diabetic.

If we were to examine this man's advanced lipoproteins (e.g., NMR from Liposcience, or VAP from Atherotech), we would see that there has been an explosive increase in small LDL particles, along with a shift of large HDL to small, and the appearance of multiple abnormal classes of particles called VLDL and IDL (signalling abnormally slowed clearance of dietary by-products from the blood).

Familiar scenario? The "after-carbohydrate" situation is the rule among the people who I first meet who claim to be eating a "healthy" diet, though their patterns are usually much worse, with higher LDL, lower HDL, and much higher triglycerides, an exaggeration of our hypothetical man's abnormalities.

What if our hypothetical man now goes to his conventionally thinking (read "taught medicine by the pharmaceutical industry") physician? What will likely be the advice he receives? Reduce his saturated fat intake, eat plenty of healthy whole grains, take a statin drug.

Although my illustrative man is hypothetical, I've seen this scenario play out many thousands of times. It happens in real life all the time. It is predictable, it is highly manipulable. Sadly, it is rarely recognized for what it is: the result of excess carbohydrates, or what I call "Carbohydrate Intolerance Syndrome."

The misinterpretation of this condition has created 1) an epidemic of diabetes and pre-diabetes, 2) a nation of frustrated obese Americans, 3) a $27 billion per year statin industry, 4) another growth opportunity for the drug industry in diabetes drugs.

Wheat Belly Revisited

23. March 2009 William Davis (24)
Do you have a wheat belly?

When I first coined this phrase back in July, 2007, I had witnessed the phenomenal health effects of wheat elimination in several hundred patients.

In the nearly two years that have passed since my original post, I have witnessed hundreds more people who have done the same: eliminate pretzels, crackers, breads of all sorts, bagels, pasta, muffins, waffles, pancakes, etc.

If anything, I am convinced now more than ever that wheat is among the most destructive foods in the human diet. At least 70% of people who eliminate wheat from their diet obtain at least one, if not several, substantial health benefits.

Now, if I were trying to sell you something, say, an alternative to wheat, then you should be skeptical. If I tell you that drug or nutritional supplement X is great and you should take it, only to follow it with a sales pitch, you should be skeptical.

What am I selling? Nothing. I gain nothing by telling everyone to avoid wheat. In fact, I wish it wasn't true. Wheat foods taste good. Wheat flour makes great comfort foods. In years past, I spent many hours sitting at the bagel shop reviewing papers over a cup of coffee and a bagel. No longer.

So here, back by popular demand, the original Wheat Belly post:



Wheat Belly

You've heard of "beer bellies," the protuberant, sagging abdomen of someone who drinks excessive quantities of beer.

How about "wheat belly"?

That's the same protuberant, sagging abdomen that develops when you overindulge in processed wheat products like pretzels, crackers, breads, waffles, pancakes, breakfast cereals and pasta.



(By the way, this image, borrowed from the wonderful people at Wikipedia, is that of a teenager, who supplied a photo of himself.)

It represents the excessive visceral fat that laces the intestines and triggers a drop in HDL, rise in triglycerides, inflames small LDL particles, C-reactive protein, raises blood sugar, raises blood pressure, creates poor insulin responsiveness, etc.

How common is it? Just look around you and you'll quickly recognize it in dozens or hundreds of people in the next few minutes. It's everywhere.

Wheat bellies are created and propagated by the sea of mis-information that is delivered to your door every day by food manufacturers. It's the same campaign of mis-information that caused the wife of a patient of mine who was in the hospital (one of my rare hospitalizations) to balk in disbelief when I told her that her husband's 18 lb weight gain over the past 6 months was due to the Shredded Wheat Cereal for breakfast, turkey sandwiches for lunch, and whole wheat pasta for dinner.

"But that's what they told us to eat after Dan left the hospital after his last stent!"

Dan, at 260 lbs with a typical wheat belly, had small LDL, low HDL, high triglycerides, etc.

I hold the food companies responsible for this state of affairs, selling foods that are clearly causing enormous weight gain nationwide. Unfortunately, the idiocy that emits from Nabisco, Kraft, and Post (AKA Philip Morris); General Mills; Kelloggs; and their kind is aided and abetted by organizations like the American Heart Association, with the AHA stamp of approval on Cocoa Puffs, Cookie Crisp Cereal, and Berry Kix; and the American Diabetes Association, whose number one corporate sponsor is Cadbury Schweppes, the biggest soft drink and candy manufacturer in the world.

As I've said many times before, if you don't believe it, try this experiment: Eliminate all forms of wheat for a 4 week period--no breakfast cereals, no breads of any sort, no pasta, no crackers, no pretzels, etc. Instead, increase your vegetables, healthy oils, lean proteins (raw nuts, seeds, lean red meats, chicken, fish, turkey, eggs, Egg Beaters, low-fat yogurt and cottage cheese), fruits. Of course, avoid fruit drinks, candy, and other garbage foods, even if they're wheat-free.

Most people will report that a cloud has been lifted from their brains. Thinking is clearer, you have more energy, you don't poop out in the afternoon, you sleep more deeply, some rashes disappear. You will also notice that hunger ratchets down substantially. Most people lose the insatiable hunger pangs that occur 2-3 hours after a wheat-containing meal. Instead, hunger is a soft signal that gently prods you that it's time to consider eating again.

You will also make considerable gains towards gaining control over your risk for heart disease and your heart scan score, a crucial step in the Track Your Plaque program.

Thank you, Crestor

20. March 2009 William Davis (9)
I'm sure everyone by now has seen the Crestor ads run by drugmaker, AstraZeneca. TV ads, magazine ads, and the Crestor website all echoing the same message:

"While I was busy building my life, something else was busy building in my arteries: dangerous plaque."

While previous drug trials with Mevacor, Pravachol, Zocor, and Lipitor have focused mostly on examining whether the drugs reduced incidence of cardiovascular events, Crestor studies have also focused on effects on atherosclerotic plaque volume. The best example is the ASTEROID trial that demonstrated approximately 7% reduction in plaque volume by intracoronary ultrasound.

So the AstraZeneca decision makers took the leap from cholesterol reduction to plaque reduction.

I'm sure this switch wasn't taken lightly, but was the topic of discussion at many meetings before the decision to make plaque reduction the focus of hundreds of millions of dollars of advertising. After all, billions of dollars are at stake in this bloated statin market.

Ordinarily, I couldn't care less about how the drug manufacturers conduct their advertising campaigns. But this one I paid attention to because the Crestor ads are helping fuel a new way of thinking about coronary heart disease: It's not about the cholesterol; it's about the atherosclerotic plaque that accumulates in arteries.

It's not cholesterol that grows, limits coronary blood flow, and causes angina. It's not cholesterol that "ruptures" its internal contents to the surface within the interior of the blood vessel and causes blood clot and heart attack. It's not cholesterol that fragments from the carotid arteries and showers debris to the brain, causing stroke. It's all plaque.

I took the same leap years ago, though not backed by hundreds of millions of dollars of marketing money. When I first called my book Track Your Plaque, some of the feedback I got from editors included comments like "I thought this was a book about teeth!" Even now, the word "plaque" in the book title and website is responsible for confusion.

But AstraZeneca is helping me clear up the confusion. As the word plaque gains hold in public consciousness, it will become increasingly clear that cholesterol reduction is not what we're after. We are looking for reduction of plaque.

If you are trying to develop an effective means to reduce or reverse coronary heart disease, then there are two simple equations to keep in mind:


Plaque = coronary heart disease

Cholesterol ? coronary heart disease


Plaque is the disease, cholesterol is not. Cholesterol is simply a crude risk for plaque.

While I'm no friend to the drug industry nor to AstraZeneca, some good will come of their efforts.

Supermarkets and buggy whips

17. March 2009 William Davis (17)
Will supermarkets eventually phase out, joining the history books as a phenomenon of the past? Or are supermarkets here to stay, an emblem of the industrialization of our food--easy access to foods that are convenient, suit the undiscriminating masses, stripped of nutritional value despite the prominent health claim on the package front?

Anna left an insightful comment on the last Heart Scan Blog post, Sterols should be outlawed, along with some useful advice on how to avoid this trap for poor health called a supermarket:


I rarely shop in regular supermarkets anymore (farm subscription for veggies, meat bought in bulk for the freezer, eggs from a local individual, fish from a fish market, freshly roasted coffee from a local coffee place, etc.). What little else I need comes from quirky Trader Joe's (dark chocolate!), the fish market, farmer's markets, a small natural foods store, or mail order.

When I do need to go into one of the many huge supermarkets near me, not being a regular shopper there, I never know where anything is, so I have to ramble a bit around the aisles before I find what I'm looking for (and I almost always can grab a hand basket, instead of a trolley cart).

It's almost like being on another planet! There's always so many new products (most of them I hesitate to even call food). It's really a shock to the senses now to see how much stuff supermarkets sell that I wouldn't even pick up to read the label, let alone put in a cart or want to taste. I'm not even tempted by 99% of the tasting samples handed out by the sweet senior ladies in at Costco anymore (only thing I remember tasting at Costco in at least 6 mos was the Kerrygold Irish cheese, because I know their cows have pasture access and it's real food).

What's really shocking to me is how large some sections of the markets have become in recent years. While Americans got larger, so did some sections of the supermarket (hint - good idea to limit the consumption of products from those areas). Meat and seafood counters have shrunk, though. Produce areas seem to be about the same size as always (but more of it is pre-prepped and RTE in packaging.

But the chilled juice section is h-u-g-e! And no, I don't think there is a Florida orange grove behind the cases. Come on, how much juice do people need? Juice glasses used to be teeny tiny, for a good reason. To me it looks like a long wall stocked full of sugar water. Avoiding that section will put a nice dent in the grocery expenses.

The yogurt case is also e-n-o-r-m-o-u-s! Your 115 yo Bulgarian "grandmother" wouldn't know what to make of all these "pseudo-yogurts"! Chock full of every possible variety, but very little fit to eat. The only yogurts I'll look at are made with plain whole milk, without added gums, emulsifiers, or non-fat milk solids, and live cultures (I mostly buy yogurt now and then to refresh my starter culture at home). I can flavor them at home if needed. The sterols are showing up in processed yogurts, too, along with patented new strains of probiotic cultures (I'll stick to my old fashioned, but time-proven homemade lacto-cultured veggies and yogurt instead).

I found the same "cooler spread" in the butter & "spread" section. The spread options were just grotesque sounding. Actually, the butter options weren't much better, as many were blended with other ingredients to increase spreadability, reduce calories or cholesterol/saturated fat, etc. A few plain butters were enhanced with "butter flavor" - say what? And on no package could it be determined if the butter came from cows that were naturally fed on pasture or on grain in confined pens.


Well said, Anna.

There's a huge supermarket about 1 mile away from my house similar to the one Anna describes with aisle after aisle of eye-catching cellophane-wrapped foods. I go there about every 3 or 4 months, and then I only go to get something I need in a pinch. Every time I go, I too am reminded just how many products there are that look more like junk food than real food.

But there's no real money in real food. Who gets rich off of selling green peppers, tomatoes, and eggs?

Supermarkets sell these modern industrial foods because people buy it: Look around you. You don't get to be a 250 lb 5 ft 2 inch-woman by eating too many cucumbers.

Like Anna, I drive an additional several miles to Trader Joes', buy at farmers' markets whenever possible, buy some odds and ends like wine and cheese and raw nuts at specialty stores. I grow my own basil in a big pot I keep in the kitchen and we are just about to start turning over the soil in the back yard for our vegetable garden. I don't need nor do I miss having the choice among 40 different chips, 25 brands of ready-made microwavable dinners, an entire aisle of breakfast cereasl (all of which are virtually the same with different names and labels), or 75 varieties of salad dressing.

The supermarket for me--and I hope for many of you--has become a place rarely frequented, and only for the odd forgotten item. Oh, I forgot the dog chewies the grocery does have--my dogs love them. So perhaps they are good for something after all.

Sterols should be outlawed

14. March 2009 William Davis (10)
While sterols occur naturally in small quantities in food (nuts, vegetables, oils), food manufacturers are adding them to processed foods in order to earn a "heart healthy" claim.

The FDA approved a cholesterol-reducing indication for sterols , the American Heart Association recommends 200 mg per day as part of its Therapeutic Lifestyle Change diet, and WebMD gushes about the LDL-reducing benefits of sterols added to foods.


Sterols--the same substance that, when absorbed to high levels into the blood in a genetic disorder called "sitosterolemia"--causes extravagant atherosclerosis in young people.

The case against sterols, studies documenting its coronary disease- and valve disease-promoting effects, is building:

Higher blood levels of sterols increase cardiovascular events:
Plasma sitosterol elevations are associated with an increased incidence of coronary events in men: results of a nested case-control analysis of the Prospective Cardiovascular Münster (PROCAM) study.

Sterols can be recovered from diseased aortic valves:
Accumulation of cholesterol precursors and plant sterols in human stenotic aortic valves.

Sterols are incorporated into carotid atherosclerotic plaque:
Plant sterols in serum and in atherosclerotic plaques of patients undergoing carotid endarterectomy.




Though the data are mixed:

Moderately elevated plant sterol levels are associated with reduced cardiovascular risk--the LASA study.

No association between plasma levels of plant sterols and atherosclerosis in mice and men.




The food industry has vigorously pursued the sterol-as-heart-healthy strategy, based on studies conclusively demonstrating LDL-reducing effects. But do sterols that gain entry into the blood increase atherosclerosis regardless of LDL reduction? That's the huge unanswered question.

Despite the uncertainties, the list of sterol-supplemented foods is expanding rapidly:




Each Nature Valley Healthy Heart Bar contains 400 mg sterols.












HeartWise orange juice contains 1000 mg sterols per 8 oz serving.













Promise SuperShots contains 400 mg sterols per container.














Corozonas has an entire line of chips that contain added sterols, 400 mg per 1 oz serving.














MonaVie Acai juice, "Pulse," contains 400 mg sterols per 2 oz serving.














Kardea olive oil has 500 mg sterols per 14 gram serving.










WebMD has a table that they say can help you choose "foods" that are sterol-rich.

In my view, sterols should not have been approved without more extensive safety data. Just as Vioxx's potential for increasing heart attack did not become apparent until after FDA approval and widespread use, I fear the same may be ahead for sterols: dissemination throughout the processed food supply, people using large, unnatural quantities from multiple products, eventually . . . increased heart attacks, strokes, aortic valve disease.

Until there is clarification on this issue, I would urge everyone to avoid sterol-added "heart healthy" products.


Some more info on sterols in a previous Heart Scan Blog post: Are sterols the new trans fat? .

Texas today, tomorrow . . . the world?

10. March 2009 William Davis (0)
Texas state representative, Rene Oliveira, has introduced legislation that mandates heart scans for adults in the state of Texas.

Rep. Oliveira

A press release from the SHAPE Society ( Society for Heart Attack Prevention and Eradication) reads:

Assessment of heart attack risk on the basis of traditional risk factors alone such as high cholesterol and high blood pressure and so forth, while useful, misses many who are at high risk and also incorrectly flags some for high risk who are in fact at very low risk of near term heart attack; on the other hand detection of atherosclerosis by non-invasive imaging, as suggested by the SHAPE group, accurately identifies plaque and improves the ability to identify at-risk individuals who could benefit from aggressive preventive intervention while sparing low-risk subjects from unnecessary aggressive medical therapy," said Dr. P.K. Shah, Director of Cardiology at Cedars Sinai Heart Institute in Los Angeles, a leading member of the SHAPE Task Force who is also an active member of the American Heart Association. "Sadly, these vulnerable patients go undetected until struck by a heart attack, because insurance companies don't cover the newer heart attack screening imaging tests."


Rep. Oliveira, whose coronary disease was first uncovered by a heart scan and prompted a bypass operation, states:

"It is about time that we cover preventive screening for the number one killer in Texas, and take action to reduce healthcare costs through preventive healthcare. Right now, we are extending the lives of those who can afford the procedure while hundreds of thousands of Texans with hidden heart disease go undetected because of antiquated thinking. The time has come for this change."


Is this what we've come to? Since practicing physicians are either so entranced by the drug and procedural solutions to heart disease, do we need to resort to heart scan by legislation?

It does indeed appear that we've come to this point. Should this trend catch on, it will surely mean an upfront increase in healthcare costs to cover the expense of heart scans. But in the long run, it will mean reduction in healthcare costs--dramatic reduction--if heart scans prompt effective preventive action.

What your doctor doesn't know about heart disease

9. March 2009 William Davis (12)
What causes coronary heart disease or coronary atherosclerotic plaque, this thing that we track with heart scans?

Well, here are a few little-publicized facts about heart disease that you are unlikely to hear from your When's-the-next-stent? cardiologist or the What is there besides statins? primary care doctor.

(Since everybody knows that smoking is a modifiable risk for heart disease that can be readily identified, let's focus on the blood tests that reveal heart disease causes.)


What's the number one most common cause for heart disease?

Small LDL particles. The proliferation and popularity of the snack food/processed food culture, compounded with the "eat more healthy whole grain " propaganda has launched small LDL solidly to first place as the most common reason to have heart attacks, stents, and bypass. All that advice to increase your "healthy whole grain" intake? It increases heart attack risk.


What's the number one most aggressive cause for heart disease?

That's lipoprotein(a), or Lp(a). It's certainly not high cholesterol, though the drug industry loves that you think that. We could argue over whether smoking is more aggressive, but the two are pretty darned close. Combine the two--Lp(a) in a smoker--and the combination is an explosively powerful trigger for heart disease and stroke.


What's the number two cause for heart disease?

After small LDL comes low HDL cholesterol. Ask anyone who has had a heart attack: What was your cholesterol panel like? 9 out of 10 will say "My LDL cholesterol was 135 mg/dl" while knowing little or nothing about HDL, which is commonly in the 30-42 mg/dl range--sufficient to contribute to heart disease risk considerably.


Can "normal" thyroid hormone tests still contribute to heart disease?

Yes. Hypothyroidism is an exceptionally powerful risk factor for heart disease. Many people have been told that their thyroid tests are "normal," when in reality risk for heart disease may be as much as tripled from low thyroid with thyroid blood tests in the "normal" range.


Does a "balanced, healthy diet" prevent heart disease?

No, it does not. In fact, the modern notion of a "balanced, healthy diet" increases risk for heart disease. Of course, the dangers of such diets vary, depending on how you define it. If it's the diet advocated by the USDA Food Pyramid, then it is an enormously destructive diet that causes your health to careen towards both diabetes and heart disease. The American Heart Association TLC diet is little better.


Does eating fish twice a month reduce heart attack risk?

Yes, it does--but just barely. Unfortunately, large studies that show that eating fish as infrequently as twice per month reduce risk for dying from heart attack have led some authorities to suggest that's all you need to do. What they fail to understand is that the benefit is dose-dependent--the greater the intake of omega-3 fatty acids, the greater the benefit (within reason, of course). So, while the effect can be detected by eating fish twice per month, it doesn't mean that full benefits are achieved with this "dose." Full benefits are obtained by mimicking the omega-3 intake of the Japanese.


Do nutritional supplements reduce risk for heart attack?

If you are referring to vitamin D, then, yes, nutritional supplements reduce risk for heart attack . . . enormously. We need more data to validate this phenomenon, though epidemiologic observations strongly bear this out, including the Health Professionals Follow-up Study, the Framingham Heart Study and NHANES, all of which demonstrate a graded effect: the lower the vitamin D blood level, the greater the risk for heart attack.

Over the years, we've experienced more than our share of disappointments in nutritional supplements for heart disease, including vitamin E and B vitamins to reduce homocysteine. But I believe that nothing approaches the solid feel of vitamin D--no other nutritional supplement raises HDL, reduces triglycerides, reduces blood sugar, enhances insulin responses, reduces the inflammatory C-reactive protein, reduces blood pressure like vitamin D. Vitamin D is here to stay--and I'm very grateful.

And don't forget omega-3 fatty acids from fish oil, yet another supplement with unquestioned benefits for reduction of heart attack and death from heart attack.


Why didn't your doctor counsel you on the importance of these issues?

The primary reasons your doctor didn't tell you any of the above:

1) He/she has been persuaded that only drugs are of any real use in health. Nutritional supplements? Hah!

2) Neither the number one cause of heart disease in the U.S.--small LDL particles--nor the most aggressive cause for heart disease--Lp(a)--are corrected by patent-protectable, high profit pharmaceutical agents promoted to your doctor. Instead, these abnormalities can be corrected inexpensively, without prescription. That means no expensive commercials, no media spots, no write-ups in magazines.

3) Your doctor's business is to treat crisis: sore throat, broken ankle, lung tumor, heart attack. Prevent heart disease 10 or 20 years before it shows itself? Heck, no (unless the marketing pull of the drug industry is involved, of course).


It's best that you bear in mind: What your doctor doesn't know can kill you.

Thank you, Dr. Eades

6. March 2009 William Davis (7)

Thanks to some readers of The Heart Scan Blog, I've become acquainted with Dr. Michael Eades' wonderful blog, Health and Nutrition by Dr. Michael R. Eades, MD.

Dr. Eades is co-author (with his wife, Mary Dan Eades, MD) of Protein Power

In one of his conversations, I stumbled on this exchange between Dr. Eades and one of his readers:



Reader: Regarding EBT scans, I looked up the topic on Google and read an informative 5-page article: EBT (Ultrafast CT) Scans - Godsend, or Scam? Dr. Fogoros says that false positives (where the EBT shows the presence of calcium, but the patient has little coronary artery blockage) occur about 50 percent of the time. The next step, if the EBT is positive, is to do a heart catherterization to find out whether there actually is coronary artery blockage. So the odds are that I’d have to worry!

Dr. Michael Eades: The info you got from Google is one of the reasons one shouldn’t get medical information online. As far as I’m concerned the EBT is the BEST way to determine the presence of plaque. If you have a positive calcium score, you have plaque, and there’s an end on’t (as Samuel Johnson would say). Now you may have a low calcium score for your age or you may have a calcium score that doesn’t change, which means you have stable plaque, but if you have a positive calcium score, you have some amount of plaque in your coronary arteries.

And whoever says that the next step to take if you receive a positive calcium score is a coronary artery cath is a real moron. That’s probably the last thing you would want to do if you are asymptomatic. All the cath procedure does is shows whether or not you have a blockage - you can have huge amounts of plaque (which are a disaster waiting to happen) and have a normal cardiac cath.

If you want to get a little more information on the validity of EBT than what you find on Google, take a look at Dr. Davis’ blog or get a copy of his book: Track Your Plaque. I’m not crazy about all of Dr. Davis’ dietary recommendations because he comes to diet from a different perspective than I, but the EBT info in his book is terrific.

Cheers–

Dr. Eades "gets" it. He understands that quantification of coronary plaque is a tool for prevention, not something to be subverted into the service of procedures for the financial benefit of my colleagues.

And I think that he is absolutely correct on the diet discussed in Track Your Plaque--it's due for a revision. I wrote the book in 2003, while we were still locked into the low-fat mindset. Much has changed.

Since then, our enormous experience in metabolic manipulation and lipoprotein analysis has shown that there is a far better way to correct the causes of coronary plaque and seizing hold of heart scan scores. In particular, the explosion of small LDL has prompted major changes in the diet, specifically removal of wheat and cornstarch, the foods that trigger small LDL particles.

(I am still in the midst of negotiations for release of a bigger and better Track Your Plaque II. In the meantime, Track Your Plaque Members can refer to the New Track Your Plaque Diet, Parts I, II, and III.)

Can millet make you diabetic?

5. March 2009 William Davis (10)















If wheat is so bad, what about all the other grains?

First of all, I demonize wheat because of its top-of-the-list role in triggering:

--Appetite--Wheat increases hunger dramatically
--Insulin
--Blood sugar--Wheat is worse than table sugar in triggering a rapid, large rise in blood sugar
--Triglycerides
--Small LDL particles--the number one cause for heart disease in the U.S.
--Reduced HDL
--Diabetes
--Autoimmune diseases--Most notably celiac disease and thyroiditis.

Most other "healthy, whole grains" aren't quite as bad. It's a matter of degree.

Millet, quinoa, oats, sorghum, bulghur, spelt, barley, cornmeal--While they don't trigger appetite nor autoimmune diseases like wheat does (oat can in some people), they still pose a significant carbohydrate load sufficient to generate the other phenomena like excessive insulin and blood sugar responses. The grams of carbohydrate of these grains are virtually identical to wheat: 43.5 grams per 1/2 cup (uncooked). The exceptions are barley, which is especially loaded with carbohydrates: 104 grams per 1/2 cup, while oats are lower: 33 g per 1/2 cup.

It's all a matter of degree. Some people who are exceptionally carbohydrate-sensitive (like me) can have diabetic blood sugars with just slow-cooked oatmeal or quinoa. Others aren't quite so sensitive and can get away with eating them.

People with high blood sugars (100 mg/dl or greater) can be very sensitive to the blood sugar effects of these grain carbohydrates. The best marker of all are small LDL particles measured on a lipoprotein panel, such as NMR. Small LDL particles are exquisitely sensitive to your carbohydrate intake: small LDL gets worse with excessive sensitivity to grain carbohydrates, gets better with reduction or elimination.

Flagrant small LDL, in combination with low HDL, high triglycerides, and pre-diabetic or diabetic patterns all develop from carbohydrate indulgence, along with "wheat belly."

Don't believe it? The prove it to yourself: Go to Walmart and buy an inexpensive glucose meter and check your blood sugar one hour after eating. You can gauge the health of these foods by observing the blood sugar increases. (Small LDL closely parallels blood sugar rises.)

The grain that fails to trigger any of these abnormal patterns? Flaxseed. Flaxseed is entirely protein, fiber, and healthy oils, with virtually no digestible starches. In fact, flaxseed is one of the few foods that reduces the quantity of small LDL particles.

Are you a tree?

5. March 2009 William Davis (6)
I assume you answered no. Then why would you consider taking the plant form of vitamin D (ergocalciferol)? That's the prescription form of vitamin D, often dispensed as 50,000 unit tablets.

There's nothing wrong with plants. Some of my favorite foods are plants, full of nutritional value.

Then why shouldn't vitamin D2 from plants be every bit as good as the human form of vitamin D?

I believe the issue boils down to taking hormones from non-human sources. (Remember: Vitamin D is a hormone, a very powerful one at that.) Plants can be wonderful sources of flavonoids, fibers, protein, fats, vitamins, minerals, and other healthy components. But hormones?

There are other examples of non-human hormones being given to humans with undesirable or unpredictable effects:

--Xenoestrogens, phytoestrogens, and non-human mammalian estrogens--While non-human estrogens may partially mimic human estrogens, they can also block estrogen effects, or exert altogether novel effects. Non-human mammalian estrogens like Premarin can exert very peculiar (side-)effects, despite their role as prescription estrogen supplementation in humans.

--Progestins--The synthetic versions of human progesterone, like their non-human estrogen counterparts, exert weird effects that are a world apart from real progesterone.

--Sterols--Similar in structure to human cholesterol (while not a hormone, a building block for hormones), sterols have been used to reduce intestinal cholesterol absorption. However, if sterols are absorbed into the blood, they can enormously accelerate growth of atherosclerotic plaque.

--Anabolic steroids--These modifications of the testosterone molecule build muscle, but also cause liver cancer, kidney failure, violent behavior, suicide and homicidal behavior. That's not normal.

Outside of a pharmacologic effect (e.g., prednisone in place of human cortisol), there is no reason to take a non-human hormone in place of a human hormone. For that same reason, there is NO reason to take plant vitamin D2 (prescription or over-the-counter) in place of human vitamin D3.

If the non-human hormone is identical to the human form, then there is no difficulty. The best example of this are thyroid hormones from pigs. That's what Armour Thyroid is, a thyroid hormone replacement that works wonderfully well.

You will notice that virtually all of the examples of non-human hormones substituted for human hormones share one common motivation: profit. Synthetic or modified versions are more readily patent-protectable, unlike their natural counterparts which are not.

Vitamin D2 is an anemic facsimile of the real human hormone, vitamin D3 (cholecalciferol). Stay away from it.
Atkins Diet: Common errors

Atkins Diet: Common errors

18. March 2010 William Davis (74)
No doubt: The diet approach advocated by the late Dr. Robert Atkins was a heck of a lot closer to an ideal diet than the knuckleheaded advice emitting from the USDA, American Heart Association, American Diabetes Association, and the Surgeon General's office.

But having just spent a week with Atkins low-carbers, here are some common errors that I see many make, errors that I believe have long-term health consequences, including impairment of weight loss.

Excessive consumption of animal products--Non-restriction of fat often leads to over-reliance on animal products. Higher intakes of red meats (heme proteins?) have been strongly associated with increased risk for colon and other gastrointestinal tract cancers. It is not a fat issue; it is an animal product issue. We should consume less meat, more vegetables and other plant-sourced foods.

Consumption of cured meats--Cured, processed meats, such as sausage, hot dogs, salami, bologna, and bacon, have a color fixative called sodium nitrite, an additive that has been confidently linked to gastrointestinal cancers. Risk is likely dose-dependent: The more you ingest, the greater the long-term risk.

Overconsumption of dairy products--Dairy products, especially milk, yogurt, cottage cheese, and butter, are potent insulinotropic foods, i.e., foods that trigger insulin release. There can be up to a tripling of insulin (area-under-the-curve) levels. This is not good in a world populated with tired, overworked pancreases, exhausted from a lifetime of high-carbohydrate eating.

Too many calories--While I agree that "a calorie is a calorie" and "calories in, calories out" are faulty concepts, I have anecdotally observed that long-time low-carbers often trend towards unlimited consumption of food, a phenomenon that seems to result in weight gain, especially in the sedentary. I wonder if this is a reflection of the insulinotropic action of dairy products and other proteins, compounded by the poor insulin responsiveness that develops with lack of physical activity. Factor into this conversation that lower calorie intake extends life, probably substantially (Sirt-2 activation and related phenomena, a la resveratrol). If lower calorie intake extends life, unlimited calorie intake likely shortens life.

Please don't hear this as low-carb bashing--it is not. It is a call to improve diets and not stumble into common traps that can impair heart health, weight loss, and longevity.
Tags :

Comments (74) -

  • Fred Hahn

    3/18/2010 1:02:21 PM |

    Nice post Bill. People really need to get this info into their heads.

    Great meeting you  on the cruise!

  • thequickbrownfox

    3/18/2010 1:14:09 PM |

    Please could you provide links to the interventional controlled (not observational) studies that have shown a link between eating meat and cancer risk, that separate the effect from eating junk food, and the fact that vegetarians are more likely to eat healthily in general than meat eaters due to the widespread and incorrect belief that saturated fat is harmful to health.

    Also, could you explain lack of cancer in traditional tribal societies with a high meat intake? You would need to do this before stating that meat intake necessarily increases cancer risk.

  • maxwell

    3/18/2010 1:25:40 PM |

    Hi doc,

    Great blog. How do you explain the Inuit, Masaai, Komi (Siberia), Native American and similar cultural groups whose diets seemed to subsist primarily on animal products? ie. including my ancestors.

    Perhaps its an emphasis on wild/grass-fed/raw dairy(or as close to) animal products as opposed to the grain-fed animal products which encompass the majority of the US that you need to be addressing?

    Thanks.

  • ET

    3/18/2010 1:31:21 PM |

    Interesting point of view.  Can you please provide references to support your claims?

  • Sandra Anderson

    3/18/2010 1:38:14 PM |

    Great diet, and yes, it seems that we should talk about healthy eating instead of weight loss or diets. Anyway the purpose of any diet is to move your eating habits to new healthy level.

    Thanks for sharing and possibility to comment! Welcome to visit Ideal Weight Blog to find some recipes and great articles! Thanks!

  • Mario Renato

    3/18/2010 1:40:29 PM |

    Just on the nitrate/nitrite subject: as far as I know nitrate is a naturally occurring compound and the human exposure to it is mostly through  consumption of vegetables, and to a lesser extent water and other foods...

    http://www.efsa.europa.eu/en/scdocs/scdoc/689.htm

  • Matt Stone

    3/18/2010 1:48:56 PM |

    I would say there are 3 primary pitfalls of low-carb dieting:

    1) Being too low in carbohydrates - being in ketosis is anti-metabolic and induces insulin resistance, and probably why Atkins suggested that his diet "tends to shut down the thyroid."  

    2) Too much protein - this strains the thyroid as well, and encourages gluconeogenesis, which is also problematic - especially when in ketosis and insulin resistance is extreme.  

    3) Extremely high in omega 6 polyunsaturated fat.  Eating a low carb diet with lots of pork fat, chicken skin, peanut butter, and nuts - the typical standbys of many low-carb dieters, provides an astronomical amount of omega 6.

    By my best guesses, I was consuming 15+ grams of omega 6 while on a low-carb diet.  I've since cut that back to less than 3 grams per day and the change has been dramatic.  Of course the 400 grams of carbs per day helps too.

  • Dana Law

    3/18/2010 2:14:43 PM |

    Dr. Davis,
    Thank you for this post.  I'm certainly culpable of the "common errors" you mention.  I find that making daily decisions on what to eat difficult. I want to eat healthy and have some variety. Here's the question.  What do you eat?  What did you have for breakfast this morning?  What did you eat last night?  What do you keep in the fridge and on the counter to make following your dictates easier.
    I don't want to over-think it but all this information is overwhelming.  I feel like a scientist and my body is the research subject.
    Thank you for your blog.  I've learned a lot but need some direct guidance.
    Sincerely,
    Dana Law
    San Diego, Ca

  • Andrew

    3/18/2010 2:21:17 PM |

    Why is "Calories in vs. calories out" a faulty concept?

  • Tim

    3/18/2010 3:03:47 PM |

    Have you really read the meat leading to cancer literature carefully or do you just think it's like that? Others like Gary Taubes and Eades (who I really trust when it comes to research) have found no evidence that meat cause cancer.

    On sodium nitrate, I totally agree. I get so mad when I'm walking in the grocery stores. All meat has sodium nitrate added. Grrr.

    I share your thought about dairy. But do you really mean that butter triggers insulin spikes?

  • Daniel

    3/18/2010 3:11:55 PM |

    Most nitrite is form your own spit and originally ingested by eating vegetables.  

    I believe the epidemiological studies (which also typically find fat to have bad associations...) have more to do with a lack of fruits/vegetables/polyphenols than anything that is bad about meat.  

    Also, I don't think glycemic index or the insulinotropic nature of certain proteins matters one lick for people that are healthy.  I can eat a boiled potato for breakfast without my blood sugar breaking 100... I don't think diabetes is an overuse injury - more likely, it is cause by damage to the liver and then pancreas from PUFA and fructose overconsumption.  

    I think Matt Stone is correct about the top three problems with Atkins.

  • Lena

    3/18/2010 3:17:06 PM |

    If you're really concerned about your nitrite intake, watch your celery, arugula and spinach (and many other vegetables) consumption, too. Nitrites galore. Though it's not nitrites and nitrates in and of themselves that are linked to cancer, it's the nitrosamines that can form from them.

    Sodium nitrite isn't primarily a colour fixative, it's a an anti-bacterial agent. Meats cured with sodium chloride only have to be done quite carefully to avoid botulism. Nitrite has been used since the 16th century to preserve meat. Modern cured meats also add sodium ascorbate, and ascorbates have been shown to inhibit nitrosation reactions and thus the nitroamine level in these cured meats is usually at undetecable levels.

    Nitrites are produced in our mouths from bacterial reactions to the nitrates in food and water, and at least 70% of our dietary nitrite comes from this salivary nitrite (which came from our food and water). The nitrites and nitrates we then ingest are mostly either excreted fairly promptly or used to make nitric oxide. Human gastric secretions have a pH which isn't condusive to nitrosamine formation, and also include ascorbates which reduce nitrosamine formation, and keeping one's vitamin C at good levels will also have an effect. People with achlorhydria will obviously be more susceptible to nitrosamine formation. But interestingly, there are studies which now suggest that nitrite consumption is a good thing: http://www.ncbi.nlm.nih.gov/pubmed/20005970 - and branched-chain amino acids are also suggested as suppressing the effect of nitrosamines. However the amount of nitrosamines you get from smoking is definitely Not Good, and no amount of ascorbate will ameliorate it.

    So, a good intake of nitrates and nitrites primarily through vegetables, some fruit, and some cured meat is good: the vegetables and fruit contain ascorbates as does your body, and most of hte meat should have it added also, minimising the formation of nitrosamines, leaving your body to get on with making use of the nitr*tes to make needed nitric oxide. (Oral nitric oxide/arginine supplements are rubbish though - the studies showing their benefit used intravenous/injected supplement.)

    Personally, I'll take nitrites over botulism, thanks.

  • Anna

    3/18/2010 4:00:07 PM |

    Hmmm, I've never been on a cruise, but if I did go on one, I'll bet I'd have to eat somewhat differently than I do at home, regardless of the carb count.  Between not having access to the pastured bison and wild game, raw dairy, "backyard" eggs, and organic CSA produce subscription, and so on that make up most of my family's daily diet, and no access to a kitchen, my meals on a cruise would hardly be representative of my usual diet.  

    I'll bet LC cruisers are as prone to anyone when it comes to the excesses of endless supply of prepared foods on cruises, but I'm not sure we can assume that's the way they always eat.  Most people  eat somewhat differently on vacation, whether it's because they are on somewhat of a "diet vacation", or because they have to make the best of what's available.  When I was on vacation in Italy I had a gelato every day, but I certainly don't do that at home (it was a conscious decision to take a slight vacation from my diet and enjoy a local specialty for a limited time).  And I've been places where it was impossible to get eggs cooked in real butter instead of the ubiquitous "griddle grease" hydrogenated veggie oil, let alone pastured eggs and humanely produced bacon (seriously, we breakfasted at a tiny roadside diner outside Twenty-Nine Palms that had NO butter on the premises).  

    And not all LC eaters are following an Atkin's diet plan, though I understand the Atkins label has become be a generic term for LC eating.  I've read an Atkins book (as well as at least a half dozen other LC diet books).  I eat LC (& GF now) but I've never followed specifically an Atkin's diet plan, nor do I describe myself as at Atkin's dieter.

    I think the points you make point out that even on low carb, people can and do still rely on far too much industrial food.  It's convenient and it's everywhere (hard to avoid, esp when dining away from home).  Frankly, one of the reasons cruise vacations hold little appeal to me is the idea of having to nothing to eat all week but cr@p industrial food, no matter how talented the chefs may be at making it look and taste good.   I may be making a sweeping assumption, but somehow I don't imagine that cruise chefs are simmering their own bone broth stocks, curing charcuterie themselves, and making their own cheese (or even sourcing from small artisan vendors  very much).    I'd be extremely surprised if cruise ship food ingredients weren't offloaded from US Food tractor trailer trucks.  That's what I've seen at many land-based resorts.  When I travel,  as much as possible, I want to try the local traditional foods and specialties, prepared as authentically as possible.  That might mean eating more of something than usual (and less, too).

  • Anonymous

    3/18/2010 4:15:55 PM |

    Isn't it also an Atkins diet error that low-carb eaters tend to be on a constant and frantic quest for processed fake food items that are pretend substitutes for the food that got them in trouble in the first place?  And many of them have made Jimmy Moore, a huge hawker of low-carb substitutes and a less-than-successful low-carber, their role model.  

    I noticed on Swedish physician Dr. Andreas Eenfeldt's blog that his description of his experience on the cruise was that "[t]he big difference with Sweden is that many are fond of low-carb versions of traditional junk food, sugar, and so. Low carb cake, low carb icecream, low carb potato chips, diet sodas ... In my eyes seemed to just those participants who ate such did not have the same persuasive power of the diet. To put it nicely. Perhaps it was the roundest of them all, the man [Andrew DiMino -- Carbsmart.com?] who handed out the various "low carb" products that are advertising for his company. [Google translation]

    People I know who have been totally unsuccessful on Atkins have gleefully loaded up on "substitutes" that probably have derailed them.  And the Atkins company that sells this crap will forever keep the Atkins mantra from the gaining the credibility it probably deserves.

  • Emily

    3/18/2010 4:15:55 PM |

    also curious as to how butter could cause a rise in insulin. butter has even less/no carbs compared to cheese, and in previous posts you've said cheese doesnt cause blood sugar rises...

  • Emily

    3/18/2010 4:20:11 PM |

    also many health food stores, grocery co-ops, and whole foods and trader joes sell either no nitrate-added or uncured deli meats and bacon. applegate and niman ranch are brands that sell these foods.

  • Fred Hahn

    3/18/2010 4:48:10 PM |

    Bill you said:

    "Excessive consumption of animal products--Non-restriction of fat often leads to over-reliance on animal products. Higher intakes of red meats (heme proteins?) have been strongly associated with increased risk for colon and other gastrointestinal tract cancers. It is not a fat issue; it is an animal product issue. We should consume less meat, more vegetables and other plant-sourced foods."

    I don't think this is true Bill. As far as I'm aware, there is no good evidence to support protein as cancer causing. Dr. Eades has debunked this on his blog.

  • Beth@WeightMaven

    3/18/2010 5:15:58 PM |

    Andrew, scroll down and see the section on conservation of energy for why calories in vs out is faulty: http://entropyproduction.blogspot.com/2009/02/all-medical-science-is-wrong-within-95.html

  • Beth@WeightMaven

    3/18/2010 5:19:08 PM |

    Ditto what Tim said. My understanding is that it's the whey in dairy that is insulinogenic (tho it's a bit like the glycemic index ... it depends on when and what you eat it with).

    Butter should not be as big a problem. One of my go-tos is ghee from grass-fed cows. The small amount of milk solids left in butter are removed when ghee is made.

  • Gretchen

    3/18/2010 6:27:26 PM |

    If you cut out animal protein, dairy, and carbs, there's not much left to eat.

    The protein sources favored by vegetarians, beans, rice, and grains, make blood sugar increase too much for people with diabetes.

    One can not live on tofu and fat alone, and anyway some people say too much soy is not good.

    I don't know why people have a prejudice against dairy. See this:

    http://care.diabetesjournals.org/content/29/7/1579.full

    If you have a diabetic tendency, it means your beta cells aren't producing enough insulin, so a food that helps them along is good.

  • Jimmy Moore

    3/18/2010 6:30:13 PM |

    Well said Dr. Davis!  We were certainly appreciative of your presence on the Low-Carb Cruise.  THANK YOU so much for all of your contributions...we need to get you back on the podcast later this year. Smile

  • zach

    3/18/2010 6:32:46 PM |

    Too many calories on a high fat diet? Good luck keeping that up. I can't get 2000 most days. Too full.

    Why were there traditional societies that used dairy as a staple yet were free of CVD and diabetes, including the super long lived people on the border of Eastern Europe and Central Asia?

    Copy and paste the above argument for "eating too much meat."

    Low carb may not be for everyone, but the biggest problem with some low carbers is probably too much n-6 from processed meat. Lots of nuts aren't that good for you either.

  • Anonymous

    3/18/2010 6:46:12 PM |

    What is the alternative for animal protein? Soy, gluten,beans, nuts all cause other problems?

    Please suggest some sample of improved Atkin diet.

  • PJNOIR

    3/18/2010 6:54:50 PM |

    Again Low carb is NOT zero carb. Many atkins folks don't really read the diet. I used atkins succesfully last year and eat more veggies then I ever did. It is not all about meqat meat meat or even high protein. And as much as I enjoy your blog- you still have a huge fear of fat. With Atkins I have improved my metabolic problems.

  • Helen

    3/18/2010 7:12:05 PM |

    I've been concerned to learn, here and elsewhere, that dairy products are insulinogenic, particularly since I can't seem to manage a reasonable diet without a fair amount of them.  (Nuts don't do well with me, soy is a no-go, I can only eat so much meat, my family has egg-allergy issues, and the fish that is non-contaminated, sustainably caught, not-BPA-canned, not-fed omega-6 and dioxin-laced stuff in a disgusting fish farm, is wicked expensive and logistically impossible to get fresh for my family more than once a week....)

    On the other hand, there are several dairy-reliant cultures that are quite long-lived and healthy, and dairy-consuming people in our own culture tend to be healthier than non-dairy eaters.  So maybe something mitigates the insulin question with dairy.  Just saying.

    In the end, you have to eat something, and sometimes reading this blog I feel I can't eat anything.  Like Dana Law, I'd like a better picture of what an ideal, or at least acceptable, day's or week's diet would look like from your point of view.

  • Jenny

    3/18/2010 8:56:12 PM |

    I've followed Atkins for these last three years, losing 80lbs in the process, so am quite familiar with what's permitted and not.

    Atkins did not recommend consuming any milk, nor was much yogurt or cottage cheese permitted. Hard cheese, cream cheese and heavy cream are allowed, but the Atkins diet permits less than 2-3 oz per day.

    Butter is allowed liberally, but is 100% fat so can't be very insunlinotropic, if at all.

    Because I raise dairy goats, until three years ago, I drank goat milk freel.  Now I never drink it, though I do have a glass of very sour kefir now and then, after the probiotics have cultured most of the lactose into lactic acid.  The kefir I drink is very tart. Most people don't like it that sour. lol

    The "Atkins is High-Protein" myth is often bandied about by anti-low-carb groups. I track my daily intake on FitDay and it's usually about 15-18% protein, 65-70% fat, and 10-20% carbs... pretty much what Atkins recommended; even 20% protein is not especially high protein.

    My carbs come mostly from eggs, green vegetables, heavy cream for coffee, berries and other LC fruit, and certain nuts and seeds, like flax.  Peanut butter is very carby, and not freely allowed in Atkins.

    I recommend reading the old Atkins book to understand what his diet really contains. Read the 1972 version, as the newer books (after 1999) were changed by Atkins Nutritionals to allow low-carb junk food that they conveniently sell.

  • Dr. William Davis

    3/18/2010 9:51:41 PM |

    I don't want anybody to hear "don't eat meat" here.

    I think that you should eat meat. I am a former vegetarian and I don't particularly like meat. Despite this, I do feel that humans are meant to be carnivorous. I just don't believe that piling your plate high with animal products several times per day is the ideal way to eat.

  • Haggus

    3/18/2010 9:58:20 PM |

    Dr. Davis, you sure it was "Atkins low-carbers" you were with?

    "Excessive consumption of animal products"

    At least with DANDR 2002, as you go up higher on the rungs, meat is replaced somewhat by veggies.  Personally, I eat around 200g of meat per day.  Of that, less than 90g is red meat (the rest is fish.)

    "Consumption of cured meat"

    I love bacon as much as the next guy, but in even Dr. Atkins stated in DANDR 20002 that one should "try to avoid meat and fish products cured with nitrates, which are known carcinogens."

    As for dairy, it's not taboo but still has to be fitted into the carbs you are allowed per day.

    This is the second blog post since the trip you have me scratching my head.  I hit your 60-60-60 markers using oat bran all the while being IGT and sporting an A1c of 4.8%.  (And before anyone asks, in DANDR 2002 Dr. Atkins mentions oat bran to bring down your cholesterol levels.)

  • zach

    3/18/2010 10:12:54 PM |

    Dr. Davis says:

    "I just don't believe that piling your plate high with animal products several times per day is the ideal way to eat."

    Try to do that for an extended period of time. I lasted about 2 weeks. Now I have a very small meaty breakfast, and a modest size meaty dinner, and I'm STUFFED. Been like this for years. Can't eat lunch-not hungry.

    You prefer plant foods which is great, but you're not in a carnivore's shoes. From our perspective, what you say is rather silly because many of us actually worry about not getting enough calories! Fat is filling. I'm a 6ft, 165 lb male and I can barely get 2000 calories I feel so full.

  • homeskillet

    3/18/2010 10:40:42 PM |

    Amen to Zach. I'm a PUFA-phobe, and if there's no grass-fed meat or butter in my diet, where am I going to get my fat?
    Nuts? (PUFAs)
    Soy? (Won't eat it unless it's fermented--like miso)
    SUPER-skeptical about your claim regarding insulinotropic dairy. If it is so chronic disease-inducing, wouldn't the Swiss of the Loetschental Valley been prematurely "toes up in the dirt" of the emerald green countryside before Weston Price would have arrived to find out how spectacular their health was because of the dairy they consumed?

    Brilliance abounds here: http://www.paleonu.com/panu-weblog/2010/3/18/sat-fat-or-pufa-which-one-do-you-fear.html

  • Helen

    3/18/2010 10:47:42 PM |

    Hey, Gretchen,

    Thanks for the link!  Good to know, and I was wondering about whether producing more insulin would be good or bad for me.  I had gestational diabetes, so I do have a diabetic tendency.  I'll keep eating my yogurt, then.

    Helen

  • kilton9

    3/18/2010 10:49:35 PM |

    Here's a good take on the conventional "wisdom" of nitrates: http://junkfoodscience.blogspot.com/2008/07/does-banning-hotdogs-and-bacon-make.html

    Matt:

    "Being too low in carbohydrates - being in ketosis is anti-metabolic and induces insulin resistance, and probably why Atkins suggested that his diet 'tends to shut down the thyroid.'"

    I generally find your thoughts to be spot-on, so there's no need to manipulate Atkins' quote to enhance your point.  What he said was that dieting in general tends to shut down the thyroid.

    "[P]rolonged dieting [including ‘this one’] tends to shut down thyroid function."

  • Paul

    3/18/2010 10:59:54 PM |

    Dr Davis -
    Could you please post your "typical" breakfast, lunch, and dinner? I've been reading this blog for awhile (and it's great), and have read a lot of what NOT to eat, but haven't read much on what TO eat. What should our 3 square meals/day look like?

  • sonagi92

    3/18/2010 11:25:42 PM |

    I knew that dairy was insulinotropic, but like Emily, I was surprised to see butter on the list as butter is mostly fat, and clarified butter entirely fat.  As I understand, it is protein-rich foods like beef, chicken, and fish, that provoke unexpectedly high insulin responses, so I thought it was either the sugars or the protein in dairy, not the fat, that spiked a rise in blood sugar.  Is butter really insulinotropic like other dairy products containing lactose sugars and proteins?

  • sonagi92

    3/18/2010 11:39:43 PM |

    Another comment about dairy and weight gain:

    I have noticed that melted cheese in particular - a warm, creamy fat with some carbs and protein - is highly palatable.  Full-fat yogurt, whipped cream, and guacamole are similarly irresistible.  I could not consume more than a couple tablespoons of olive oil yet have no trouble gobbling down a few slices of cheese melted onto a piece of chicken or beef.  I'm trying to shave off 5 more pounds to reach my goal, so I've given up all dairy except for clarified butter, which I use to saute veggies.  Will see if this works.

  • Sue

    3/18/2010 11:55:11 PM |

    Most of the low-carbers on the cruise seemed to be overweight.  I don't know if some of them were just starting eating low carb.  I think this is what prompted Davis' post.  If you are still overweight doing low-carb - are you doing something wrong? Should slimness be a goal every low-carber can meet (apart from all the other health benefits)?

  • Dr. William Davis

    3/19/2010 12:58:36 AM |

    Hi, Fred!

    We had some great conversations. I learned a lot from your "slow-burn" discussions and I've been applying them to my workouts.

    Good to see you here! I will be detailing some of the fat/animal product/cancer discussions in future.

  • frogfarm

    3/19/2010 12:58:37 AM |

    "I do feel that humans are meant to be carnivorous. I just don't believe that piling your plate high with animal products several times per day is the ideal way to eat."

    I'm scratching my head trying to reconcile these two statements.

    How about eating animal products to hunger once or twice a day?

  • Dr. William Davis

    3/19/2010 1:00:10 AM |

    Haggus--

    Excellent point.

    What Bob Atkins called "the Atkins Diet" was somewhat different from what is commonly practiced as "the Atkins Diet."

    As time passes, I continue to marvel at how much he got right.

  • Anonymous

    3/19/2010 1:01:16 AM |

    How high is "too high?" I say this not to be a smart aleck or to overlook the wisdom in "you'll know it when you see it," but this is a bit too vague to be of much use.

    Clearly a largely plant-based diet supplemented with a decent amount of animal protein will trump loading up heavily on animal products to the exclusion of plant-based foods. But there's far too many vague generalizations being bandied about by so-called dietary experts these days and not a lot of concrete recommendations that can be tailored to fit a person's unique context.

    -Bob Sutcliff

  • Rick

    3/19/2010 1:54:31 AM |

    Wow. Echoing a few other commenters, I'd really like some guidelines on what a good diet would look like.

  • Anonymous

    3/19/2010 3:23:10 AM |

    Jenny said: "I track my daily intake on FitDay and it's usually about 15-18% protein, 65-70% fat, and 10-20% carbs... pretty much what Atkins recommended...."

    Whenever I read this sort of thing, I get confused. 15-18% of WHAT? the total calories? and if so then how do I translate that percentage into actual amounts (like grams or ounces?)

    I'm sure most of you can straighten me out on this once and for all. Thanks!

  • Renfrew

    3/19/2010 10:36:00 AM |

    Dr. Davis,

    it would be great after such lengthy and detailed discussions about this topic to give us a typical sample food or meal list for a day of yours.
    Looking forward to it.

    Renfrew

  • Peter

    3/19/2010 1:11:35 PM |

    Fred Hahn: I'm mixed up about your two posts here, "People need to get this into their heads" and "Not true."

  • Lucy

    3/19/2010 1:46:53 PM |

    I would also like to see a typical day in the life of Dr. Davis.

    Anon-  Yes, they mean a % of total calories.  You can figure it this way:

    1g Protein = 4 cals
    1g Carb = 4 cals
    1g Fat = 9 cals

    So if a person eats 2000 cals/day and 18% was from protein, then that person ate approximately 360 cals of protein.  Divide 360 by 4 and you get 90 grams of protein.

  • scall0way

    3/19/2010 2:29:51 PM |

    I agree that there are many low carbers who follow their eating plan less than optimally. I see them posting on the low carb forums I follow. But as one who was also on the cruise, I don't think you can really equate cruise eating with what people eat on a normal day-to-day basis!

    I had resolved to eat only "real food" on the cruise, as I almost always do at home, and I had resolved not to snack. And I was pretty good about my resolve. I didn't snack, ate only three meals a day, avoided the flour, sugar, even the sugar-free cheesecake and other things provided.

    But did I eat exactly the way I would eat at home? No, I didn't. I undoubtedly ate more than I would have eaten at home, and probably certainly more protein sources than I would have eaten at home. The last night of the cruise I even broke down and had one of the sugar-free margaritas, and I had a half glass of red wine at the comedy show.

    And I'm sure my PUFA intake was higher than I would normally like. We had no control over how foods were prepared in the kitchen after all, or very little.

    But this was 5 days out of my life, not a lifetime of eating. Smile I didn't gain any weight on the cruise and indeed have even hit a new low this week since being back. Overall I've lost more than 100 pounds.  

    I'm not convinced of the meat/cancer link either - though too much protein raises my blood sugar so I don't normal OD on protein much. I was never a vegetarian but often thought I could have gone that way as I'm not all that crazy about meat. But now I have an "It's them or me" attitude and look for meats I  enjoy better - just not too much.

    Apparently Matt Stone has challenged my son to try out a super-low-calorie, essentially fat-free diet, based on 1930s research by Evans and Strang, and I'm following his progress with interest. But at the moment it's not for me. I still love my butter and coconut oil.

    But we are all so different, and what works for one may not work well for another. But I wonder how many low carbers eat at home the same way they ate on the cruise?

  • Anonymous

    3/19/2010 2:34:39 PM |

    Well said Dr. Davis!

    Jimmy this is not at all what you promote.  I am confused by your comment.

    Dr. Davis, are you choosing to ignore all those who have asked you to defend your claims (and the great questions asked).  This is the first post I have ever read by you that makes me shake my head.  

    Sally Sue

  • Jenny

    3/19/2010 3:01:52 PM |

    Anon said: "Whenever I read this sort of thing, I get confused. 15-18% of WHAT? the total calories? and if so then how do I translate that percentage into actual amounts (like grams or ounces?)"

    Percentages of my daily food intake. I used percentages because everyone has a different calorie ceiling where we stop losing weight. The ceiling calorie limit usually changes as you lose weight; but the percentage of Protein, Fat and Carbohydrates should remain the same.

    My daily calorie limit is now around 1500 calories; when I weighed 80 lbs more, it was closer to 2000 calories; and at 2000 calories back then I was losing 3-4 lbs a week.  Either way, the grams/oz of Potein/Fat/Carbs that I eat probably won't relate well to you; but percentages can and will.

    By the way, I use a food-tracking program called FitDay, that calculates your food entries into P/F/C, and into grams/oz and percentages, and also gives daily vitamin/mineral counts as well as for individual foods.  It's really quite interesting to compare the nutrition counts of different foods; that way you can see what's really worth eating.  Meat contains a lot more than just protein... it has a lot of essential vitamins and minerals, actually.

    FitDay is free online, but the purchased version is much more convenient; I paid $25 three years ago and consider the money well spent.

    You should track your own food intake to see for yourself what percentages your current diet contains... you might be surprised. Food tracking, whether through FitDay or some other program, is the single most useful thing that helps keep me on track.

  • Nancy

    3/19/2010 3:40:20 PM |

    Red meat and intestinal cancer isn't strongly linked.  In fact, it seems to be dissolving under tougher scrutiny.

    http://www.medicalnewstoday.com/articles/73040.php

    "Recent studies published in the journal Cancer Science have disproved the common myth that consumption of red meat increases colorectal cancer  risk."

  • Martin Levac

    3/19/2010 5:29:56 PM |

    Eat for health, not for weight loss. I agree.

    However, if, perchance, you believed that you ate for health, yet the same diet kept you fat, or God forbid kept you emaciated, would you really be eating for health then?

  • Anonymous

    3/19/2010 7:07:20 PM |

    Re Anonymous and "percentages."  This drives me crazy too.  Without a total daily calorie count, percentages are meaningless.  So what if I eat "10%" carbs, if I am noshing on 6000 calories a day?

    To answer your question: yes, you do have to do some simple math.  First, figure out the number of calories in the given percentage, using a hypothetical total daily caloric intake.  40% of 2,000 calories, for example, would be 800 calories.  A carb has roughly 4-5 calories per gram, so that would equate to around 200 grams of carbs.  Protein is similar.  Fat, on the other hand, has 9 calories per gram.  So those 800 calories would be slightly less than 90 grams of fat.

    Once you start doing it, it gets easier.  Practice on food labels!

  • HSL

    3/19/2010 8:11:21 PM |

    Anon - most food values are given as a % of calories.  For example if you are eating 2000 calories/day of which 70% is fat, then you're eating about 155 gms of fat per day (2000 x 0.70 = 1400/9 = 155 gms). Fat has about 9 calories/gm; carbs & protein each have about 4 calories/gm.

    As for "...15 to 18% of what" that would depend on what you're eating.  Three ounces of white fish (raw) has about 16 gms of protein; 3 oz of beef chuck (raw) has about 28 gms of protein.

  • Andrew

    3/19/2010 8:39:27 PM |

    Beth:

    That doesn't prove that calories in vs. calories out is faulty.  The calories in vs. calories out concept is simply the theory that you will lose weight if you eat below BMR, regardless of what foods you eat.  The Thermodynamics argument is misapplied to this concept, IMO.

    Perhaps we are simply thinking of two different concepts.

  • Lori Miller

    3/20/2010 12:24:31 AM |

    Some highlighted words from the original post: overconsumption, excessive consumption, and too many calories. The point seems to be that a little rich food goes a long way. Oh, and don't eat food that causes cancer.

  • Kim

    3/20/2010 2:59:58 AM |

    Sue said,"Most of the low-carbers on the cruise seemed to be overweight. I don't know if some of them were just starting eating low carb. I think this is what prompted Davis' post. If you are still overweight doing low-carb - are you doing something wrong? Should slimness be a goal every low-carber can meet (apart from all the other health benefits)?"

    I was on the cruise and yes, many of the cruisers were overweight.  Some are just starting a low carb lifestyle, and some are not.  I personally have lost over 150 lbs on low carb and maintained that loss for nearly 2 years now.  I consider that a success, however, I am not thin by any means and am working on about 50 more lbs.  I took the advice from many of the speakers, Dr. Davis included, and have worked it into my daily routines.  As a registered nurse, I am aware of nutrition both mainstream and low carb.  I do my research.  I try to eat cleanly most of the time.  Life interferes sometimes, much as is does for anyone who is human and as I know it has for some of the individuals who were on the cruise.  I do believe individuals who are or have been morbidly obese are vastly different from your average American with 30 lbs to lose.  Everything happens on a grander scale.  We lose weight bigger and gain weight bigger.  All I know is I've lost 100+ lbs using the Standard American Diet--twice.  Within a year I gained it back--twice.  Finding a low carb diet has saved my life.  I eat in normal portion sizes, I maintain. Is it for everyone? No.  Is it the only way? No.  But it is one way that works for many people who really need it.  

    Thanks Dr. Davis, for your presentation.  I truly enjoyed it.

  • Hilary

    3/20/2010 3:08:32 PM |

    "Higher intakes of red meats (heme proteins?) have been strongly associated with increased risk for colon and other gastrointestinal tract cancers."

    Really? Strong association? If that's true, then how do you explain this?:
    http://www.ajcn.org/cgi/content/abstract/ajcn.2008.26838v1

  • Edward

    3/20/2010 8:36:45 PM |

    Hilary said:

    "Really? Strong association? If that's true, then how do you explain this?:
    http://www.ajcn.org/cgi/content/abstract/ajcn.2008.26838v1"

    Hilary, I have not formed an opinion one way or the other on this issue yet, but the study you cite was "Supported in part by the Cattlemen's Beef Board, through the National Cattlemen's Beef Association, and the National Pork Board."

  • Anonymous

    3/20/2010 10:36:51 PM |

    Re my question as to how to translate percentages of protein, fat and carbs into grams, I should've have asked my trusted friend "google" instead of taking up someone's time here. So please forgive me.

    But Thanks! to those who responded. Your explanations were very helpful.

    Meanwhile, I found a site which will do all that computation for me and thought I'd pass it on.
    http://www.freedieting.com/tools/nutrient_calculator.htm

  • Anonymous

    3/21/2010 1:09:02 AM |

    Hi I was on the cruise and thoroughly enjoyed it. Sue, Yes I am overweight according to my BMI of 29, I was on the cruise the first year by the second i was 20 pound lighter by the time I got on this years cruise since last year I have lost 54 pound. Yes I am still as you say overweight but I am doing something about it. Sorry I wasn't "normal" for this year but I will be for next year. Snacks were handed out but the message was clear that these are treats and a preferable treat than something high carb and sugar loaded. There were new people there and others who have been doing it a while and of those we are all less than when we started. We had some excellent speakers i.e. Dana Carpender who spends her life educating us how to make foods using our own ingredients she even said you can put weight on eating low carb as we still can make the wrong choices. We all have the same problem with food do we not but we are prepared to be educated by the fabulous speakers who went to help us and gave their time freely to pass on their knowledge.

    A big big thank you to them and you Dr Davis

    Ailsa who came one the cruise all the way from the UK.

  • Mike Turco

    3/22/2010 2:21:16 AM |

    I've been reading your blog for a couple years and really enjoy doing so. I think you've got it wrong on the Atkins diet, though. I don't know where you got your information and I'm pretty sure you didn't read the books. Milk and yogurt aren't on the "diet". Atkins also told you to not eat cured meats. As far as calories are concerned, Atkins also told people to not eat too much! So... I'm having a lot of difficulty with this article in particular & wanted to pipe up. I'll go back to readin' the rest of your blog now. Thanks for all your efforts in keeping this blog up and running. -- Mike

  • George

    3/22/2010 3:46:11 PM |

    Dr. Davis, have greatly enjoyed your insights on this blog over the year. Have had your book for a couple of years. Have noticed great benefits from your vitamin D recommendations. When is your updated Track Your Plaque book coming out? I thought it was coming out toward the end of last year? Any ETA on it? Very interested in seeing your recommendations as it relates to diet? Typical recommended breakfasts, lunchs, and dinners?

    George

  • Owen

    3/28/2010 12:13:24 PM |

    This seems consistent with Ray Peat's advice as far as meat meat is concerned- he recommends balancing meat intake with gelatin so as to not get too much iron (hemeprotein afterall) as well as the fact that it has a less inflammatory amino acid profile (muscle is high in tryptophan and histidine wheras gelatin has no tryptophan and lots of glycine and proline...)

    Also he mentions that he always drinks coffee when he eats red meat so as to block iron overload even more!

    Of course he has no problems with milk, butter and cheese consumption but prefers the latter b/c curds have a better amino profile than whey.

  • Anonymous

    3/28/2010 5:35:14 PM |

    Over the years, I've looked closely at the studies associating red meat with colorectal cancer, and it appears to be impossible from them to separate the effects of modern meat production practices from that of the meat. In other words, it is as likely as not that what's wrong with the red meat is what we put into it, and how it is grown, versus any attribute of the meat itself.

    However, whatever the cause of the problem, it pays to at least limit consumption of red meat that you buy in a supermarket.

  • Atkins Diet

    4/24/2010 11:14:47 PM |

    Hi Dr Davis,

    Thanks for sharing your comments. I am a big Atkins Diet follower, and we all need to remind ourselves to keep the intake of "processed" meat & foods to a minimum. Vegetables are a good way to go! Thanks for providing us <a href ="http://atkinsdietinformation.blogspot.com>Atkins Diet</a> followers with such relevant and important information

    Cheers,

    John

  • jpatti

    5/7/2010 8:27:28 AM |

    I think it's bizarre to associate ANYONE'S eating habits on a cruise with what their day-to-day life is like.

    My normal food would not be available on a cruise: homemade yogurt and kefir made from fresh raw whole milk mixed with berries, pastured eggs with dark yellow yolks cooked in pastured butter, pastured meat, fresh organic fruits and vegetables, homemade chocolate made with coconut oil, cocoa, almonds and stevia... I don't see a cruise line providing food like this.

    So, I'd probably do sugar-free cheesecake too, or wind up overeating fresh fruit, just cause there'd not be any of my food there.

    When I travel, I do Wendy's burgers using the lettuce as a bun if hitting a drive-through or really crappy salad bars with not much beyond iceberg lettuce.

    Sometimes, you do the best you can with the circumstances... cause to eat really WELL, you pretty much need a kitchen.

  • R. Eductil

    6/7/2010 6:08:32 PM |

    This article contains huge inventory of knowledge and telling about the diet and what to eat or not.

  • suzan

    6/8/2010 11:06:10 AM |

    healthty diet is important..nice article about diet

  • Atkins Diet Copy

    7/11/2010 11:09:15 PM |

    Thanks for sharing this very useful tips.

  • cheapcalorad

    10/22/2010 10:58:27 AM |

    Really some truth to the fact that people from Mediterranean areas are seldom obese despite eating a very high fat diet? Did science get it all wrong before? Was there a national conspiracy to force people to eat boring, healthy foods? Thanks for your good suggestion.

    Welcome to visit-
    weight loss accelerator.
    Cheap Calorad

  • Anonymous

    11/2/2010 11:54:28 PM |

    I haven't eaten meat or dairy in long time. Humans don't need meat or dairy. I think meat is disgusting and I'm glad I don't have to eat it. I've seen meat-eaters B-12 deficient, so this shows eating meat doesn't necessarily make someone sufficient in B-12. Methylcobalamin B-12 works great. Eating red meat apparently increases colon and breast cancer risk. I think meat was meant to be an option, just like grains or legumes. Humans were designed to survive on many different things. Plant foods are affordable and bearable for me - meat is not.

  • buy jeans

    11/3/2010 2:21:15 PM |

    Overconsumption of dairy products--Dairy products, especially milk, yogurt, cottage cheese, and butter, are potent insulinotropic foods, i.e., foods that trigger insulin release. There can be up to a tripling of insulin (area-under-the-curve) levels. This is not good in a world populated with tired, overworked pancreases, exhausted from a lifetime of high-carbohydrate eating.

  • atkins diet plan

    12/7/2010 12:42:49 PM |

    hey guys,
    you out there had some great conversations that help me learn a lot from your, atkins diet, "slow-burn" discussions, meat consumption and being vegetarian.

    Nice exchange of great ideas, keep going guys and thanks Dr. Davis.

  • Lance Strish

    9/25/2011 8:44:37 AM |

    What do you make of this 'physiological insulin resistance' and its role in creeping weight gain on too low carb
    http://www.lowcarbconversations.com/344/22-barbara-rose-dean-dwyer-paleo-guy-weston-price-gal-discuss-body-image-more/#comment-306963040

  • Dr. William Davis

    9/25/2011 1:26:12 PM |

    Hi, Lance--

    I've not heard this argument before. If you've got the references for the studies showing this effect, I'd be happy to take a look.

    In real life, I've not seen this play out. People who restrict carbs, lose visceral fat, drop HbA1c, glucose, and insulin. Maintaining the diet does not, over the years, allow recrudescence of the phenomena of insulin resistance.

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