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

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

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

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

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






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

Oatmeal: Good or bad?

11. March 2010 William Davis (67)

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

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

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

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

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

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

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

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

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

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

Mustard: Super health food?

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

Consider that mustard contains:

Vinegar

Turmeric

No appreciable sugar


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

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

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

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

Exercise and blood sugar

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

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

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

Think about it. Reduced blood sugar:

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

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

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

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

The most important weight loss tool

4. March 2010 William Davis (15)

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


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

A treadmill? 




A bicycle?






No. None of the above. 

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



Timing of blood sugars

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

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

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

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


From Juntunen et al 2002

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

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


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

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

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

Psssst . . . There's sugar in there

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

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

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

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

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

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

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


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

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

How low should blood sugar be?

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

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

Here's what they found:




From Brunner et al 2006.
This is your brain on wheat II

This is your brain on wheat II

29. July 2010 William Davis (24)
In the original Heart Scan Blog post, This is your brain on wheat, I discussed how opioid peptides (i.e., small proteins that act like opiates such as heroine or morphine) that result from digestion of wheat cause unique effects on the human brain, particularly addictive behaviors. I also briefly reviewed how elimination of wheat has been shown to reduce auditory hallucinations and other psychotic behaviors in a subset of people with paranoid schizophrenia.

These two phenomena, addictions and schizophrenia, are most likely the result of exorphins that cross the blood-brain barrier. Exorphins--exogenous morphine-like compounds--can be blocked by opiate-blocking drugs like naloxone and naltrexone. Naloxone is used in hospitals to reverse morphine or heroine overdoses; naltrexone is being repackaged into a weight loss drug, since blocking wheat-derived exorphins reduces appetite. (Yes: The USDA tells us to eat more wheat, the drug industry sells us the antidote.)

There's another way that wheat can affect the brain and nervous system: immune-activated damage.

This is similar to the effect seen in celiac. There's even overlap with some of the antibody markers used to diagnose celiac, like the anti-gliadin antibodies and the anti-endomysium antibodies.

The most common immune neurological syndrome consequent to wheat consumption is cerebellar ataxia, a condition in which an immune response causes damage to the Purkinje cells of the cerebellum, the portion of the brain responsible for balance and coordination. This results in stumbling, incoordination, incontinence, and eventually leads to reliance on a cane or walker and wearing a diaper. Average age of onset: 53 years. A shrunken, atrophied cerebellum can be seen on an MRI of the brain.

Problem: Most people with central nervous system damage caused by wheat do not have any intestinal symptoms, like diarrhea and abdominal pain, the sort of symptoms usually associated with celiac disease. It means the first sign of wheat-induced brain damage may be bumping into walls and wetting your pants.
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Comments (24) -

  • LeonRover

    7/28/2010 9:18:57 PM |

    Being Irish an' all, my jeans will only allow me to thrive on a few spuds served with lashin's of butter an' onions and o' course sides of bacon and eggs washed down with Whiskey Go Leor, sometimes called The Juice o' the Barley.

    Minimal wheat.

  • Thrasymachus

    7/28/2010 10:35:34 PM |

    It only makes sense that there are vast numbers of people actually addicted to food, not metaphorically, but in the same way people are addicted to drugs and nicotine. A good start would be stop subsidizing this addiction, but since we have a government of the grain farmers, by the grain farmers, and for the grain farmers, that's not likely.

  • Anonymous

    7/29/2010 4:26:28 AM |

    Is wheat induced brain damage reversible, if one goes off wheat say at 50.?

  • Anonymous

    7/29/2010 5:34:31 AM |

    I would bet good money that this post will get more people off wheat than all your posts about wheat and heart disease combined!

  • Hans Keer

    7/29/2010 6:35:47 AM |

    You are totally right the devastating effects of wheat and its palls goes from gut to brain http://bit.ly/cAbZry VBR

  • Anonymous

    7/29/2010 10:22:18 AM |

    Dr. Davis

    As usual you are SPOT ON. exactly right with the symptoms and age. Just amazing all clinical symptoms described were seen by me in my father from 53 (stumbling and falling) to 58 (requiring help walking) to 60 (epilepsy hallucinations and fears)to 61 (bedridden) to 64 (last year November) death.

    Come to think, it was so simple to save him. It is just unreal.

  • Yogi Sinzapatos

    7/29/2010 3:55:16 PM |

    Sprouted wheat however is I believe extremely good for health.

  • Anonymous

    7/29/2010 3:59:26 PM |

    YOU HAVE DEFINITELY MADE YOUR POINT QUITE CLEAR.  NO NO MORE WHEAT.

    Does anyone how tequila is made?

  • lisa32989

    7/29/2010 6:16:37 PM |

    No wheat in tequila Smile

  • stop smoking help

    7/29/2010 9:05:39 PM |

    Is it time to join the bandwagon? No more drinking, no more smoking, no more wheat? Really, did I just write that? I have to say, I really enjoy my PB&J on whole grain wheat bread, as do my kids.

    Eating wheat is like apple pie and July 4th fireworks. How can we possibly do without and find a relatively cheap substitute? Is rice any good or is that a bad carb too?

    To eat healthy, is it just you need to eat organic and nonwheat foods and watch your carb-mix?

    Does it have to be this complicated? Has anyone written a book with easy to find, cheap/healthy ingredients that is easy to prepare in 30 minutes or less and feeds a family of 4?

    Right now, we're basically down to grilled chicken/fish/pork with steamed fresh brocolli/green beans and long-grain rice. That's pretty much all we eat anymore, with the occassional cheeseburger/steak indulgence.

  • Anonymous

    7/29/2010 9:38:25 PM |

    I started Low Dose Naltrexone 2 months ago to help with Autoimmune Disease.  I started at 1.5 and now am at 3.0
    I will increase to 4.5 in 2 weeks.

    I eliminated grains and dairy 1 month ago.

    I have lost 10 pounds.

    I could be as simple as the diet changes but I think more is going on.

    I have less pain which allows me to sleep through the night.
    I have more energy.
    I am more active and actually exercising.
    I am supplementing Vit. D and getting daily sun exposure (my Vit. D level was 41).
    My moods have greatly improved.

    Ironically, any time I have been prescribed an opiate pain medication, I have had severe allergic reactions.

    As far as the Neuro symptoms, I do have Meniere's complete with dizziness and vertigo.  So far I have not noticed any positive impact but still hopeful.

    Thanks Dr. Davis for all your information.

    J9

  • Anne

    7/30/2010 2:36:19 AM |

    "This results in stumbling, incoordination, incontinence, "

    I know you are right on. I was having mild ataxia and stress incontinence. Off gluten for 7 years and balance is better and no stress incontinence.

    This also affects dogs. My 12 year old cairn terrier was stumbling, falling over and urinating in her sleep. Got her off grains 2 years ago and she improved immediately.

  • Anonymous

    7/30/2010 4:35:39 AM |

    I can not say it enough times..............  Be healthy, not Paranoid.

    Dr. D emphasizes extremes for effect.  Do not fall into either side of the trap. Complacency nor paranoia.  informed decisions are critical for you and your family's well being

    Trevor

  • Anonymous

    7/30/2010 7:28:00 AM |

    i'd agree with Trevor as well.

    sourdough wheat (traditional preparation) and boiled raw milk go together.

    sourdoughing helps breakdown anti nutrients in wheat making the nutrients more bio available. Further Raw milk takes care of the rest by providing necessary enzymes (phystase etc) to digest wheat completely.

    pasteurized milk and wheat consumed without sourdoughing give both milk and wheat a bad name and will improve health when stopped simultaneously.

    traditional preparations eliminate such problems to a large extent.

  • Parag

    7/30/2010 9:55:55 AM |

    Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food.  Is an inherited, autoimmune disease in which the lining of the small intestine is damaged from eating gluten and other proteins found in wheat, barley, rye, and possibly oats.
    celiac disease symptoms

  • Alex

    7/30/2010 10:48:56 AM |

    Sprouting wheat begins the process of breaking down gluten, but it is not a complete process. Same goes for fermenting. Making a suboptimal food less bad for you does not mean that food is now good for you.

    As for boiled raw milk, taking raw milk to a boil heats it to an even higher temperature than is done during regular, non-UHT pasteurization, and it keeps it at that high temperature for a much longer time than any commercial pasteurization process. Raw milk that's been pasteurized at home at a higher temperature for a much longer time is not somehow magically superior to commercially pasteurized milk.

  • Anonymous

    7/30/2010 2:51:05 PM |

    I'd personally like to see an experiment on sourdough whole wheat combined with boiled raw milk to see what Dr Davis notes. That should settle it.

    Alex share your experience rather than float around in clouds.

  • Anonymous

    7/30/2010 5:08:37 PM |

    Just out of curiosity, I would like to know what is the point of buying something raw (supposedly because "raw" holds more benefits) only to then get it home and cook it. Boiling raw milk, in my estimation, defeats the purpose of consuming raw milk. Boiling kills everything. I buy raw milk weekly and I drink it "raw." That's why I buy it.  
    Am I missing something? (serious question).

  • Alex

    7/30/2010 5:33:10 PM |

    Anonymous, I don't have acute gluten sensitivity, but I've read enough about gluten sensitivity to know that sprouting and fermentation are not 100% effective at making wheat a tolerable food for people with gluten sensitivity.

    Why cling desperately to consumption of a crap quality food when it's so much easier and simpler to just not eat it at all? One personal experience I can draw on is the addictive nature of wheat. I've been addicted to both tobacco and alcohol, but the most addiction-triggering image I can visualize in my mind is a loaf of locally made, crusty Italian bread. I think people cling to wheat consumption because it's addictive, plus it's deeply embedded in human culture.

  • Anonymous

    7/30/2010 5:45:51 PM |

    raw milk is a relatively new fad in usa while india is the highest wheat and milk consumer since hundreds of years. The way they consume raw milk, is, after boiling it and the way they consume whole wheat is after making sourdough.

    I personally consume raw milk without boiling but whats important is to understand the effects of consuming wheat and milk traditionally on health viz a viz consuming it in modern style.

  • Anonymous

    7/30/2010 6:15:05 PM |

    Alex wheat is sub optimal as are many other foods. the only complete food is milk, everything else is had in combination with a complementary food.

    Wheat is also not easy to avoid while its consumed traditionally  daily in the east, it is everywhere in its modern avatar in the west.

    its not a bad idea to figure out wheats' complement and how it works than declare wheat suboptimal and write it off.

  • Tommy

    7/30/2010 8:13:55 PM |

    I think that more than the problems wheat may cause for some, the problem is the amount of wheat we consume. Consuming the bulk of your calories from wheat (or grain) is a problem, even for those who don't have any existing conditions. Drinking beer all day or more than you should isn't good either but that doesn't mean that a beer here and there or even one per day is a big deal. For an alcoholic one beer is a bad thing but for the average person 1 or 2 isn't. For someone with a problem, wheat is bad; for the average person a little here and there in moderation isn't. There are a lot of things modern man eats that he didn't eat at one time. But then again, there are many things in life in general that modern man does that we didn't do years ago. We will always look to make things easier and in doing so compromise ourselves in some way. The best thing is to be educated enough to make good decisions but not get too carried away in either direction.
    Eating store bought chicken and meat tainted and chemically enhanced isn't good either. What does that do to us long term? What about our children. Eat less wheat and grains and avoid one illness but get another from mystery meat. So I guess we can't win no matter what we do. We can't get crazy, we just have to make good decisions.
    Middle of the road always seems like a good starting point.

  • Anonymous

    8/3/2010 2:59:12 AM |

    "The most common immune neurological syndrome consequent to wheat consumption is cerebellar ataxia"

    Where is the study or other reference that supports this statement? How common is this neurological syndrome in the American general population?

    Thank you.

  • elwiemo

    8/18/2010 10:43:52 PM |

    How exactly are the Purkinje cells damaged, and how specific is the effect to gluten/wheat?  What is your source for this?

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