Fish oil: The natural triglyceride form is better

2. February 2011 William Davis (43)
If you have a choice, the triglyceride form of fish oil is preferable. The triglyceride form, i.e., 3 omega-3 fatty acids on a glycerol "backbone," is the form found in the body of fish that protects them from cold temperatures (i.e., they remain liquid at low ambient temperatures).

Most fish oils on the market are the ethyl ester form. This means that the omega-3 fatty acids have been removed from the glycerol backbone; the fatty acids are then reacted with ethanol to form the ethyl ester.

If the form is not specified on your fish oil bottle, it is likely ethyl ester, since the triglyceride form is more costly to process and most manufacturers therefore boast about it. Also, prescription Lovaza--nearly 20 times more costly than the most expensive fish oil triglyceride liquid on a milligram for milligram basis--is the ethyl ester form. That's not even factoring in reduced absorption of ethyl esters compared to triglyceride forms. Remember: FDA approval is not necessarily a stamp of superiority. It just means somebody had the money and ambition to pursue FDA approval. Period.

Taking any kind of fish oil, provided it is not overly oxidized (and thereby yields a smelly fish odor), is better than taking none at all. All fish oil will reduce triglycerides, accelerate clearance of postprandial (after-eating) lipoprotein byproducts of a meal (via activation of lipoprotein lipase), enhance endothelial responsiveness, reduce small LDL particles, and provide a physical stabilizing effect on atherosclerotic plaque.

But if you desire enhanced absorption and potentially lower dose to achieve equivalent RBC omega-3 levels, then triglyceride forms are better.

Here are cut-and-pasted abstracts of two of the studies comparing forms of fish oil.

Bioavailability of marine n-3 fatty acid formulations.

Dyerberg J, Madsen P, Moller JM et al. 
Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Copenhagen, Denmark.

Abstract

The use of marine n-3 polyunsaturated fatty acids (n-3 PUFA) as supplements has prompted the development of concentrated formulations to overcome compliance problems. The present study compares three concentrated preparations - ethyl esters, free fatty acids and re-esterified triglycerides - with placebo oil in a double-blinded design, and with fish body oil and cod liver oil in single-blinded arms. Seventy-two volunteers were given approximately 3.3g of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) daily for 2 weeks. Increases in absolute amounts of EPA and DHA in fasting serum triglycerides, cholesterol esters and phospholipids were examined. Bioavailability of EPA+DHA from re-esterified triglycerides was superior (124%) compared with natural fish oil, whereas the bioavailability from ethyl esters was inferior (73%). Free fatty acid bioavailability (91%) did not differ significantly from natural triglycerides. The stereochemistry of fatty acid in acylglycerols did not influence the bioavailability of EPA and DHA.
(Full text of the Dyerberg et al study made available at the Nordic Naturals website here.)



Eur J Clin Nutr 2010 Nov 10. 

Enhanced increase of omega-3 index in response to long-term n-3 fatty acid supplementation from triacylglycerides versus ethyl esters.

Neubronner J, Schuchardt JP, Kressel G et al. 
Institute of Food Science and Human Nutrition, Leibniz Universität Hannover, Am Kleinen Felde 30, Hannover, Germany.

Abstract

There is a debate currently about whether different chemical forms of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are absorbed in an identical way. The objective of this study was to investigate the response of the omega-3 index, the percentage of EPA+DHA in red blood cell membranes, to supplementation with two different omega-3 fatty acid (n-3 FA) formulations in humans. The study was conducted as a double-blinded placebo-controlled trial. A total of 150 volunteers was randomly assigned to one of the three groups: (1) fish oil concentrate with EPA+DHA (1.01?g+0.67?g) given as reesterified triacylglycerides (rTAG group); (2) corn oil (placebo group) or (3) fish oil concentrate with EPA+DHA (1.01?g+0.67?g) given as ethyl ester (EE group). Volunteers consumed four gelatine-coated soft capsules daily over a period of six months. The omega-3 index was determined at baseline (t(0)) after three months (t(3)) and at the end of the intervention period (t(6)). The omega-3 index increased significantly in both groups treated with n-3 FAs from baseline to t(3) and t(6) (P < 0.001). The omega-3 index increased to a greater extent in the rTAG group than in the EE group (t(3): 186 versus 161% (P < 0.001); t(6): 197 versus 171% (P < 0.01)). Conclusion: A six-month supplementation of identical doses of EPA+DHA led to a faster and higher increase in the omega-3 index when consumed as triacylglycerides than when consumed as ethyl esters.

Diarrhea, asthma, arthritis--What is your wheat re-exposure syndrome?

30. January 2011 William Davis (52)
Have you experienced a wheat re-exposure syndrome?

As I recently discussed, gastrointestinal distress--cramps, gas, diarrhea--is the most common "syndrome" that results from re-exposure to wheat after a period of elimination.

Others experience asthma, sinus congestion and infections, mental "fogginess" and difficulty concentrating, or joint pains and/or overt swelling.

Still others say there is no such thing.

Let's take a poll and find out what readers say.

Marathoners, triathletes, and heart disease

30. January 2011 William Davis (0)
Curious thing: People with lipoprotein(a) gravitate towards elite levels of exercise.

I tell my lipoprotein(a) patients that, if they want to see a lot of other people with lipoprotein(a), go to a marathon or triathlon.

This effect applies more to males than to females, just as the fascination with numbers seems to be confined to men, too. That's why I've posted in past about the "prototypical" lipoprotein(a) male.

I believe this is a big part, perhaps the only, reason why there seems to be a modest increased risk for cardiovascular events despite high exercise levels in marathoners. It has nothing to do with the exercise itself; it has to do with the kind of people who choose to exercise at this level.

The best fish oil

29. January 2011 William Davis (30)
The best fish oils available are the liquid forms. Contrary to many people's expectations, the best liquid fish oils have no fishy odor or taste.

I use a lot of liquid fish oils because of the higher doses we use in the Track Your Plaque program, as well as our strategy of high-dose fish oil to reduce lipoprotein(a). Women, in particular, don't like taking the oodles of capsules required to achieve the higher doses we need. So the ladies really like the liquid forms.

The best liquid fish oils are non-fishy, highly-concentrated, and come in the better absorbed triglyceride form. Many capsules, including prescription Lovaza, are the less well-absorbed ethyl ester form. Several studies, such as this one, have now demonstrated that the naturally-occurring triglyceride form yields higher blood (RBC) levels of omega-3 fatty acids, likely due to more efficient digestion via pancreatic lipase.

While there are many good forms of fish oil and only a few bad, these are the best of the best:

Pharmax
The Pharmax Finest Pure Fish Oil with Essential Oil of Orange contains 1800 mg EPA + DHA per teaspoon. This is the preparation I've been taking.

Nordic Naturals
The Nordic Naturals lemon-flavored ProOmega Liquid contains 2752 mg EPA + DHA per teaspoon, the most concentrated of any fish oil I've seen.

(This list is not exclusive. These are just two brands I've used extensively with good results.)

These highly-concentrated, triglyceride forms are more expensive, due to their concentrated nature. 1 teaspoon Pharmax fish oil, for example, provides an equivalent quantity of omega-3 fatty acids as 6 standard fish oil capsules on a milligram for milligram basis, but more like 8 to 9 capsules when absorption efficiency is factored in. The triglyceride form is also more laborious to manufacture. On our Track Your Plaque Marketplace, our Pharmax 500 ml runs $58.95 list. (500 ml provides 100 teaspoons or 600-capsule equivalent.)

Note that, minus the protection of the capsule, liquid fish oils will oxidize if not refrigerated. So be sure to keep your liquid fish oil in the fridge.

What do Salmonella, E coli, and bread have in common?

28. January 2011 William Davis (22)
Say you happen to eat some chicken fingers contaminated with bacteria because the 19-year old kid behind the counter failed to wash his hands after using the toilet, or because the kitchen is poorly managed with unwashed counters and cutting boards, or because the food is undercooked. You get a bout of diarrhea and cramps, along with a desire to banish chicken from your life.

Here's yet another odd wheat phenomenon: About 30% of people who eliminate wheat from their lives experience an acute food poisoning-like effect on re-exposure. You've been wheat-free for, say, 6 months. You've lost 25 lbs from your wheat belly, you've regained energy, joints feel better. You go to an office party where they're serving some really yummy looking bruschetta. Surely a couple won't hurt! Within a hour, you're getting that awful rumbling and unease that precede the explosion.

The majority of people who experience a wheat re-exposure syndrome will have diarrhea and cramps that can last from hours to days, similar to food poisoning. (Why? Why would a common food trigger a food poisoning-like effect? It happens too fast to attribute to inflammation.) Others experience asthma attacks, joint pains that last 48 hours to a week, mental fogginess, emotional distress, even rage (in males).

Wheat re-exposure in the susceptible provides a tidy demonstration of the effects of this peculiar product of genetic research. So if you are wheat-free but entertain an occasional indulgence, don't be surprised if you have to make a beeline to the toilet.

The world of intermediate carbohydrates

28. January 2011 William Davis (0)
There are clear-cut bad carbohydrates: wheat, oats, cornstarch, and sucrose. (Fructose, too, but in a class of bad all its own.)

Wheat: The worst. Not only does wheat flour increase blood sugar higher than nearly all other carbohydrates, it invites celiac disease, neurologic impairment, mental and emotional effects, addictive (i.e., exorphin) effects, asthma, irritable bowel syndrome, acid reflux, sleepiness, sleep disruption, arthritis . . . just to name a few.

Oats: Yeah, yeah, I know: "Lowers cholesterol." But nobody told you that oats, including slow-cooked oatmeal, causes blood sugar to skyrocket.

Cornstarch: Like wheat, cornstarch flagrantly increases blood sugar.It also stimulates appetite. That's why food manufacturers put it in everything from soups to frozen dinners.

Sucrose: Not only does sucrose create a desire for more food, it is also 50% fructose, the peculiar sugar that makes us fat, increases small LDL particles, increases triglycerides, slows the metabolism of other foods, encourages diabetes, and causes more glycation than any other sugar.

But there are a large world of "other" natural carbohydrates that don't fall into the really bad category. This includes starchy beans like black, kidney, and pinto; rices such as white, brown, and wild; potatoes, including white, red, sweet, and yams; and fruits. It includes "alternative" grains like quinoa, spelt, triticale, amaranth, and barley.

For lack of a better term, I call these "intermediate" carbohydrates. They are not as bad as wheat, etc., but nor are they good. They will still increase blood glucose, small LDL, triglycerides, etc., just not as much as the worst carbohydrates.

The difference is relative. Say we compare the one-hour blood glucose effects of 1 cup of wheat flour product vs. one cup of quinoa. Typical blood sugar after wheat product: 180 mg/dl. Typical blood sugar after quinoa: 160 mg/dl--better but still pretty bad.

Some people are so carb-sensitive that they should avoid even these so-called intermediate carbohydrates. Others can have small indulgences, e.g., 1/2 cup, and not generate high blood sugars.

Heroin, Oxycontin, and a whole wheat bagel

25. January 2011 William Davis (27)
For a substantial proportion of people who remove wheat from their diet, there is a distinct and unpleasant withdrawal syndrome. Here are the comments of Heart Scan Blog reader, Scott, from Texas:

Hello Dr. Davis,

I've been experimenting with diet, converging upon a Paleo type diet, but I keep running into problems. I have isolated the problem to cutting out wheat.

Sugar, rice, fruit, corn, potatoes, etc. are relatively ok to add or remove from the diet, but cutting out wheat in particular brings on a moderate headache with heavy fatigue all day long. This resembles the wheat withdrawal symptoms I found on your blog. As I write this, I'm on day 8 of wheat-free. I consume a fair variety of meat and veggies each day with a moderate amount of white rice for carbs. Perhaps a bowl of corn flakes with milk and half a bar of dark chocolate a day. I've learned from experience over the past 5 months or so that none of these foods affect the withdrawal. It's purely wheat.

My question is, what is the range of times for withdrawal symptoms that you've heard from different people? Has there been anyone who never recovered from the wheat withdrawal symptoms even after many months?

It's very tough to get work done like this, and even though my body and head feel much healthier in general, my sinuses have cleared, don't have to take a big nap after I eat, etc., I don't want to go down a path where this is the way things are going to be forever. 


People who have never experienced wheat withdrawal pooh-pooh the effect. But, for about 30% of people, wheat withdrawal is a real, palpable, and sometimes incapacitating experience.

Beyond removing an exceptionally digestible carbohydrate that yields blood sugar rises higher than nearly any other known food (due to the unique amylopectin structure of wheat-derived carbohydrate), wheat withdrawal is a form of opiate withdrawal, somewhat like stopping heroin, Oxycontin, and other opiates. Stop eating whole wheat toast for breakfast, whole grain sandwiches for lunch, or whole grain pasta for dinner, and the flow of exorphins, i.e., exogenous morphine-like compounds, stops. You experience dysphoria (sadness, unhappiness), mental "fog," inability to concentrate, fatigue, and decreased capacity to exercise. It is milder than withdrawal from prescription opiates. Unlike withdrawal from more powerful opiates like heroine, there are, thankfully, no seizures or hallucinations. There are also no deaths.

In my experience, most people get through with wheat withdrawal in about 5 days. An occasional person will struggle for as long as 4 weeks. Thankfully for Scott, I've never seen it last longer than 4 weeks. (Interestingly, people who survive the withdrawal syndrome are often prone to a peculiar re-exposure phenomenon that I will discuss in future, i.e., they get sick upon re-exposure.)

The modern dwarf mutant variant of Triticum aestivum (that our USDA urges us to eat more of) contains greater proportions of gluten proteins compared to wheat pre-1970; glutens are the source of wheat-derived exorphins.

Incidentally, a drug company should be releasing a drug in the next year that will contain naltrexone, an oral opiate blocking drug, for a weight loss indication. They claim it is a blocker of the "mesolimbic reward system." I say it's a blocker of wheat exorphins.

The five most powerful heart disease prevention strategies

24. January 2011 William Davis (39)
You've seen such lists before: 5 steps to prevent heart disease or some such thing. These lists usually say things like "cut your saturated fat," eat a "balanced diet" (whatever the heck that means), exercise, and don't smoke.

I would offer a different list. You already know that smoking is a supremely idiotic habit, so I won't repeat that. Here are the 5 most important strategies I know of that help you prevent heart disease and heart attack:

1) Eliminate wheat from the diet--Provided you don't do something stupid, like allow M&M's, Coca Cola, and corn chips to dominate your diet, elimination of wheat is an enormously effective means to reduce small LDL particles, reduce triglycerides, increase HDL, reduce inflammatory measures like c-reactive protein, lose weight (inflammation-driving visceral fat), reduce blood sugar, and reduce blood pressure. I know of no other single dietary strategy that packs as much punch. This has become even more true over the past 20 years, ever since the dwarf variant of modern wheat has come to dominate.

2) Achieve a desirable 25-hydroxy vitamin D level--Contrary to the inane comments of the Institute of Medicine, vitamin D supplementation increases HDL, reduces small LDL, normalizes insulin and reduces blood sugar, reduces blood pressure, and exerts potent anti-inflammatory effects on c-reactive protein, matrix metalloproteinase, and other inflammmatory mediators. While we also have drugs that mimic some of these effects, vitamin D does so without side-effects.

3) Supplement omega-3 fatty acids from fish oil--Omega-3 fatty acids reduce triglycerides, accelerate postprandial (after-meal) clearance of lipoprotein byproducts like chylomicron remnants, and have a physical stabilizing effect on atherosclerotic plaque.

4) Normalize thyroid function--Start with obtaining sufficient iodine. Iodine is not optional; it is an essential trace mineral to maintain normal thyroid function, protect the thyroid from the hundreds of thyroid disrupters in our environment (e.g., perchlorates from fertilizer residues in produce), as well as other functions such as anti-bacterial effects. Thyroid dysfunction is epidemic; correction of subtle degrees of hypothyroidism reduces LDL, reduces triglycerides, reduces small LDL, facilitates weight loss, reduces blood pressure, normalizes endothelial responses, and reduces oxidized LDL particles.

5) Make exercise fun--Not just exercise for the sake of exercise, but physical activity or exercise for the sake of having a good time. It's the difference between resigning yourself to 30 minutes of torture and boredom on the treadmill versus engaging in an activity you enjoy and look forward to: go dancing, walk with a friend, organize a paintball tournament outdoors, Zumba class, plant a new garden, etc. It's a distinction that spells the difference between finding every excuse not to do it, compared to making time for it because you enjoy it.

Note what is not on the list: cut your fat, eat more "healthy whole grains," take a cholesterol drug, take aspirin. That's the list you'd follow if you feel your hospital needs your $100,000 contribution, otherwise known as coronary bypass surgery.

Topping up your vitamin D tank

22. January 2011 William Davis (17)
Now that my vitamin D replacement experience dates back nearly 5 years, I've been witnessing an unusual phenomenon:

The longer you take vitamin D, the less you need.

Let me explain. You take 10,000 units D3 in gelcap form. 25-hydroxy vitamin D levels, checked every 6 months, have remained consistently between 60 and 70 ng/ml. Three years into your vitamin D experience and 25-hydroxy vitamin D level rises to 98 ng/ml--an apparent need for less vitamin D.

So we cut your intake from 10,000 units per day to 8000 units per day. Another 25-hydroxy vitamin D level 6 months later: 94 ng/ml. We cut dose again to 6000 units, followed by another 25-hydroxy vitamin D level of 66 ng/ml.

This has now happened in approximately 20% of the people who have been taking vitamin D for 3 or more years. I know of no formal analysis of this effect, what I call the "topping up" phenomenon. Reasoned simply, it seems to me that, once your vitamin D "tank" is topped up (i.e., tissue stores have been replenished), it requires less to keep it full.

No one has experienced any adverse consequence of this topping up effect though it has potential for some people to develop toxic levels if 25-hydroxy vitamin D levels are not monitored long-term. In my office, I measure 25-hydroxy vitamin D levels every 6 months.

It means that long-term monitoring of 25-hydroxy vitamin D is crucial to maintain favorable and safe levels.

Thirteen catheterizations later

21. January 2011 William Davis (16)
When I first met her, Janet couldn't stop sobbing. She'd just been through her 10th heart catheterization in two years.

It started with chest pains at age 56, prompting her first heart catheterization that uncovered severe atherosclerotic blockages in all three coronary arteries. Her cardiologist advised a bypass operation.

Six months after the bypass operation, Janet was back with more chest pains, just as bad as before. Another heart catherization showed that two of the three bypass grafts had failed. The third bypass graft contained a severe blockage that required a stent, along with multiple stents in the two now unbypassed arteries.

In the ensuing 18 months, Janet returned for 8 additional catheterizations, each time leaving the hospital with one or more stents.

Janet's doctor was puzzled as to why her disease was progressing so aggressively despite Lipitor and the low-fat diet provided by the hospital dietitian. So he had Janet undergo lipoprotein testing (NMR):

LDL particle number: 3363 nmol/L
Small LDL particle number: 2865 nmol/L
HDL cholesterol: 32 mg/dl
Triglycerides: 344 mg/dl
Fasting blood glucose 118 mg/dl
HbA1c 5.8%

Unfortunately, Janet's doctor didn't understand what these values meant. He pretty much threw his arms up in frustration. That's when I met Janet.

From her lipoprotein panel and other values, it was clear to me that Janet was miserably carbohydrate-sensitive and carbohydrate-indulgent, as demonstrated by the extravagant quantity (2865 nmol/L) and proportion (2865/3363, or 85%) of small LDL, the form of LDL particles created by carbohydrate exposure. Janet struggled with depression over the years and had been using carbohydrate foods as "comfort" foods, often resorting to cookies, pies, cakes, breads, and other wheat-containing foods for emotional solace.

It took a bit of persuasion to convince Janet that it was low-fat, "healthy whole grains," as well as comfort foods, that had led her down this path. I also helped Janet correct her severe vitamin D deficiency, mild thyroid dysfunction, and lack of omega-3 fatty acids.

Since meeting Janet and instituting her new prevention program, she has undergone three additional catheterizations (performed by another cardiologist), all performed for chest pain symptoms that struck during periods of emotional stress. All showed . . . no significant blockage. (Apparently, the repeated "need" for stents triggered a Pavlovian response: chest pain = "need" for yet more stents.)

In short, correction of the causes of coronary atherosclerotic plaque--small LDL, vitamin D deficiency, omega-3 fatty acid deficiency, and thyroid dysfunction--and Janet's disease essentially ground to a halt.

Imagine, instead, that Janet had undergone 1) a heart scan to identify hidden coronary plaque 5-10 years before her first heart procedure, then 2) corrected the causes before they triggered symptoms and posed danger. She might have been spared an extraordinary amount of life crises, hospital procedures, expense (nearly $1 million), and emotional suffering.
Wheat hip

Wheat hip

10. August 2010 William Davis (39)
You've heard of wheat belly. How about wheat hip?

Recall that the innocent appearing wheat belly is actually a hotbed of inflammatory activity beneath the surface. The visceral fat of the wheat belly, i.e., fat kidneys, fat liver, fat intestines, fat pancreas, produces abnormal inflammatory signals, such as various interleukins, tumor necrosis factor, and leptin. These are the inflammatory signals that create insulin resistance and diabetes, heart disease, hypertension, and cancer.

These same inflammatory mediators are able to enter the joint spaces, such as those in your hips, knees, and hands. This leads to osteoarthritis, the exceptionally common form of arthritis that affects 1 in 7 Americans. In particular, the level of leptin in joints mirrors that in blood, a phenomenon that has been associated with joint destruction.

The previously widely-held notion that arthritis is simply a wear-and-tear phenomenon due to the mechanical stress of excess weight is proving to be an oversimplification. Arthritis is also part of the carbohydrate-driven, weight-increasing, inflammatory condition of insulin resistance or metabolic syndrome.

Throw into this cytokine storm the fact that glycation, i.e., glucose modification of proteins, also causes cartilage destruction. The cells of human cartilage lack the ability to divide, so the cartilage cells you had at age 18 are the cartilage cells that you will hopefully still have at age 80. However, high blood sugars (glucose) glycate the proteins in cartilage. (Wheat raises blood glucose higher than almost all other foods, higher than a Milky Way bar, higher than a Snickers bar.) The process is irreversible and cumulative. Because cartilage has next to no capacity for repair or regeneration, it becomes brittle. Over years, it essentially crumbles, leading to the "bone on bone" that prompts conversations about total hip and total knee replacement.

So that ciabatta or blueberry muffin in your mouth takes you a step or two closer to joint destruction via heightened inflammation arising from the visceral fat of the wheat belly, worsened by glycation of high blood sugars after carbohydrate consumption.

My solution: Lose the ciabatta.
Tags :

Comments (39) -

  • Anonymous

    8/10/2010 4:21:02 PM |

    how much daily carbs is a good amount to try to stay under?

    my high fiber cereal in the morning alone has 49g of carbs (7g sugar, 10g Fiber) and 10g protein,

  • Matt Stone

    8/10/2010 5:25:39 PM |

    Anonymous-

    I try to keep my carb intake above 500 grams per day - almost all unrefined starches. This causes instant fat loss, a drop in insulin levels due to improved insulin sensitivity, and reversal of metabolic syndrome in most people - hence why the leanest people on earth almost invariably eat a very high-carbohydrate starch-based diet, such as the Yuzuri Hara of Japan, the Kitavans, the Q'ero of the Andes, the Southest Asians, people all over subSaharan Africa, and other of the rare places on earth where obesity and metabolic syndrome is still exceedingly rare.

  • Anonymous

    8/10/2010 6:22:35 PM |

    Don't believe Matt Stone.  His current photos and videos show a bloated face and pot belly.  Photos from his low carb days reveal that he was much leaner back then.  He couldn't carve out a niche for himself as a low-carber so he switched tactics and became insanely anti-low-carb in order to create a name for himself.  Cynicism at it's absolute worst.  You would do well to ignore everything this guy has to say.

  • Tommy

    8/10/2010 7:08:19 PM |

    "Don't believe Matt Stone. His current photos and videos show a bloated face and pot belly. Photos from his low carb days reveal that he was much leaner back then. He couldn't carve out a niche for himself as a low-carber so he switched tactics and became insanely anti-low-carb in order to create a name for himself. Cynicism at it's absolute worst. You would do well to ignore everything this guy has to say."

    I have found that the internet in general is loaded with extremes. On one end you have the extreme of equating eating any grains or carbs with worshiping false gods while on the other, tiny bits of meat garnish loads of carbs. As always the answer is somewhere in the middle. Add to that personal requirements taking into account illness, body type, exercise, sensitivities or allergies etc and you can do well just "eating healthy" and exercising.
    I do find the Yuzuri Hara and their potato eating very interesting. Add to that the fact that you have 95 year olds smoking like chimney's and healthy as 20 year olds and it makes you wonder.
    Eat right, everything in moderation (even moderation) and no lab or factory created foods (refined/processed crap), exercise, the right intake of calories compared to the outgo of energy, and forget about extremes. There are many ways....mix and match.

  • Anonymous

    8/10/2010 9:06:16 PM |

    The native people in your list, Matt, lived much more labor-intensive lives than we here in the Western world.  That enabled them to burn off the blood sugar as it developed, before it had a chance to be deposited as fat.

    That was combined with the fact that, without industry available to refine the starches, they tended to absorb less of the energy from the food, leaving them hypocaloric.  It's easier to remain lean when you are in starvation mode.  Doesn't paint a rosy picture of life, however.

    The foods they ate, unrefined starches, are by design very nutrient-poor other than as glucose-storage methods.  Why would it seem logical to center one's diet BY CHOICE around such nutrient-poor foods, just because highly active people can mitigate their negative effects?

    If you have to choose between vitamin and mineral-rich foods which are inherently satiating, such as meat and fat, and fibrous starches which impose an energy load on the body which then must utilize emergency methods to mitigate their negative impact on blood sugar, I just don't understand why one would choose the latter.

    Yes, there have been primitives living in primitive societies which did not suffer as adverse effects from their starch-based existence as do we in the more affluent world, but that does not automatically mean that their method is superior.

  • Anonymous

    8/10/2010 10:16:20 PM |

    If one gets and uses a glucometer, what is revealed is how the body responds to a high carb diet. In my case, it reveals that a low carb diet the way to go. No seeking of the mean between the so-called extremes. For me, the high carb diets are just wrong. YMMV

    Trig

  • Tommy

    8/10/2010 11:14:43 PM |

    "If one gets and uses a glucometer, what is revealed is how the body responds to a high carb diet. In my case, it reveals that a low carb diet the way to go. No seeking of the mean between the so-called extremes. For me, the high carb diets are just wrong. YMMV"

    This is why I said depending on the individual and any preexisting conditions. But I said nothing about "high carb." Those aren't my words. "High carb" is an extreme. Of course your meter readings would be out of whack.  High carbs would probably get to me eventually also and I currently have no problems with carbs. Actually without some grains I would lose so much weight I'd fade away!! I train hard and my body requires a lot of food and I couldn't eat enough meat or protein alone to satisfy that. But moderate carb works well for me (and many people). (I don't eat processed foods or wheat or sugar) Middle of the road. In the post above that responds to Matt, there is mention of the natives burning off what they ate. That doesn't ring right with me. It seems too much like a justification "not to" exercise. "What can I eat that doesn't require me to move and burn it off?" Exercise might help balance a moderate eating style. "use" the fuel rather than saving it.

    For me...reading a meter everyday would be the same as weighing yourself everyday. When I have blood work done every 6 months and my glucose is fine I don't worry about what is going on daily. It's the average that counts.  Why stress about it? That's not good either. But as you say "YMMV" and we need to approach it as individuals. I tend to lose weight if I miss a meal. At one point I was consuming close to 4500 calories per day. But I work out a lot. Right now 3000 calories isn't cutting it and I keep losing weight. I need my rice (brown/soaked overnight), oats (soaked) and quinoa, sweet potatos.

  • stratis

    8/11/2010 12:12:49 AM |

    check out his current photos and videos---wheat face!! he's a schemester, that is for sure. lurks in these areas and pops out like a turd from a full bowel from time to time.  

    but then again Dr. D's face looks quite plump too. And he has never shown his body pictures..hmmmmm

  • Anonymous

    8/11/2010 2:25:29 AM |

    Dr, you have sold me

    Ten days without any wheat products, I never thought I could do it, thank you

  • Anonymous

    8/11/2010 2:35:14 AM |

    Dr. D,

    Please screen your responses and restrict the destructive kooks/vegans. They negate your message, and should start their own blogs rather than trashing other's.

    I suggest you also scrub portions of messages that are merely arguments with previous posters.

  • Anne

    8/11/2010 3:37:45 AM |

    When I stopped eating gluten 7 years ago, the first of many improvements I noticed was my knees no longer hurt. Slowly my fingers improved and the knobby look disappeared. Then my hip pain vanished.  I am 67 and I wake up with NO joint pain now. I use to hurt all over. There is no "moderate" amount of wheat that is safe for me.

  • V. Iagra

    8/11/2010 7:13:26 AM |

    The heart scan blog measure, track and reduce atherosclerotic plaque and gives the details of wheat hip.

  • Ed Terry

    8/11/2010 11:17:45 AM |

    I discovered that infrequent blood glucose measurements led me to a false sense of comfort.  Several times this year, I had laboratory blood glucose measurements and even after a low-carb meal, the level never rose above 100.

    Just for the heck of it, I ordered an HbA1c test and the result was 5.6 which corresponds to an average level of 114.  After that I spent a couple of weeks using a glucose meter to track my blood glucose around the clock for several weeks.  Interestingly enough, my blood glucose was always higher after a weightlifting session in proportion to the intensity of the workout.  For example, after back squats my blood glucose was 154.

    I also dicovered that different batches of blood glucose testing strips produce wildy different measurements, sometimes as much as 30 mg/dL between batches on the same meter.

  • Peter

    8/11/2010 12:15:55 PM |

    I stopped eating grain 5 weeks ago and I would like to test my lipid levels to see if there's any change.  Is it too soon?

  • Tommy

    8/11/2010 12:20:20 PM |

    @ Ed Terry

    Hi Ed
    Let me ask a stupid question (only because I tend to think of things in simple terms). When we have our blood pressure checked or take our pulse we do it at rest. We look for a resting (true) reading. There are other things we read at rest also. Why is it that we would take a reading for glucose after a meal that would naturally raise our levels? I would think that our concern would be what our body is doing at rest when there would be no reason (normally) for an elevated reading.  By your example and the reasoning I have been reading... cutting out that which makes your levels rise...it seems by the same logic you should not squat either.  Or lift weights?

  • Donna

    8/11/2010 3:55:55 PM |

    Dr. D....show us your wheatless body! It would be nice to see how a body looks without inflammation.

  • Tommy

    8/11/2010 4:40:05 PM |

    "Please screen your responses and restrict the destructive kooks/vegans. They negate your message, and should start their own blogs rather than trashing other's.

    I suggest you also scrub portions of messages that are merely arguments with previous posters."

    I have learned a lot from this site but a lot of it has been not only from the information here, but references to other sites.  The problem with blog comments or "screening" is that it then becomes very one sided. Without a flip side people take everything as gospel. But in actuality, for every great piece of evidence and data found here, or on any other site, there is just as convincing data in the opposite direction somewhere else. Once again I have to think the answer is somewhere in the middle. If a site like this had some "debate" and alternate views it might open up intelligent and helpful discussion rather than blind following.

  • Thumb

    8/11/2010 5:33:17 PM |

    Heart Health

    Heart Disease, in all of its various forms can be avoided.

  • David M Gordon

    8/11/2010 6:31:40 PM |

    Having a private argument with a doctor-friend who claims,

    "Niacin (nicotinic acid) comes in prescription form and as dietary supplements. Dietary supplement niacin is not regulated by the U.S. Food and Drug Administration (FDA) the same way that prescription niacin is. It may contain widely variable amounts of niacin — from none to much more than the label states. The amount of niacin may even vary from lot to lot of the same brand.

    "Thus, dietary supplement niacin must not be used as a substitute for prescription niacin. It should not be used for cholesterol lowering because of potentially very serious side effects."


    Would (could) somebody knowledgeable please argue whether this doctor-friend is full of hot air, and merely protects his fiefdom...?

    Thank you in advance,

  • Onschedule

    8/11/2010 9:51:49 PM |

    @David M Gordon

    Dr. Davis has written a blog entry on this topic. Search for "niaspan" in the search box (upper left-ish corner). I believe it's about the third article down...

  • Anonymous

    8/11/2010 9:51:55 PM |

    Like Anne, I have found that removing grains from my diet has resulted in pain-free joints.  If I get "glutened" by mistake, I almost always respond with an inflammation in a large joint - shoulder, knee, even back - with heat and sharp pain.  Before a grain-free diet, I had what I thought were normal aches and pains in my finger joints.  Those are completely gone with a grain-free diet.

  • David M Gordon

    8/11/2010 10:53:31 PM |

    Thank you, Onschedule. Perfect!

    And thank you, Dr Davis.

  • stop smoking help

    8/12/2010 3:24:47 AM |

    Two days into my no wheat experiment and I'm not having any cravings like I thought. I probably have a lot of those wheat carbs still floating around.

    So far though, I think this may be easier than I first thought. Although, I might get tired of eggs for breakfast pretty soon, then what. Everything else has wheat (pancakes, waffles, cereal) and I'm allergic to oats. Maybe yogurt and fruit?

    Lunches and dinners are, so far so good. We'll see what happens.

  • Anna

    8/12/2010 11:30:07 PM |

    stop smoking health:

    re: what to eat for breakfast

    Rethink "breakfast".  The cereal companies have done a good job convincing Americans that breakfast is a sweet and starchy meal, but that isn't so around the world.   In Poland and other parts of Eastern and Northern Eastern Europe, I have happily enjoyed breakfasts that included salad or cut up vegetables, smoked or pickled fish, salami or sausage, cheese, as well as simple yogurt and fresh cut fruit.  

    How about some leftovers from the previous dinner?  

    When I'm in a hurry I make a Real Food high fat protein shake:  I blend together a couple raw eggs or egg yolks, a couple tablespoons of heavy cream or coconut milk, a tablespoon of Dutched cocoa powder, and either some water, crushed ice,  or cold coffee/espresso.  I don't sweeten my shakes, but they can be sweetened a little, too.  Frozen berries can be substituted for coffee and ice to change the flavor/add sweetness.  Plain whole fat yogurt is a nice tart probiotic addition, too.  Make it up the night before if needed and store in the fridge.  With practice and keeping the ingredients stocked, this shake is blended and cleaned up in less than 5 minutes.  

    My main point is to explore different ideas for breakfast and don't let the food processing companies define "breakfast" foods for you.  Redefine "breakfast" for yourself.

  • RaySolution

    8/13/2010 12:01:57 AM |

    Thanks for pointing out the connection between high carbs and inflammation of the joints.  I very much enjoyed the many comments and learned from them.

  • Tom

    8/13/2010 12:27:11 AM |

    Thanks to this blog I avoid wheat almost completely nowadays but for the sake of interest I would like to add a rejoinder: what should one replace the ciabatta with?

    People eat food to *get high* and maintain their moods as much as to supply their bodies with fuel and raw materials.

    So, in the absence of fundamental personal change, my guess is that the ciabatta is going to be replaced by:

    (a) more coffee,
    (b) more alcohol,
    (c) more getting angry,
    (d) drugs/painkillers, or
    (e) some other vice

    This is the cental issue of low-carb eating, in my opinion.

    The body and mind are part of a *system* which inclues the rest of the eater's life.

  • Vlado

    8/13/2010 12:56:34 AM |

    how about no breakfast in the morning, that is if you had a good dinner. Our energy should be the highest in the morning with cortisol and testosterone at the highest levels so any food just messes it up. This is something natural for us as I don't think our ancestors ate in the morning as they didn't have refrigeration, we are genetically predisposed eating later in the day. Only a few nuts or berries in the morning may be all right.

  • Anonymous

    8/13/2010 3:13:54 PM |

    "People eat food to *get high* and maintain their moods as much as to supply their bodies with fuel and raw materials."

    Blimey, never looked at it like that.

    What's your opinion of Sauerkraut?

  • Anonymous

    8/13/2010 3:30:46 PM |

    This just in:

    Low-carb diet causes profound increase in HDL cholesterol

    MedWire News: Long-term adherence to a low-carbohydrate diet is associated with marked improvements in lipid levels, in particular a large increase in levels of high-density lipoprotein (HDL) cholesterol, US researchers report.

    The low-carbohydrate diet was also associated with significant weight loss, leading the study authors to recommend the diet as a "viable option for obesity treatment for obese adults."

    Gary Foster (Temple University, Philadelphia, Pennsylvania) and colleagues undertook a randomized trial to compare the efficacy of a low-carbohydrate versus a low-fat diet, both of which were given alongside a comprehensive lifestyle modification program.

    http://lipidsonline.org/news/article.cfm?aid=9601

  • Tom

    8/13/2010 3:54:37 PM |

    >What's your opinion of Sauerkraut?

    It's been quite a while since I ate any, but, if memory serves, I don't think it's a particular favourite of mine Smile

    However, it might be a good example of how various sour and bitter foodstuffs have evolved into expensive delicacies within human culture.

    This is despite the fact that bitterness is a fairly reliable indicator of toxicity.

    Thus we do not eat foods directly for the sake of our bodies but for the the way we interpret the tastes and other internal sensations. It's a mental thing, and causes addiction for many of us I think.

  • Alex

    8/13/2010 6:40:41 PM |

    Sauerkraut? An expensive delicacy? It's just cabbage and salt!

    I make my own so that I can eat it raw. The recipe I use is a half-tablespoon of additive-free salt per pound of shredded cabbage. I make it in mason jars, with the lids tightened, loosening the lids once a day for the first 5 days to release the CO2 gas (loosening them only enough to release pressure but not allow air to get in.) I put the jars in the fridge after 3-5 days to finish aging.

  • Matsmurfen

    8/14/2010 1:02:14 PM |

    Matt Stone wrote:

    I try to keep my carb intake above 500 grams per day - almost all unrefined starches. This causes instant fat loss, a drop in insulin levels due to improved insulin sensitivity, and reversal of metabolic syndrome in most people

    WHAT A JOKE!  500g of carbs is 2000 kcal per day!  The body won't take the fat when it has that much carbs available... you need to get down to at least below 100g, perhaps as low as 20g...

    I must agree with others here - remove such comments or at least respond to it so it won't be uncontradicted.

  • Tommy

    8/14/2010 1:22:19 PM |

    Matsmurfen wrote:

    "I must agree with others here - remove such comments or at least respond to it so it won't be uncontradicted."

    I truly wish that rather than removing such posts there could be an open discussion. I think everyone would learn a lot more if such things were addressed and both sides dissected. Counterpoints from Dr. Davis would really be great. A lot of questions get raised here but never answered or addressed in any way. That can be potentially very bad because people read and then go of with half baked info. That could be dangerous.  What is needed here is a "forum" where these things can be discussed and many sides looked at.

  • Neonomide

    8/16/2010 12:58:04 AM |

    Ok, so here are so many wheat topics it's hard to know where to put stuff so that things get noticed.

    Regarding wheat and heart disease, Loren Cordain has written interesting pieces called “Whole Wheat Heart Attack” part 1 and 2. I found the second one on google:

    “Common dietary lectins are potent stimulators of
    inflammatory cytokines in white blood cell cultures20,21.
    In Figure 3 you can see that lectins
    from lentils, kidney beans, peas and WHEAT
    potently increase the production of inflammatory
    cytokines (IL-12, IL-2, and INFγ). WHEAT lectin
    (WGA) also stimulates production of two other
    inflammatory cytokines (TNFα and IL-1β)21 that
    promote the atherosclerotic process.”
    - -
    “Enzymes
    called matrix metalloproteinases (MMPs),
    secreted by white blood cells and other cells
    within the plaque, are known to cause collagen
    and elastic tissue within the fibrous cap to disintegrate.
    Consequently, any dietary or environmental
    factor which facilitates synthesis of MMPs
    is not a good thing for cardiovascular disease
    patients. Well guess what? Lectins from wheat,
    WGA22, and lectins from kidney beans, PHA23,
    cause tissue cultures of white blood cells to increase
    their production of MMPs.”
    - -
    “WHEAT lectin also influences
    the final and fatal step in
    atherosclerosis, the formation
    of a blood clot in an artery.
    Integral to the formation of
    clots are platelet cells, which
    circulate in the bloodstream..
    Platelets are normally activated when they contact
    collagen from a damaged blood vessel.
    WGA directly causes the activation of platelets
    and potently increases their aggregation
    (clumping) 24. Hence, the consumption of WHOLE WHEAT
    may be integral in the thinning and destruction
    of the fibrous cap as well
    as the formation of the fatal clot.”

    http://www.deflame.com/Portals/0/Wheat%20lectins,%20heart%20disease,%202008.pdf

  • Eva

    8/17/2010 4:17:11 AM |

    What is for breakfast?  (I think that was the original question).  I like a bit of fruit like berries and banana. Or I will put a bit of berries with coconut milk and blend it in the blender.  Bacon and/or eggs are always another option.  Cheese with a bit of meat or leftover meat from the day before works nicely.  Or a breakfast burrito with lowcarb tortilla. Or muffins made with almond butter and banana taste great with a slab of butter on top!  Another classic is a grapefruit half.

  • Anonymous

    8/18/2010 12:56:27 PM |

    Dr. Davis:
    Interesting article, in the NY Times about Moose and arthritis.Also about native American Indians, developement of arthritis on change of their nutrition to corn and food eaten by the misionaries.

    http://www.nytimes.com/2010/08/17/health/research/17moose.html?_r=1&hpw

    kasing12

  • Hans Keer

    8/18/2010 2:06:33 PM |

    Follow our series of posts: "Grains, the world would be better off without them" http://bit.ly/a8GqfY VBR

  • Anonymous

    8/18/2010 8:45:15 PM |

    Do you have a link to the study for your comment "Wheat raises blood glucose higher than almost all other foods, higher than a Milky Way bar, higher than a Snickers bar." as I would be interested in following up on this.

  • Dr. Berg effective diets plan

    9/2/2010 2:26:28 PM |

    You have an interesting topic with very interesting comments as well. I learned a lot. Thanks!

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