Biscuits and Gravy



Biscuits and gravy: the ultimate comfort food . . . one you thought you’d never have again!

The familiar dish of breakfast and holiday meals is recreated here with a delicious gravy that you can pour over piping hot biscuits. Because it contains no wheat or other unhealthy thickeners like cornstarch made with “junk” carbohydrates, there should be no blood sugar or insulin problems with this dish, nor joint pain, edema, acid reflux, mind “fog,” or dandruff—life is good without wheat!

While the gravy is also dairy-free for those with dairy intolerances, the biscuits are not, as there are cheese and butter in the biscuits, both of which are optional, e.g., leave out the cheese and replace butter with coconut or other oil.

Makes 10 biscuits

Gravy:
2 tablespoons extra-virgin olive oil
1 pound loose sausage meat
2½ cups beef broth
¼ cup coconut flour
½ cup coconut milk (canned variety)
1 tablespoon onion powder
1 teaspoon garlic powder
½ teaspoon sea salt
Dash ground black pepper

Biscuits:
1 cup shredded cheddar (or other) cheese
2 cups almond meal/flour
¼ cup coconut flour
¾ teaspoon baking soda
½ teaspoon sea salt
2 large eggs
4 ounces butter, melted (or other oil, e.g., extra-light olive, coconut, walnut)

To make gravy:
In large skillet, heat oil over medium heat. Sauté sausage, breaking up as it browns. Cook until thoroughly cooked and no longer pink.

Turn heat up to medium to high and pour in beef broth. Heat just short of boiling, then turn down to low heat. Stir in coconut flour, little by little, over 3-5 minutes; stop adding when gravy obtains desired thickness. Pour in coconut milk and stir in well. Add onion powder, garlic powder, salt, and pepper and simmer over low heat for 5 minutes. Add additional salt and pepper to taste. Remove from heat and set aside.

To make biscuits:
Preheat oven to 325° F.

In food chopper or processor, pulse shredded cheese to finer, granular consistency.

Pour cheese into large bowl, then add almond meal, coconut flour, baking soda, and salt and mix thoroughly. Add the eggs and butter or oil and mix thoroughly to yield thick dough.

Spoon out dough into 10 or so ¾-inch thick mounds onto a parchment paper-lined baking pan. Bake for 20 minutes or until lightly browned and toothpick withdraws dry.

Ladle gravy onto biscuits just before serving.

The Perfect Carnivore

People who carry the gene for lipoprotein(a), Lp(a), tend to be:

--Intelligent--The bell curve of IQ is shifted rightward by a substantial margin.
--Athletic--With unusual capacity for long-endurance effort, thus the many marathoners, triathletes, and long-distance bikers with Lp(a).
--Tolerant to dehydration
--Tolerant to starvation
--Resistant to tropical infections

In other words, people with Lp(a) have an evolutionary survival advantage. More than other people, they make clever, capable hunters who can run for hours to chase down prey, not requiring food or water, and less likely to succumb to the infections of the wild. In a primitive setting, people with Lp(a) are survivors. Evolution has likely served to select Lp(a) people for their superior survival characteristics.

But wait a minute: Isn't Lp(a) a risk for heart attack and stroke? Don't we call Lp(a) "the most aggressive known cause for heart disease and stroke that nobody gives a damn about"?

Yes. So what allows this evolutionary advantage for survival to become a survival disadvantage?

Carbohydrates, especially those from grains and sugars. Let me explain.

More so than other people, Lp(a) people express the small LDL pattern readily when they consume carbohydrates such as those from "healthy whole grains." Recall that the gene for Lp(a) is really the gene for apoprotein(a), the protein that, once produced by the liver and released into the bloodstream, binds to an available LDL particle to create the combination Lp(a) molecule. If the LDL particle component of Lp(a) is small, it confers greater atherogenicity (greater plaque-causing potential). Thus, carbohydrate consumption makes Lp(a) a more aggressive cause for atherosclerotic plaque. The situation can be made worse by exposure to vegetable oils, such as those from sunflower or corn, which increases production of apo(a).

Also, more than other people, Lp(a) people tend to show diabetic tendencies with consumption of carbohydrates. Eat "healthy whole grains," for instance, or if a marathoner carb-loads, he/she will show diabetic-range blood sugars. I have seen long-distance runners or triathletes, for instance, have a 6 ounce container of sugary yogurt and have blood sugars of 200 mg/dl or higher. The extreme exercise provides no protection from the diabetic potential.

Because carbohydrates are so destructive to the Lp(a) type, it means that people with this pattern do best by 1) absolutely minimizing exposure to carbohydrates and vegetable oils, ideally grain-free and sugar-free, and 2) rely on a diet rich in fats and proteins.

The perfect diet for the Lp(a) type? It would be a diet of feasting on the spoils of the hunt, devouring the wild boar captured and slaughtered and eating the snout, hindquarters, spleen, kidneys, heart, and bone marrow, then eating mushrooms, leaves, nuts, coconut, berries, small rodents, reptiles, fish, birds, and insects when the hunt is unproductive.

Capable hunter, survivor, consumer of muscle and organ meats: I call people with Lp(a) "The Perfect Carnivores."

Track Your Plaque in the news

The NPR Health Blog contacted me, as they were interested in learning more about health strategies and tools that are being used by individuals without their doctors. The Track Your Plaque website and program came up in their quest, as it is the only program available for self-empowerment in heart disease.

Several Track Your Plaque Members spoke up to add their insights. The full text of the article can be viewed here.

How's Your Cholesterol? The Crowd Wants To Know
Mainstream medicine isn't in favor of self-analysis, or seeking advice from non-professionals, of course. And anyone who does so is running a risk.

But there are folks who want to change the course of their heart health with a combination of professional and peer support. Some are bent on tackling the plaque that forms in arteries that can lead to heart disease. They gather online at Track Your Plaque, or "TYP" to the initiates.

"We test, test, test ... and basically experiment on ourselves and have through trial and error came up with the TYP program, which is tailored to the individual," Patrick Theut, a veteran of the site who tells Shots he has watched his plaque slow, stop and regress.

The site was created in 2004 by Bill Davis, a preventive cardiologist in Milwaukee, Wisc. Davis is also the author of Wheat Belly: Lose the Wheat, Lose the Weight and Find Your Path Back to Health, which argues that wheat is addictive and bad for most people's health. Davis recommends eliminating wheat from the diet to most new members of Track Your Plaque.

"The heart is one of the hardest things to self-manage but when you let people take the reins of control, you get far better results and far fewer catastrophes like heart attacks," Davis tells Shots.

Doctors typically give patients diagnosed with heart disease two options: take cholesterol-lowering statin drugs, or make lifestyle changes, like diet. It's usually far easier for both parties — the doctor and the patient — to go with the drugs than manage the much more difficult lifestyle changes, Davis says.

"Doctors say take the Lipitor, cut the fat and call me if you have chest pain," he explains. "But that's an awful way to manage care."

TYP has members submit their scores from heart CT scans, cholesterol values, lipoproteins and other heart health factors to a panel of doctors, nutritionists and exercise specialists. Then they receive advice in the form of an individualized plaque-control program. But the online forum, where users share their results with other members and exchange tips, is where most of the TYP action happens.

The community currently has about 2,400 members who pay $39.95 for a quarterly membership, or $89.75 for a yearly membership. Davis says all proceeds go towards maintaining the website.

Ilaine Upton is a 60-year-old bankruptcy lawyer from Fairfax, Va., and a TYP member. At a friend's suggestion, Upton decided to get a heart CT scan in July. Her score was higher than it should have been (22 instead of 0), so she decided to get her blood lipids and cholesterol tested, too, and sent a sample off to MyMedLabs.com.

She learned that her LDL particle count was over 2,000 ("crazy high," she says), and she posted her results on TYP. Davis advised her that a low-carb diet would reduce it, so she decided to try it.

Since July, she says she has had "excellent results" with the program, and her LDL counts are coming down.

"It would be nice to have a [personal] physician involved in this, but [my insurer] Blue Cross won't pay if you are not symptomatic, and I am trying to prevent becoming symptomatic," says Upton. "I feel very empowered by this knowledge and the ability to take better control of my health by getting feedback on the decisions I make."

Pecan Streusel Coffee Cake


This is about as decadent as it gets around here!

Here’s a recreation of an old-fashioned coffee cake, a version with a delicious chewy-crunchy streusel topping.

I’ve specified xylitol as the sweetener in the topping, as it is the most compatible sweetener for the streusel “crumb” effect and browning.

Variations are easy. For example, for an apple pecan coffee cake, add a layer of finely-chopped or sliced apples to the cake batter and topping.

Additional potential carbohydrate exposure comes from the garbanzo bean flour and molasses. However, distributed into 10 slices, each slice provides 7.2 grams “net” carbs (total carbs minus fiber), a perfectly tolerable amount. Be careful not to exceed two slices!

Yield 10 slices

Cake:
2½ cups almond flour
½ cup garbanzo bean flour
1 tablespoon ground cinnamon
1 teaspoon baking soda
Sweetener equivalent to ¾ cup sugar
Dash sea salt

3 eggs separated
3/8 teaspoon cream of tartar
1 tablespoon vanilla extract
4 ounces butter, melted
Juice of ½ lemon

Topping:
½ cup almond flour
¼ cup pecans, finely chopped
1 tablespoon ground cinnamon
½ cup xylitol
1 tablespoon molasses
6 ounces butter, cut into ½-inch widths, at room temperature

Preheat oven to 325º F. Grease bread pan.

In bowl, combine almond flour, garbanzo flour, cinnamon, baking soda, sweetener, salt, and mix.

In small bowl, whip egg whites and cream of tartar until stiff peaks form. At low speed, blend in egg yolks, vanilla, melted butter, and lemon juice.

Pour liquid mixture into almond mixture and mix thoroughly. Pour into microwave-safe bread pan and microwave on high for 3 minutes. Remove and set aside.

To make topping, combine almond flour, pecans, cinnamon, xylitol, and molasses in small bowl and mix. Mix in butter

Spread topping on cake. Bake for 20 minutes or until toothpick withdraws dry.

Recipe: Peanut Butter and Jelly Macaroons



If you miss peanut butter and jelly sandwiches, you’re going to absolutely love these peanut butter and jelly macaroons!

Not everybody loves the taste or texture of coconut. This issue is solved by the first step: toasting shredded coconut, then reducing them down to a granular consistency. This yields a macaroon consistency without the dominant coconut taste, replaced instead with the flavors of PB & J.

I’ve specified liquid stevia as the sweetener, but this is easily replaced by your choice of sweetener. Note that, regardless of which sweetener used, they vary in sweetness from brand to brand and the quantity required to equal the ½ cup of sugar equivalent can vary. It always helps to taste your batter and adjust sweetness.

Also, I used Swerve in this recipe, the erythritol-inulin mix that enhances texture, but its use is optional.

As written, each macaroon contains just over 3 grams “net” carbohydrates (total carbs minus fiber), meaning you can have several before doing any damage!

Makes 24 macaroons

3 cups shredded unsweetened coconut
2 tablespoons vanilla extract
1 teaspoon almond extract
¼ cup coconut flour
¼ cup dried unsweetened cherries (or other unsweetened berries)
2 tablespoons coconut oil
¼ cup natural peanut butter, room temperature
2 egg whites
½ teaspoon liquid stevia or sweetener equivalent to ½ cup sugar
2 tablespoons Swerve


Preheat oven to 300° F.

In large bowl, combine coconut, vanilla and almond extracts, and mix.

Spread mixture on baking sheet and bake for 10 minutes, stirring occasionally, until very lightly browned. Be careful not to burn. Remove and cool. (Leave oven at 300° F.)

When cooled, using food chopper, food processor, or coffee grinder, pulse coconut mixture until coconut reduced to consistency of coffee grounds. Pour back into bowl. Stir in coconut flour.

Place cherries or other berries in food chopper, food processor, or coffee grinder and pulse until reduced to small granules or paste. Remove with spatula and add to coconut mixture. Set aside.

Place egg whites in bowl and whip until frothy and stiff peaks form.

In small microwave-safe bowl, combine coconut oil and peanut butter and microwave in 10-second increments until warm (not hot) liquid. Stir in egg whites, followed by stevia and Swerve, and blend thoroughly.

Dispense dough onto a parchment paper-lined baking sheet using a 1 ½-inch cookie scooper or spoons.

Bake for 15 minutes or until lightly browned.

I Wish I Had Lipoprotein(a)!

Why would I say such a thing? Well, a number of reasons. People with lipoprotein(a), or Lp(a), are, with only occasional exceptions:

--Very intelligent. I know many people with this genetic pattern with IQs of 130, 140, even 160+.
--Good at math--This is true more for the male expression of the pattern, only occasionally female. It means that men with Lp(a) gravitate towards careers in math, accounting, financial analysis, physics, and engineering.
--Athletic--Many are marathon runners, triathletes, long-distance bicyclists, and other endurance athletes. I tell my patients that, if they want to meet other people with Lp(a), go to a triathlon.
--Poor at hydrating. People with Lp(a) have a defective thirst mechanism and often go for many hours without drinking water. This is why many Lp(a) people experience the pain of kidney stones: Prolonged and repeated dehydration causes crystals to form in the kidneys, leading to stone formation over time.
--Tolerant to dehydration--Related to the previous item, people with Lp(a) can go for extended periods without even thinking about water.
--Tolerant to periods of food deprivation or starvation--More so than other people, those with Lp(a) are uncommonly tolerant to days without food, as would occur in a wild setting.


In short, people with Lp(a) are intelligent, athletic, with many other favorable characteristics that provide a survival advantage . . . in a primitive world.

So when did Lp(a) become a problem? When an individual with Lp(a) is exposed to carbohydrates, especially those from grains. When an evolutionarily-advantaged Lp(a) individual is exposed to carbohydrates, more than other people they develop:

--Excess quantities of small LDL particles--Recall that Lp(a) is a two-part molecule. One part: an apo(a) made by the liver. 2nd part: an LDL particle. When the LDL particle within the Lp(a) molecule is small, its overall behavior is worse or more atherogenic (plaque-causing).
--Hyperglycemia/hyperinsulinemia--which then leads to diabetes. Unlike non-Lp(a) people, these phenomena can develop with far less visceral fat. A Lp(a) male, for instance, standing 5 ft 10 inches tall and weighing 150 pounds, can have as much insulin resistance/hyperglycemia as a non-Lp(a) male of similar height weighing 50+ pounds more.

Key to gaining control over Lp(a) is strict carbohydrate limitation. Another way to look at this is to say that Lp(a) people do best with unlimited fat and protein intake.

What WERE they thinking

When the Dietary Guidelines for Americans were drafted and the USDA and U.S. Department of Health and Human Services charged with disseminating this information to us . . .

When the American Heart Association created its Total Lifestyle Change (TLC) diet to reduce cardiovascular risk and reduce cholesterol . . .

When the American Diabetes Association developed its diet to help diabetics manage their blood sugars and prevent hypoglycemia . . .


How did conditions like Familial Hypertriglyceridemia fit into this scheme?

Green Tea Ginger Orange Bread

How about all the health benefits of green tea in wheat-free bread form, spiced up with the magical combined flavors of ginger and orange?

Frequent consumption of green tea accelerates loss of visceral (“wheat belly”) fat, increases HDL and reduces triglycerides, reduces blood pressure, and may provide cardiovascular benefits that go beyond these markers such as reduction of oxidative stress. In this Green Tea Ginger Orange Bread, we don’t just drink the tea—we eat it! This provides an even more powerful dose of the green tea catechins believed to be responsible for the health benefits of green tea.

You can grind your own green tea from dried bulk leaves or it can be purchased pre-ground. I’ve used sencha and matcha green tea varieties with good results. The Teavana tea store sells a Sencha preground green tea that works well. If starting with bulk tea leaves, pulse in your food chopper, food processor, or coffee grinder (cleaned thoroughly first!) to generate green tea powder. You will need only a bit, as a little goes a long way.

The entire loaf contains 26 grams “net” carbohydrates; if cut into 10 slices, each slice therefore yields 2.6 grams net carbs, a perfectly tolerable amount.


Bread:
1¼ cup almond meal/flour
½ cup coconut flour
2 tablespoons ground golden flaxseed
1 teaspoon baking powder
Sweetener equivalent to 1 cup sugar
1 tablespoon ground green tea
1½ teaspoons ground ginger
1½ teaspoons ground allspice
1½ ground cinnamon
2 large eggs, separated
¼ teaspoon cream of tartar
1 tablespoon vanilla extract
1 teaspoon almond extract
Grated zest from 1 orange + 2 tablespoons squeezed juice
1/2 cup coconut milk

Frosting:
4 ounces cream cheese, room temperature
1 teaspoon fresh lemon juice
Sweetener equivalent to 1 tablespoon sugar

Preheat oven to 350° F. Grease a 9” x 5” bread pan.

In large bowl, combine almond meal/flour, coconut flour, flaxseed, baking powder, sweetener, green tea, ginger, allspice, and cinnamon and mix.

In small bowl, whip egg whites and cream of tartar until stiff peaks form. At low mixer speed, blend in egg yolks, vanilla extract, almond extract, orange zest and juice, and coconut milk.

Pour egg mixture into almond meal/flour mixture and mix by hand thoroughly.

Pour dough into bread pan and place in oven. Bake for 40 minutes or until toothpick withdraws dry. Remove and cool.

For frosting, combine cream cheese, lemon juice, and sweetener and mix. When cooled, spread frosting over top of bread.

Chocolate Bomb Bars

These healthy bars will blast you with chocolate from several directions!

Look for cacao nibs in health food stores, Whole Foods Market, or at nuts.com. If unavailable, the bars are still delicious without them.



These bars contain around 4-5 grams "net" carbs per bar, well within the tolerance for most people.

Yields approximately 10 bars

1 cup ground almonds
2 tablespoons coconut flour
1 tablespoon unsweetened cocoa powder
1/2 cup cacao nibs
1/2 cup unsweetened shredded coconut
2 ounces 85-90% cocoa chocolate, finely chopped
3/4 cup raw pumpkin or sunflower seeds
Sweetener equivalent to 3/4 cup sugar
2 tablespoons almond butter
1/4 cup coconut milk
2 tablespoons coconut oil or cocoa butter (food grade)

Preheat oven to 200 degrees F. Lay sheet of parchment paper on large baking pan.

In large bowl, combine ground almonds, coconut flour, cocoa powder, cacao nibs, coconut, chocolate bits, pumpkin seeds, and sweetener (if dry) and mix.

In microwave-safe bowl or in small sauce pan, add almond butter, coconut milk, and coconut oil and sweetener (if liquid) and heat for 15 second increments in microwave until liquid, but not hot. If using stove, heat at low-heat enough to make liquid easily mixed, but not hot.

Pour liquid into dry almond mixture and mix together thoroughly. If too stiff, add water one tablespoon at at time until the consistency of thick dough.

Spoon out approximately 1 1/2-inch balls, shaping with the spoon and/or your hands into bar shapes.

Bake for 35 minutes. Remove and cool.

An iodine primer

What if your diet is perfect--no wheat, no junk carbohydrates like that from corn or sugars, you are physically active--yet you fail to lose weight? Or you hit a plateau after an initial loss?

First think iodine.

Iodine is an essential nutrient. It is no more optional than, say, celebrating your wedding anniversary or obtaining vitamin C. If you forget to do something nice for your wife on your wedding anniversary, I would fear for your life. If you develop open sores all over your body and your joints fall apart, you could undergo extensive plastic surgery reconstruction and joint replacement . . . or you could just treat the scurvy causing it from lack of vitamin C.

Likewise iodine: If you have an iodine deficiency, you experience lower thyroid hormone production, since T3 and T4 thyroid hormones require iodine (the "3" and "4" refer to the number of iodine atoms per thyroid hormone molecule). This leads to lower energy (since the thyroid controls metabolic rate), cold hands and feet (since the thyroid is thermoregulatory, i.e., temperature regulating), and failed weight loss. So iodine deficiency is one of the items on the list of issues to consider if you eliminate wheat with its appetite-stimulating opiate, gliadin, and high-glycemic carbohydrate, amylopectin A, and limit other carbohydrates, yet still fail to lose weight. A perfect diet will not fully overcome the metabolism-limiting effects of an underactive thyroid.

Given sufficient time, an enlarged thyroid gland, or goiter, develops, signaling longstanding iodine deficiency. (The treatment? Iodine, of course, not thyroid removal, as many endocrinologists advocate.) Your risk for heart attack, by the way, in the presence of a goiter is increased several-fold. Goiters are becoming increasingly common and I see several each week in my office.

Iodine is found in the ocean and thereby anything that comes from the ocean, such as seafood and seaweed. Iodine also leaches into the soil but only does so coastally. It means that crops and livestock grown along the coasts have some quantity of iodine. Humans hunting and foraging along the coast will be sufficient in iodine, while populations migrating inland will not.

It also means that foods grown inland do not have iodine. This odd distribution for us land dwelling primates means that goiters are exceptionally common unless iodine is supplemented. Up to 25% of the population can develop goiters without iodine supplementation, a larger percentage experiencing lesser degrees of iodine deficiency without goiter.

In 1924, the FDA became aware of the studies that linked goiters to lack of iodine, reversed with iodine supplementation. That's why they passed a regulation encouraging salt manufacturers to add iodine, thought to be an easy and effective means for an uneducated, rural populace to obtain this essential nutrient. Their message: "Use more iodized salt. Keep your family goiter free!" That was actually the slogan on the Morton's iodized salt label, too.

It worked. The rampant goiters of the first half of the 20th century disappeared. Iodized salt was declared an incredible public health success story. Use more salt, use more salt.

You know the rest. Overuse of salt led to other issues, such as hypertension in genetically susceptible people, water retention, and other conditions of sodium overexposure. The FDA then advises Americans to slash their intake of sodium and salt . . . but make no mention of iodine.

So what recurs? Iodine deficiency and goiters. Sure, you eat seafood once or twice per week, maybe even have the nori (sheet seaweed) on your sushi once in a while . . . but that won't do it for most. Maybe you even sneak some iodized salt into your diet, but occasional use is insufficient, especially since the canister of iodized salt only contains iodine for around 4 weeks, given iodine's volatile nature. (Iodized salt did work when everybody in the house salted their food liberally and Mom had to buy a new canister every few weeks.)

Iodine deficiency is common and increasing in prevalence, given the widespread avoidance of iodized salt. So what happens when you become iodine deficient? Here's a partial list:

--Weight loss is stalled or you gain weight despite your efforts.
--Heart disease risk is escalated
--Total and LDL cholesterol and triglyceride values increase
--Risk of fibrocystic breast disease and possibly breast cancer increase (breast tissue concentrates iodine)
--Gingivitis and poor oral health increase (salivary glands concentrate iodine)

(Naturopathic doctor Lyn Patrick, ND, has written a very nice summary available here.)

So how do you ensure that you obtain sufficient iodine every day? You could, of course, eat something from the ocean every day, such as coastal populations such as the Japanese do. Or you could take an inexpensive iodine supplement. You can get iodine in a multivitamin, multimineral, or iodine drops, tablets, or capsules.

What is the dose? Here's where we get very iffy. We know that the Recommended Daily Allowance (RDA), the intake to not have a goiter, is 150 mcg per day for adults (220 mcg for pregnant females, 290 mcg for lactating females). Most supplements therefore contain this quantity.

But what if our question is what is the quantity of iodine required for ideal thyroid function and overall health? Ah, that's where the data are sketchy. We know, for instance, that the Japanese obtain somewhere between 3,500 and 13,000 mcg per day (varying widely due to different habits and locations). Are they healthier than us? Yes, quite a bit healthier, though there may be other effects to account for this, such as a culture of less sweet foods and more salty, less wheat consumption, etc. There are advocates in the U.S., such as Dr. David Brownstein in Michigan, who argues that some people benefit by taking doses in the 30,000 to 50,000 mcg per day range (monitored with urinary iodine levels).

As is often the case with nutrients, we lack data to help us decide where the truly ideal level of intake lies. So I have been using and advocating intakes of 500 to 1000 mcg per day from iodine capsules, tablets, or drops. A very easy way to get this dose of iodine is in the form of kelp tablets, i.e., dried seaweed, essentially mimicking the natural means of intake that also provides iodine in all its varied forms (iodide, sodium iodate, potassium iodide, potassium iodate, iodinated proteins, etc.) This has worked out well with no ill effects.

The only concern with iodine is in people with Hashimoto's thyroiditis or (rarely) an overactive thyroid nodule. Anyone with these conditions should only undertake iodine replacement carefully and under supervision (monitoring thyroid hormone levels).

Iodine is inexpensive, safe, and essential to health and weight management. If it were a drug, it would enjoy repeated expensive marketing and a price tag around $150 per month. But it is an essential nutrient that enjoys none of the attention-getting advantages of drugs, and therefore is unlikely to be mentioned by your doctor, yet carries great advantage for helping to maintain overall health.
Heroin, Oxycontin, and a whole wheat bagel

Heroin, Oxycontin, and a whole wheat bagel

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.

Comments (27) -

  • Tree

    1/25/2011 1:50:08 PM |

    Celiac disease is often noticed by people who go off wheat for health reasons, then when they try to eat it again, it makes them sick.  

    For the record, Corn Flakes contain barley malt which has the same protein, gliadin, as wheat.  I have celiac and the "formula" is no wheat, barley or rye because they are so closely related and have the same "gluten" protein.

  • Martin Levac

    1/25/2011 1:55:45 PM |

    Isn't it interesting. They treat obesity by fixing the "mesolimbic reward system" because they believe eating too much "food" makes us fat. But then you say wheat isn't food, it's a drug.

    Are we really eating too much "food"?

  • Emily Deans, M.D.

    1/25/2011 2:15:16 PM |

    A heroine is a very different concept than "heroin."  And withdrawal from oxycontin or heroin is unlikely to cause hallucinations or seizures (Trainspotting babies on the ceiling notwithstanding) - though it is exceedingly unpleasant, it is not typically medically dangerous.  Perhaps you are thinking withdrawal from alcohol, barbituates, or benzodiazepines, all of which can cause hallucination, seizures, or death if done without medical supervision.

  • Anonymous

    1/25/2011 2:35:18 PM |

    I have celiac and had similar problems when I first went off gluten.  It took me about a month to stop reacting.  I get quite ill whenever I accidentally am exposed to gluten, say at a restaurant.  My symptoms are migraine and flue like aching in my joints, plus severe fatigue.  None of my doctors thought I might have celiac by the way, because I am slightly overweight (BMI 25) and didn't have severe digestive symptoms, but there is recent research showing that many patients present with migraine as their only celiac symptom.

  • Dr. William Davis

    1/25/2011 2:47:15 PM |

    Oohh. Thanks for catching the typo, Dr. Deans. Fixed.

    By the way, I've seen plenty of hallucinations and seizures with opiate withdrawal, as well as benzodiazepine withdrawal. Or, perhaps it was combination addictions that were at fault.

    That, however, was not the point.

  • Emily Deans, M.D.

    1/25/2011 3:11:53 PM |

    I think the point was well-made - just didn't want anyone to fear that wheat withdrawal was medically dangerous (quite the opposite).  I've had a few cases where I was able to stop night (carb - typically bread) binging with (off-label) use of naltrexone - pretty telling, I would say.

  • Dr. William Davis

    1/25/2011 10:21:46 PM |

    Dr. Deans--

    I am VERY impressed you knew of this effect.

    I have tried this, too, in people who are, despite their best effort, unable to resist temptation to consume this drug-disguised-as-food called wheat.

  • Anonymous

    1/26/2011 12:24:48 AM |

    My health improved dramatically after I stopped eating wheat, grains, and other carbs, I even had a cataract disappear.  But it required nine months before I could adjust to the low carb way of eating. It's worth all the trouble, no more high blood pressure or diabetes medicine.  Most of my arthritic pain is gone, I am able think more clearly. Lost 30 pounds. No more allergies or indigestion.
    Thank you for writing this blog!

  • DK

    1/26/2011 4:08:13 AM |

    I was able to stop night (carb - typically bread) binging with (off-label) use of naltrexone - pretty telling, I would say.

    Nothing at all particularly telling I would say. Other than telling that opioid receptors are part of the reward circuit. Which is obvious and not disputed by anyone. Naltrexone main use is in treatment of alcohol dependence. Using your logic ethanol is an agonist of opioid receptors. Which is self-evidently not true. The effects are indirect.

  • Might-o'chondri-AL

    1/26/2011 5:30:17 PM |

    Question here:

    Is the "craving" for wheat due to psychoactive tri-peptides derived from wheat protein ?  If that is the molecule that "dopes" our opiod receptors then decreasing levels of tri-peptides as the day progresses will make some look for their wheat "fix".

    Naltrexone @50mg was FDA approved (1984) in 1984 opiod addition; to block receptors. I think the doctors here are referring to single evening doses of 3 to 4.5 mg.
    for screened patients.

  • BWR

    1/27/2011 3:08:46 AM |

    Here's what I don't understand: Why is it that entire countries of people who eat bread by the basket, like Spain, have exceptionally low levels of heart disease? This is a sincere question. I want to do what's right for my heart, but it seems to me that a naturally occurring sample size of several million people is pretty compelling. What am I missing?

  • Anonymous

    1/27/2011 8:25:08 AM |

    Jack LaLane on sugar:

    http://www.youtube.com/watch?v=LJVEPB_l8FU

  • Jonathan Byron

    1/27/2011 1:56:02 PM |

    Milk and dairy products are also a source of endorphin-like chemicals. Would it make sense to try to kick a wheat habit by temporarily drinking more milk?

  • Anonymous

    1/27/2011 3:42:20 PM |

    BWR

    It is possible that Spanish bread is made from a much healthier wheat variety.

    The devil is on the details.
    From a HSB comment May 24, 2010
    Here in France, Einhorn( Triticum monococcum) has been cultivated since the 9 th millennium BC in a small area of Haute Provence. It is called petit epeautre and it is truly delicious! It has very little gluten.
    There is much regulation in the cultivation in order to protect the genetic purity of this ancient grain. Like wines it has a AOC (appelation d'origine controlee

    Please note: Higher Mg and Lysine in einkorn

    Modern wheat has had much of the Mg bred out
    http://petitepeautre.com/nutritiona.html

    Scandinavian Journal of Gastroenterology
    http://www.einkorn.com/toxicity-of-einkorn-gluten/

    Same for casein in milk where A1 milk can be a serious problem and the casein is similar to gluten
    http://www.guernsey.net/~wgcf/PageMill_Resources/Acres_Woodford.pdf

  • Dr. William Davis

    1/27/2011 4:37:27 PM |

    Hi, BWR--

    There are some unanswered questions with this thing called wheat. As the anonymous commenter pointed out, there may be differences in strains grown worldwide. While 99% of all wheat grown today are dwarf variants of Triticum aestivum, there are pockets of agricultural adherence to older cultivars.

  • revelo

    1/27/2011 8:41:02 PM |

    I am perfectly willing to believe than many people cannot tolerate wheat. But this obsession with villifying wheat discredits Dr Davis's very valuable promotion of regular heart scans and other diagnostics, as well as D3, Iodine and other supplements.

    It isn't just the Spaniards. My own ancestors are a mix of French, German and English, and I don't seem to have any problems with wheat, rye, barley, to speak nothing of oats. Furthermore, I believe a heavy grain diet is precisely why I am able to keep my weight down and my test results good. I experimented with going to a somewhat more paleo diet recently and the result was to DECREASE my insulin sensitivity when I went back to eating oats. Now that I'm back to eating mostly oats, my insulin sensitivity has returned to normal. Worse, the paleo diet caused a surge in uncontrollable hunger. One particularly bad day, I ran through a dozen eggs, a pound of meat, another pound of nuts and all sorts of other food before my appetite finally settled down. I never had these uncontrollable appetite problems with my usual mostly oats diet, nor did I have problems when I used to eat mostly pasta (though I was younger then and had higher metabolism than now).

    Appetite is the key. If a food sends appetite soaring, then it doesn't matter how healthy that food is by itself--it will make you fat and thereby reduce insulin sensitivity and thus destroy you in the end. Conversely, if a food depresses appetite, then assuming it isn't absolute poison (like arsenic), eating that food will allow you stay lean, and by staying lean you stay insulin-sensitive (assuming you also do some daily exercise), and that is the ultimate key to avoiding most health problems, from what I understand. For some people, wheat and oats may very well be the keys to appetite suppression, and it is thus a disservice to condemn these foods for everyone.

  • Anonymous

    1/27/2011 10:47:13 PM |

    what do you make of this new study citing adverse effects of a high fat diet?

    http://www.ajcn.org/content/early/2011/01/26/ajcn.110.002758.abstract

  • Onschedule

    1/28/2011 1:21:46 AM |

    @revelo,

    In his practice of Cardiology, Dr. Davis has apparently observed great results with a good number of his patients that choose to avoid wheat. Apparently, an impressive enough effect, in his opinion, to make the statements that he does. These observations, and the recommendations he makes based upon them, hardly "discredit" his professional advice.

    It may be true, as you suggest, that not every single person will have a problem eating wheat, but a person's weight (or appetite) is not the only indicator of potential heart-health related issues. While wheat might not make everyone fat, it may still provoke immune response, inflammation, surge in blood glucose and triglycerides, etc.

    Anecdotally, thanks to Dr. Davis' advice regarding wheat, my 68 year-old mother lost 15% of her bodyweight in four months, without exercise, and without any other change in her diet except to replace the pastas and breads with eggs, vegetables, and meats. She had always taken great pride in the "healthy" foods she ate, but over the past twenty years had very slowly gained weight and a bloated appearance. She started crying during our last visit because she is so happy to "recognize" herself again in the mirror, and is wearing clothes that haven't fit in over a decade. I stopped eating wheat one year ago. Since then, I've dropped from size 34 to 28 pants and get compliments weekly concerning how young I look; I feel great and lab results (blood tests, radiology) are unbelievably improved.

    Wheat avoidance may not indeed be necessary for everyone; but, it's done wonders for *all* of those around me that have given it a good chance.

  • reikime

    1/28/2011 3:53:27 AM |

    Jonathan,
    Subbing milk for the wheat wold NOT work as milk produces a morphine- like substance called caseomorph and wheat produces gliadimorphs. Two different types of exogenous morphines.

    This is one of the rationales for the gluten free- casein free diet that seems to greatly help some children on the autistic spectrum.  Sorry to be a spoilsport!

  • reikime

    1/28/2011 3:55:31 AM |

    oops!  typo alert ...sorry
    Subbing milk for the wheat would NOT work as milk...

  • Might-o'chondri-AL

    1/28/2011 7:55:05 AM |

    reikime,
    thanks for the answer.

  • reikime

    1/30/2011 12:39:45 AM |

    You're welcome Might-.

  • Olive Kaiser

    1/30/2011 3:13:16 AM |

    Check out www.theglutensyndrome.net

    I get folks who contact me from my site who have strange neurological symptoms when they either withdraw from gluten/wheat the first time or  flip flop on and off too much. I have a page on temporary adverse effects from going gluten free.

    Our 23 year old nursing student daughter experienced a very strange neurological effect from a 6 week gluten challenge after being strictly gluten free for 6 months.  Ischemia/reperfusion injury is a possibility, and gluteomorphin withdrawal also.  Her story is on the site.  For sure she is very strictly gluten free now, and doing fine 6 years after the experience. http://glutensensitivity.net/cases.htm#ztop

    In the book, "Mendel in the Kitchen, Nina Federoff, a strong proponent of GMO technology, relates how wheat was genetically altered by the 1950's by both x ray irradiation and chemical mutation, and the gluten levels were raised far above older varieties. The wheat today is not the same as our ancestors, at least not here in the States.

    FYI, a new lab (www.Cyrexlabs.com)  has just opened 2 weeks ago with much more complete gluten syndrome testing.  They are testing many more antibodies than previous standard panels, and expected to turn up many more folks with gluten syndrome.  They also teach that gluten can damage multitudes of tissues by molecular mimicry between gluten related antibodies and look alike innocent tissues all over the body.  The villi, which have been the gold standard target tissue in the celiac community, are turning out to be just one of many possible sites of damage.  

    Many folks have gluten/wheat related antibodies, but their main target of autoimmune tissue damage is in places other than the villi, such as the heart, nerves, organs, joint lining, etc.  Villi as the target tissue is found in relatively a few folks, and that is the tissue damage that has gotten most of the attention.

    Dr. Aristo Vojdani, PhD, Immunology, and others have accumulated a lot of research to support these theories, and they fit the gluten syndrome community like a glove.

  • Jonathan Byron

    1/30/2011 3:39:54 AM |

    >> "Subbing milk for the wheat wold NOT work as milk produces a morphine- like substance called caseomorph and wheat produces gliadimorphs. Two different types of exogenous morphines."

    Right, but is the fundamental problem generally the morphine-like effect, or is it some other antigen specific to gliadins? My wife has hashimoto's thyroiditis, and the smallest trace of wheat, barley, or other gliadin grains quickly makes her miserable... she can feel her thyroid swell, she gets cold, she has other problems. Dairy does not have this effect. Since cutting out gluten from grains, her T3, T4, and TSH levels have returned to normal, while her anti-thyroid antibody level has dropped to very near normal.

    I am willing to consider that with some conditions (like autism), both gluten and milk can be a problem. It is not clear to me that if gluten is a problem then milk must also always be a problem. If the casomorph proteins allows some people to quit wheat with fewer withdraw symptoms due to the substitution of endorphin-like molecules, that could be a good thing.

  • reikime

    1/30/2011 10:37:28 PM |

    Jonathan,

    The issues your wife has with gliadin really dont seem related to the morphine like responses some people have with gluten and /or dairy.

    Sure some people that have a wheat/gluten intolerance can ingest dairy just fine...that said, if the microvilli are damaged from wheat and not healed yet, you are much more likely to have a problem with dairy.
    The tips of the villi are where lactase is produced.
    Also, if one is subject to the effects of gliadiamorphins, IMHO one would likely be sensitive to caseomorphins, because the unhealed intesine is permeable.. ie leaky gut syndrome. This allows proteins into the bloodstream that would normally not be there. (and to wreak havoc)

    Willing to say I may be wrong, though. Anyone?

    I spend alot of time on celiac  research issues, so naturally this is where my brain goes!  lol

  • Dr Charles Parker

    3/22/2011 1:02:56 PM |

    Great to see that others have identified gluten as a potential pathogen/allergen that can significantly contribute to both mind and body deterioration through compromised immune dysfunction. I know you, Dr Davis, often think of the heart as the canary in the coal mine, and I see the brain as a canary partner showing first signs of impending acute deterioration.

    This link will take you to a series of interviews I did with Dr Peter Osborne on similar issues as discussed in this posting:

    http://www.youtube.com/watch?v=dJCZmNzkRNA&playnext=1&list=PLD61FCED98A4A5C66

    Hope this helps encourage more discussion and awareness, and thanks for your excellent work!
    cp

  • Carb Flu « The Paleo Spot

    9/16/2012 4:53:03 PM |

    [...] The first couple of weeks without grains and sugars were not pleasant.  In the beginning, I had a headache nearly every single day.  By body was detoxing and coming off the caffeine, carbs and sugars.  I was crazy tired.  For several days, I was so ravenous I wanted to gnaw my arm right off my body (would somebody please pass the sea salt…?)  If this lifestyle is sooo healthy, why have I been feeling like I’ve been run over twice by a dinosaur?  The answer is simple and thanks to in-depth research before starting my journey, it is something that I anticipated would happen – I have been experiencing the classic symptoms of Low Carb Flu. [...]

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