Phytosterols, or just "sterols" to its friends and neighbors, are a group of cholesterol-like compounds that are abundant in the plant world. Lately, however, sterols have proliferated in the processed food supply, thanks to the observation that sterols reduce LDL cholesterol when ingested by humans.

This must mean that sterols are good for you.

Uh oh. Wait a minute: There is a rare disease called sitosterolemia in which there is unimpeded intestinal absorption of all sterols ingested through diet. They must have really low LDL cholesterols! Nope. They develop coronary disease--heart attacks, angina, etc.--in their late teens and 20s. In other words, if sterols gain access to your bloodstream, they are bad. Very bad.

Conventional thinking is that only a modest quantity of dietary sterols gain access to the bloodstream. But there are two potentially fatal flaws in this overly simplistic line of thinking:

1) What happens when you load up your diet with "heart healthy" sterols, such as those in "heart healthy" margarines, mayonnaise, and yogurt, effectively increasing sterol intake 10-fold?

2) What happens in people with the genetic pattern, apo E4, that is carried by 25% of the general population that permits much greater intestinal absorption of sterols?

My prediction: Despite the fact that sterols reduce LDL, they may, in certain genetically-susceptible people, such as those with apo E4, increase risk for heart disease: heart unhealthy.

Here are two studies that suggest that greater sterol absorption in people without sitosterolemia are at higher risk for heart disease:

Alterations in cholesterol absorption/synthesis markers characterize Framingham offspring study participants with CHD

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

As I suggested in a previous Heart Scan Blog post, a glucose meter is your best tool to:

1) Lose weight
2) Cure diabetes
3) Reduce or eliminate small LDL particles
4) Achieve anti-aging or age-slowing effects

But it means getting hold of a glucose meter and applying it in a very different way.

Diabetics typically check fasting morning glucose and again several times during the day to assess medication effects. But you and I can measure blood glucose to assess the immediate effects of food choices--two very different approaches.

The concept is simple: Check a blood glucose just prior to a food or meal of interest, then one hour after finishing.

Let's take two hypothetical breakfasts. First, oatmeal, a so-called "low-glycemic index" food. Slow-cooked, stone ground oatmeal with skim milk, a handful of walnuts, just a few blueberries.

Blood glucose just prior: 95 mg/dl
Blood glucose one hour after finish: 175 mg/dl

I made those numbers up, but this is a fairly typical response for many adults. (This is why "low-glycemic index" is an absurd notion.) This kind of response causes 1) glycation, the adverse effects of glucose modification of proteins that leads to cataracts, kidney disease, cartilage damage and arthritis, atherosclerosis, skin wrinkles, etc., 2) high insulin response that cascades into fat deposition, especially visceral fat ("wheat belly"), and 3) glucotoxicity, i.e., direct damage to the pancreas that can, over years, lead to diabetes.

Next day, let's try a breakfast of 3-egg omelet made with green peppers, sundried tomatoes, and olive oil.

Blood glucose just prior: 95 mg/dl
Blood glucose one hour after finish: 93 mg/dl

This is a meal of virtually zero-glycemic index. This kind of response triggers none of the effects experienced following the oatmeal. Repeated over time and you fail to trigger glycation, you stop provoking insulin, and visceral fat mobilizes rather than accumulates: you lose weight, particularly around the middle.

We therefore aim to keep the one-hour blood glucose 100 mg/dl or less. If you start with a high fasting blood glucose of, say, 118 mg/dl, then we aim to keep the one-hour after-eating blood glucose no higher than the pre-meal.

It works. Plain and simple.

This makes the primary care docs crazy: "How dare you check your blood sugar! You're not diabetic." In truth, blood glucose meters are relatively simple devices to use. The test strips and lancets will cost a few bucks. (The meters themselves are either low-cost or free, just like Gillette sometimes sends you a beautiful new razor for free but expects you to buy the blades). These are direct-to-consumer products. While a prescription written by your doctor for a glucose meter and supplies helps insurance cover the costs, you can easily get these devices without a prescription. Some stores, like Target, keep their devices out on the shelves with the shampoo and bath soap.

Warning: Anyone taking diabetes drugs will have to consult with their doctors about the safety of such an approach. Because this approach can actually cure diabetes in some people, if you are taking some diabetes drugs, especially glyburide, glipidize, and glimepiride, you can experience dangerously low blood sugars, just as any non-diabetic taking these drugs would.

Here are the results of the week-long poll asking the question:

Have you experienced a wheat re-exposure syndrome?

Yes, undesirable gastrointestinal effects 223 (41%)
Yes, asthma or sinus problems 51 (9%)
Yes, joint pains and/or swelling 85 (15%)
Yes, emotional or other nervous system effects 59 (10%) No, nothing, nada 107 (19%)

No. Wheat is sacred and you're all nuts 13 (2%)

There are several interesting observations to make from this informal poll. First, as I have observed, the most common wheat re-exposure syndrome is gastrointestinal, usually involving cramps, diarrhea, and lame explanations to your dinner partner.

Second most common: joint pains and/or swelling.

Third: asthma or sinus congestion.

The incidence of emotional or nervous system effects surprised me a bit. I didn't expect 10% of people to share this effect. This is an effect I also experience personally, along with the gastrointestinal consequences.

To be sure, this is a skewed poll, since many people likely come to this blog in the first place because of such issues. But I was nonetheless impressed with the relatively modest proportion of people who did not share such a re-exposure syndrome: only 19%.

Beyond the interesting numbers provided by readers, a good many also provided some fascinating and graphic comments. Here's a sample:

Sassy said:

Reflux -- starts a day later and goes for up to a week. And Bloat:2-5 inches on my waistline in a day, lasting up to three. Miserable. And why, having experienced this once, have I done it often enough to verify the connection with certainty? I am working on that one.

Anonymous said:

Wheat increased hunger with even with only a small amount. Crackers in soup was enough to set it off.

Also, when I was trying to get off wheat, I noticed that 2 eggs and 2 bacon and I could go 5 hours before hunger, or 2 eggs and 2 bacon and toast was good for three hours before hunger. That was the final step to giving up wheat. Now three years and 59 Kg [130 lbs!] loss later, there is no doubt in my mind that wheat is evil, and I do not regard it as suitable for human food. I speculate that it increases ghrelin or cortisol.

Anna said:

For me, in the two years since I began eating Gluten-Free (Low Carb for 6 years), the few times I've had re-exposure to wheat, I've experienced fast onset and intense abdominal pain (known exposure during the daytime) and heartburn, indigestion, intense nausea, and disrupted sleep (exposures during evening meal not discovered until the next day).

My husband wants to think he's fine with wheat (though I know that he has at least one gene that predisposes to celiac), but IMO, he isn't. He eats no wheat at home because that's the default, and he's OK with that. But if he goes out to dinner at a restaurant that serves "good" artisan bread, he will indulge in a few bites (he does restrict his carb intake, so it's still a limited amount). More often than not, he will sleep fitfully on those nights, snore more, and wake in the night with indigestion. He wants to bury his head in the sand and will only acknowledge the discomfort being due to eating too many carbs, not the wheat itself. I notice he sleeps fine if he eats a small amount of potato or rice. Go figure.

Our 12 yo son has been eating GF for two years also. About 6 months into GF, he unknowingly ate wheat a number of times (licorice candy laces at a friend's house), which resulted in outbreaks of canker sores in his mouth each time. He also exhibits mood and behavior changes when he eats wheat, which is what prompted me to test him for gluten intolerance in the first place.

Mark said:

If I go for 3-4 days without wheat, grains or sugar and then go out and binge on a pizza and ice cream or something like that I become explosive within 20 minutes to an hour. It's like a wheat and sugar rage.(I'm not saying this is an excuse for rage, I'm saying it has happened to me and I believe partly do to re-exposure) It seems the combination of the wheat plus sugar can be the worst.

I get red rashes around my neck sometimes right away and sometimes up to a day or later and sometimes get bad diarrhea.

I think it can be almost dangerous to cut things like gluten and sugar suddenly out of the diet without being very serious about keeping them out. I have found it very hard to cut out wheat without binging on it later after 4 or 5 days. I don't believe that my symptoms are just psychological either.

I was also diagnosed with ADHD as a young kid and then rediagnosed with adult ADHD by 3 different doctors. I also have bouts of mania at times too. I am considering trying to go completely gluten/refined carbohydrate free to see if it helps with the symptoms and gives me some relief.

I have never been tested for celiac or gluten intolerance but I would like to be. I think it would help explain to my girlfriend, family and friends why I can't go out and eat pizza or have a beer or ice cream. Right now they all think I'm a hypochondriac. At times I have experienced an intense fatigue the next day like I can't wake up and also sharp pains in my body and headaches.

Anonymous said:

I ditched wheat a year ago after my wife was diagnosed celiac. I immediately experienced a number of health improvements (blood lipids, sleep, allergies, etc.).

Fast forward: We all suffered some inadvertent wheat exposure yesterday via some chocolate covered Brazil nuts (of all things). This accidental A-B-A experimental design resulted in the following:

1. My celiac wife experienced what she calls "the flip" within an hour of exposure (i.e., intense GI distress).
2. My five-year old son went to bed with some wicked reflux.
3. I woke up with some twinges in my lower back and an ache in my football-weary left shoulder. I was also complaining to my wife about fuzzy-headedness that refused to respond to caffeine or hydration. I could only describe it as "carb flu"...

And then I read your post!

Anne said:

Depression, agitation and brain fog if I get glutened. Some times this comes with abdominal pain and a rash on my back - I think it is dose dependent. Cross contamination with wheat is a big issue when eating out. Needless to say, I eat out infrequently and then try to stick with the restaurants that are the most aware of gluten issues.

Terrence said:

Several weeks ago, I started Robb Wolf's 30 day challenge.

The first two weeks were brutal - calling it a withdrawal flu was a massive understatement. So, I thought I would try some wheat and see what happened (could not be worse, I thought). Well, it was.

I still felt extremely crappy, but I was now MASSIVELY GASSY - AMAZINGLY GASSY, for about 48 hours - flatulence on wheels, in spades. I did not go out at all in those 48 hours - when the gas came on, it went out, LONG, and QUICKLY and LOUDLY.

I am easing back into wheat and grain free. I am gluten free today and tomorrow (Sunday and Monday). I expect to try a small amount of wheat on Thursday, then maybe a little more the following Thursday.

Donald said:

I have limited wheat consumption severely over the last 8 months. I have lost 120 pounds, no longer have bouts of illness, asthma, depression, or low energy. I also take vitamin D and other supplements that have helped (many are from your blog recommendations).

Last week I ate a small piece of cake and dessert pizza. Shortly thereafter I started sneezing, had a scratchy throat, and runny nose. I called off sick the next day for fear of being contagious. My symptoms subsided quickly and I am now attributing them to the processed flour eaten at my work luncheon. I think it was an allergic reaction since I recall having much more severe symptoms fairly regularly in my wheat eating days. Those were attributed to an "allergy" of unknown origin back then.

John said:

I suffered from Ankylosing Spondylitis, Iritis, Plantar Fasciits, etc for a number of years. I restricted carbs, especially wheat and I've been symptom free for the past two years now.

Lori said:

I found wheat to be one of the worst things for giving me gas bloating and acid reflux, and I'd had sinus and nasal congestion my whole life. When I ate that cookie, it just re-introduced old problems. I can occasionally eat a gluten-free, grainy goody at my party place without any side effects. I also have a little sprouted rice protein powder every day.

Another odd thing about wheat: it was hard for me to stop eating it once I started. I could go through a whole box of cookies in one sitting, even though I wasn't a binge eater. But I can have a couple of gluten-free cookies and stop.

Paul said:

Except for one slip up this recently past holiday season, I've been sugar-grain-starch free since July 2008. Mental fog was the most noticable re-exposure symptom I had.

My mom has had the worst acid-reflux for 40-plus years. It had become so bad that she was on three medications just to deal with the symptoms. After much training and coaxing, I finally got across to her how to totally get off wheat. Not at all to my surprise, after being wheat free for a few weeks, she lost weight and her acid reflux was GONE!

But she had been addicted to wheat for so long, she relapsed, and the reflux fire soon returned. Wheat must be akin to heroin with some people. Even though they know it's very bad for them, they can't help themselves.

Onschedule said:

Re-exposure often leads to diarrhea for me, or such a heavy feeling of tiredness that all I can do is lay down and pass out. A local pizzeria makes a darn good pie, but since I started practicing wheat-avoidance, I can't keep my eyes open after eating there. I can't say for sure that it's the wheat causing it, but definitely something in the crust. Diarrhea, on the other hand, is definitely triggered by the wheat for me.

My mom complained of gastric reflux for years, but never filled the prescriptions that her doctors would give her. I suggested wheat-avoidance- gastric reflux disappeared within 3 days and hasn't returned (has been 6 months now). I've already commented elsewhere on this blog about how much weight and bloating she has lost...

Steve said:

Interesting that I should sit down, turn on my computer and find your poll. Having gone several weeks, maybe months, avoiding gluten, I took my daughter and her boyfriend out to eat because my wife has been working late at the office lately. Although I was thinking I would just eat my steak and chicken, I succumbed to the temptation of eating about a dozen greasy, breaded shrimp that my daughter and her boyfriend ordered. It's 1:39am and I still do not feel sleepy. My left nostril is completely blocked, my stomach feels bloated, really, really full and I've been burping. In your poll I checked sinus problems but could have chose gastrointestinal or nervous problems just as well.

A few weeks ago my daughter brought home a pizza and, once again, despite my knowing that I shouldn't, I ate a couple of pieces. I was sick for two days. The pain in what I think was my transverse colon was so bad I thought I might have to go to ther emergency room. Before I ate the pizza I had never gone grain-free that long before. I did this after reading Robb Wolf's book.

I AM CONVINCED. No more wheat for me! Please, Lord, give me strength.

LV said:

What don't I experience! I typically avoid wheat (and gluten for that matter) as I'm pretty sure it makes me sick, but when I slip (or someone else slips me some) I end up with massive amounts of joint swelling and tenderness, diarhea, cramping, gas, bloating and brain fog. I'm absolutely miserable. Just that alone is enough to keep me off gluten. I have RA, so if I have repeated exposures I'll have a flare which SUCKS!

A carpenter wouldn't build a house using just his bare hands. You shouldn't stumble your way through nutritional blunders without the proper tools to guide you.

Best tool to lose weight:

Best tool to cure diabetes:

Best tool to reduce small LDL particles:

Best tool for anti-aging:

Observing blood sugar excursions after eating is proving to be among the most powerful tools I have come across.

Pretend I'm a mad food scientist. I'd like to create a food that:

1) Wreaks gastrointestinal havoc and cause intractable diarrhea, cramps, and anemia.
2) Kills some people who consume it after a long, painful course of illness.
3) Damages the brain and nervous system such that some people wet their pants, lose balance, and lose the ability to feel their feet and legs.
4) Brings out the mania of bipolar illness.
5) Amplifies auditory hallucinations in people with paranoid schizophrenia.
6) Makes people diabetic by increasing blood sugars.
7) Worsens arthritis, such as osteoarthritis and rheumatoid arthritis.
8) Triggers addictive eating behavior.
9) Punishes you with a withdrawal process if you try to remove it from your diet.

I will develop a strain that is exceptionally hardy and tolerates diverse conditions so that it can grow in just about any climate. It should also be an exceptionally high yield crop, so that I can sell it cheaply to the masses.

Now, if my evil scheme goes as planned, I will then persuade the USDA that not only is my food harmless, but it is good for health. If they really take the bait, they might even endorse it, create a diet program around it.

Dag nabit! Such a plan has already been implemented. Another evil food scientist already beat me to the punch. The food is called wheat.

Diabetics experience long-term health difficulties, including atherosclerosis/heart attacks, peripheral vascular disease, hypertension, cataracts, kidney disease, neuropathies, male erectile dysfunction, osteoarthritis, and colorectal cancer. They also die, on average, 10 years earlier than non-diabetics.

In effect, diabetics compress their lives into a shorter period of time. They experience all the "complications" of aging at a younger age. People without diabetes, of course, can develop atherosclerosis, cataracts, kidney disease, etc., but they tend to do so later in life compared to diabetics.

One index of the rate of aging (but not chronologic age itself) is hemoglobin A1c, or HbA1c, a "moving average" of glycated hemoglobin, i.e., glucose-modified hemoglobin. Blood glucose glycates hemoglobin linearly and irreversibly; measuring HbA1c thereby provides an index of the last 60 or so days average blood glucose.

To put HbA1c values into perspective:

Average HbA1c of hunter-gatherers: 4.5%
Average HbA1c for Americans: 5.6%
American Diabetes Association definition of diabetes: 6.5% or greater
American Diabetes Association definition of adequate control of diabetes: 7.0% or less

Why do diabetics age faster? There are likely several reasons. One important reason is glycation, as indexed by HbA1c. Glycated proteins in the lens of the eye causes cataracts. Glycated proteins in cartilage leads to arthritis. Glycated LDL particles (apo B) leads to atherosclerosis. Glycated nerve cells causes neuropathy. And so on.

If glycation underlies many of the phenomena of aging, then we might surmise that:

1) The less you glycate, the slower you age.
2) The more you glycate, the faster you age.

Therefore, the higher the HbA1c, the faster you are aging.

What foods increase HbA1c? Carbohydrates. That bowl of slow-cooked, stone ground oatmeal? A one-hour after-eating blood sugar of 170 mg/dl is common. Your doctor says that's okay because it's below 200 mg/dl and you don't "need" medication yet.

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.

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.

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 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.

Anonymous
2/3/2011 9:03:26 PM |

Interesting story from the UK:

How can a fit, clean-living 32-year-old have a heart attack? For Martin the answer was in his genes. Like thousands he suffers from INHERITED high cholesterol

"He was diagnosed with familial hypercholesterolaemia (FH), an inherited condition where the body cannot clear â€˜badâ€™ LDL cholesterol from the blood."

His arteries were so clogged that he needed a triple heart bypass â€” where blood vessels are taken from elsewhere in the body, usually the chest and legs, and used to create a new route for the blood to flow around the blockages.

An estimated 100,000 people in Britain are living with FH but donâ€™t know it, according to a report published last week by the Royal College of Physicians.

The condition could kill them at any moment.

So how could an apparently healthy man have such dangerous levels of cholesterol? Cholesterol is a waxy Âsubstance produced by the liver from the saturated fat we eat.

It plays a vital role in the function of cells and production of hormones and vitamin D.

Once it has done its job in the body, itâ€™s also the liverâ€™s job to remove it. In healthy people, this happens automatically.

â€˜The liver has â€œfinger receptorsâ€ that reach out and grab hold of â€œbadâ€ LDL cholesterol particles as they pass,â€™ says Professor Steve Humphries, the new reportâ€™s author and director of the Centre for Cardiovascular Genetics at University College London.

â€˜Goodâ€™ HDL cholesterol travels to the Âarteries to help unblock them before it also goes back to the liver to be removed by another set of receptors.

â€˜Once inside the liver, the cholesterol gets broken down, sent to the intestines and is then passed out of the body,â€™ says ÂProfessor Humphries.

â€˜But in people with FH, these receptors donâ€™t work properly, so the cholesterol builds up in the blood.â€™

(With the more common form of high cholesterol, the problem is that the patient has too much LDL for the receptors to cope with.)

Over time, cholesterol deposits build up in the arteries, restricting blood flow to the heart and increasing the risk of heart attacks and strokes.

By the age of 55, if left untreated, half of men with FH will have developed heart disease, while a third of women with it will develop heart disease by 60.

While most FH sufferers have heart attacks in their 50s and 60s, some, such as Martin, can be affected in their 30s and 40s â€” with no warning signs."

http://www.dailymail.co.uk/health/article-1352284/How-fit-clean-living-32-year-old-heart-attack.html

chaim
2/3/2011 9:35:02 PM |

Dr
what is better to use regular glutten bread or whole wheat?

Anonymous
2/3/2011 9:55:31 PM |

Doc Davis,

I am a fan of your blog, follow it religiously and have commented many times. You provide great advice and we are all thankful for it.

That being said it, the content has become repetitive. Wheat is unhealthy. It has many negative side effects. It hates puppies and kittens. And babies. We get it.

I'd love to read more content about other health subjects.

Please take this in the spirit it was intended.
-WheatFreeSince2003NotReallyButItRhymes

chaim
2/3/2011 10:09:57 PM |

Anon

there are new ppl in this blog like me ,that did not reed all the posts

For me ,it is a new thing as for many newcomers

I never liked wheat, but I thought that was healthy

We eat challah every Friday, my wife wanted to change it for whole wheat challah

I dunno if to keep the same challah or to change for whole wheat

Dr. William Davis
2/3/2011 11:47:58 PM |

Hi, Chaim--

Makes no difference. All the same.

Hi, Anonymous--

I hear you. However, as Chaim points out, there are usually several hundred new people here per day who still ask questions like "why no wheat?" So I re-explore some of the most common concerns.

terrence
2/3/2011 11:56:37 PM |

Dr Davis - I read your blog regularly, and have for a year or two now.

I do NOT find your posts about the ills of wheat to be at all repetitive. What you have to say is always informative and often very funny.

Please do NOT stop posting about wheat.

Might-o'chondri-AL
2/4/2011 12:18:28 AM |

Bedside manners may not be Doc's strong point. Once he almost insulted Frankengrain's Aunt Butter (newbies can scroll blog's Labels, click "butter" & view comments).

DK
2/4/2011 1:08:28 AM |

Any evidence for any of this? And I mean real and solid evidence, not a bunch of anecdotes.

revelo
2/4/2011 1:13:15 AM |

You still haven't explained why the traditional people of Sardinia and Crete were so long-lived and healthy in old age (shepherds carrying heavy loads up steep mountain trails at the age of 90, etc), despite eating huge amounts of wheat (we're talking upwards of 750 grams of wheat bread per day for an active worker). For poor folk, the diet was mostly wheat, olive oil and wine, plus fruits, nuts and vegetables in season. Those with some money supplemented with dairy products, fish and meat. The Cretans and Sardinians were notoriously healthy, but the other traditional people of the Mediterranean basin plus the mountains of central Asia were also quite healthy on this wheat-based diet.

Note that I use the past tense, because now that most of these peoples have moved to the cities, they are all becoming obese and diabetic and plagued with heart disease and other ailments.

Dr. William Davis
2/4/2011 1:57:14 AM |

Hi, Revelo--

I don't know for certain, but I suspect that they are consuming a different genetic strain, e.g., emmer or a different, non-dwarf, variant.

Wheat is literally 25,000+ different strains. While the majority are quite destructive, there are likely a few less destructive forms. This is one of the reasons I discuss the appeal of einkorn.

DK and others--

The evidence for much of this is actually overwhelming. It will be fully articulated in my forthcoming book from Rodale, Wheat Belly,

Jim White
2/4/2011 2:09:07 AM |

Thanks for the tip on Einkorn wheat. I have now added pasta back into my diet. I had eliminated it due to the huge blood sugar spikes. After eating pasta made from Einkorn wheat my blood sugar tests 100-108 just one hour after eating. Traditional durem wheat pasta was producing 140+ even 2 hours later. Plus it is good.

Amy Dungan
2/4/2011 4:31:53 AM |

This is great! I'll be sure to share with the doubters.

Anonymous
2/4/2011 5:55:10 AM |

Here's what would be more helpful: what to eat once you swear off wheat?
What are we supposed to do for carbs? Potatoes and rice are glycemic bombs, we're told. Corn doesn't belong in a human diet either. High fructose corn syrup is in absolutely everything. Too much fruit is no good. Short of somehow becoming a traditional Inuit or living in the induction phase of Atkins the rest of my life, I'm at a loss for ideas. I allow myself some pizza each week and a nice bowl of breakfast cereal, but I'm not extravagant with wheat, yet I have a trigylceride level of 292, HDL of 35, even with fish oil and niacin, and three days a week in the gym.

Anonymous
2/4/2011 8:12:46 AM |

Anonymous, my own Triglyceride levels came down from 214 just a year ago (at some point they were in the 300s) to 89 just before Christmas. This was by seriously cutting down on all sorts of carbs, I.e, only minimal amounts of bread, pasta, rice, etc. Hilariously, the doctor commented: â€œbut remember, you don't need to cut fat from your diet completely!â€. I just grinned. Having said that, I know exactly what you mean. If you go out for food, it is virtually impossible to avoid refined carbs in huge amounts in just about any dish. If you prepare your own food, you will have to discard the bulk of your favorite recipes from the past, and focus on stews etc. It's not easy. Regards, neuroscan.

majkinetor
2/4/2011 2:30:33 PM |

There is lot of CH in vegetables.

For instance, 100g of brussels sprout has around 4g of CH.
Its so delicious when cooked for few minutes in olive oil and/or butter that you can easily eat around 300g per day which gives you 16g.

Potato is good alternative. Its hi GI (and GL) but, high GI foods in small amounts don't rise sugar. Amount is important. One boiled potato for instance.

Other stuff: carrot, black chocolate (75%++ cocoa), oat brans, cashews, cranberries.

Those are extremely healthy foods with good amount of slow carbs.

Might-o'chondri-AL
2/4/2011 4:32:03 PM |

Hi Revelo,
Twice here I've seen mention of Crete & Sicily intake. Those islands' heat and humidity foster unique symbionts.

Temperature will influence the varieties of soil bacteria. Based on the prophylactic gastro-intestinal affect of Japan's Natto I'd look to a local strain of Bacillus subtilis found on the drying wheat stalks.

Humidity will influence the varieties of mycotic (fungi) strains post-harvest grain is exposed to. Rural storage isn't hermeticly controlled conditions.
Based on human prophylactic gastro-intestinal affect of Japan's Koji (Amazake)I'd look for fungal mycellium of a local Aspergillus strain.

Swine, whether kept as pigs or feral boars, expose country folk to non-symptomatic helminths (worms). Human immune system modulates away from auto-immune response in reaction to them. I'd look at the swine Whipworm species interaction.

Robust rural 90 year olds are gaunt and conditioned. Carbohydrate based diets facilitate this by producing triglycerides to send out from the liver. In between the muscle cell's, and not fat, these are stored as di-acyl-glycerides.

A genetic/epigentic determined copy number variation of an enzyme influences our ability to convert "di-" back into tri-acyl-glyceride (triglycerides). The muscle then "burns" this on site for a lot of energy. My 2000 decade co-villagers relied on tubers (carbohydrate); one reputedly closing in on 100 years regularly walked many kilometers.

thehurricane
2/4/2011 6:59:00 PM |

That pretty much sums it up... I love this blog.

thehurricane
2/4/2011 7:01:03 PM |

Anonymous...
It might be repetitive but he does update his blog EVERY day... this in addition to being a doctor, husband, parent. The fact is that wheat really is so destructive and addictive for some people that it's worth repeating every day.
Keep at it Doc and I am looking forward to your book!

Patricia D.
2/4/2011 7:50:30 PM |

Regarding the connection between Urinary incontinence and wheat ...

A connection has also been noted between Vitamin D3 deficiency and urinary incontinence.  There was a study from SUNY Upstate Medical University in Syracuse, N.Y from March 2010:
http://www.webmd.com/urinary-incontinence-oab/news/20100322/low-vitamin-d-linked-incontinence

I began to optimize my VD3 levels late in 2009 and this was one of the first benefits I realized - within a few months this situation had improved dramatically for me.

Then we started to cut way back on our wheat consumption in the fall of last year.

It would be hard at this point for me to determine that having cut back on wheat is also having an impact - but there has been no obvious improvement.  Perhaps complete wheat elimination would have a more telling effect - but I do feel my situation now is near normal, whereas before it was an inconvenient problem of considerable concern.
*

Patricia D.
2/4/2011 8:02:49 PM |

I know Dr. Davis did some baking (experiments) with Einkorn wheat. I've found a few other sites for "heirloom wheat" flours ....
Anson Mills:
http://www.ansonmills.com/wheatflour.htm
and ...
Kamut: Ancient Grain in Modern Times:
http://www.suite101.com/content/kamut-ancient-grain-in-modern-times-a89648

... and I'm sure there are more.

These grains also predate the dwarf wheat mutant, and I wonder if anyone here has any experience with these flours?

I now consider that cutting back on wheat consumption is a lifestyle choice for us and we won't be going back. But I do occasionally bake a cake, or use a bit of flour to thicken a sauce, and sometimes bake bread.

I would like to have an alternate flour in the house that I feel comfortable cooking with.

paleoish
2/5/2011 1:10:12 AM |

Dr Davis, you have the patience of a saint to humour anonymous coward(s). I DO like reading the reminders of how bad wheat is, because people like me with ambiguous symptoms may or may not ever get a diagnosis of gluten intolerance or celiac disease. My last wheat cheat involved blood, so it's very possible that I have CD, but I dread the diagnostic process. Either way, it is emotionally draining to swim against the tide! Your posts help keep me on the straight and narrow.

Doc, are there any references or further info on the issue of wheat triggering bipolar manic episodes? I'm having a major "a-ha" moment over this one. I'd love to read more about it. I've been reading your blog and that of Dr Emily for a while, and I don't recall seeing any info on that. Pardon me if I missed it.

Kevin
2/5/2011 8:18:07 PM |

I can't give up wheat products. Because if this website I've drastically reduced my intake but haven't been able to make a total break. Dr D's continual wheat-is-bad theme is pushing me toward my goal. I do not want him to change this web's focus. Without it I'd probably revert.

kevin

skcubrats
2/9/2011 2:26:15 AM |

Aren't corn and soybeans just as bad? I thought he was going to end up with corn. Remember, 95% aren't eating enough whole grains! Zero is enough for me!

Josh
2/9/2011 2:51:15 PM |

Chaim -

Shalom! If you make your own hallah try to find some emmer or einkorn and see if that helps.

If not try making sourdough, since at least the phytic acid is removed by the fermenation.

It is possible that many Jews are not as sensitive to wheat since we have been eating it for a long time (of cource that was einkorn and emmer).

Keep in mind you only need to eat a cbeya to wash with a bracha and czayit to bench on. That's 2oz of bread - really not such a big deal if you're not eating wheat the rest of the week.

I will also point out that Abraham served cream, butter, and organ meats to his guests.

The Cigar Defense For Bread | Critical MAS
4/18/2012 1:07:52 AM |

[...] The Perfect Frankengrain – Dr William Davis [...]

Bioavailability of marine n-3 fatty acid formulations.

Abstract

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

Abstract

Related posts

Comments (25) -

Anonymous

chaim

Anonymous

chaim

Dr. William Davis

terrence

Might-o'chondri-AL

DK

revelo

Dr. William Davis

Jim White

Amy Dungan

Anonymous

Anonymous

majkinetor

Might-o'chondri-AL

thehurricane

thehurricane

Patricia D.

Patricia D.

paleoish

Kevin

skcubrats

Josh

Add comment