Mammogram of the heart

Some people have called CT heart scans the "mammogram of the heart." The analogy contains a lot of wisdom.

First of all, both--mammograms and CT heart scans--are screening tests, one for cancer, of course, the other for coronary atherosclerotic plaque. Both are performed in specific age groups, mammograms in women 40 years and over (generally), heart scans in women 50 years and over (generally).


















Mammograms: Left, normal; right, a small mass. (Courtesy Nat'l Institutes of Health and Wikipedia.)



Both are also meant to be repeated periodically when normal as a surveillance process.

Both use low quantities of radiation of about 0.3-0.4 mSv (the most real-life measure of total body exposure), a modest quantity of radiation.

Both are good for their purposes, though not perfect. Can a mammogram performed properly miss a small cancerous mass? Sure it can, but it's still unusual. Can a CT heart scan miss the non-calcified plaque prone to rupture? Sure it can, but this is also unlikely (<5% probability).

Given the exorbitant costs of medical tests, both are quite inexpensive. On the flip side, they are both also quite unprofitable for the centers providing the tests. Unfortunately, this means that mammography centers and heart scan centers come and go because of the difficulties of the profit-side of these services.

Both tests initially struggled to gain acceptance among the medical community. In 1960, for instance, mammograms were performed on standard x-ray devices, the same as that used to perform chest x-rays--low precision, high radiation back then. In 1969, dedicated mammography devices made the scene. However, it took over 10 years for even these new dedicated devices to become widely used. Use of mammograms has gradually increased over the ensuing 20 years. In other words, 47 years have passed since the introduction of mammography.

CT heart scans, of course, have had a shorter history of approximately 20 years, since engineer, Dr. Douglas Boyd, first invented the "ultra-fast" EBT devices, the first devices with sufficient scanning speed to scan the heart and coronary arteries.

One interesting difference between the two: In a woman between the age of 50 and 60, the likelihood of detecting cancer is 1 in 237. The likelihood of detecting coronary atherosclerotic plaque? About 1 in 4. Coronary disease eventually kills 1 in 3 females, hugely overshadowing breast cancer in frequency.


Progress on both fronts, one in cancer detection, the other in atherosclerotic coronary plaque detection. But still lots more progress to go.

Comments (3) -

  • Anonymous

    10/7/2007 12:05:00 PM |

    Great blog on the comparison between the histories of the two tests - thanks for writing it.    

    Curious, have you heard if progress has been made with MRIs being able to perform heart scans?

  • Dr. Davis

    10/7/2007 12:20:00 PM |

    Not to my knowledge. I believe they are still bogged down by the slow data acquisition. It will be a fabulous tool if the speed is accelerated and the price can be lowered.

  • buy jeans

    11/2/2010 8:07:00 PM |

    CT heart scans, of course, have had a shorter history of approximately 20 years, since engineer, Dr. Douglas Boyd, first invented the "ultra-fast" EBT devices, the first devices with sufficient scanning speed to scan the heart and coronary arteries.

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Glucomania

Glucomania

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.

Comments (52) -

  • Robert Burton Robinson

    2/8/2011 3:47:09 PM |

    Had a bowl of oatmeal less than one hour ago. Old-fashioned oats, artificial sweetener, cinnamon. Now I am wiped out. Tired, sleepy. I don't even need a glucose meter to tell me the oatmeal reeked havoc on my blood sugar.

    I always feel this way after eating certain carbs. Used to think old-fashioned oatmeal was okay. But it's just not. Not for me anyway. By the way, I'm hypoglycemic.

  • Steve Cooksey

    2/8/2011 3:50:18 PM |

    Agreed Dr. Davis... wish all would "Read and Heed" this advice.

    Question: you are referring to Type 2 Diabetes only, right?

    All the best.

    Steve

  • Jonathan

    2/8/2011 3:53:13 PM |

    Most drug stores including Walmart and Target carry a small disposable meter that looks like a 35mm film bottle.  Very cheap and includes 50 test strips.  Next cheapest I've found is the Walmart ReliOn Ultima meter which is around $9 and you buy the strips at the Pharmacy (only since people steal them) for around $39 for 100.  When I first started Primal, my sugar readings were all over the place and then within 3-4 months of eating low-carb my reading became really stable all day long.  I think I had to burn through my over abundant glycogen stores first (it was mostly causing high waking pre-breakfast readings).

  • Desia

    2/8/2011 4:39:06 PM |

    I'm going to try this with the BG meter we use for our diabetic cat. It measures in mmol/L and the recommended BG targets are 4.0-7.0 before meals/5.0-10.0 2hrs. after. (for humans)
    Is this similar to your recommendation of100 mg/d,l Dr Davis?

  • Anonymous

    2/8/2011 4:41:35 PM |

    Can it cure type I diabetes as well?

  • Steve Cooksey

    2/8/2011 5:04:04 PM |

    I am a diabetic and I find the inexpensive Wallmart brand ReliOn Micro is a great value.

    @ $20 for meter and strips. Refill strips @ $12 per 20.

  • Anonymous

    2/8/2011 5:22:48 PM |

    Just a "heads up" for others.  I ordered the Walmart Relion BG meter ($9) and a supply of strips and lancets online only to have Walmart CANCEL the BG meter (no reason available) and send me the strips and lancets (which I will have to return as they are useless to me without the Relion BG meter).  Walmart's website still says the BG meters are "in stock" when clearly they are not and customer service had no explanation for that either.

    I'll visit your earlier post to find a comparable meter.

  • Jeff

    2/8/2011 5:41:44 PM |

    Dr. Davis: "This is why low-glycemic index is an absurd notion."

    Does this mean the Dreamfields pasta claim of being low-carb is misleading, at best?

    I've been contemplating trying it, but fear it really isn't low carb.

  • Jack

    2/8/2011 5:48:20 PM |

    i am curious about the effect that the oatmeal that i sometimes eat would have on my blood glucose levels.

    i take 3 cups of raw oats, soak them in warm water with 8 tablespoons of raw whey and add 2 heaping tablespoons of organic buckwheat flour and let them soak for 24 hours. drain and rinse thoroughly. pour the oats into a baking casserole dish and add some coconut oil, blueberries, pure vanilla, cinnamon, buttermilk. bake at 350 for 40 minutes.

    the result is a very delicious and highly altered form of oats. the whey and buckwheat drastically reduce the phytic acid and 'ferment' or predigest the oats. when it's done, i just add a couple spoons of pasture butter and enjoy. i've noticed a significant change in texture as a result. the oats are no longer firm. they feel quite 'broken down' and they do not sit in my stomach like a brick.

    why go through all that trouble? well... you should taste it. it is quite the treat.

  • ~Amy Jo~

    2/8/2011 5:55:34 PM |

    I appreciate the information in your blog.  I started checking my blood sugar and was shocked at the results of some 'low glycemic index' foods.  Besides the basic health benefits of maintaining healthy blood glucose, I've also lost a few pounds.  Bonus!

  • Anne

    2/8/2011 6:02:39 PM |

    Desia,

    I'm diabetic and from the UK where we measure blood glucose in mmol/L - to convert from mg/dl to mmol/L just divide by 18 - so 100 is 5.5. Multiply by 18 to convert your mmol/L to mg/dl.

  • revelo

    2/8/2011 6:06:01 PM |

    Oatmeal and other high-carb foods won't cause blood sugar spikes if you are lean, get regular exercise,  eat high-carb foods on a regular basis, and don't have health problems. All 4 of the above conditions must be met. In particular, you MUST exercise, though the exerciser doesn't have to be lengthy.

    I find keeping my bodyfat under 15% (I'm a 50 year-old male, women would have a higher percentage) and doing 5 to 10 minutes of one-legged squats, which gets my blood pumping and is much more convenient than running, is enough to keep my insulin sensitivity high enough to avoid blood sugar surges.

    Yesterday, for example, I had a single large meal in the late afternoon, due to being too busy to eat most of the day: a half can of salmon, a large salad, 300g (dry) of cooked oats mixed with about 6 grams of cinnamon all eaten within about 30 minutes. My blood sugar never exceeded 110 mg/dL during the subsequent 3 hours (I measured every 30 minutes) and eventually fell back to the normal level of about 85.

    When I experimented with a paleo diet for a while, my insulin sensitivity plummeted, so that when I broke the paleo regime temporarily and ate a mere 100g (dry) of cooked oats, my blood sugar skyrocketed to 195 mg/dL 30 minutes later. And note that those oats were eaten together with 2 eggs and some veggies, which would normally tend to mute the glycemic index as opposed to eating oats by themselves. Evidently, what happened while eating paleo is that my body's cells had down-regulated their insulin sensitivity. This makes sense, since there is no need for high insulin sensitivity when eating paleo, and the greater danger under these conditions is low blood sugar rather than high blood sugar. Only when glucose is abundant (regularly eating a high carb diet) does the body upregulate insulin sensitivity. But the upregulation won't occur if the body is fat or doesn't get regular exercise. And, of course, it obviously won't occur for someone with a "burned out" pancreas, such as Type II diabetics supposedly have.

  • Desia

    2/8/2011 7:43:01 PM |

    Anne, thanks for the info. (I'm from Canada)

  • AndreAnna

    2/8/2011 7:56:23 PM |

    Has there been any studies citing any differences in regular oats versus soaking/sprouted oats? I wonder if the neutralizing of the phytic acid that helps in digestions would also help the way the body breaks down the oats and, therefore, insulin response.

  • Brent

    2/8/2011 9:36:23 PM |

    Jeff -

    I have used Dreamfields for about 6 months now.  They claim the carbs are "locked up" and can't be digested.  I have found they do not affect blood glucose like regular pasta would.

    However they are still wheat, which has it's own problems even if the special processing prevents blood glucose spikes. I still have it once or twice a month when the rest of my "non-low carb" family has pasta, but I know I have to quit wheat all together soon, just hard to do. For now it's the lesser of two evils.

  • donny

    2/9/2011 1:34:07 AM |

    "Oatmeal and other high-carb foods won't cause blood sugar spikes if you are lean, get regular exercise, eat high-carb foods on a regular basis, and don't have health problems."

    Absolutely. But this is a blog about reversing heart disease...

  • Gretchen

    2/9/2011 2:02:45 AM |

    It's dangerous to talk about "curing" diabetes with a low-carb diet. Someone with type 2 who goes on a LC diet may be able to maintain normal blood sugar levels as long as s/he stays on the diet. But the diabetes is not cured. Returning to a standard American diet would result in high blood sugar again.

    A diabetes cure would mean you could eat cereal, skim milk, orange juice, toast, and jam and keep your blood sugar levels normal.

    The danger of telling someone he/she is cured is that the person will believe it, will return to a regular diet, and will stop testing, not realizing how high blood sugars are and will end up in a worse situation than he/she started with.

  • Galina L.

    2/9/2011 2:49:37 AM |

    That is it! I am buying a glucosameter! I sometimes get a little bit lethargic from any big meal, if I simple add cabbage soup to my usual stake + sauerkraut lunch.

    To Gretchen:
    It is very dangerous to be so stupid(or reluctant to think) as the individual you just described.

  • Anonymous

    2/9/2011 3:36:25 AM |

    I enjoy this blog, but I do frequently agree with those who say that the grandiose effects of eating grains that you present are often times found more common place in people with metabolic problems. For example, while I was in college, I had a dorm mate who read some random article about gluten and suddenly believed herself to be suffering from Celiac Disease. My friends and I labeled her an hypochondriac, going so far as feeding her a deadly, lethal oatmeal cookie (gasp!) which we passed off as consisting of "a grain-like substance produced from the dried roots of a Japanese plant." My dorm mate ate the cookie and low and behold - nothing. Weeks prior she claimed to have taken a few bites of Frosted Mini Wheats in the cafeteria and subsequently suffered a debilitating pain in her stomach. Moral of the story is that her fear of gluten and the pain she felt from consuming Frosted Mini Wheats were purely psychosomatic.

    I guess what I'm at getting at is you provide good information, but often times the entries you write are reminiscent of the blogs/journals/prose/essays written by individuals such as the Unibomber. In a half-serious, half-jocular manner, I always feel like one day I'll read/hear in the news, "Man opens [gun] fire within an oatmeal factory," and [to no one's surprise] it'll be you. I'm not accusing you of actually perpetuating such an act, but you write with such vigor about something like wheat/grains, and it gives off the "vibe" that you are harboring some hardcore resentment.

    Once again, I enjoy your overall blog, but your hasty generalizations and confusing cause-and-effect can be misleading and overly exaggerated.

  • Dr. William Davis

    2/9/2011 3:40:26 AM |

    Hi, Steve--

    Actually, the same advice applies to all forms of diabetes. Type 1 and "intermediate" types, i.e., slender people with diabetes, LADA, etc., can still follow a similar program with equally extravagant results.

    However, the blood sugar tightrope is much more difficult to walk for these people and should be undertaken with the assistance of the (sadly, rare) assistance of a knowledgeable expert in doing so.

  • Dr. William Davis

    2/9/2011 3:45:38 AM |

    Hi, Amy Jo--

    Ahh. Your comment alone made writing this post worth it. Thank you.

    There is an odd sentiment that sometimes prevails: If it doesn't apply to me, it must not be true. As if everyone wore a size 13 shoe.

  • Anonymous

    2/9/2011 4:42:37 AM |

    How about oatmeal (steel cut)if:
    15 min blood sugar 127
    30 min blood sugar 150s
    45 min blood sugar 125
    60 min blood sugar back to 95?

  • Anonymous

    2/9/2011 5:45:11 AM |

    As much as this wheat-free idea kills me, I'm going to try to at least quit my sweetened cereal habit each morning. My fasting sugar is good - 81, but my triglycerides are still monstrous at 292 even with niacin and fish oil. On a semi-related matter, I confirmed for myself that dry Vitamin D doesn't work. I've been using Life Extension brand cholecalciferol 5,000 units a day for months, and my levels barely rose - from 33 to 36. Got a shipment of the carlson oil caps and I'm going to try 8,000 and see where that leads.

  • Anonymous

    2/9/2011 9:05:42 AM |

    Hi,
    Thank you for this great post!  
    I was diagnosed borderline diabetic, glucose intolerant/insulin resistant over 10 years ago. I figured out that a glucose meter could really help improve my health so I used it faithfully for many years. Now the strips are very expensive so I have cut back. But I learned an incredible amount while  using the glucometer.
    This is a fabulous method, and I highly recommend it.

  • Peter

    2/9/2011 12:24:20 PM |

    My friend started feeding his diabetic cat low carb chow, and the cat went into shock when she got her insulin shot.
    The vet said her blood sugar had returned to normal, should no longer get insulin.

  • Anonymous

    2/9/2011 4:18:10 PM |

    Thanks Dr. Davis.  I have been following your advice to use the meter to lose weight and I find it really works!  I am finding the food that sends my blood sugar high and I am trying to avoid them.  
    Char

  • notrace

    2/9/2011 6:30:24 PM |

    Here's a way of using the glucose meter that I came across just this week: don't eat unless blood glucose has dropped to a normal level even if it means eating once a day.

    http://shurie.com/lee/writing_defeat_diabetes.htm

  • Might-o'chondri-AL

    2/9/2011 8:07:30 PM |

    Heart effect of Doc's recommendation is very important if you are not young. Human ageing is accompanied by histological (molecular and cellular) changes in the vascular smooth muscle cells of the artery wall. It means that over time formation of atheroscleroma (plaque) becomes easier to develop - even if it has not done so, yet.

    Technically the molecules that are big players in the pro-inflammatory cycle are MCP-1 (monocyte chemo-attractant protein 1), MMP-2 (matrix metallo-proteinase type-II) and TGF-B1 (transforming growth factor beta-1). With age these are found circulating in elevated amounts; even in individuals without clinical problems. In other words genetic expression of them is upregulated, and it appears that age induces this epigenetic activation even if there is no diagnosable pathology.

    Now, Doc's clinical instruction is to hold down the small LDL production and reign in circulating triglycerides. This is because those are what will provide the fodder for the pro-inflammatory molecules' loop of interaction to actually go on to "make" actual plaque.

    Blood sugar spikes, according to Doc, are apparently the stalking horse for setting up our aged vascular system for pathological problems. We are accustomed to think of blood sugar as only a diabetics dilema; and so, many non-diabetics mistake Doc's insistance as not applicable to them.

    And, to those readers who have their own method of carbohydrate consumption it would be instructive to learn if any have tested, and might share, your small LDL percentage (mine is unsatisfactory to me, based on Doc's recommended %). This can add some perspective to see if this blog's "glucomania" is somewhat overblown.

  • Anonymous

    2/9/2011 8:34:29 PM |

    Ebay is also a good source of meters and test strips.  Some out of date, but less important for non diabetic purposes.

  • revelo

    2/9/2011 8:34:41 PM |

    donny wrote: "But this is a blog about reversing heart disease..."

    It's for Dr. Davis and not me to say what this blog is about, but my impression is that the goal is not just reversing but also preventing heart disease in the first place (and also the other ailments mentioned in the current post).

    Many of the people on the blog are healthy and want to stay that way, as opposed to being sick and wanting to be cured. I think I am in the first category myself, though I'm still awaiting the results of blood tests to know for sure. Already, I have made the following changes in my life due to reading this blog:

    1) taking 2000 IU/day of vitamin D3 in gel capsule.
    2) vitamin D blood test after a few months of the D3 supplement regime.
    3) using the glucose monitor to learn about my response to carbs.
    4) getting a VAP test to learn if I have Lp(a) and also get my VLDL numbers.
    5) Hb1Ac test.

    I am quite grateful for Dr Davis for pushing me to making these changes, but I think the anti-grain/anti-oatmeal focus is misguided.

    There is an epidemic of obsesity and type II diabetes in Pacific Islanders who eat junk food nowadays, but who were formerly lean on their traditional paleo low-carb diet of fish and coconuts. So why don't they go back to the fish and coconuts? BECAUSE CARBS ARE TASTY AND LOW-CARB DIETS ARE BORING. And there you have the argument against the paleo low-carb diet in a nutshell. The evidence is clear: Atkins works in the short run, but not the long run (at least for most people) because we naturally crave carbs. Sure, if you have willpower, you can hold off a year or so, but eventually you'll fall off the wagon. And when you do, you'll go ape over those carbs, because you haven't learned how to manage them. Whereas if your normal diet is high-wholegrain-carb (after using Atkins for losing weight in a hurry), then there is much less danger of losing control of yourself when you eat some sugar in addition to your usual wholegrains.

    High-carb diets are tricky to manage, because there is nothing to stop you from overeating, unlike with Atkins, where the body tends to resist overeating. But tricky is not the same as impossible. Part of the trick, in my experience, involves eating lots of wholegrains or tubers: wheat, rice, oats, corn, potatoes, etc. (Another part involves staying lean, and by lean, I mean ribs showign for men, as is a little strenuous exercise each day.) And that is why I keep arguing against this blanket indictment by Dr Davis against grains, and especially against oatmeal, which is the most health-inducing of the common grains for many people.

  • revelo

    2/9/2011 8:49:22 PM |

    @Might-o'chondri-AL: The chemistry panel I got back in December shows the following:

    Total chol: 152
    HDL       :  70
    Trig      :  39
    VLDL calc :   8
    LDL calc  :  74

    The two LDL scores are calculated, not measured. I just got back this very morning from getting blood drawn for a VAP test (ordered through lef.org), so I'll know my tested, as opposed to calculated, VLDL numbers in a week or so.

  • revelo

    2/9/2011 9:31:41 PM |

    @Might-o'chondri-AL:
    The chemistry panel I had back in December showed:

    Total chol: 152
    Trig      : 39
    HDL chol  : 70
    VLDL calc : 8
    LDL calc  : 74

    Just this morning, I had blood drawn for a VAP test (ordered through lef.org), so when the results come back, I'll know the measured VLDL percentage numbers, as opposed to the calculated values from the chemistry panel. (I'll also learn if I have Lp(a)).

    My diet back in December was similar to now: 200g to 400g (dry) per day of rolled oats, 1/3 to 1/2 can salmon, salad, sometimes low-fat cottage cheese or eggs instead of salmon, plus small quantities of "forbidden foods" that I'm allowed to eat on the way home from the grocery but am not allowed to keep in my apartment: chocolate, nuts, fruit.

    I should note that I spent October and November hiking the Appalachian trail, and so was in extremely good cardiovascular condition, and also quite lean, but I was feeling damaged internally from the constant alternation of famine and feast. The feasts typically involved a gallon of ice cream, a package or two cookies, plus anything else that struck my fancy. These feasts during town stops were to avoid losing too much body fat, since it was getting cold as November progressed and I needed to retain some body fat to stay warm. It was because of that feeling of being internally damaged that I began researching health on the internet and came across this blog.

    (I posted this comment before and it got deleted somehow.)

  • free diabetic meters

    2/9/2011 9:39:52 PM |

    Fascinating! This is such a great idea! Thanks!

  • Dr. William Davis

    2/10/2011 2:24:03 AM |

    Hi, Revelo--

    Great comments.

    However, it helps to keep one thing in mind: The reduction or elimination of grains is not just about weight control (though it certainly does help that); it's about reduction of small LDL, triglycerides, other inflammatory phenomena, blood pressure, visceral fat, and glycation.

    Wheat and oats increase blood sugar, small LDL, triglycerides, etc. to extravagant degrees.

  • Might-o'chondri-AL

    2/10/2011 2:35:45 AM |

    @Revelo,
    Very good reading lipid panel profile; can see why you speak up against "glucophobia".

  • B

    2/10/2011 1:45:19 PM |

    @revelo: Hey, this is the only lipid panel I have ever seen anyone post that's close to my last one! At the time, I was eating 200-300g of carbs per day, mostly from grains. Of course I am only in my mid-20s now, but it's worth noting that this kind of lipid profile is typical for my extended family and we have absolutely no history diabetes or heart disease despite most of us being over. Bodies can handle carbohydrate so, so differently.

    Like you I am lean and need to put effort into gaining body fat, but I wasn't very active when I was eating high carb, lots of grains (and plenty of junky food too as I was trying to put on weight), and it made me ill in various ways.  

    I do feel my best with starch in my diet, but stick to potatoes, other tubers/root veg, and white rice - and not too much, I have always had issues with blood sugar 'crashes' although I haven't tested with a blood glucose meter to see just what's going on there. I feel awful an hour or two after eating too many carbs (and more ill after eating smaller amounts of oats, whear).

  • Anonymous

    2/10/2011 4:46:38 PM |

    I have a question as a breakfast cereal junkie trying to kick the wheat and sugar habit: would something like rice crispies be significantly better? No wheat as far as I can tell, but there is some fructose and some malted barley involved...

  • Anonymous

    2/11/2011 1:13:36 AM |

    For those interested in blood glucose I recommend the presentation 'What is Normal Glucose? – Continuous Glucose Monitoring Data from Healthy Subjects' by Professor Christiansen.

    He uses a continuous blood glucose monitoring for 30 or so patients over a 5 day trial.  Days 2-3 set meal in clinic and days 4-5 free meals at set times.

    This should give you an idea of  the expected daily ranges are for healthy subjects.

    He then does an additional study on breakfast and comes to the conclusion that perhaps the fast adsorbing breakfasts we've be told to eat arn't that good for us.  Ref this blog post on oatmeal vs omelet.

    Finally he looks at mortality vs blood-glucose levels.

    http://www.diabetes-symposium.org/index.php?menu=view&source=&sourceid=0&chart=1&id=322

    Enjoy.

  • Anonymous

    2/11/2011 1:34:34 AM |

    Here is another presentation that y'all may find interesting as part of the 'cut grains out' argument is vLDL production that is the bad cholesterol.  I'm no biochemist but this presentation on Sugar focusing on Fructose and how it treated by the liver may interest.

    Other carbs though seem to get converted to Glucose and only a tiny amount to vLDL / triglycerides.

    The huge vLDL / Triglycerides production comes from fructose.  I limit my fructose to less than 10g/day.

    'Sugar: The Bitter Truth'

    http://www.youtube.com/watch?v=dBnniua6-oM

    Enjoy.

  • Tom

    2/11/2011 3:21:39 AM |

    I recently bought a ReliOn micro glucometer from Walmart after reading your recommendations, Dr. Davis. I'm 31, in excellent health, eat low-grain/starch most of the time, frequent anaerobic and aerobic exercise. My fasting glucose seems to rest in the 70-90 range.

    Recently I decided to measure my glucose response after eating oatmeal. I used organic instant rolled oats and soaked them > 1 day in water with salt and lime juice, WAPF-style. I made a huge bowl of oatmeal (about 20 fluid ounces) and added blueberries and an appropriately huge amount of butter before eating. One hour later I measured my blood glucose using 2 separate test strips. I got 79 and 78. This surprised me, and I thought I'd add my data point to the discussion here.

    No doubt a high fat load slowss gastric emptying and helps minimize the spike in blood glucose. Perhaps my reading would have been higher 2 hours after the meal.

  • Anonymous

    2/11/2011 2:20:27 PM |

    What about 1 carb whey protein isolate with unsweetened almond milk?  Why does it raise blood glucose?

  • Anonymous

    2/12/2011 4:56:41 AM |

    http://www.futurepundit.com/archives/007893.html

    Fructose Alters Brain Metabolism
    One of the competing theories to explain the obesity epidemic is a rise in fructose consumption causing alterations in hormone levels that increase appetite. UCSF med school prof Robert Lustig has a pretty good rant-lecture on the evils of fructose. Well, here's another study on part of the mechanism in the brain of how fructose might be causing increased obesity.

    PORTLAND, Ore. – The dietary concerns of too much fructose is well documented. High-fructose corn syrup has become the sweetener most commonly added to processed foods. Many dietary experts believe this increase directly correlates to the nation's growing obesity epidemic. Now, new research at Oregon Health & Science University demonstrates that the brain – which serves as a master control for body weight – reacts differently to fructose compared with another common sweetener, glucose. The research is published in the online edition of the journal Diabetes, Obesity and Metabolism and will appear in the March print edition.

    In humans the cortical brain control areas of the brain were inhibited by the influx of fructose.

    Functional MRI allows researchers to watch brain activity in real time. To conduct the research, nine normal-weight human study subjects were imaged as they received an infusion of fructose, glucose or a saline solution. When the resulting brain scans from these three groups were compared, the scientists observed distinct differences.

    Brain activity in the hypothalamus, one brain area involved in regulating food intake, was not affected by either fructose or glucose. However, activity in the cortical brain control areas showed the opposite response during infusions of the sugars. Activity in these areas was inhibited when fructose was given but activated during glucose infusion.

    This is an important finding because these control brain areas included sites that are thought to be important in determining how we respond to food taste, smells, and pictures, which the American public is bombarded with daily.

    The result increases the plausibility of fructose as a causal agent.

    "This study provides evidence in humans that fructose and glucose elicits opposite responses in the brain. It supports the animal research that shows similar findings and links fructose with obesity," added Purnell.

    If you want to reduce your weight also consider other theories for the cause of obesity including grains as a possible major cause.

    By Randall Parker 2011 February 09 05:42 PM  Brain Appetite

  • Anonymous

    2/15/2011 12:45:07 AM |

    Oats are often cross contaminated with wheat.  Would certified gluten free oats give the same results?

  • semsons.group

    2/21/2011 4:04:55 PM |

    I think this post is really very important. Looking forward to future extensions of it.

      I've been able to control my cholesterol cutting wheat to zero, a moderate version of paleo diet, and a little of supplements with DHA/EPA, as suggested by Dr. Davis. Now is the turn of glucose Wink

      After reading this post I bought a glucometer (Bayer USB device) and I'm slowly learning some important things. My fasting glucose is good, about 80, however I've just seen (measured) that a simple dish of rice with fried egg rises my glucose one hour after lunch to  170!. My wife experienced a similar change. Amazing. I have lunch at work, and these measures of glucose are going to be very helpful to help me decide what to choose for the menu. I plan to continue measuring my glucose for the next weeks, so I guess news surprise will come.

    I just want to thank Dr. Davis for the great help  he's providing to many people from his blog.

      Best.

  • Anonymous

    2/26/2011 7:01:06 PM |

    Hi,

    I have bought a glucometer and wnted to ask you a question.
    This morning my bg was 4.9 (fasting) so very good then I ate pork then I had cashews and at 5pm I felt shakey not right, hungry so I checked it and it was 4.3 (isnt it a bit low?) so I had a pear and an hour after the pear it was 6.1, is it normal? does it mean i should avoid fruits?

    thanks for your help!

  • Anonymous

    3/31/2011 2:36:10 PM |

    I know I'm late to this party, but I took your advice and got a free glucose meter from Walgreens (came with 10 strips). Fasting blood sugar 75, ate a giant meal of steak, eggs, bacon, sausage, and sliced tomatoes, it went up to 85. On seperate days, a plain protein shake with a tad of reds powder spiked it to 112 (!!!) and my "low-carb" meat chili (no beans, just meat) launched it to 102 (lots of tomato paste/sauce). Needless to say, it's been an eye opener, especially since so-called "healthy" foods are raising my blood sugar more than I'd like, and of course stopping fat loss in it's tracks.

  • Duncan

    5/5/2011 8:21:07 AM |

    Hi,

    Am late to this party too but had a question.

    I too bought a blood glucose monitor and, following almost exactly the info above, I've been tracking my numbers for a few days now. And I have a few questions I was hoping someone could help me with...

    A few facts first:

    Age - 45
    Male
    Do Crossfit 3-4 times per week

    So far my BG levels have not gone over 108 and are averaging around 91/92, fasting BS is around 86.

    The 108 number came 1 hour after a breakfast of uncooked oatmeal, some apple sauce. milk and a handful of almonds - all blended. BUT last night I ate a green salad, chicken and vegetables, with a piece of thin pie crust (!) and 2 lattes (!!) that only gave me a BS  number of 85 after 1 hour and 83 after 3 hours.

    Do these numbers sound right? And how 'bad' is a BS level of 108?

    Hoping someone can advise...

    Duncan

  • Fred

    7/25/2011 5:36:21 AM |

    Insulin is meaningless. All the answers are on this site - http://carbsanity.blogspot.com/. Thank you and have a blessed day.

  • tam

    7/25/2011 7:52:13 PM |

    I've been testing stuff after 20 minutes.  The highest things were: whole wheat bread, whole wheat cereal, potatoes, and whole oranges.  But so far I've only had the 'low carb flu' or 'reactive hypoglycemia', and I've actually gained some weight.  But I think I'm on the right track.

  • LS

    10/4/2011 1:46:16 PM |

    Dr. Davis,
    If a person has a high fasting number, is the goal to stay at the original number?  I have a fasting glucose number of 83-85, so should my ideal number one hour or so post meal be close to or identical to the start or just below 100?  I'm a little confused.

  • Dr. William Davis

    10/5/2011 1:43:44 AM |

    At this low a starting value, just staying below 100 mg/dl is a great goal.

    The "no higher" advice was meant for people who start at 100 mg/dl or higher blood sugar.

  • jpatti

    5/29/2012 3:11:45 AM |

    Those who can keep tight control of bg with diet are not "cured" of diabetes anymore than those who avoid peanuts are "cured" of peanut allergies.

    Minimizing carb content keeps bg lower, yes, and many diabetics can control bg with just that.  Others need meds regardless of how clean their diets are.  

    Managing the disease is NOT curing it.  Unless they can pass a GTT, they're still diabetic.

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