Throw away total cholesterol!

17. May 2006 William Davis (1)
Richard's total cholesterol without treatment was 186 mg/dl. "That's great!" his doctor declared, referring to the conventional dictum that total cholesterols less than 200 carry low risk. Several fingersticks in a mall kiosk set up by a local hospital to check total cholesterols confirmed Richard's low number.

But after Richard's unexpected hospitalization and two stents for severe coronary blockages, he demanded better answers.

Tragically, the answer was there all along: Despite a "favorable" total cholesterol, his HDL ("good") cholesterol was a miserable 32 mg (ideal >60 mg).

Total cholesterol is actually the sum total of HDL cholesterol, LDL cholesterol, with a contribution from triglycerides. That's why a low total cholesterol can conceal a low HDL.

This situation is quite common. And low HDL is accompanied by a constellation of other undesirable causes of heart disease, most notably small LDL.

Don't accept total cholesterol as your sole measure of risk. It's nearly worthless. If you live in Bangladesh or a third world country, well perhaps that's the best you can get. But if you live in the U.S. or developed world, it's absurd to rely on total cholesterol.

Smart Start not so smart

15. May 2006 William Davis (2)



Kellogg's has crafted a campaign to support the American Heart Association featuring acress Sela Ward. Her attractive face, familiar to many TV and movie viewers, does add a comforting face to their efforts.

What's in this cereal made by the manufacturers of Pop-Tarts, Cheez-It, Rice Krispies, and Chips Deluxe cookies?

There are, indeed, some healthy ingredients: oat bran, potassium; you can even get a version made with soy protein. But there's sugar listed as the second ingredient. High-fructose corn syrup is also listed prominently. (Remember this issue? High-fructose corn syrup causes overwhelming sugar cravings, causes your triglycerides to skyrocket, and is probably among the principal food ingredients that make you obese.)

Upon detailed questioning of my patients struggling to lose weight, this and products like it are often among the "healthy" foods they've gravitated towards. We spend a great deal of time dissuading them of this idea.

A one-cup serving of Smart Start is low in fat (1 gram) but contains 43 grams of carbohydates, of which there are 14 grams of sugar. There are a meager 3 grams of fiber. To me, this sounds like a cupcake.

The Kellogg's people are exceptionally clever marketers. Partner with the American Heart Association and movie stars? Brilliant!

You should trust food manufacturer advertising about as much as you trust drug manufacturer advertising, which is to say not at all.

Kellogg's sold $10 billion dollars of food products last year. They are the world's leading producer of breakfast cereals. They are a leading producer of convenience foods: cookies, crackers, cereal bars, and frozen waffles under the brands Keebler, Pop-Tarts, Eggo, Cheez-It, Nutri-Grain, Rice Krispies, Famous Amos, and Kashi.

Can they cash in on healthy trends? They'll certainly try.

Does anybody have a normal vitamin D level?

15. May 2006 William Davis (0)
We now routinely check everyone's vitamin D blood level at the start of the program. (The measure to obtain is 25-OH-Vitamin D3. This is not to be confused with 1,25-OH2-vitamin D3, which is a kidney function measure.)

Of the 10 people with levels drawn today, none were even close to normal levels (which we define as 50 ng/ml)--not a single one.

The majority were in the range of severe deficiency (<20 ng/ml). Only two had levels in the 30s. None had higher. (Remember: I'm talking about people in Wisconsin, a terribly sunlight-deprived area much of the year. This might not apply quite as vigorously to Florida residents or others in sun-exposed regions.)

Curiously, I've also seen several people this week who had extraordinary quantities of coronary plaque on their heart scans (scores >1000), all of whom had extremely low vitamin D levels. One of these people had fairly unimpressive lipoproteins, with very minimal abnormalities identified. (This is quite unusual, by the way.) It makes you wonder if a profound deficiency of vitamin D is sufficient to act on its own as an instigator of coronary plaque.

The more we examine the issue of vitamin D deficiency, the more fascinating it gets. I suspect we've just scratched the surface and there's a lot more to learn about this tremendously interesting nutrient. Nonetheless, with what we're seeing in our experience, I'm urging everyone to get a blood vitamin D level.

Don't believe your LDL cholesterol!

14. May 2006 William Davis (0)
Harry's case is typical. For years, his doctor told him his LDL cholesterol of 123 mg was okay. But a heart scan score of 490 (90th percentile at age 52) made him question just where his coronary plaque came from.

Lipoprotein analysis told a very different story: His LDL particle number was 2400 nmol, meaning his trueLDL was more like 240 mg, nearly double the value of LDL obtained through his doctor. Harry had other sources of risk, too, but the LDL particle number was a clear stand-out.

Why does this happen? How can LDL cholesterol be so terribly inaccurate?

LDL cholesterols obtained in virtually all labs are not measured, they're calculated. The calculation was developed in the 1960s by Dr. Friedewald at the National Institutes of Health and therefore goes by his name (the Friedewald calculation). Dr. Friedewald derived this simple calculation to permit doctors across the U.S. to obtain LDL cholesterols, which were technically difficult to measure in those days by using measured HDL, total cholesterol and triglycerides.

Doctors were told that the only time that the Friedewald calculated LDL was inaccurate was when triglycerides exceeded 400 mg. So most family practitioners and internists still believe that calculated LDL's are, for the most part, quite accurate.

Nothing could be further from the truth. When LDL's are actually meaured, you find that LDL is rarely accurate. In fact, in our experience, inaccuracy of 30-50% is the rule, sometimes 100%. The one telltale hint that calculated LDL is wrong is when HDL is <50 mg--that's nearly everybody.

So what's your LDL? You won't really know unless it's measured. Our preferred method is NMR (LipoScience) LDL particle number, probably the most accurate of all. Second best: apoprotein B, direct measured LDL, and non-HDL. (We'll cover this issue much more extensively in an upcoming report on the www.cureality.com website in an extensive Special Report.)

Are you the exception?

14. May 2006 William Davis (0)

I read about 40 heart scans this morning. In the stack was a 41-year old man with a heart scan score of 841.

That's terribly high for anyone, let alone a 41-year old person. He's lucky to find out about this before catastrophe strikes.

People like this worry me. In general, we advise men to consider a heart scan age 40 and older; women 50 and older. If there's anything exceptional about your family history or your own history, then you might notch these numbers down another 5-10 years. For instance, if your Dad had a heart attack at age 43, you might consider a scan at age 35. Or, if you've had diabetes for several years and you're a 42-year old woman, you might think about a scan. (Men tend to develop measurable plaque by heart scans 10 years before women.)

There are no hard and fast rules. It's unusual for a male to have a score >0 before age 40. Likewise, it's very uncommon for a woman to have a score >0 before age 50. But there are occasional exceptions--but they can be very important exceptions.

Our 41-year old man with the score of 841, for instance, probably had a high score since his mid-30s. I've seen several women without any obvious risk factors with scores in the several hundred range in their early 40s.

My rule: When in doubt, opt for safety. Every day, I still read about people in their 30s, 40s, and 50s dying of heart attacks. It shouldn't happen.

When in doubt, get the heart scan. The most you'll lose is the cost of the scan and a modest exposure to radiation. If your score is zero, you know you're safe for the next 5 or more years. But if you have an exceptional score at a young age, take preventive action.

Self-empowerment in health: The new wave in health care

12. May 2006 William Davis (0)
Track Your Plaque is just one facet of the broad and powerful emerging wave of self-empowerment in health.

Hospitals, drug and device manufacturers, and the medical establishment don't like this idea. People managing their own health? That's ridiculous! Dangerous! But mostly unprofitable.

Self-empowerment means having easy access to simple, safe, and inexpensive diagnostic tests like heart scans, carotid scans, bone densitometry (for osteoporosis), cholesterol tests, abdominal ultrasound, even brain scans (e.g., CT or MRI) for people with a family history of brain aneurysm.

Opponents of this idea worry about the "false-positives" that come about with broad testing, i.e, detection of abnormalities that are artifactual. Our experience is that false-positives are only an occasional problem with any test. Instead, we find that most people have many true-positives. In CT heart scanning, for example, we find many unsuspected enlarged aortas (potential future aneurysms), valve disorders, and aortic calcium. These are all important in a preventive program. Unfortunately, your doctor's definition of false-positive often means that no corrective procedure or operation is required.

Other evidence that self-empowerment in health is growing:

--The nutritional supplement movement. What better example of power in managing your own health is there than the fabulous array of nutritional supplements available?

--Medications moving to over-the-counter status. Gradually, more and more medications are trickling into availability for you to obtain without a doctor's prescription.

--What I call "retail imaging", i.e. screening ultrasound, heart scans, full body scans, etc. that are available in most states without a doctor's order.

--The Internet. The rapidity and depth of information available on the Internet today is mind-boggling. It will fuel the self-empowerment movement by providing sophisticated information to the health care consumer previously available only through your physician.

--High-deductible health insurance plans. If health care consumers will bear more and more of the costs of health care, they will seize greater responsibility for early identification and prevention to minimize long-term costs.

There are more. But the movement is powerful and broad--and unstoppable. Let the establishment with vested interests in preserving the status quo fuss and complain, just like horse and buggy manufacturers did in the early 1900's when the autmobile came along.

Vitamin D deficiency is rampant

12. May 2006 William Davis (0)
Today alone I've seen several people with severe deficiencies of vitamin D.

We're now checking everyone's blood vitamin D level at the start of the program. The measure that most accurately reflects your vitamin D status is 25-OH-vitamin D3. This is very confusing to many physicians, who traditionally have thought of 1,25-di-Hydroxy vitamin D3 as the standard test to measure. What they're failing to recognize is that this second measure is a kidney product, not a reflection of vitamin D status.

Using 25-OH-vitamin D3, several people today alone had levels of <10 ng/ml, clearly in the category of severe deficiency (generally regarded as <20ng/ml).

The majority of people we see in the office are Wisconsin residents. It's no wonder they're deficient. Although it's mid-May, we've seen the sun only a handful of days this year. And most of the days have been too chilly to wear short sleeves and shorts to permit sufficient surface area for UV exposure.

Living in a sunny climate, however, is no guarantee that you have sufficient blood vitamin D levels. Two recent studies have shown that 30-50% of the residents of sunny southern Florida and Hawaii are also deficient. (Why, I'm not sure.)

Although our experience thus far is anecdotal in several hundred people, my impression is that people who have normal blood levels of vitamin D (we regard normal as 45-50 ng/ml) have a far easier time of halting or regressing coronary plaque.

Vitamin D is among the most exciting nutritional tools we've come across in a long time. The conversation is making the media, which impresses me tremendously, given the fact that nobody stands to profit financially to any significant degree through vitamin D supplementation.

For a wonderful collection of discussions on vitamin D, go to Dr. John Cannell's website, www.vitaminDcouncil.com. You'll find a huge quantity of scientific background and conversation on the whole idea. I believe you will be thoroughly impressed with just how powerful the argument in favor of vitamin D has become.

What if wheat products were illegal?

11. May 2006 William Davis (3)
Imagine if anything made of wheat were illegal: bread, bagels, crackers, pasta, pretzels, donuts, Shredded Wheat cereal, Raisin Bran, pastry, cookies, cakes, cupcakes. . . Your grocery store would then be unable to carry any of these products.

How empty would the grocery store shelves be?

There would be very little. The stores would be filled instead with vegetables and fruits, meats, and dairy products. But aisle after aisle would be empty. There'd be no cereal aisle. There'd be no snack chip aisle. The ordinarily overcrowded bread shelves wouldn't be there.

Bakery? Nope, not there either. Pasta and noodles? Empty. How about cakes and pastries? Also gone.

Getting the picture? American groceries are dominated by wheat products. What would happen to your health and the health of your family if wheat were abruptly removed from your choices? Would you be less healthy?

No. In fact, your health would be hugely improved. You'd lose a significant quantity of weight. Extraordinary numbers of people would lose diabetic or pre-diabetic tendencies. Feelings of sluggishness, sleepiness, and moodiness would dissolve. Blood pressure would be reduced. The incidence of cancer, skin disease, and inflammatory diseases would plumet.

From a plaque control perspective, your HDL cholesterol would rise, triglycerides drop. Small LDL would improve dramatically.

The message: Slash wheat products from your diet. Yes, you'll miss the smell and taste of freshly baked bread. But you'll do it for many more healthy years. And you may do it without a 14 inch scar in your chest.

The sobering tale of small LDL

10. May 2006 William Davis (0)
Every day, I learn to respect small LDL more and more.

Small LDL particles, and its evil partner, low HDL, is among the most common reasons why someone fails to fully gain control of coronary plaque and heart disease risk.

Just yesterday, I saw a slender businessman (6 feet 1 inch in height, 186 lb.) whose small pattern persisted despite niacin, fish oil, oat bran, and raw almonds. We generally think of small LDL as an overweight person's pattern, but in some people the genetics are quite powerful and it can be expressed even in slender people.

The solution: More physical activity and exercise; cut back on processed carbohydrates, particularly wheat products like breads, pasta, crackers, breakfast cereals; think about magnesium (see our two recent reports on magnesium on the www.cureality.com membership website, the latest report to be posted this week); be sure sleep is adequate (gauge this by whether you're energetic during the day and don't fall asleep watching TV or movies). Lack of sufficient physical activity in people with sedentary jobs is probably among the most common reason the small LDL pattern persists.

Ignore small LDL and it can be like a hidden cancer in your body, growing and metastasizing (not literally, of course), fueling coronary plaque growth. Be sure your doctor assesses whether you have small LDL if you hope to gain control of your coronary risk.

Burn off the fat

9. May 2006 William Davis (0)

If you've ever wondered just how many calories you're burning with various activities like yard work, driving, climbing stairs, etc. go to this great website that will calculate it for you: http://www.caloriecontrol.org/exercalc.html.

Here are some examples:


Dancing for 30 minutes(fast, e.g., tango): 193 calories
Yoga for 30 minutes: 204 calories
Washing the car for 30 minutes: 173 calories
Vacuuming for 30 minutes: 88 calories

(All are for a 170 lb person.)

As you see, physical activity does not necessarily have to consist of exercise. It doesn't require fancy equipment or expensive outfits. But it does require you to keep moving. Sedentary work is among the most common reasons I see in my patients for failing to control weight and its associated lipoprotein patterns, like low HDL and small LDL.

If your work is sedentary, then a minimum of 60 minutes of physical activity per day is necessary to begin to correct weight-related patterns. If you gauge by calories burned, then a useful goal is 500 calories per day in physical activity--at a minimum.
Indian buffet

Indian buffet

24. February 2011 William Davis (56)
I took my family to a local all-you-can-eat Indian buffet. It was delicious.

I confined my food choices mostly to vegetables and soups. Within about 30 minutes, I started to get that odd buzz in my head that usually signals a high blood sugar.

When I got home, my fingerstick blood glucose: 173 mg/dl. Darn it! Must have been cornstarch or other sugars in the sauces.

I got on my supine stationary bike and pedaled for 40 minutes at a moderate pace while I played Modern Warfare on XBox. (A great way, by the way, to fit in some low- to moderate-intensity exercise while occupying your brain. My wife often has to yell at me to get off, it's so much fun.)

Blood glucose at the conclusion of exercise: 93 mg/dl-- a nice 80 mg/dl drop.

This is a useful strategy to use in a pinch when you've either been inadvertently exposed to more carbohydrate than you can tolerate, or if you'd like to blunt the adverse glucose effects of a bowl of ice cream or other carbohydrate indulgence.

Should we explore the idea of a "morning-after" pill, or actually a "meal-after" pill, a supplement pill or liquid that blunts or eliminates the blood glucose rise after a meal? I've considered such an idea, but have been fearful that people would start to use it habitually. Thoughts?
Tags :

Comments (56) -

  • Flavia

    2/24/2011 4:42:00 PM |

    That's why the European tradition of walking after a meal is best. On weekends I always walk to and from the restaurants I frequent, which results in a 30 minute walk each way (or more).

  • Steve

    2/24/2011 4:54:39 PM |

    If we had a pill for that folks would definitely abuse it.

  • reikime

    2/24/2011 4:59:29 PM |

    If memory serves...doesn't taking a shot of apple cider vinegar after a high carb/sugar meal do just that?

    Diluted with some water, of course, to spare the esophagus.

    Steve, you are so right!  we would be starting rehab services for such a pill!

  • Chuck

    2/24/2011 5:00:48 PM |

    interesting strategy.  bet the fitness purists would have other ideas about your exercise choice.  it got the job done though.

    honestly, i have not been as physically active as i should be and i wonder if that is why my fasting glucose is not low.  it can be over 90 some mornings.  not outrageous but not low for someone habitually eating low carb.

  • Ari

    2/24/2011 5:48:20 PM |

    That post makes me wonder what food choices should be for athletes?  Should they stick to a higher carb diet with the knowledge that they're going to burn it off with a few hours of intense exercise?

    (I'm not an athlete, but I'm curious as to your answer).

  • praguestepchild

    2/24/2011 5:52:20 PM |

    Thank you, Dr Davis, I can now ask my wife to buy an Xbox and a stationary bike for my, ehrm, our, health.

  • semsons.group

    2/24/2011 6:12:38 PM |

    L-carnosine, l-arginine, l-lysine don't have anti-glycation properties?. They might help after lunches.

  • Kent

    2/24/2011 6:13:08 PM |

    I like to have, dare I say Pizza 2-3 times a year. It has been shown to have the biggest spike in my blood sugars, so I time it before a work out.

    I eat my Pizza usually at lunch not dinner, then do something like pushups and running up and down the stairs.

    The first time I tested after pizza, I was shocked. I started the pushups, then the stairs. Within 20 minutes of working those muscles blood sugar dropped more than 80 points.

  • Anonymous

    2/24/2011 6:17:22 PM |

    My name is Maureen and I have been reading your blog since last fall and I have found it very interesting and informative.  I have not fully incorporated paleo diet but understand its merits.  I try to follow the Mediterranean diet with some "cheating" for the past year and a half.

    I have had a weight isssue most of my life with a few times of successful dieting. I am happy to say that I have never regained all the weight  back and then some like you hear most people do. I currently want to lose 15lbs and for me the best way to do that is with structure, ie a specific diet plan that tells you what to eat and how much such as so many carbs, proteins and fats.

    My question to you is if I were to follow this way of eating and I gain the weight  back would it be better than if I were to follow the Mediterranean  diet?

    I would appreciate your feedback.

  • Anonymous

    2/24/2011 6:20:57 PM |

    Is there such a thing as an emergency glucose lowering pill?

  • Berny3

    2/24/2011 6:37:42 PM |

    As background, I'm not diabetic, but I am glucose-impaired, as they say, and follow my blood sugars fairly often.  I don't know why I don't see this more often, but I've found that drinking wine (I drink red) can help keep blood sugars down on a questionable meal.  For instance, if I eat potatoes without wine, my sugars will go high.  If I drink wine with a meal with potatoes, my sugars behave themselves.  If I remember correctly from my reading, apparently alcohol prevents the liver from pushing out sugars into the bloodstream.

  • Chuck

    2/24/2011 6:43:55 PM |

    fyi, this is no magic pill but dietary fat is known to blunt blood glucose spikes.

  • Anonymous

    2/24/2011 7:01:18 PM |

    Such a thing exists. It is called insulin. Just kidding of course. By the way, I used to love Indian food, great way to get a good low-carb meal, but now I worry that most indian places use lots of vegetable oil and I don't need the omega 6.

  • Anonymous

    2/24/2011 7:05:40 PM |

    Berny3, my understanding is that alcohol simply gets in front of carbs, and is digested first.  But eventually your potato will get its turn to raise your sugar levels. So could it be just a matter of timing your glucose measurements to catch that delayed spike?

  • Anonymous

    2/24/2011 7:07:40 PM |

    Anti-glucose pill = Pycnogenol.

    http://findarticles.com/p/articles/mi_pwwi/is_200702/ai_n17168252/

  • Pascal

    2/24/2011 7:18:48 PM |

    You mentioned "a 'morning-after' pill, or actually a 'meal-after' pill, a supplement pill or liquid that blunts or eliminates the blood glucose rise after a meal".

    Doesn't Alpha Lipoic Acid already do just that?

  • John

    2/24/2011 7:58:50 PM |

    There isn't likely to be much (or any) cornstarch in Indian restaurant food. Do you tend to have problems with lentils, chickpeas, and/or dairy?

  • Anonymous

    2/24/2011 8:05:19 PM |

    (Kenneth - I'm not anonymous for the sake of it, but because I can't remember the 500 passwords I need for all these sites)

    There IS a pill for this. Acarbose. It's an alpha glucosidase inhibitor which prevents, or at least slows the hydrolysis of small to mid size sugars into glucose. It would be entirely possible to design even more potent inhibitors or ones that target multiple pathways on the route to carb absorption. However, there is no free ride. That undigested sugar isn't going to go away. It's going to ferment in the gut and cause gas and may act as an osmotic laxative.

    GI complaints are quite common with acarbose, and anyone who is lactose intolerant knows firsthand the downside of carbohydrate malabsoption. Remember that lactose is half glucose. They can gorge themselves on dairy and not get a blood sugar spike, at least from the lactose - if they don't mind spending the rest of the day in the toilet.

  • Anne

    2/24/2011 8:14:31 PM |

    @ Steve "If we had a pill for that folks would definitely abuse it" and @ anonymous "Is there such a thing as an emergency glucose lowering pill?"

    Yes, it's called Repaglinide or Prandin - you take it just before your high carb meal and it makes your pancreas produce a bit more insulin to cover the carbs in that meal and that meal only. It works just for the meal so it's not like other oral hypoglycaemic meds. Not that that is a good thing - it could stress the pancreas and some would say it could lead to beta cell burnout, but if you only took it occasionally when you wanted an Indian buffet ?

  • Eric

    2/24/2011 8:40:28 PM |

    Doesn't cinnamon taken with a meal lessen the spike?

  • Anonymous

    2/24/2011 8:55:33 PM |

    LifeExtension's CinSulin may provide modest lowering of blood glucose:
    http://www.lef.org/magazine/mag2010/ss2010_Protect-Your-Body-from-a-Silent-Killer_01.htm

  • Anya

    2/24/2011 9:17:38 PM |

    40 minutes on a stationary bike ?

    Just place 4 - 5 all out sprints for 10 seconds each, spaced 2 minutes apart.
    Done in less then 10 minutes, same result.

    But this is the caveat, the sprints must be all out/as fast as you possibly can sprint.

    Your muscles are like a giant glucose sink when they are empty.
    The most efficient way to get them to  empty quickly is by explosive complete all body movements.

  • Anonymous

    2/24/2011 9:36:01 PM |

    Kenneth again. The more I think about it, I suspect that none of the pharmacological strategies proposed would do much good in terms of truly offsetting a high-carb lifestyle or heavy binge. I already mentioned the problems inherent to blocking absorption.

    Raising insulin directly or indirectly will drive down the glucose spike, but to what end? For non-diabetics, the glucose bump is temporary and likely doesn't do much direct damage - maybe some extra glycation. The real problem for the purposes of this blog is atherogenic problems - fat storage and triglyceride formation and all of the bad things that happen with lipoproteins as a result. Using insulin will lower the glucose spike by ramming it into those processes faster. Lots of diabetics who have decent control still have awful lipid panels, especially those following the standard diet.

    Maybe supplements which enhance insulin sensitivity might help. Or metformin, which lowers liver production of glucose and helps sensitivity somewhat. But at the end of the day, the only solution is probably not to abuse carbs in the first place and to stay active.

  • Dr. William Davis

    2/24/2011 11:05:41 PM |

    In response to several commenters:

    Apple cider vinegar, cinnamon, acarbose, fats/proteins can indeed blunt postprandial glucose rises, as can a number of other strategies.

    However, I believe that lipoic acid and l-carnosine are better blockers of glycation than of glucose excursions, a bit different.

    Also, I did not mean to suggest that riding a stationary bike while playing Xbox was somehow superior to, say, jogging or dancing. It just happened to be what I felt like doing that day.

  • Anonymous

    2/24/2011 11:06:38 PM |

    Anya is right on the money!

  • Dr. William Davis

    2/24/2011 11:06:44 PM |

    Flavia--

    Excellent point.

    Don't you love when traditional or intuitive practices seem to provide real benefit?

  • Dr. William Davis

    2/24/2011 11:08:12 PM |

    Hi, Ari--

    I am not a believer in "carb loading." I believe that most athletes overdo carbs and pay the health price for it down the road.

    Most people who engage in serious exercise may need to ingest carbs during exercise, particularly during extreme efforts. But I believe the notion of carb loading is overblown, particularly if you are already on a low-carbohydrate restriction.

  • Anonymous

    2/24/2011 11:23:23 PM |

    The closest thing I can think of to a magic pill would be Ortho Glucose from AOR..

    http://www.aorhealth.com/html/products.php?id=204

    and Mito Charger

    http://www.aorhealth.com/html/products.php?id=194

  • Gretchen

    2/25/2011 1:42:55 AM |

    I don't trust any restaurants anymore. A lot of "ethnic" restaurants think Americans want food sweet and salty and amend traditional recipes appropriately.

    I ate in an Indian restaurant that adds potatoes to their raita, which is supposed to be just yogurt and cucumbers and spices.

    So I always ask about ingredients.

    Question: How long would it have taken you to come down from 170 or so *without* the bike? Sometimes a spike from carbs comes down quickly if you don't eat a lot of fat.

  • Scott

    2/25/2011 2:23:43 AM |

    GUAR GUM CAPS BEFORE, pectin would probably work also.  I've taken 6 guar gum caps before and lowered the measured peak glucose after e.g. oatmeal.

  • Anonymous

    2/25/2011 2:24:16 AM |

    Dr Mirkin says that you will improve your athletic performance by eating high carb/high sugar at the beginning or during an intense endurance race....but he adds, not to eat that way when not exercising.

  • revelo

    2/25/2011 3:27:51 AM |

    Here's an compromise between Anya's all out effort sprints and 40 minutes on the stationary bicycle. Try some deep knee bends. Once you get the rhythm down (squat down, rising on your toes and placing your hands behind your heels to stabilize you, then stand up, lowering your heels back to the ground and raising your arms straight out in front of your chest), these comfortable, but very effective at getting your heart rate up and opening the muscles to take up glucose. Also, you can perform deep knee bends anywhere and while wearing any sort of clothing.

    The real problem, I suspect, is not being lean (body fat over 15% for a man). All it takes is being a few pounds overweight and metabolism changes dramatically for the worse.

  • Nancy

    2/25/2011 6:54:07 AM |

    Wow!  After YEARS of studying the effects of carbohydrates on the body in an effort to prevent diabetes, I never knew that simply exercising after a meal would lower your blood sugar.  This is news to me!  I have NEVER heard this, not even from my doctor.  I have heard exercise is good of course, and I have heard that walking can lower your blood sugar overall, but not so directly as you say.  I will definitely not be getting diabetes now.  My mom got it at age 30, but I'm 43 and still have kept blood sugar low.  I guess its now about to get lower.  Thanks.

  • Nancy

    2/25/2011 6:54:54 AM |

    Also, laptop on treadmill is fun too, and has a way of keeping me walking for up to 4 miles.

  • Dr Liz Miller

    2/25/2011 7:20:56 AM |

    The danger is in fructose which is converted directly to fat, because the body has no mechanism with which to use fructose.

    Fructose comes from starch, bread, pasta - anything made from grains and leads to increased fatty acids in the blood.

    A healthy diet means you don't need to worry about eating too much!

  • Anonymous

    2/25/2011 8:37:18 AM |

    I always eat a high carb/sugar meal before I run, and since I've been training for a half marathon, I can use the extra energy from glucose spikes.

  • Anonymous

    2/25/2011 8:42:04 AM |

    My main criticism of this article is: why are you not playing Black Ops!!!!!1

  • RC

    2/25/2011 10:35:40 AM |

    C'mon, Dr. Davis! When was the last time the pharmaceutical industry invented a new drug then chose NOT to sell it? But if they did come up with a pill to reverse the blood sugar spike from eating hi-carb foods, would it be able to reverse glycation, inflammation & all the other damage that sugar does to to our bodies?

    Too many Americans would definitely abuse a pill like that unless it was prohibitively expensive. But the side effects from the pill would prolly be worse than the damage from the sugar.

    My suggestion: Do what the French & the Italians have always done: Have a glass or 2 of wine with your high-carb meals. I've been a low-carber for more than a decade now & it's a lifestyle (not a 'diet') that I swear by. But I have yet to find a medical professional who can explain how the French can eat baguettes & croissants every day, how the Italians can have pasta at practically every meal, yet they remain thin & gorgeous & Syndrome X is practically unknown in those countries.

    Maybe there's some truth to that Blood Type Diet business, but I say it's gotta be the wine. Smile

  • Terry

    2/25/2011 1:00:11 PM |

    If memory serves, there are test strips you can dip in sauces or soups ahead of time to detest the presence of sugars (presumably starches as well?)

  • Larry

    2/25/2011 3:41:16 PM |

    In the January 2011 issue of LEF magazine they address this matter.
    They talk about Glucose...the Silent Killer.
    They also recommend/sell two supplements for this very subject.
    One is for Glucose Absorption Control.
    The other is a Calorie Control Weight Management Formula.

  • Anonymous

    2/25/2011 3:41:24 PM |

    @RC:  Wine won't necessarily correct a starch centered diet in the long-run.  Obesity is not unheard of in Italy -- quite the opposite -- about half the men and over a third of the women. Huge amounts of obesity in Southern Italy and even in places where my father's relatives hail from -- Rome -- kids start out slender but decades of  pasta result in the common pot belly (pregnant looking men) and plump women by middle age and beyond.  Sicily -- another pasta and wine loving country has plenty of obese adults as well as children.  Even if pasta doesn't result in fat -- it does its damage in other ways such as the type 2 diabetes my thin father had. The benefits to the diet there is that pasta is merely a course of many courses and can be skipped.  Also, this is changing now but families used to cook meals at home -- no junk food meals.  Fresh veggies and meats, cheeses, plus of course the pasta and bread etc.  Modern times have made junk/convenience foods invade Italy -- McDonalds, fast-foods, packaged frankenfoods...ugh.

  • Anonymous

    2/25/2011 3:41:39 PM |

    Yes, I wish that there was such a pill. Better yet, I wish that there was a pill that one could take that would provide for world peace and tranquility ...

    It is disappointing to watch this once informative blog descend to its current level of mediocrity.

    Count me as another reader that is finished with this blog.

  • Berny3

    2/25/2011 5:26:35 PM |

    Going back to my item about using red wine at dinner to keep blood sugars down, one of the Anonymous people said that the "alcohol simply gets in front of carbs, and is digested first. But eventually your potato will get its turn to raise your sugar levels."  Well, last night I didn't have potatoes, but I did have quite a bit more carbs than I normally would think wise, and had approximately 2 glasses of wine.  I then took my blood sugars three times at one hour intervals (I had to go to sleep, you see).  The first reading was 97, an hour later it was 92, an hour later it was 90.  I got up out of bed 2 hours later and it was down to 86.  Now, I'm the type where when I eat something that has too many carbs, my sugars go way up in the first 45 minutes to an hour.  By the second hour, the sugars come down into a decent range.  So I'm wondering – does the alcohol really go first, with the carbs waiting in the wings, or does the wine work to slow things down — allowing some carbs to be processed and delaying others?  If I had taken my blood sugar again 2 or 3 hours later, would I see the spike then?

  • Anonymous

    2/25/2011 5:47:25 PM |

    Hey "Anonymous" know exactly how you feel about the blog. Its sad.

  • Dr. William Davis

    2/25/2011 5:57:23 PM |

    Red wine does indeed reduce blood sugar, though the effect I've seen tends to be no more than 5-10 mg/dl.

    I was thinking more along the lines of, say, American ginseng. Several gram doses have the potential to reduce postprandial blood sugar by 20-40 mg/dl. However, I am uncertain of the long-term safety of such a practice due to effects on the pancreas.

  • Might-o'chondri-AL

    2/25/2011 7:39:59 PM |

    A mediocre thought to keep this
    on life support without the irreplaceable infusion from the blogosphere tribe of Annonymous. If they'd gone back just one entry of Doc's they'd have been able to read 2 comments of mine related to some of the science behind Doc's obsession with blood sugar.

    As a disclaimer, I personally don't just say no to carbs - even though my old knees won't cooperate on wind sprints or deep bends to bail me out.

    Circadian rhythm is widely known, and erroneously construed merely relate to wakefulness. There are also distinct circadian cycles involved in the liver, heart and lungs.

    Not having the time now to detail the relevant liver circadian dynamic I'll just highlight some. In short,
    blood glucose and insulin, et. al. is not always a linear reaction; a spike is not always just another bad spike for everyone everytime of day.

    O.K., for you researchers, in circadian involvement of liver up/down regulation phases
    here are some leads(in no particular order): impact on glucose and lipid balance; transcription of insulin metabolism phases; mitochondrial fat burning; gluconeogenesis; gluco-corticoid receptors; triglycerides; glucose phosphate isomerase and 6-phosphofructokinase-2; HmGCoA lysase and reductase; S-transferase theta-2 and more.

  • fatfree

    2/25/2011 7:40:05 PM |

    Sounds like chronic cardio to me.

  • Anonymous

    2/25/2011 7:49:21 PM |

    I take 500 mg metfomin each night
    I am not diabetic
    It's my "glucose lower pill"

  • support@sunstatevitamins.com

    2/25/2011 10:47:45 PM |

    I think that cinnamon capsules, GTF chormium or CLA / omega-3's would do the same thing.  It all depends on if these nutrients would cause a hypoglycemic response in some people.

  • Sarah

    2/26/2011 12:09:52 AM |

    Serious question: what would a shot of vodka do in a scenario like this? (i.e., after carbs have been accidentally consumed, and after blood sugar has consequently risen).

  • Sarah

    2/26/2011 12:11:30 AM |

    Oops I see the same question about alcohol was already raised vis a vis red wine. Though I'm still not 100% clear on the answer!

  • Davide

    2/26/2011 2:02:43 AM |

    Supposedly, pine bark extract taken with a meal supposedly keeps blood sugar from spiking. Then again, the conclusive evidence was only found in animal studies:

    http://www.ncbi.nlm.nih.gov/pubmed/15925302

  • Anonymous

    2/26/2011 5:08:38 PM |

    As a glucose intolerant, I have tried all kinds of things to keep my blood sugar under control. My biggest disappointment was vinegar before meal. It did nothing for me. I am of Indian origin and used to be a vegetarian. Tried Basmati rice which some claim has a more favorable glucose response. Again no effect on me. Tried fermented Indian dishes (dosa and idly) which also didn't help. I have now given up eating rice/wheat entirely and eat a lot of eggs and fish. It may just be that I am not meant to consume carbs.

    BTW, potato in Raita is quite common in India. To me, Indian cooking in the US is characterized by a very limited set of dishes with blunted flavors. But, I do wonder what was in Dr Davis' soups and vegetables. Some Indian dishes use sugar or jaggery (cane juice boiled into unrefined sugar) but the dish would be detectably sweet. Another possibility is indiscrimate use of tomato sauce or ketchup added as shortcut to flavor sauces which of course contains HFCS!

  • Daniel

    2/27/2011 3:36:27 PM |

    Playing Modern Warfare while pedaling away on the bike?  Your stock just went way up in my book good sir.

  • Contemplationist

    3/2/2011 8:18:37 PM |

    You people are right about the vegetable oil. Its really deplorable - our ancestors in India all used Ghee (clarified butter) heavily. Then the cholestrol propaganda from the West started a few decades ago and now everyone cooks with one or other vegetable oil.
    Original Indian dishes made with ghee are much more delicious, especially non-vegetarian ones.

  • Anonymous

    4/27/2011 7:56:46 PM |

    -Fructose comes from starch, bread, pasta - anything made from grains and leads to increased fatty acids in the blood.-

    I pity those who are in care of this ignorant british MD. Starch breaks down to a glucose in the body - never a fructose. Also fructose increases liver fat more than fatty acids in the blood.

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