What's that in your mouth?

7. January 2010 William Davis (17)



Fat = triglycerides

In other words, eat fat, whether it's saturated, hydrogenated, polyunsaturated, or monounsaturated, and blood levels of triglycerides will go up over the next 6 hours. This remains true if there are carbohydrates in the meal, or if there are NO carbohydrates in the meal. It also remains true if you chronically consume fats.

While fats are the primary determinant of postprandial (after-eating) triglycerides, carbohydrates are the primary determinant of fasting triglycerides.

So, if your triglycerides are high on a fasting cholesterol (lipid) panel, it's most likely because you overconsume carbohydrates.


Thanks to cartoonist Eli Stein, who has generously allowed me to reprint his artwork on these pages. Mr. Stein has published his work in dozens of magazines and newspapers, including the Wall Street Journal, Barron's, and Good Housekeeping. More of his work can be found at Eli Stein Cartoons.

De Novo Lipo-what?

5. January 2010 William Davis (16)
Humans have limited capacity to store carbohydrates. Beyond the glucose and glycogen in our blood and tissues, we have relatively little carbohydrate to draw from in time of energy need. That's why long-distance runners and triathletes have to carry sugar sources to keep blood sugar from plummeting.

Fat, of course, is different. We have virtually unlimited capacity to store energy as fat.

Because we have limited carbohydrate storage capacity, what can the body do with the excessive quantities of carbohydrates that Americans ingest? What becomes of a bagel for breakfast, wheat crackers for snacks, a whole wheat sandwich for lunch, pretzels, and whole wheat pasta that many people eat every day, not to mention the chips, soft drinks, and juices?

Excess carbohydrates are diverted to an interesting metabolic pathway called de novo lipogenesis (DNL). This refers to the liver's ability to make triglycerides from excessive carbohydrates in the diet. Triglycerides are packaged for release into the blood as VLDL. VLDL, in turn, interacts with other lipoproteins, creating small LDL particles, reduced HDL and smaller, less protective HDL. High VLDL will be measured on a standard cholesterol panel as higher triglycerides.

A University of California (Berkeley, San Francisco) group has done much of the work describing DNL.

A diet weighed towards carbohydrates, especially if 50% or greater calories are carbohydrate, is sufficient to provoke plenty of DNL, even in slender people. DNL is a big part of the reason why low-fat (and, thereby, high-carbohydrate) diets result in higher triglycerides. DNL really gets turned on many-fold if the carbohydrates are "simple," rather than "complex."

Overweight people, however, can demonstrate five-fold greater DNL even with lesser quantities of carbohydrate intake (e.g., 40% fat, 46% carbohydrate, 14% protein):





From Schwarz et al 2003. Mean (± SEM) fractional de novo lipogenesis in lean normoinsulinemic (NI), obese NI, and obese hyperinsulinemic (HI) subjects after 5 d of consuming a high-fat, low-carbohydrate diet and in different lean NI and obese HI subjects after 5 d of consuming a low-fat, high-carbohydrate diet. Values with different superscript letters are significantly different.


Excessive carbohydrates, a la standard low-fat diets, are good for nobody. The concept of de novo lipogenesis fills in a theoretical hole that now explains why people who eat carbohydrates have higher triglycerides, VLDL, and, eventually, insulin resistance and diabetes.

Gretchen's postprandial diet experiment II

3. January 2010 William Davis (37)
I previously posted Gretchen's postprandial diet experiment, in which she consumed a low-fat diet for a day, followed by a low-carbohydrate diet for a day. Grethen monitored blood glucose and triglycerides with fingerstick checks. (Blood glucose can be checked on any widely available glucose monitor; triglycerides can be monitored with the Cardiochek device.)

Let's now discuss what happened.

On the low-carb, high-fat day, there was an initial surge in triglycerides to 250 mg/dl late morning, followed by a secondary peak several hours following dinner. Because fat is mostly triglycerides, Gretchen's high-fat (sausage, bacon, butter, whole-fat yogurt) breakfast provided a large quantity of triglycerides that needed to be absorbed. This generally occurs over approximately 6 hours, varying depending on body weight, how accustomed you are to fat, activity level during the day, the kind of fat in the meal. The high content of saturated fat in Gretchen's high-fat breakfast likely caused the somewhat slower drop in triglycerides over approximately 7 1/2 hours.

As Gretchen herself had noted, triglycerides the following day were lower, a typical low-carb response. Blood sugar throughout showed only minor variation, with only small postprandial increases.

Thus, Gretchen experienced what we'd expect with a low-carb, high-fat diet: an initial high surge in triglycerides, followed by a decline in fasting levels, while blood sugar shows a normal contour.







Now, the more confusing low-fat experience:



Blood glucose makes a striking peak at 200 mg/dl after the low-fat breakfast of pasta and rice, in contrast to the low-carb breakfast. Triglycerides behaved very differently from the low-carb experiment: While there was no initial postprandial surge, there was a late surge developing 6-24 hours later. The late surge continued into the next day, with fasting levels the following morning (210 mg/dl) exceeding the starting triglyceride level (60 mg/dl).

The one potentially confusing aspect of all this is Gretchen's late rise in triglycerides on the low-fat diet. This phenomenon is due to something called de novo lipogenesis, or the liver's conversion of carbohydrates to triglycerides that occurs when an excessive carbohydrate load comes through diet. Because the human body cannot store anything beyond a minor quantity of carbohydrates (as glucose and glycogen), carbohydrates are converted to fats.

Another factor causing the late triglyceride increase is insulin resistance, given the high blood sugar response. When insulin resistance is present, the activity of the enzyme, lipoprotein lipase, is reduced. Less lipoprotein lipase activity allows slower VLDL degradation, allowing VLDL (and thereby triglycerides contained in VLDL) to "stack up" in the blood. Thus, the higher triglycerides late after eating and into the next morning.

One issue to be aware of: Acute responses can differ from chronic responses. In other words, had Gretchen had the luxury (and time and money) to conduct the experiment over, say, 4 weeks, rather than a single day, there would be somewhat different responses. The best data on this come from Dr. Jeff Volek of the University of Connecticut, in which 4 weeks of low-carbohydrate eating modify fasting and postprandial responses over time.

Several conclusions can be made from Gretchen's experience:

1) Low-carb, high-fat acutely generates extravagant postprandial triglyceride responses.
2) Low-fat causes a late triglyceride surge and higher fasting triglycerides.
3) Low-fat leads to high blood sugars and, by implication, diabetes.


Both the low-carb and the low-fat responses are undesirable, both leading to increased risk for heart disease. Which is worse? I believe that low-fat is more destructive, since it leads over time to both high triglycerides and diabetes, while low-carb/high-fat only leads to postprandial triglyceride surges, at least acutely.

How to best balance the responses to reduce risk for heart disease? That's a discussion for future.


Again, my thanks to Gretchen and the substantial amount of effort that went into generating these numbers. More of Gretchens' own writing can be found on her blogs:
http://wildlyfluctuating.blogspot.com
http://www.healthcentral.com/diabetes/c/5068

A wheat-free 2010

2. January 2010 William Davis (22)
A Heart Scan Blog reader sent this fascinating description of his wheat-free adventure.

Whenever I discuss this notion of going wheat-free and the incredible health effects that develop, I invariably receive comments or emails saying something like "I eat wheat and feel fine. That can't be true." The problem is that not everybody needs to go wheat-free. 20-30% of people can include wheat in their diet and suffer little more than weight gain, some not at all.

But stories like Michael's (below) are commonplace in my experience. I've had many patients who, at first, refused to believe that wheat exposure might be the underlying cause for health struggles. But they finally give it a try and find that rashes, arthritis, acid reflux, irritable bowel symptoms, mood swings, anger, etc. are miraculously improved or gone.

Anyway, hear what Michael has to tell us:


Dr. Davis,

I want to thank you. I was browsing the web a while back and happened to stumble upon your blog post about wheat belly. The first thing that caught my attention was that I thought you had somehow gotten a photograph of me. The young man you posted an image of looked exactly like me. So I read what you had to say. After reading, I thought "Four weeks isn’t so bad. I think I can handle this."

It has now been nine weeks and all I can say is that I am completely amazed. Let me say first that twice in the past twenty years I have been tested for allergies. The first time I was tested I showed a slight reaction to Timothy Grass, but not enough to cause me any problems. The second testing I did not show a reaction to anything. So, I have always assumed that my chronic sinus problem were due to sensitivities to environmental pollutions. Now I am not so sure. I would like to list for you everything that has happened to me since I eliminated wheat from my diet.

1. I have lost a total of 12 pounds in the last 9 weeks.
2. I have lost 1 ¼ inches of belly fat
3. I have lost a tremendous amount of fat from my neck.
4. My entire life I have had problems with oily hair. I could wash my hair and three hours later I looked as if I hadn’t washed in a week. Now my hair stays clean and soft for two to three days without shampoo.
5. My hair was always flat and stringy. Now it has lots of body.
6. I used to have thick layers of dry skin on my scalp. It would come loose in chunks as large as a fingernail. That dry scalp is gone.
7. I used to have dry flaky skin that seemed to secrete oil. That no longer happens. My skin is now soft and smooth.
8. I have lived with bad acne for at least 35 years. Now it is hard to find a pimple on my body.
9. I have always had to fight dehydration. That is no longer a problem.
10. I used to drink two large cups of coffee every morning just to be able to function. I now have enough energy that I have eliminated caffeine from my diet.
11. I sleep more soundly than ever before and my dreams are clear and vivid.
12. My thought processes are more active and clear than they have ever been.
13. My chronic sinus issue is now a thing of the past.
14. I used to have problems with getting the “shakes” if I had gone more than a couple of hours without eating. It was as if I was suffering from low blood sugar. I would even be afraid that I would pass out. Now all I feel is hunger. I can go all day without eating and never feel in danger of losing consciousness.


Today is Thursday. This past Monday my wife and I were eating out and I ordered a burger without a bun. What I didn’t realize was that the burger would arrive covered in onion rings. I knocked the mountain of onion rings onto the plate but there were still a couple that were embedded in the cheese. I decided, what the hell, a couple of onion rings shouldn’t make that much of a difference. I will not make that mistake again anytime soon. Within 30 minutes I felt like there was a steel spike going through my left eye socket. I don’t remember ever being in that much pain. My sinuses were exploding. This morning, as I write this, I still feel the vestiges of that pain. Just enough that I know it is there. But after two and a half days, I am at least able to function again.

I owe you a debt of gratitude. You may have just saved my life. In the very least you have given me the means to improve my life in ways that I never thought possible.

Thank you so much,
Michael B.


Now, if wheat exposure can do that in Michael, what damage can it do in other people?

Personally, I previously experienced many of the same symptoms that Michael suffered, all gone with wheat elimination.

My advice: If you have any inkling that you might have a wheat sensitivity, make a New Year's resolution to stay wheat-free for 4 weeks and see whether you can feel any difference. Not everybody will, but many will be telling us about the dramatic health turnarounds they experienced.

Lipoprotein lipase and you

30. December 2009 William Davis (0)
Lipoprotein lipase can make the difference between having heart disease and not having it. Having sky-high triglycerides or normal triglycerides. It can mean dinner hanging around for over 12 hours in the bloodstream, rather than the usual 4-6 hours.

If you take niacin, you must exercise

30. December 2009 William Davis (23)
We use a lot of niacin in the Track Your Plaque program.

Niacin:

--Increases HDL and shifts HDL towards the large, protective fraction

--Reduces small LDL--In fact, niacin is the best treatment we have to reduce small LDL after wheat elimination and carbohydrate reduction.

--Reduces fasting and postprandial (after-eating) triglycerides

--Reduces heart attack risk by 20-28%--even as a sole agent.


But . . . niacin also triggers higher blood sugar because it partially blocks the effects of insulin (insulin "resistance").

While the net effect of niacin remains positive, the provocation of insulin resistance is not such a good thing. Can it be minimized or eliminated?

Yes, through exercise. Here's one interesting observation in obese (BMI 34.0), sedentary men given placebo, exercise, niacin (1500 mg Niaspan, once per day), or niacin + exercise:





From Plaisance et al 2008.

Blood was drawn following a high-fat meal challenge. (Yes, a high-fat challenge, not a carbohydrate challenge. In this study, there were only 17 grams carbohydrates in the test meal, but 100 grams fat. More on this in future.) Exercise consisted of walking for 50 minutes at a moderate pace one hour prior to the meal challenge.

You can see from the graph that exercise partially corrected the increased insulin level provoked by niacin.

Judging from this and other studies, exercise can help minimize the insulin-blocking effects of niacin. It doesn't take much, just moderate exercise for at least 30 minutes.

Adequate sleep can also help, since sleep deprivation is a potent trigger for insulin resistance, only worsened in the presence of niacin. Vitamin D supplementation to achieve desirable blood levels (which I define as 60-70 ng/ml) is also an effective means to minimize this effect.

To track small LDL, track blood sugar

24. December 2009 William Davis (28)
Here's a trick I learned after years of fussing over people's small LDL.

To gain better control over small LDL, follow blood sugars (blood glucose).

When you think about it, all the foods that trigger increases in blood sugar also trigger small LDL. Carbohydrates, in general, are the most potent triggers of small LDL. The most offensive among the carbohydrates: foods made with wheat. After wheat, there's foods made with cornstarch, sucrose (table sugar), and the broad categories of "other" carbohydrates, such as oats, barley, quinoa, sorghum, bulghur, etc.

Assessing small LDL requires a full lipoprotein assessment in which small LDL particles are measured (NMR, VAP, GGE). Not the easiest thing to do in the comfort of your kitchen.

However, you can easily and now cheaply check your blood sugar. Because blood sugar parallels small LDL, checking blood sugar can provide insight into how you respond to various foods and know whether glucose/small LDL have been triggered.

Here's how I suggest patients to do it:

1) Purchase an inexpensive blood glucose monitor at a discounter like Walmart or Walgreen's. You can buy them now for about $10. They're even sometimes free with promotional offers. You will also need to purchase lancets and test strips.

2) With a meal in question, check a blood sugar just prior to the meal, then again 60 minutes after finishing the meal. Say, for example, your pre-meal blood sugar is 102 mg/dl. You eat your meal, check it 60 minutes after finishing. Ideally, the postprandial (after-meal) blood sugar is no more than 102 mg/dl, i.e., no higher than pre-meal.

Perhaps you're skeptical that oatmeal in skim milk with walnuts and raisins will do any damage. So you perform this routine with your breakfast. Blood sugar beforehand: 100 mg/dl. Blood sugar 1 hour post: 163 mg/dl--Uh oh, not good for you. And small LDL will be triggered.

This approach is not perfect. It will not, for example, identify "stealth" triggers of blood sugar and small LDL like pasta, for the same reasons that pasta has a misleadingly low glycemic index: sugars are released slowly and not fully evident with the one-hour blood sugar.

Nonetheless, for most foods and meals, tracking your one-hour postprandial blood sugar can provide important insight into your individual susceptibility to sugar and small LDL-triggering effects.

C-reactive protein: Fiction from the drug industry?

21. December 2009 William Davis (0)
C-reactive protein (CRP) is the liver product of inflammatory responses anywhere in the body. If there's an inflamed left knee, CRP will be increased. If viral bronchitis is making you cough, then CRP will be increased.

The argument put forward by the drug industry is that, because CRP indicates underlying inflammation, very low-grade levels that can be measured in the absence of overt inflammation like the sore knee or bronchitis is associated with increased risk for cardiovascular events. There are now many studies that conclusively demonstrate that, the higher the CRP, the greater the cardiovascular risk.

Naturally, any marker of risk is followed by the inevitable study: Do statin drugs reduce the excess cardiovascular risk of excessive CRP?

And, yes, indeed they do. My statin-crazed colleagues rave about the so-called "pleiotropic," or non-lipid, effects of statins. CRP reduction and the reduction of risk associated with CRP result with statin treatment.

But is life really statin vs. placebo, as most statin trials are constructed? Are there strategies that can outdo statins like Crestor for reduction of CRP?

Watch your fish oil labels

17. December 2009 William Davis (36)
A quick quiz:

How much omega-3 fatty acids, EPA + DHA, are in each capsule of fish oil with the composition shown on the label below:





If you said 1340 mg (894 mg + 446 mg), sorry, but you're wrong. There are 670 mg EPA + DHA per capsule.

Did you notice that the composition, or "Supplement Facts," lists the contents of two capsules? Rather than the usual one capsule contents, this product label lists two capsules.

I don't know why some manufacturers or distributors do this. However, I have seen many people tripped up by this kind of labeling, taking half the omega-3 fatty acids they thought they were taking. This can be important when you are trying to obtain a specific dose of EPA + DHA to reduce triglycerides, reduce Lp(a), control abnormal heart rhythms, reduce bipolar mood swings, or other important effects.

I liken this to pulling up to a gas station where the sign says gasoline for $1.25. Wow! Can't beat that! You then find out that it's really $1.25 for a half-gallon, or $2.50 a gallon.

In truth, the labeling is accurate; it's just very easy to not notice the two capsule composition.

Why do I need a prescription for Olava?

16. December 2009 William Davis (0)
Imagine this:





What is OLAVA?

Olava is prescription olive oil. It is the purest, highest concentration of olive oil available.




Why Do I Need a Prescription for OLAVA?

Studies show that olive oil contains essential fatty acids, "good" fats that:



--Contain natural compounds your body needs for good health but can't produce on its own.

--Has antioxidants that may provide protection from heart disease.



So, it is common for people to ask why they need a prescription for OLAVA if it is made from a natural ingredient--olive oil. It's time to get the facts about OLAVA. Learn why OLAVA is different from olive oil you can buy at a store.



OLAVA Is an FDA-Approved Medication

OLAVA is the only FDA-approved medicine made from olive oil that's proven, along with diet, to reduce risk for heart disease


The FDA enforces standards to make sure that prescription medications like OLAVA are safe, effective, and quality controlled.


The way OLAVA is manufactured is reviewed and approved by the FDA.


OLAVA uses a 10-step purification process that helps remove lead and other environmental toxins that can be present in olive oil.


Each 1-gram capsule of OLAVA contains 1000 mg of pure olive oil.


The FDA-approved dose of OLAVA is 4 capsules per day. It could take up to 2 tablespoons per day of regular olive oil to provide the same amount of active ingredients proven to lower heart disease risk.




What Else You Should Know About Olive Oil

Regular olive oil has not been approved by the FDA to treat any specific disease like heart disease.



Olive oil doesn't have specific dosing information; it has a food label.



Olive oil does not go through an FDA-approved manufacturing process.





Talk to Your Doctor About OLAVA

If you have very heart disease, you may need a prescription medicine, along with diet, to treat your condition. Talk to your doctor about OLAVA. Print a trial offer to use on your first prescription of OLAVA.

Insulin secretagogue

Insulin secretagogue

14. March 2011 William Davis (34)
Dairy products have the peculiar property of triggering pancreatic release of insulin. The research group at Lund University in Sweden have contributed the most to documenting this phenomenon:




Mean (±SEM) incremental changes (?) in serum insulin in response to equal amounts of carbohydrate from a white-wheat-bread reference meal (x) and test meals of whey (?), milk (?), cheese (?), cod (?), gluten-low (?), and gluten-high (?) meals. From Nilsson 2004.

Note that it is the area under the curve (AUC), not the peak value, that assumes greatest importance.

Dairy products, especially milk, whey, and yogurt, are insulin secretagogues: they stimulate pancreatic release of insulin. The effect is likely due to amino acids and/or polypeptides in dairy products. (The effect is less prominent with cheese. Also see this study.)

By conventional wisdom, this may be a good thing, since the excess insulin will blunt the glucose rise after consumption. However, in my book, this is not such a good thing, since most of us have tired, beaten, overworked pancreatic beta cells from our decades of carbohydrate overconsumption. I fear that the effect of dairy products just take us a bit closer to beta cell failure: diabetes.

Good news: The effect is least with cheese.
Tags :

Comments (34) -

  • praguestepchild

    3/14/2011 8:49:45 AM |

    Dr Davis, interesting study. But both links go to the same study, Nilsson 2004, shouldn't the second link go to second study?

  • Dr. William Davis

    3/14/2011 12:00:13 PM |

    Hi, Prague-

    Absolutely right. Thanks for catching that.

    Actually, both observations were best made in the same study. While the effect of milk on insulin secretion is firm, the question of cheese has not been as well explored. There's also the possibility that, because cheese is like wine in that there are thousands of variations (organism chosen for fermentation, fat content, etc.), there might even be variation from cheese to cheese.

  • Stephen

    3/14/2011 12:31:43 PM |

    I would assume that heavy cream devoid of proteins and carbohydrates would result in less area under the curve?  Are there any studies of this?

  • Brent

    3/14/2011 2:21:34 PM |

    How can you have a test meal of cod which contains the same carbohydrate count as a reference bread meal when cod has no carbohydrates?

  • praguestepchild

    3/14/2011 5:32:53 PM |

    But I'm not sure why they used reconstituted milk. Why not normal (3.5%) milk, or perhaps normal and skim? They do say, "Interestingly, there is epidemiologic evidence suggesting that overweight subjects with a high intake of milk and dairy products are at a lower risk of developing diseases related to the insulin resistance syndrome" Perhaps because the SFA content?

    I know that a tall glass of milk can surprisingly jack up blood sugar, and they say that "The insulin response to milk products does not relate solely on the lactose component." Interesting. Still, much better a glass of milk than a glass of apple juice.

  • Dr. William Davis

    3/14/2011 10:19:50 PM |

    Hi, Stephen--

    Yes, crucial distinction. To my knowledge, that has not been done, though I would fully expect that there is no effect.

    Hi, Brent--

    The cod must have been breaded. The cod they used was purchased in a grocery store.

  • Cheryl

    3/14/2011 11:04:02 PM |

    What about the recent information on trans-palmetic (spc) acid formation being BENEFICIAL to diabetes? More so, forms from raw, full fat dairy?

  • Might-o'chondri-AL

    3/15/2011 12:00:55 AM |

    It would be interesting to see how different sources of milk influence insulin secretion. Aside from the distinct breeds of cattle many pastoralists use goat & sheep; plowmen milk  buffalo and some artic milking of reindeer (it takes 2 people, one to hold the horns).

    My dairy consumption is in the form of Kefir "Quark". This is cultured milk that is then drained of it's whey. In the Mediterranean & Mid-east regions they use yogurt "quark"; but named differently by each culture in their own vernacular. In India it would be "curd", and usually from water buffalo milk.

    "Quark" is a fermentation process byproduct and the minerals in milk are lost (soluble) in the whey. In other words, there is minimal calcium in "quark".(A few Posts back readers may recall Doc restricting calcium for reducing aortic calcification. Elsewhere, some men may recall having seen prostate studies suggesting excess calcium is not ideal.)

  • Anonymous

    3/15/2011 12:50:16 AM |

    What about full-fat kefir? I no longer consume grains and eat raw cranberries as my small daily portion of fruit. But I will not give up my kefir even if it takes 10 years off my life! So be it.

  • Ken

    3/15/2011 1:27:36 AM |

    Heck, no more yoghurt.I'll have to grind flaxseeds or eat eggs for breakfast.

  • Donna

    3/15/2011 1:53:58 AM |

    What about heavy whipping cream?  It has low carbohydrate content and high fat.  Did the study differentiate between the different fat contents of milk/cream?

  • Paul

    3/15/2011 7:39:40 AM |

    Don't forget "Butter and Insulin".

    It was one of Dr. Davis' more controversial blog posts, especially among us butter lovers...

    I'm also not quite so eager to throw out my whey protein and BCAA supplements either. Not when they provide the most bio-available protein that has long been proven to be beneficial for human muscle synthesis.  Why eliminate a dietary source that can help tip the balance toward a favorable muscle to fat composition ratio?... that in turn actually improves fat metabolism and insulin sensitivity?

  • Might-o'chondri-AL

    3/15/2011 8:55:39 AM |

    Study used 28 gr. spray dried whey (among other items) that was reconstituted in 550 gr. water. It showed that whey had fastest uptake of insulin-otrophic (secretagogue) amino acids (namely leucine, valine, isoleucine, lysine and theonine).

    Compared over 1.5 hours to same gr. weight of white bread (studies reference food) whey's insulin reaction was 90% greater. It's blood glucose however rose notably less than the reference food's blood sugar did.

    I'd like to understand better the way insulin "spikes" have beneficial functions in non-diabetics. It seems to me that there may be times of day (circadian) when elevated insulin serves a signalling purpose; late night in front of the TV seems unlikely. Anybody?

  • What will there be left to eat

    3/15/2011 11:09:38 AM |

    Pretty damn depressing. Is it safe to breathe still? Can someone explain what the observed danger of eating Whey Protein actually is. This seems to be quite speculative.

  • Terry

    3/15/2011 4:10:25 PM |

    Someone please correct me if I am mistaken - but I think that what this boils down to is the amount of lactose in a particular dairy product and would that not explain the difference between, for example, the effects of milk v.s cheese?

  • Might-o'chondri-AL

    3/15/2011 7:02:59 PM |

    Hi Terry,
    Cheese doesn't have the whey any more; it gets drained off. The whey proteins are the insulin spiker (Doc's post is on how insulin reacts). Milk's lactose (milk sugar) apparently has more to do with the way blood glucose (sugar)reacts to milk, irregardless of the milk still containing it's whey.

  • Karn

    3/16/2011 1:14:36 AM |

    Did anyone actually read the study.  The cod was not breaded, they added lactose to each product to bring the carb count up to 25g, including the cod.

    Also, yogurt is not mentioned at all in this study, so not sure why you are lumping it in here.

  • Anonymous

    3/16/2011 7:04:00 AM |

    It would be difficult to design a diet using the II of these two papers, because their insulin index (II) is based on equal carb portions. Some foods do not have much carbs, so they add carb (lactose) to them.  A better table for a variety of foods is given in this  paper * where II is calculated based on equal calorie portions, so we know the weight of each portion (from Table 2).  In this paper the values for GI (glucose index) and II are (from Table 4)

    Food
    Weight gr
    GI
    II
    White bread
    Yogurt
    Cheese
    Eggs
    Beef
    94
    241
    59
    159
    158
    100
    62
    55
    42
    21
    100
    115
    45
    31
    51

    (how do you paste atable here???)

    Some of the GI of the protein-rich foods is due to  glucagon  which raises blood sugar levels by gluconeogenesis.  The GI and II of cheese, eggs and beef are not much different,  but for yogurt II is almost double of its GI.

    * An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods
    http://www.ajcn.org/content/66/5/1264.full.pdf+html

  • Elliot

    3/17/2011 12:18:16 PM |

    Don't forget they are testing isolated products for blood sugar impact. The impact will be blunted if combined with something that has that effect. Like adding eggs to a whey protein shake.

  • Terry

    3/17/2011 3:54:43 PM |

    So the whey protein isolate (100%) protein that I add to my morning smoothie is causing an insulin spike?

    My greek yogurt as well? (high protein, low carb)

    I always understood that milk was high carb and would cause a spike, but these others are bewildering.

  • Mike

    3/17/2011 6:26:49 PM |

    Bodybuilders favor whey protein for its insulin spiking properties. Their idea that the insuin drives creatine and amino acids to muscle tissue Ne c'est pas?

    Could they be engaging in diabetogenic behavior?

    These insulin-boosting properties of some foods (especially dairy, and yes, fish) appear to have been well known for awhile:

    http://www.mendosa.com/insulin_index.htm

    The site lined below suggests eating carbs in the morning before and immediately after working out, to help achieve the holy grail of nearly all who work out -- that is, lose fat, build muscle. Can't vouch for the validity of this, but here it is:

    http://shadowfit.com/articles/index.php/archives/794

    So, the fundamental question remains. Is it the spike or the area under the curve that is the worst? Kind of like radiation, now back in the news because of Fukishima

    Mike

  • Might-o'chondri-AL

    3/17/2011 7:17:20 PM |

    Hi Terry,
    Greek yogurt is reduced whey (they drain some off); that's how they make it thicker.
    Yogurt's carb level is less than milk because the fermentation bacteria mainly fed on the milk sugar(lactose).

  • Anonymous

    3/17/2011 8:14:36 PM |

    Bodybuilders favor whey protein for its insulin spiking properties. Their idea that the insuin drives creatine and amino acids to muscle tissue Ne c'est pas?

    Could they be engaging in diabetogenic behavior?

    These insulin-boosting properties of some foods (especially dairy, and yes, fish) appear to have been well known for awhile:

    http://www.mendosa.com/insulin_index.htm

    The site lined below suggests eating carbs in the morning before and immediately after working out, to help achieve the holy grail of nearly all who work out -- that is, lose fat, build muscle. Can't vouch for the validity of this, but here it is:

    http://shadowfit.com/articles/index.php/archives/794

    So, the fundamental question remains. Is it the spike or the area under the curve that is the worst? Kind of like radiation, now back in the news because of Fukishima.

    Mike

  • Jason R.

    3/17/2011 8:36:03 PM |

    Right thats dairy of the list now. Not much left to eat!

  • What will there be left to eat said...

    3/17/2011 9:12:10 PM |

    @Jason R. lol too right... there will be an epidemic of malnourished dead people with perfect arteries !

    Just don't understand (other than water and air) what's ok to eat...

  • Terry

    3/18/2011 12:59:07 PM |

    It appears we can safely conclude that just eating (anything!) will spike your insulin!

  • Terry

    3/18/2011 1:04:11 PM |

    I am not sure what's left that hasn't been found to be problematic to health in some way Smile

    It all makes for good news stories though!

  • Anonymous

    3/18/2011 8:33:00 PM |

    praguestepchild gives us the money quote which I shamelessly repeat here:

    "Interestingly, there is epidemiologic evidence suggesting that overweight subjects with a high intake of milk and dairy products are at a lower risk of developing diseases related to the insulin resistance syndrome"

    We are left to conclude that with dairy you look bad on paper but turn out to look pretty darn good in real life.  Especially considering that overweight would be associated with higher risk of insulin resistance syndrome indicating, potentially, that dairy actually has a powerful protective effect.

    So Terry, Jason cheer up! Smile

  • Anonymous

    3/18/2011 9:52:34 PM |

    It would be difficult to design a diet using the insulin index (II) given in these two papers, because their  II values are based on equal carb portions. Some foods do not have much carbs, so the studies of both papers add carb (lactose) to them and that creates unrealistic foods (but proves their point).   A better table for a variety of foods is given in the paper * below where II is calculated based on equal calorie portions, so we know the weight of each portion (see Table 2). See Table 4  for the values for GI (glucose index) and II.

    I think, some of the high GI of the protein-rich foods is not due to their high carb content, but their release of glucagon,  which raises blood sugar levels by gluconeogenesis.  The GI and II of cheese, eggs and beef are not much different, but for yogurt, II is almost double of its GI.

    * An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods
    Susanne HA Holt, Janette C Brand Miller, and Peter Petocz
    http://www.ajcn.org/content/66/5/1264.full.pdf+html

  • Might-o'chondri-AL

    3/19/2011 7:15:38 PM |

    Is it not possible whey's sustained insulin response indicates it is part of a feed back loop? For active people (ex: body builders, herdsmen) the dynamic is more valuable than for the sedentary; modern sedentary lifestyle & insulin spike are a different dynamic.  

    Many crucial cells must get their glucose diffused to the extra-cellular spaces; blood doesn't get to touch every cell.
    Insulin "spike" and steady reign may be evolutionary to give crucial cells chance to sip some glucose. The spike is a signal
    there's plenty for every cell; it prevents first come first served cells from going into overdrive and pulling in all the blood glucose.

  • Anonymous

    3/20/2011 5:38:44 PM |

    "By conventional wisdom, this may be a good thing, but not in my book."

    Well dear doctor we are all entitled to opinions, but in this particular case your book needs revision:

    A population-based prospective study (CARDIA) revealed that dairy consumption was inversely associated with the incidence of all components of the insulin resistance syndrome (IRS) among overweight individuals (BMI>=25kg/m2).

    *** Each daily occasion of dairy consumption was associated with 21% lower odds of IRS. ***

    These associations were similar for blacks and whites and for men and women.


    If you believe this to wrong, please direct us to what bases your conclusion.

  • Might-o'chondri-AL

    3/20/2011 10:13:27 PM |

    Hi Annon.,
    ? Insulin resistance decreased by dairy in what form; ie:
    hard cheese (essentially no whey), klabbered (yogurt/kefir) with bacteria, fluid w/or w/o "x" % milk fat ...? My reply to you on "Smoothies" thread got lost, so am pleased you posted again here.

    BMI is a ratio of proportionality to the persons height. A tall and thin individual can score a higher BMI than a short and fat one. BMI doesn't tell ratio of lean:fat in our body mass.

    One day I'd like to see all studies use their subject's "Ponderal" proportion. This is the individual weight (in kilograms) divided by their height cubed (in meters).

    It is superior for assesing what's happening with obesity. The "ponderal" change will reflect basal inflammation and can be cross-referenced to previous C Reactive Protein measurements to track if any complication are occuring.

  • Anonymous

    3/21/2011 9:08:05 PM |

    Is there a home insulin meter, like the home glucose meter? It would help a lot.

  • Stephen

    3/23/2011 11:41:15 AM |

    We tend to over think things latching on to this isolated nutrient or that. Your overall diet is what counts. People have been drinking milk/yoghurt/kefir and eating cheese for thousands of years. Dairy is a pretty damned good food (especially cheese).

    It seems to me that Weston Price (the man and organization) has it just about right.

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